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A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: A Cambodian Refugee Example.
Cult Med Psychiatry. 2016 Dec; 40(4):570-619.CM

Abstract

We present a general model of why "thinking a lot" is a key presentation of distress in many cultures and examine how "thinking a lot" plays out in the Cambodian cultural context. We argue that the complaint of "thinking a lot" indicates the presence of a certain causal network of psychopathology that is found across cultures, but that this causal network is localized in profound ways. We show, using a Cambodian example, that examining "thinking a lot" in a cultural context is a key way of investigating the local bio-cultural ontology of psychopathology. Among Cambodian refugees, a typical episode of "thinking a lot" begins with ruminative-type negative cognitions, in particular worry and depressive thoughts. Next these negative cognitions may induce mental symptoms (e.g., poor concentration, forgetfulness, and "zoning out") and somatic symptoms (e.g., migraine headache, migraine-like blurry vision such as scintillating scotomas, dizziness, palpitations). Subsequently the very fact of "thinking a lot" and the induced symptoms may give rise to multiple catastrophic cognitions. Soon, as distress escalates, in a kind of looping, other negative cognitions such as trauma memories may be triggered. All these processes are highly shaped by the Cambodian socio-cultural context. The article shows that Cambodian trauma survivors have a locally specific illness reality that centers on dynamic episodes of "thinking a lot," or on what might be called the "thinking a lot" causal network.

Authors+Show Affiliations

Center for Anxiety and Traumatic, Massachusetts General Hospital, Harvard Medical School, Stress Disorders, One Bowdoin Square, 6th Floor, Boston, MA, 02114, USA. devon_hinton@hms.harvard.edu.Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA.Leiden University Medical Center, Leiden, The Netherlands. Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands. The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands. Boston University School of Medicine, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27085706

Citation

Hinton, Devon E., et al. "A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: a Cambodian Refugee Example." Culture, Medicine and Psychiatry, vol. 40, no. 4, 2016, pp. 570-619.
Hinton DE, Barlow DH, Reis R, et al. A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: A Cambodian Refugee Example. Cult Med Psychiatry. 2016;40(4):570-619.
Hinton, D. E., Barlow, D. H., Reis, R., & de Jong, J. (2016). A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: A Cambodian Refugee Example. Culture, Medicine and Psychiatry, 40(4), 570-619.
Hinton DE, et al. A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: a Cambodian Refugee Example. Cult Med Psychiatry. 2016;40(4):570-619. PubMed PMID: 27085706.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Transcultural Model of the Centrality of "Thinking a Lot" in Psychopathologies Across the Globe and the Process of Localization: A Cambodian Refugee Example. AU - Hinton,Devon E, AU - Barlow,David H, AU - Reis,Ria, AU - de Jong,Joop, PY - 2016/4/18/pubmed PY - 2017/2/28/medline PY - 2016/4/18/entrez KW - Cross-cultural psychiatry KW - Cultural concepts of distress KW - Idioms of distress KW - Rumination KW - “Thinking a lot” KW - “Thinking too much” SP - 570 EP - 619 JF - Culture, medicine and psychiatry JO - Cult Med Psychiatry VL - 40 IS - 4 N2 - We present a general model of why "thinking a lot" is a key presentation of distress in many cultures and examine how "thinking a lot" plays out in the Cambodian cultural context. We argue that the complaint of "thinking a lot" indicates the presence of a certain causal network of psychopathology that is found across cultures, but that this causal network is localized in profound ways. We show, using a Cambodian example, that examining "thinking a lot" in a cultural context is a key way of investigating the local bio-cultural ontology of psychopathology. Among Cambodian refugees, a typical episode of "thinking a lot" begins with ruminative-type negative cognitions, in particular worry and depressive thoughts. Next these negative cognitions may induce mental symptoms (e.g., poor concentration, forgetfulness, and "zoning out") and somatic symptoms (e.g., migraine headache, migraine-like blurry vision such as scintillating scotomas, dizziness, palpitations). Subsequently the very fact of "thinking a lot" and the induced symptoms may give rise to multiple catastrophic cognitions. Soon, as distress escalates, in a kind of looping, other negative cognitions such as trauma memories may be triggered. All these processes are highly shaped by the Cambodian socio-cultural context. The article shows that Cambodian trauma survivors have a locally specific illness reality that centers on dynamic episodes of "thinking a lot," or on what might be called the "thinking a lot" causal network. SN - 1573-076X UR - https://www.unboundmedicine.com/medline/citation/27085706/A_Transcultural_Model_of_the_Centrality_of_"Thinking_a_Lot"_in_Psychopathologies_Across_the_Globe_and_the_Process_of_Localization:_A_Cambodian_Refugee_Example_ L2 - https://doi.org/10.1007/s11013-016-9489-4 DB - PRIME DP - Unbound Medicine ER -