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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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In medicine and medical anthropology, a culture-bound syndrome, culture-specific syndrome, or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture. There are no objective biochemical or structural alterations of body organs or functions, and the disease is not recognized in other cultures. The term "culture-bound syndrome" was included in the fourth version of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) which also includes a list of the most common culture-bound conditions (DSM-IV: Appendix I). Counterpart within the framework of ICD-10 () are the "culture-specific disorders" defined in Annex 2 of the "Diagnostic criteria for research".
More broadly, an epidemic that can be attributed to cultural behavior patterns or suggestion is sometimes referred to as a behavioral epidemic. As in the cases of drug or alcohol abuse or smoking, transmission can be determined by communal reinforcement as well as by person-to-person interactions. On etiological grounds, it can be difficult to distinguish the causal contribution of culture in disease from other environmental factors such as toxicity.
Risk factors for mental illness include genetic inheritance, such as parents having depression, or a propensity for high neuroticism or "emotional instability".
In depression, parenting risk factors include parental unequal treatment, and there is association with high cannabis use.
In schizophrenia and psychosis, risk factors include migration and discrimination, childhood trauma, bereavement or separation in families, and abuse of drugs, including cannabis, and urbanicity.
In anxiety, risk factors may include family history (e.g. of anxiety), temperament and attitudes (e.g. pessimism), and parenting factors including parental rejection, lack of parental warmth, high hostility, harsh discipline, high maternal negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, and child abuse (emotional, physical and sexual).
Environmental events surrounding pregnancy and birth have also been implicated. Traumatic brain injury may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health.
Social influences have been found to be important, including abuse, neglect, bullying, social stress, traumatic events and other negative or overwhelming life experiences. For bipolar disorder, stress (such as childhood adversity) is not a specific cause, but does place genetically and biologically vulnerable individuals at risk for a more severe course of illness. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures.
Correlations of mental disorders with drug use include cannabis, alcohol and caffeine, use of which appears to promote anxiety. For psychosis and schizophrenia, usage of a number of drugs has been associated with development of the disorder, including cannabis, cocaine, and amphetamines. There has been debate regarding the relationship between usage of cannabis and bipolar disorder.
A culture-specific syndrome is characterized by:
1. categorization as a disease in the culture (i.e., not a voluntary behaviour or false claim);
2. widespread familiarity in the culture;
3. complete lack of familiarity or misunderstanding of the condition to people in other cultures;
4. no objectively demonstrable biochemical or tissue abnormalities (signs);
5. the condition is usually recognized and treated by the folk medicine of the culture.
Some culture-specific syndromes involve somatic symptoms (pain or disturbed function of a body part), while others are purely behavioral. Some culture-bound syndromes appear with similar features in several cultures, but with locally specific traits, such as penis panics.
A culture-specific syndrome is not the same as a geographically localized disease with specific, identifiable, causal tissue abnormalities, such as kuru or sleeping sickness, or genetic conditions limited to certain populations. It is possible that a condition originally assumed to be a culture-bound behavioral syndrome is found to have a biological cause; from a medical perspective it would then be redefined into another nosological category.
Clinical vampirism, more commonly called Renfield's syndrome or Renfield syndrome, is an obsession with drinking blood. The earliest formal presentation of clinical vampirism to appear in the psychiatric literature, with the psychoanalytic interpretation of two cases, was contributed by Richard L. Vanden Bergh and John F. Kelley in 1964. As the authors point out, brief and sporadic reports of blood-drinking behaviors associated with sexual pleasure have appeared in the psychiatric literature at least since 1892 with the work of Austrian forensic psychiatrist Richard von Krafft-Ebing. Many medical publications concerning clinical vampirism can be found in the literature of forensic psychiatry, with the unusual behavior reported as one of many aspects of extraordinary violent crimes. The behavior has never gained official recognition by the psychiatric profession and is not found in any edition of the "International Classification of Diseases" or the "Diagnostic and Statistical Manual of Mental Disorders".
CGD is an atypical grief response, occurring only in a minority of the bereaved population. It is considered more common in those experiencing disasters, violence or the loss of a child.
It has also been found in family members (or friends) of:
- Patients with life-threatening illnesses
- Suicides and homicides
CGD is found to be prevalent cross-culturally in Europe, the Middle East, Africa, and Asia.
The diagnostic criteria for Dorian Gray syndrome are:
- Signs of dysmorphophobia
- Arrested development (inability to mature)
- Using at least two different medical-lifestyle products and services:
- Hair-growth restoration (e.g. finasteride)
- Antiadiposita to lose weight (e.g. orlistat)
- Anti-impotence drugs (e.g. sildenafil)
- Anti-depressant drugs (e.g. fluoxetine)
- Cosmetic dermatology (e.g. laser resurfacing)
- Cosmetic surgery (e.g. a face-lift, liposuction)
Episodes of major depressive disorder and of suicidal crisis occur in the man afflicted with Dorian Gray syndrome when the defense mechanism activities, the pursuit of eternal youth, fail to indefinitely preserve his handsome face and sculpted physique; usually, anti-depressant drugs and psychotherapy are prescribed and applied to counter his feelings of failure.
Furthermore, if the man misunderstands the self-defensive character of "acting out" the DGS, and continues pursuing the timeless beauty of male youth, without being aware of the psychodynamics of narcissism, then he, as a psychiatric patient, establishes a cycle of chronic psychological depression. In extreme cases of DGS, the man seeks self-destruction, by means either of drugs or with plastic surgery, or both, in order to fill the narcissistic emptiness that is the Dorian Gray syndrome.
Due to the rarity of this disorder and its similarities to other delusional misidentification syndromes, it is debated whether or not it should be classified as a unique disease. Because subjective doubles rarely appear as the only psychological symptom, it has been suggested that this syndrome is a rare presentation of symptoms of another psychological disorder. This syndrome is also not defined in the DSM-IV or ICD-10.
Additionally, some researchers use varying definitions of the syndrome. While most declare that the double is a physical copy that is psychologically independent, some refer to a definition of a double as being both physically and psychologically identical. This is also known as clonal pluralization of the self, another less common delusion that is grouped with the other delusional misidentification syndromes.
Recovery from this syndrome is situational, as some drug therapies have been effective in some individuals but not others. Patients may live in a variety of settings, including psychiatric hospitals, depending on the success of treatment. With successful treatment, an individual may live at home. In many of the reported cases, remission of symptoms occurred during the follow-up period.
This disorder can be dangerous to the patient and others, as a patient may interrogate or attack a person they believe to be a double. Inappropriate behavior such as stalking and physical or psychological abuse has been documented in some case studies. Consequently, many individuals suffering from this disorder are arrested for the resulting misconduct (see the case of Mr. B in #Presentation).
Although more research is needed to determine the multiple pathways to complicated grief disorder, preexisting conditions (such as major depression, PTSD, and sleep disorders) are thought to exacerbate the interruption of the natural healing process.
There are some known predictive characteristics for CGD. An individual is at increased risk for CGD if they are:
- Female
- Pessimistic
- Previously diagnosed with a mood disorder
- Low self-reported social support
- An insecure attachment
- High stress
- A positive caregiving experience and dependency on the deceased
- Have had a early pregnancy loss (miscarriage)
Recorded incidents of "amafufunyana" appear to have begun in the early 20th century and researchers such as Ngubane "et al" have suggested that its cultural formation may have had something to do with colonialism and migration of indigenous peoples away from their homes. There have also been widespread outbreaks of the condition, similar to events involving contagious spread of hysteria, recorded in the 1980s at a rural girl's boarding school.
The most common types of people that are identified as afflicted by the cultural group are those of the lowest economic and social level and more often during times of cultural hardship and change, such as during migrations. More women than men are also identified.
Amafufunyana is an unspecified "culture-bound" syndrome named by the traditional healers of the Xhosa people that relates to claims of demonic possession due to members of the Xhosa people exhibiting aberrant behavior and psychological concerns. After study, it was discovered that this term is directed toward people suffering from varying types of schizophrenia. A similar term, ukuthwasa, is used to refer to positive types of claimed possession, though this event also involves those suffering from schizophrenia. It has also found cultural usage among some groups of Zulu peoples.
The direct translation of the term "amafufunyana" is nerves and is a part of a much more complex cultural ideology connecting varying types of psychosis with religious, social, and recently psychiatric beliefs and activities. In a 1998 interview with Xhosa people suffering from schizophrenia by Lund et al., it was determined that through interaction with scientists and psychological services, the preferred treatment for the cultural condition had shifted from relation to traditional healers to active psychiatric assessment.
Although there is no known cause for piblokto, Western scientists have attributed the disorder to the lack of sun, the extreme cold, and the desolate state of most villages in the region. A reason for this disorder present in this culture may be due to the isolation of their cultural group.
This culture-bound syndrome is possibly linked to vitamin A toxicity (hypervitaminosis A). The native Inughuit diet or Eskimo nutrition provides rich sources of vitamin A through the ingestion of livers, kidneys, and fat of arctic fish and mammals and is possibly the cause or a causative factor. This causative factor is through the disturbance that has been reported for males, females, adults, children, and dogs. The ingestion of organ meats, particularly the livers of some Arctic mammals, such as the polar bear and bearded seal, where the vitamin is stored in toxic quantities, can be fatal to most people.
Inughuit tradition states that it is caused by evil spirits possessing the living. Shamanism and animism are dominant themes in Inughuit traditional beliefs with the angakkuq (healer) acting as a mediator with the supernatural forces. Angakkuit use trance states to communicate with spirits and carry out faith healing. There is a view among the Inughuit that individuals entering trance states should be treated with respect given the possibility of a new "revelation" emerging as a result. Treatment in piblokto cases usually involves allowing the episode to run its course without interference. While piblokto can often be confused with other conditions, (including epilepsy) in which failure to intervene can lead to the victim coming to harm, most cases tend to be more typical.
Somatization disorder is estimated to occur in 0.2% to 2% of females, and 0.2% of males.
There are cultural differences in the prevalence of somatization disorder. For example, somatization disorder and symptoms were found to be significantly more common in Puerto Rico. In addition the diagnosis is also more prevalent among African Americans and those with less than a high school education or lower socioeconomic status.
There is usually co-morbidity with other psychological disorders, particularly mood disorders or anxiety disorders. Research also showed comorbidity between somatization disorder and personality disorders, especially antisocial, borderline, narcissistic, histrionic, avoidant, and dependent personality disorder.
About 10-20 percent of female first degree relatives also have somatization disorder and male relatives have increased rates of alcoholism and sociopathy.
Queen bee syndrome was first defined by G.L. Staines, T.E. Jayaratne, and C. Tavris in 1973. It describes a woman in a position of authority who views or treats subordinates more critically if they are female. This phenomenon has been documented by several studies. In another study, scientists from the University of Toronto speculated that the queen bee syndrome may be the reason that women find it more stressful to work for women managers; no difference was found in stress levels for male workers. An alternate, though closely related, definition describes a queen bee as one who has succeeded in her career, but refuses to help other women do the same.
One important factor may be differences or changes in parts of the brain known to be involved in representing body shape (e.g., see proprioception and body image). A neuroimaging study of two people diagnosed with clinical lycanthropy showed that these areas display unusual activation, suggesting that when people report their bodies are changing shape, they may be genuinely perceiving those feelings.
Clinical lycanthropy is a rare condition and is largely considered to be an idiosyncratic expression of a psychotic episode caused by another condition such as schizophrenia, bipolar disorder or clinical depression.
However, there are suggestions that certain neurological conditions and cultural influences may result in the expression of the human-animal transformation theme that defines the condition.
Somatization disorder (also Briquet's syndrome) is a mental disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms, although it is no longer considered a clinical diagnosis. It was recognized in the DSM-IV-TR classification system, but in the latest version DSM-5, it was combined with undifferentiated somatoform disorder to become "somatic symptom disorder", a diagnosis which no longer requires a specific number of somatic symptoms. ICD-10, the latest version of the International Statistical Classification of Diseases and Related Health Problems, still includes somatization syndrome.
When the Malays were asked why they thought that women were more likely to suffer from latah, they responded with the cultural explanation that women have less 'semangat' or soul substance. They also said women are simply easier to tease than men, and coupling these two together: latah becomes more readily observable and developed throughout recurrent provocation in women than in men. This also accounts for the higher prevalence of latah in lower status persons, as they are more vulnerable to abuse than others. The Malay also believe women are more susceptible because they lose more blood than men, through menstruation. Some Malay believe that excess tickling of a child will predispose them to latah later in life.
Piblokto, also known as pibloktoq and Arctic hysteria, is a condition most commonly appearing in Inughuit (Greenlandic Inuit) societies living within the Arctic Circle. Piblokto is a culture-specific hysterical reaction in Inuit, especially women, who may perform irrational or dangerous acts, followed by amnesia for the event. Piblokto may be linked to repression of the personality of Inuit women. The condition appears most commonly in winter. It is considered to be a form of a culture-bound syndrome, although more recent studies (see "Skepticism" section) question whether it exists at all. Piblokto is also part of the glossary of cultural bound syndromes found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Wannarexia, or anorexic yearning,
is a label applied to someone who claims to have anorexia nervosa, or wishes they did, but does not. These individuals are also called wannarexic, “wanna-be ana” or "anorexic wannabe". The neologism "wannarexia" is a portmanteau of the latter two terms. It may be used as a pejorative term.
Wannarexia is a cultural phenomenon and has no diagnostic criteria, although some wannarexics may be instead diagnosed with eating disorder not otherwise specified (EDNOS). Wannarexia is more commonly, but not always, found in teenage girls who want to be trendy, and is likely caused by a combination of cultural and media influences.
Dr. Richard Kreipe states that the distinction between anorexia and wannarexia is that anorexics aren't satisfied by their weight loss, while wannarexics are more likely to derive pleasure from weight loss. Many people who actually suffer from the eating disorder anorexia are angry, offended, or frustrated about wannarexia.
Wannarexics may be inspired or motivated by the pro-anorexia, or pro-ana, community that promotes or supports anorexia as a lifestyle choice rather than an eating disorder. Some participants in pro-ana web forums only want to associate with "real anorexics" and will shun wannarexics who only diet occasionally, and are not dedicated to the "lifestyle" full-time. Community websites for anorexics and bulimics have posted advice to wannarexics saying that they don't want their "warped perspectives and dangerous behaviour to affect others."
Kelsey Osgood uses the label in her book "How To Disappear Completely: On Modern Anorexia" where she describes wannarexia as “a gateway drug for teenagers”.
Middle school and high school seems to be the place in which the queen bee syndrome is born. Much research has been devoted to the investigation of the interactions of adolescent girls. This is where vicious bullying of teen girls shows up, often with the operations spearheaded by one individual, who has as of late been dubbed the "queen bee." In recent years, research has shown that adolescent girls form (often small) groups called cliques, which are often created based on a shared characteristic or quality of the members such as attractiveness or popularity. Association with such a group is often wanted by those who are part of the larger, all encompassing group, such as a class or school. It is the association with these groups that brings an individual similar treatment.
The onset of Latah is often associated with stress. In a study done by Tanner and Chamberland in 2001, a significant number of research participants had experienced a life stressor (such as a child or husband dying) just before becoming latah. Additionally, a large number of participants from many research studies have reported strange dreams occurring just before the onset of latah. These dreams usually had a sexual element to them, often involving penises or enlarged penises. According to Tanner and Chamberland, perhaps the dreams, although with variation, indicate some sort of dysfunction in a specific anatomical area. Exploring this further might lead to more insights as to the cause and/or cure of latah.
Osborne (2001) states that latah is a possible emotional outlet in a stifling culture. Winzeler’s believes that latah is less demeaning for women than it is for men, and that women actually have more freedom in society because they are not held to as strict of standards as men are. He argues that as men age, they become more concerned with personal dignity and poise while women become less so. Because of this, women feel more freedom to engage in latah behavior, while men do not.
Courtship disorder is a theoretical construct in sexology in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in men. The specific paraphilias are biastophilia (paraphilic rape), exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the "courtship disorder hypothesis", there is a species-typical courtship process in human males consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. That is, instead of being independent paraphilias, this theory sees these sexual interests as individual symptoms of a single underlying disorder.