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首页> 外文期刊>Philosophy, Ethics, and Humanities in Medicine >Culture, salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application
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Culture, salience, and psychiatric diagnosis: exploring the concept of cultural congruence & its practical application

机译：文化，显着性和精神病学诊断：探索文化一致性的概念及其实际应用

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Introduction Cultural congruence is the idea that to the extent a belief or experience is culturally shared it is not to feature in a diagnostic judgement, irrespective of its resemblance to psychiatric pathology. This rests on the argument that since deviation from norms is central to diagnosis, and since what counts as deviation is relative to context, assessing the degree of fit between mental states and cultural norms is crucial. Various problems beset the cultural congruence construct including impoverished definitions of culture as religious, national or ethnic group and of congruence as validation by that group. This article attempts to address these shortcomings to arrive at a cogent construct. Results The article distinguishes symbolic from phenomenological conceptions of culture, the latter expanded upon through two sources: Husserl’s phenomenological analysis of background intentionality and neuropsychological literature on salience. It is argued that culture is not limited to symbolic presuppositions and shapes subjects’ experiential dispositions. This conception is deployed to re-examine the meaning of (in)congruence. The main argument is that a significant, since foundational, deviation from culture is not from a value or belief but from culturally-instilled experiential dispositions, in what is salient to an individual in a particular context. Conclusion Applying the concept of cultural congruence must not be limited to assessing violations of the symbolic order and must consider alignment with or deviations from culturally-instilled experiential dispositions. By virtue of being foundational to a shared experience of the world, such dispositions are more accurate indicators of potential vulnerability. Notwithstanding problems of access and expertise, clinical practice should aim to accommodate this richer meaning of cultural congruence.
机译：引言文化一致性是这样一种想法，即某种信念或经验在文化上是共享的，无论其与精神病病理学的相似性如何，它都不会出现在诊断判断中。这是基于这样的论点，即由于偏离规范是诊断的中心，并且因为算作偏离是相对于情境的，所以评估精神状态与文化规范之间的契合度至关重要。困扰文化一致性结构的各种问题包括文化对宗教，民族或族裔群体的定义贫乏，以及一致性被该群体验证的定义。本文试图解决这些缺点，以达到令人信服的目的。结果这篇文章将符号学与文化的现象学概念区分开来，后者通过两个来源得到了扩展：胡塞尔对背景意图的现象学分析和关于显着性的神经心理学文献。有人认为，文化不仅限于象征性前提，而且可以塑造主体的体验倾向。部署此概念是为了重新检查（一致）含义。主要论点是，从根本上说，与文化的重大偏离不是从价值或信念出发，而是从文化灌输的经验倾向中，这在特定情况下对个人而言是重要的。结论应用文化一致性的概念不应仅限于评估对象征秩序的违反，而必须考虑与文化灌输的体验倾向相一致或偏离。由于是共享世界经验的基础，因此此类处置是潜在漏洞的更准确指标。尽管存在获取和专业知识方面的问题，但临床实践应旨在适应这种文化融合的丰富含义。

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