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Book Forum: Cultural and Ethnic Issues   |    
Cultural Cognition and Psychopathology
PEDRO RUIZ, M.D.
Am J Psychiatry 2001;158:1545-1545. doi:10.1176/appi.ajp.158.9.1545
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Edited by John F. Schumaker and Tony Ward. Westport, Conn., Praeger, 2000, 304 pp., $65.00.

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This interdisciplinary book blends together cultural and cognition notions within the context of psychopathological phenomenon; that is, it offers an unique understanding of the etiology, diagnostic formulations, treatment, and prevention of psychiatric disorders and conditions. It also defies individualistic models of treatment and offers new therapeutic perspectives based on the influence of culture on cognitive operations. Additionally, it offers new concepts and theoretical formulations geared toward the understanding of the role of culture vis-à-vis cognitive mechanisms.

The book is divided into three parts. Part 1 consists of three chapters, which provide a historical perspective of the individualistic models of care and the impact of these models on cognition processes. The limitations of psychology are addressed as well as its historical reluctance to appreciate and understand the cultural origins of the cognitions that are implicit in psychopathology. There are several very good examples of cultural cognitions that illuminate mental disturbances. Furthermore, the interactions between culture and cognitions are discussed, as well as the relationship between cognition and emotion.

Part 2 encompasses nine chapters. These chapters deal with patterns of mental disturbances, including depression, anxiety, substance abuse, eating disorders, trauma, dissociative disorders, and schizophrenia. In discussing each of these disorders, the chapter authors examine and address cultural aspects of the cognitive processes. Treatment considerations and potential investigative efforts are also discussed, and we are warned about the imposition of Western models of understanding psychopathology on non-Western manifestations and interpretations of psychopathological phenomena. Chapter 5, in particular, offers a very interesting view of anxiety—not as a symptom but as part of a continuum human experience that ranges from normal states to maladaptive conditions. Chapter 6 makes an attempt to identify cognition processes that are used to protect some cultural groups from pathological conditions such as substance abuse and alcoholism.

Part 3 includes four chapters, which analyze new theoretical models and formulations developed to explain the cultural sources of cognition. These chapters also attempt to highlight the conceptualization of cultural cognition and the theoretical explanations of the relationship between culture and cognition and the applicability of this relationship to investigative efforts and treatment approaches. A model of mental disorder is presented that addresses the variables to be considered in the understanding of psychopathology. Western nations are depicted as currently retracting from social responsibilities, and the negative social impact of this is addressed, including the effects on the mental health of the poor and underserved.

Overall, this book is very persuasive in helping us understand the interrelationship among culture, cognition, and psychopathology. I enjoyed reading it, and I think that it will be a useful tool for mental health professionals who not only acknowledge the role of culture in both normal and abnormal behavior but also recognize the current pluralistic aspects of U.S. society.

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