CULTURAL DIFFERENCES IN ILLNESS REPRESENTATION

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DESCRIPTION (Adapted from the Applicant's Abstract): The project described in this application is a comparative study of the cognitive representation of medically unexplained illness across two disparate cultural groups: a community of traditional, first generation, South Asian women, and a group of European American women. Though many years of cross cultural research in anthropology, psychology, and psychiatry have found wide-spread differences in illness behavior across cultures, particularly in areas such as mental health care utilization and symptom presentation in primary care settings, very little is understood of the ways in which cultural differences in the internal representations of illness may generate these observed behavioral differences. Drawing on illness vignette, health history, and symptom checklist data, the study is designed to investigate a series of interrelated research questions about differences in illness representation between westernized, psychologically minded individuals and individuals from traditional, hierarchical, familistic societies. The study utilizes a cognitive model of illness representation developed by Leventhal and his colleagues to uncover detailed systematic differences in areas such as symptom attribution, symptom salience, perceptions of chronicity, management strategies, and patterns of lay referral. The study is conceptualized as a pilot study which will serve to develop a coding scheme for the health history and vignette response data and to generate hypotheses about pertinent cultural differences in representation which will be tested later on in a larger scale study.