Ihsan Al-Issa

Culture and Mental Illness in Algeria

The main aim of this article is to review research and observations on the associa tion between cultural factors and the rates and symptoms of mental illness in Algeria. In addition to traditional concepts and practices, modern psychiatric services and the classification of mental illness are discussed. Research on depression, schizophrenia, drug-abuse and alcoholism are reported. Two major sociocultural fac tors related to mental illness are emphasised: the Muslim religion and social changes during both the colonial and post-colonial eras. Many culture-specific family stresses are also related to mental illness.

Sociocultural Factors in Hallucinations

Sociocultural factors affect both the definition and the sense organs involved in hallucinations. It is suggested that, in addition to the importance of audition in communication on the human level, other sociocultural factors may affect the choice of sense organs in the expression of hallucinatory experience. As compared with non-Western societies, Western attitudes consider hallucinations more shameful and frightening (symptoms of mental illness) and this tend to be more liable to concealment and chronicity. It is proposed that the psychoanalytical approached to the interpretation of dreams or behavioural techniques could be used to overcome the concomitants of Western attitudes toward hallucinations. As hallucinations are considered to be the result of the interaction of the sense organs with the physical environment (i.e., misperception) they appear to reflect the biological rather than the social adaptation of the organism. It is thus not surpris ing that sociocultural factors in hallucinations have not been given as much attention as other schizophrenic symptoms such as delusions where social evaluation and interpersonal relationship seem to be clearly implicated (Murphy, 1967; Weinstein, 1962). The present paper aims at delineating the role of sociocultural factors in the definition and the frequency of different kinds of hallucinations. The implications of cultural variations in attitudes toward hallucinations for the development and treatment of hallucinatory experiences will also be discussed.

Mu-Ghayeb: a Culture-Specific Response To Bereavement in Oman

Studies with normal subjects and patients suggest that in grieving the dead, the bereaved has to go through a progressive course of psychological and social reorganization. The Mu Ghayeb belief in Omani society involves a complete denial of the loss for a relatively long period with the expectation of the return of the dead. This belief persists even after an elaborate ritual of burial and a prescribed period of mourning. The deceased are expected to leave the grave after burial and join their families when the spell placed on them by a sorcerer is broken or counteracted. Although the Mu Ghayeb belief is inconsistent with Muslim religion, it may be explained in terms of sudden and untimely death which used to be rife in the seafaring Omani society.

Psychiatric Problems in a Developing Country: Iraq

A MAJOR task in the study of psychiatric problems in the developing nonWestern cultures is to throw light on the etiology, symptomatology and prognosis of mental illness as known in the West. Westernization has brought about many changes in the social structure of the original primitive societies and these changes seem to cause repercussions in the psychiatric field. Thus, one would predict variations in psychiatric problems within cultures as well as across cultures. In a previous paper by Bazzoui and Al-Issal a description of psychiatric syndromes in Iraq has been presented. The emphasis of that paper was on the indigenous psychiatric syndromes giving little attention to intra-cultural variations resulting from social or cultural change. The main aim of the present paper is to discuss psychiatric problems in Iraq in the light of recent cultural and social change. The information presented here is based on the experience of the authors in a psychological clinic in Baghdad and on their close contact with psychiatrists both in private clinics and the mental hospital.

BEHAVIOUR THERAPY AND THE RECALL OF TRAUMATIC EXPERIENCE--A CASE STUDY.

Abstract Psychotherapy and behaviour therapy differ in many important respects, which have been discussed by Eysenck (1959). In psychotherapy it is important to reveal original traumatic incidents, but this is not necessary in behaviour therapy. This is illustrated by the present case in which a heat-phobia was satisfactorily treated without the patient being aware of the original incident which gave rise to the phobic symptoms.

Social support and depression of male and female students in Kuwait: preliminary findings

The study investigated the relationship between social support, gender and depression. Thirty male and 35 female Kuwaiti students participated in this study. Subjects were asked to list five relatives, five friends and five neighbors and to rate them on a scale of five types of social support. Results show that social support is significantly higher for males than females. The amount of perceived material-financial support by both males and females is not significantly different from other types of support. For both sexes, primary relatives (parents and siblings) are perceived to give more support than secondary relatives (uncles, aunts and cousins), friends and neighbors. The least social support is perceived from neighbors while secondary relatives and friends are not significantly differentiated from each other. Depression is higher in females than in males, showing non-significant relationship with social support. Results are discusssed within the framework of findings in the West.

Cross-Cultural Studies of Symptomatology in Schizophrenia*

This paper is an attempt to review some of the main cross-cultural studies of symptomatology in schizophrenia. Although it is shown that there are cultural variations of symptomatology, the reliability of these observations seems to be questionable. The inclusion of behaviour of different description into the concept of schizophrenia throws serious doubts on the usefulness and desirability of this concept as presently used in cross-cultural studies. However, problems of reliability or validity of observations at the cross-cultural level pose similar problems, encountered at the inter-individual. A more reliable and rigorous system of classification is needed to differentiate between normal and schizophrenic behaviour in different cultures or within the same culture. Cross-cultural studies suggest that some responses (e.g., conceptual) are more amenable to the influence of culture than others (e.g., physiological). Thus if it is demonstrated that different cultural groups show similar responses on some relatively culture-free tasks (e.g., EEG. pupillary responses) it would be plausible to suggest similar processes cross-culturally. These processes may underlie behaviour disorders such as schizophrenia despite the inter-individual or cross-cultural differences in their manifestations.

Creativity and overinclusion in chronic schizophrenia.

10 of the Guilford tests of creative abilities were given to 50 schizophrenic patients. Creativity scores were correlated with overinclusion, activity withdrawal, vocabulary, age and level of education. While level of education and vocabulary were positively related to creativity scores, overinclusion, activity withdrawal and age tended to show the opposite trend. Future use of creativity tests in the study of schizophrenia was discussed.

Application of the Dennis Uses Test to Canadian children.

The Dennis Uses Test was administered to 362 Canadian children. Ss were drawn from a middle-class area, a lower-class area, a Jewish school, and an Indian reservation school. Their responses were classified into seven categories, i.e., sustentative, benevolent, malevolent, hedonistic, esthetic, religious, and hierarchical. Comparisons of the groups of these categories show some significant differences. It is concluded that the Dennis Uses Test may be regarded as a promising measure of psychological differences which are produced by societies or cultures.

War and stress in the middle east

Abstract The idea of this special issue has its origin in a symposium organized by Ihsan Al-Issa, on stress and war in the Middle East that took palce during the 13the International Conference of the Stress and Anxiety Research Society in Leuven, Begium, July 17–19, 1992. It is, however, Knut A. Hagtvet who first suggested this special issue. His diligent and persistent effort in reviewing and commenting on the papers has helped in bringing this issue into being.