Psychiatric Diagnosis and Classification - ResearchGate

130 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION
Western and non-Western societies has been emphasized [57]. Social crises
undermine traditional institutions of social control and legitimate structures
of authority, with consequent loosening of psychological controls and the
hold of traditional systems of morality and conscience [58±60]. Modern
societies show waxing and waning of the hold of traditional values, grudging
tolerance of social deviance seen in juxtaposition to racial hatreds
and divisive competition, openness to differences in lifestyle and religion
yet increased distrust, and suspicion; they resort to adversative modes of
conflict resolution, and a heightening of narcissism. Modernity tends to
increase interpersonal self-disclosure along with an awareness and openness
to cultural differences, sometimes including sexual experience and
behavior.
One can assume that such features of culture will not only continue to
influence the character of personal experience and social behavior, but will
also sharply influence interpersonal conflicts in circumscribed communities.
Migration and cultural pluralism will likely increase and this implies not
only a clash between ``old'' traditions and the ``new'' narcissism and internationalism
of the culture of capitalism, differences between host and
parent country, but also clashes between competing traditions, values, and
sects in large urban ``melting pots''. In other words, individuals come to be
influenced by global, secular trends and migrate to foreign soils where they
then interact with other immigrant, minority populations.
Here it is important to keep in mind the distinction between the two
conceptions of culture mentioned earlier. While the demographic demarcating)
view of culture may diminish in importance because of the assimilation
of modernity, culture as lived reality shaped by diverse and even
competing tenets and feelings and different in emphasis from that of
other citizens) will continue to be important. Even if one agrees that a
brain-based model of rationality and belief formation is an innate property
of Homo sapiens, ascertaining its workings necessarily enmeshes the diagnostician
in a complex exegesis that requires knowledge of his/her and
client's language and culture. How items of information are labeled, confirmed,
disconfirmed, and incorporated into meaningful social discourse
constitutes the essence of culture and language and of higher cortical functions.
Consequently, while cultural differences across societies may lessen in
importance, intra-societal differences between an individual in work and
institutional settings, including psychiatrist/patient dialogues, are likely to
increase in societies of the future. It is thus to be expected that symbols,
meanings, and world-views will continue to be influential in shaping personal
experience and behavior, constituting aspects of social reality that
systems of psychiatric diagnosis should contend with in the future, if such
systems are to realistically incorporate important characteristics of the individual.