The place of culture in DSM-IV.
This paper critically reviews the process and outcome of an effort to enhance the cultural validity of DSM-IV and outlines recommendations to improve future diagnostic systems.
An ordered presentation of the antecedents and the main phases of this developmental effort is followed by a content analysis of what was proposed and what was actually incorporated, and a conceptual analysis of underlying biases and their implications.
The cultural effort for DSM-IV, spearheaded by a scholarly independent NIMH workgroup, resulted in significant innovations including an introductory cultural statement, cultural considerations for the use of diagnostic categories and criteria, a glossary of culture-bound syndromes and idioms of distress, and an outline for a cultural formulation.
However, proposals that challenged universalistic nosological assumptions and argued for the contextualization of illness, diagnosis, and care were minimally incorporated and marginally placed.
Although a step forward has been taken to introduce cultural elements in DSM-IV much remains to be done.
Further culturally informed research is needed to ensure that future diagnostic systems incorporate a genuinely comprehensive framework, responsive to the complexity of health problems in increasingly multicultural societies.
Mots-clés Pascal : Diagnostic and Statistical Manual IV, Classification, Nosologie, Diagnostic, Milieu culturel, Environnement social, Analyse contenu, Evolution, Santé mentale, Article synthèse, Etude critique, Homme
Mots-clés Pascal anglais : Diagnostic and Statistical Manual IV, Classification, Nosology, Diagnosis, Cultural environment, Social environment, Content analysis, Evolution, Mental health, Review, Critical study, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0419292
Code Inist : 002B18B02. Création : 22/03/2000.