Cultural concepts of distress, the CFI and dhat syndrome (MEQ)

(i) The framework and why the old term went — 5 marks

DSM-5-TR replaced the DSM-IV appendix glossary of culture-bound syndromes with three cultural concepts of distress. Name all three and give an example of each.^[1][5]

• Cultural syndrome — a co-occurring pattern recognised in a community, for example ataque de nervios.^[10][1]
• Cultural idiom of distress — a shared vocabulary for suffering that is often non-pathological, for example nervios.^[5][13]
• Cultural explanation — an account of cause, for example semen loss, soul loss or nerve weakness.^[6][13][15]

Why the old term failed — three reasons, one worked example. It implied boundedness, rarity, and a culture-free Western baseline. Sumathipala's review found semen-loss anxiety described historically in Britain, the USA and Australia, so dhat is not as culture-bound as its "neurosis of the Orient" label implied; Chowdhury made the same argument for koro.^[6][8][4]

Add the nosological line for full marks: ICD-11 carries no glossary of culture-bound syndromes; cultural context is captured in the clinical description and the person's explanatory model.^[1][8]