Cultural Factors in the Treatment of Anxiety
A 43 year-old Japanese patient comes to your office for the evaluation of his symptoms. For the last 8 months, he has been avoiding social gatherings and staying in his house. He prefers to ‘work from home’, not interested in going to work or outside activities. He does not want to engage even his friends. His wife reports that she is concerned about his persistent withdrawal inside the house for months and months. Which of the following best describes this type of social withdrawal?
A.Ataque de Nervios
B.Hikikomori
C.Taijin Kyofusho
D.Susto
E.Coraje
Correct Answer is B. In an increasingly globalized world where people from different nations constantly mingle with each other, cultural competence and sensitivity play an integral part in the effective delivery of patient care. Effective physician-patient communication involves verbal and nonverbal sharing of information across cultural and linguistic boundaries. The goal of effective cross-cultural communication is to understand an illness from the perspective of the patient and his family. Cross-cultural communication skills are best developed through practice, reflection, and reading about and interacting with diverse patient populations.
Hikikomori is a severe syndrome of persistent withdrawal into one’s residence for at least six months. Individuals with this condition avoid social situations and engagement with friends and coworkers.
Incorrect Answers
A.Ataque de Nervios is characterized by uncontrollable screaming, shouting, crying, chest tightness, shortness of breath, feelings of impending loss of control and feelings of heat in the chest that rise to the head. It is common among individuals of Hispanic-Latino heritage from the Caribbean, Dominican Republic and Puerto Rican descent.
C.Taijin Kyofusho is characterized by the fear of offending others by blushing, emitting offensive odors, or staring inappropriately; fear of offending others by presenting an improper facial expression; fear that one’s body parts might offend others etc
D.Susto a condition of intense emotion felt after experiencing a traumatic event, such as a car accident or the death of a child, which makes the soul leave the body. It is a common folk illness seen in the Latino population
E. Coraje is an emotion resulting from long-term experience of social struggles or ‘moral indignation’ is coraje. Symptoms experienced depend on where coraje falls on the body. If it falls on the head, a person gets a headache, if it falls on the stomach, they get diarrhea, in the lungs, pneumonia etc.
https://www.sciencedirect.com/science/article/pii/B9780128153109000058
Behavioral Medicine: A Guide for Clinical Practice, 5e
Mitchell D. Feldman, John F. Christensen, Jason M. Satterfield, Ryan Laponis