Abnormal Psychology

104 CHAPTER 3

Hodes, & Rangel, 2005). Thus, the reported symptoms of the British teenagers

of South Asian background may not meet enough of the criteria for a diagnosis of

anorexia (although they may still have significant distress, impairment, or

risk of harm).

Such cultural differences may underlie, at least in part, the dramatic differences

in the apparent rates of serious mental illness across countries, shown in Figure 3.4

(WHO World Mental Health Survey Consortium, 2004). (A mental illness was con-

sideredserious if the individual was unable to carry out his or her normal activities

for at least 30 days in the past year.) These rates were based on data gathered in

face-to-face interviews. Notice how much higher the rates are in the United States

compared to other developed and developing countries. One explanation for this

discrepancy is that Americans are less inhibited about telling strangers about

their psychological problems. People in other countries might have minimized the

frequency or severity of their symptoms.

3.4 • Rates of Serious Mental Illness Across Countries From 2001 to 2003, the

World Health Organization conducted surveys to measure the prevalence of serious mental

disorders in the populations of various countries. The results revealed signifi cant differences

among countries (WHO World Mental Health Survey Consortium, 2004).

Source: Copyright 2004 by the American Medical Association. For more information see the Permissions section.

Figure 3.4

34 R t f S i M t l Ill A C t i h

g34

0

1

2

3

4

5

6

7

8

100

Percentage of population

with a serious mental disorder

United States

France Belgium

Netherlands

Japan

Germany

Italy Spain

Developed countries

0

1

2

3

4

5

6

7

8

100

Percentage of population

with a serious mental disorder

ColombiaUkraineLebanon

Mexico

China (Shanghai)

China (Beijing)

Nigeria

Less developed countries

Assessment as an Interactive Process

Mental health researchers and clinicians learn about patients from assessing

psychological and social factors and, to a lesser extent, neurological and other

biological factors. Information about each type of factor should not be consid-

ered in isolation, but rather should infl uence how the clinician understands the

other types of information.

Knowledge of psychological factors must be developed in the context of the

patient’s culture. Psychiatrist Paul Linde (2002) recounts his experiences working

in a psychiatric unit in Zimbabwe: The residents of that country generally under-

stand that bacteria can cause an illness such as pneumonia, but they nonetheless

wonder why the bacteria struck a particular individual at a specifi c point in time