Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Jared W. Keeley

Second Advisor

Scott Vrana

Third Advisor

Vivian Dzokoto


Culture-bound syndromes are of increasing importance in today’s more diverse world. The current study measured the ability of clinicians trained in a western setting to accurately diagnose culture-bound syndromes from cultures outside of their background. Eight-four clinicians were recruited through the American Psychological Association (APA) membership directory. All recruited clinicians were asked to read three vignettes. In two vignettes a patient was suffering from either Hwabyung or Ataque de Nervios and the third vignette represented a control GAD vignette. The clinicians were asked to diagnose the patient in the vignette, to explain what information informed their diagnosis, to complete two indications of what portions of the vignette informed their decision, and also to describe what strategies they used to help reach their diagnosis. The clinicians then completed both the Multicultural Counseling Self-Efficacy Scale-Racial Diversity Form and the Self-Construal Scale to measure their perceived competence in interacting with clients of minority backgrounds as well as their cultural orientation toward individualism or collectivism. Demographic questions were also completed to assess information such as participants’ cultural and clinical background. The present study found that clinicians had difficulty correctly diagnosing cultural disorders while there was greater accuracy in diagnosing the western GAD vignette. Clinicians paid more attention to familiar symptoms of cultural disorders (those that resembled western symptoms) while dismissing uniquely cultural symptoms. Individualism and high perceived cultural competence levels were also correlated with reduced accuracy in the diagnosis of Hwabyung. The study revealed that western clinicians lack experience with encountering and diagnosing unique cultural disorders and are quick to give inaccurate western diagnoses to these foreign presentations. It can be concluded from the results that more cultural training whether it is through graduate programs or CE credits are needed and of great importance.


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