Cultural Perspectives on Mental Health and Illness (CAMS-UA 151)
Course Outline & Syllabus
How do different cultures view mental health and illness? Why do some ethnic groups readily accept mental health
care while others generally avoid the psychiatrist or psychologist at all costs? How does bicultural or multicultural
identity and minority status affect one’s psychological development? This course seeks to explore what we know
about how culture, ethnicity, race and minority status affect the mental health of children, adolescents, and young
adults in modern America. We will start by studying the process of acculturation and mental health issues specific to
immigrant youth and children of immigrants. We will delve into the cultural aspects of identity development, family
dynamics, parenting, stigma, and mental health disparities and then segue into stereotypes and intergroup bias.
Readings will draw from the growing body of research literature, and examples from popular arts, media and
entertainment will be incorporated as supplemental material for class discussion. Students will review current
treatments and participate in class discussions. Students of all backgrounds will be encouraged to explore mental
health and illness with a broadened cultural perspective.
Instructors:
Jessica Plauche, MD ([email protected]) and Dawn Sung, MD ([email protected])
Textbook and Readings:
Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two
cultures. New York: Farrar, Straus and Giroux. [List price $15.00]
Session Topic and Description
Pages of
Reading
1
30
Introduction: Course Overview
No assignments due.
Readings:
i.
Pumariega, A.J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., …
Smith, J. (2013). Practice parameter for cultural competence in child and
adolescent psychiatric practice. Journal of the American Academy of Child &
Adolescent Psychiatry, 52(10), 1101-1115.
ii.
Betancourt, J.R., Green, A.R., Carillo, J.E., (2014). Cross-cultural care and
communication. UpToDate. Retrieved from http://www-uptodatecom.ezproxy.med.nyu.edu/
iii.
Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her
American doctors, and the collision of two cultures. New York: Farrar, Straus and
Giroux. (To be read at student’s own pace throughout the course; otherwise
chapters will be assigned towards the end of the course. Book will be discussed in
Week 13).
2
PART 1: Coming to America
Acculturation, Adaptation, and Mental Health
Readings:
i.
Akhtar, S., (2010). Work and money. In S. Akhtar (Ed.), Immigration and
acculturation: Mourning, adaptation, and the next generation (pp. 31-54).
Plymouth, United Kingdom: Jason Aronson.
ii.
Rothe, E. M., Tzuang, D., Pumariega, A. J., (2010). Acculturation, development,
and adaptation. Child and Adolescent Psychiatric Clinics of North America 19,
40
681-696.
Other Media:
i.
Glatzer, R. (Director), Westmoreland, W. (Director). (2006). Real Women Have
Curves [Motion Picture]. United States: Sony Pictures Classics. (Will be placed on
reserve in the library.)
3
The Immigrant and Refugee Experience
45
Assignments Due:
Reflection paper: Write about a character’s experience with acculturation and/or
immigration in the movie assigned in session 2, Real Women Have Curves, and how it impacts
his or her mental health and risk for mental illness. Students should reference concepts from
the readings assigned for sessions 2 and 3.
Readings:
i.
ii.
iii.
Akhtar, S., (2010). The trauma of geographical dislocation. In S. Akhtar (Ed.),
Immigration and acculturation: Mourning, adaptation, and the next generation (pp.
3-27). Plymouth, United Kingdom: Jason Aronson.
Pumariega, A.J., Rothe, E., Pumariega, J.B., (2005). Mental health of immigrants
and refugees. Community Mental Health Journal, 41(5), 581-587.
Lustig, S.L., Kia-Keating, M., Knight, W.G., Geltman, P., Ellis, H., Kinzie, J.D., …
Saxe, G.N., (2004). Review of child and adolescent refugee mental health. Journal
of American Academy of Child and Adolescent Psychiatry, 43(1): 24-36.
Other Media:
i.
Cammisa, R. (Director). (2009). Which Way Home [Documentary]. United States:
HBO Films. (Available on http://hulu.com/watch.)
ii.
Simon, B. (Producer). (2014, January 19). Our amazing 12-year journey with the
lost boys. [Television broadcast]. In 60 Minutes Overtime. New York, NY: Central
Broadcasting Service.
4
Children of Immigrants
70
No assignments due.
Readings:
i.
ii.
iii.
Akhtar, S. (2010). The next generation. In S. Akhtar (Ed.), Immigration and
acculturation: Mourning, adaptation, and the next generation (pp. 163-211).
Plymouth, United Kingdom: Jason Aronson.
Toppelberg, C.O., Collins, B.A., (2010). Language, culture, and adaptation in
immigrant children. Child and Adolescent Psychiatric Clinics of North America, 19:
697-717.
Jen, G. (2013, March 22). Saucy dishes [Review of the book Fresh off the boat, by
E. Huang]. The New York Times. Retrieved from http://www.nytimes.com
Other Media:
i.
Matthews, A. (Director). (2001). My American girls: a Dominican story
[Documentary]. United States: PBS. (Will be placed on reserve in the library.)
5
PART 2: Culture Clash
Cultural Differences in Parenting Styles
54
No assignments due.
Readings:
i.
Bornstein, M.H., (2013). Parenting and child mental health: A cross-cultural
perspective. World Psychiatry, 12(3): 258–265.
ii.
Raman, S., Hodes, D., (2012). Cultural issues in child maltreatment. Journal of
Paediatrics and Child Health, 48(1):30-37.
iii.
Rodriguez, M.M., Donovick, M.R., Crowley, S.L., (2009). Parenting styles in a
cultural context: Observations of “protective parenting” in first-generation Latinos.
Family Process, 48(2): 195-210.
iv.
Holden, G.W., Vittrup, B., (2010). Children's assessments of corporal punishment
and other disciplinary practices: The role of age, race, SES, and exposure to
spanking. Journal of Applied Developmental Psychology, 31: 211-220.
v.
Lui, P.P., Rollock, D., (2013). Tiger mother: Popular and psychological scientific
perspectives on Asian culture and parenting. American Journal of Orthopsychiatry.
83(4): 450-456.
vi.
Chua, A. (2011, January 8). Why Chinese mothers are superior. Wall Street
Journal. Retrieved from http://www.online.wsj.com
6
Intergenerational Conflict
52
Assignments Due:
Reflection paper: Choose one of the parenting styles discussed in the previous week’s session
and reflect on how it affects a child’s development, using concepts from the readings assigned.
Discuss how the parenting style you have chosen may either exacerbate or ameliorate
intergenerational conflicts.
Readings:
i.
ii.
iii.
Hwang, W.C., (2006). Acculturative family distancing: Theory, research, and
clinical practice. Psychotherapy: Theory, Research, Practice, Training, 43(4): 397409.
Kao, T.S., Guthrie, B., Loveland-Cherry, C., (2007). An intergenerational approach
to understanding Taiwanese American girls’ and their mothers’ perceptions about
sexual health. Journal of Family Nursing 13(3): 312-332.
Szapocznik, J., Williams, R.A., (2000). Brief strategic family therapy: 25 years of
interplay among theory, research and practice in adolescent behavior problems and
drug abuse. Clinical Child and Family Psychology Review 3(2): 117-134.
Other Media:
i.
Westmoreland, W. [Director], Glatzer, R. [Director]. (2006). Quinceanera [Motion
Picture]. United States: Sony Pictures Classics. (Will be placed on reserve in the
library.)
7
Issues facing Minority Youth
Assignments Due:
Reflection paper: Recall a salient event in your life when you felt excluded or discriminated
against for differences in an aspect of belief system or appearance (e.g., ethnicity, race,
sexuality, spirituality, etc). Referencing concepts from the readings assigned, write about the
details of the event, the psychological impact it had on you, and how you coped with this
situation.
Readings:
i.
Trail, T.E., Shelton, J.N., West, T.V., (2009). Interracial roommate relationships:
51
ii.
iii.
iv.
Negotiating daily interactions. Personality and Social Psychology Bulletin 35: 671685.
Dovidio, J.F., Gaertner, S.L., Kawakami, K., Hodson, G., (2002). Why can’t we
just get along? Interpersonal biases and interracial distrust. Cultural Diversity and
Ethnic Minority Psychology, 8(2): 88-102.
Borowsky, I.W., Resnick, M.D., Ireland, M., Blum, R.W., (1999). Suicide attempts
among American Indian and Alaska Native youth. Archives of Pediatric
Adolescent Medicine, 153: 573-580.
Qureshi, A., (2007). I was being myself but being an actor too: The experience of a
black male in interracial psychotherapy. The British Psychological Society 80: 467479.
Other Media:
i.
Kramer, S. [Director]. (1967). Guess Who’s Coming to Dinner [Motion Picture].
United States: Columbia Pictures. (Will be placed on reserve in the library.)
ii.
Vedantam, S. (2013, April 22). What does modern prejudice look like? In
Vedantam, S. [Producer], All things considered. New York, NY: National Public
Radio. Retrieved from http://www.npr.org
8
Multiracial Children and Transracial Adoption
46
No assignments due.
Readings:
i.
Pumariega, A.J., Joshi, S.V., (2010). Culture and development in children and
youth. Child and Adolescent Psychiatric Clinics of North America, 49:661-676.
i.
Whaley, A.L., Francis, K., (2006). Behavioral health in multiracial adolescents:
The role of Hispanic/Latino ethnicity. Public Health Reports, 121(2), 169-174.
ii.
Choi, Y., Harachi, T.W., Gillmore, M.R., Catalano, R.F., (2006). Are multiracial
adolescents at greater risk? Comparisons of rates, patterns and correlates of
substance use and violence between monoracial and multiracial adolescents.
American Journal of Orthopsychiatry, 76, 86-97.
iii.
Brooks, D., Barth, R.P., (1999). Adult transracial and inracial adoptees: Effects of
race, gender, adoptive family structure, and placement history on adjustment
outcomes. American Journal of Orthopsychiatry, 69(1):87-99.
Other Media:
i.
Gross, T. (2013, November 20). For Key and Peele, biracial roots bestow special
comedic ‘power.’ In Gross, T. [Producer], Fresh air. New York, NY: National Public
Radio. Retrieved from http://www.npr.org/2013/11/20/246311451/for-key-and-
peele-biracial-roots-bestow-special-comedic-power
9
Stigma
Assignments Due:
Reflection paper: Apply concepts from the assigned readings to discuss the fear of stigma and
resistance towards psychiatric treatment that the main character struggles with in the assigned
movie, Antwone Fisher.
Readings:
i.
Abdullah, T., Brown, T.L., (2011). Mental illness stigma and ethnocultural beliefs,
values, and norms: An integrative review. Clinical Psychology Review, 31: 934948.
ii.
Cheng, H.L., Kwan, K.L., Sevig, T., (2013). Racial and ethnic minority college
students’ stigma associated with seeking psychological help: Examining
44
iii.
psychocultural correlates. Journal of Counseling Psychology, 60(1): 98-111.
Vogel, D.L., Heimerdinger-Edwards, S.R., Hammer, J.H., Hubbard, A., (2011).
Boys don’t cry: Examination of the links between endorsement of masculine norms,
self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal
of Counseling Psychology, 58(3): 368-382.
Other Media:
i.
Washington, D. [Director]. (2002). Antwone Fisher [Motion Picture]. United States:
Fox Searchlight Pictures. (Will be placed on reserve in the library.)
10
Stereotype Threat
50
Assignments Due:
Reflection paper: What stereotypes apply to your ethnic group(s) and how have these
assumptions impacted your performance (academic, social, or otherwise) and mental health?
With what aspects of the stereotypes applying to your in-group do you identify or reject? How
can the impact of stereotype threat be ameliorated? While answering these questions a
discussion of this week’s readings should be employed.
Readings:
i.
Aronson, J., Quinn, D.M., Spencer, S.J., (1998). Stereotype threat and the
academic underperformance of minorities and women. In J. K. Swim (Ed), C.
Stangor (Ed) Prejudice: The target's perspective (pp. 83-103). San Diego, CA, US:
Academic Press.
ii.
Steele, C.M., Aronson, J., (1995). Stereotype threat and the intellectual test
performance of African Americans. Journal of Personality and Social Psychology,
69(5): 797-811.
iii.
Maddux, W.W., Galinsky, A.D., Cuddy, A.J., Polifroni, M., (2008). When being a
model minority is good...and bad: Realistic threat explains negativity toward Asian
Americans. Personality and Social Psychology Bulletin, 34:74-89.
11
Part 3: Integrating Culture into Clinical Practice
87
Mental Health Disparities
No assignments due.
Readings:
i. Alegria, M., Vallas, M., Pumariega, A.J., (2010). Racial and ethnic disparities in
pediatric mental health. Child and Adolescent Psychiatric Clinics of North America,
19: 759-774.
ii. Stewart, S.M., Simmons, A., Habibpour, E., (2012). Treatment of culturally diverse
children and adolescents with depression. Journal of Child and Adolescent
Psychopharmacology, 22(1): 72-79.
iii. Canino, I.A., Spurlock, J., (1997). Mental health issues of culturally diverse
underserved children. Journal of the Association for Academic Minority Physicians,
8(4): 63-66.
iv. Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her
American doctors, and the collision of two cultures. New York: Farrar, Straus and
Giroux. (Read Chapters 1-6. Book will be discussed in Week 13).
12
Cultural Formulation
Assignments Due:
Reflection paper: Describe how a character in one of the previously assigned movies
113
identifies his or herself through race, ethnicity, gender, sexuality, or religious ties by utilizing
the concepts described in the DSM-5 cultural formulation chapter, and using the Takeuchi
formulation as an example.
Readings:
i.
American Psychiatric Association. (2013). Cultural formulation. In Diagnostic and
Statistical Manual of Mental Disorders (5th ed.). doi:
10.1176/appi.books.9780890425596.886032
ii.
Takeuchi, J., (2000). Treatment of a biracial child with schizophreniform disorder:
Cultural formulation. Cultural Diversity and Ethnic Minority Psychology, 6(1): 93101.
iii. Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her
American doctors, and the collision of two cultures. New York: Farrar, Straus and
Giroux. (Read Chapters 7-13. Book will be discussed in Week 13).
13
Cultural Concepts of Distress (Formerly known as Culture-Bound Syndromes)
123
Assignments Due: Students will be required to turn in their final reports.
Readings:
i. Levine, R.E., Gaw, A.C., (1995). Culture-bound syndromes. Psychiatric Clinics of
North America, 18(3): 523-536.
ii. Guarnaccia, P.J., Martinez, I., Ramirez, R., Canino, G., (2005). Are ataques de
nervios in Puerto Rican children associated with psychiatric disorder? Journal of
American Academy of Child and Adolescent Psychiatry, 44(11): 1184-1192.
iv. Demarque, M., Guzman, G., Morrison, E., Ahovi, J., Moro, M.R., Blanchet-Collet, C.,
(2013). Anorexia nervosa in a girl of Chinese origin: Psychological, somatic and
transcultural factors. Clinical Child Psychology and Psychiatry, [Epub ahead of
print].
v. Fadiman, A. (1998). The spirit catches you and you fall down: A Hmong child, her
American doctors, and the collision of two cultures. New York: Farrar, Straus and
Giroux. (Read Chapters 14-19. Book will be discussed in Week 13).
14
Review, Wrap-Up and Selected Presentations
Methods of Assessment:
1) Reflection Papers (30%): Six written responses of approximately three to five double spaced typed pages will be
required throughout the course. Papers will be graded from 1 (very poor) to 10 (spectacular) with 3 points deducted
for every day late. Each paper will count as 5% of the final grade. Papers will be reflections on the readings and
supplemental media assigned and will be discussed in the second half of each class. Hard copies will be handed in at
the end of each class.
2) Short-Answer Quizzes (30%): Six quizzes in short-answer format will be administered throughout the course,
during sessions in which reflection papers are not assigned. The questions will assess knowledge of major concepts
covered in the required readings and will be discussed after the quiz is administered. Each quiz will be graded from 1
(very poor) to 10 (spectacular). One missed quiz due to tardiness or sickness will be allowed; otherwise missed
quizzes will be failed automatically and assigned a score of 0. The best five quiz scores will be summed at the end,
and the average score will be the assigned grade.
3) Participation (10%): Students will be graded upon their attendance and participation in class, specifically their
demonstrated familiarity with the academic material and research. Each student will be responsible for being the
main discussant/moderator for one class, to be assigned in the first session. If there are more students than available
class sessions, students may moderate in pairs.
4) Final Research Paper (30%): Students are required to complete a scholarly project and write a 10-page report with
references in APA style. Students will choose a specific ethnic minority group to study the specific child and
adolescent mental health needs and disparities for this group. Instructors must approve the topic, and a hard copy will
be turned in during the second to last class session.