Interpretation of symptom presentation & distress. A Southeast Asian refugee example

Symptom expression or the manifestation of distress is greatly
influenced by one's cultural background. This exploratory
study investigated symptom presentation of distress among a
community sample of Vietnamese, Chinese-Vietnamese, Cambodian,
and Lao refugees. The study examined whether or not the
Western-designed distress measure used in the study was
culturally sensitive enough to accurately capture culturally
framed expressions of distress.

The results of the factor
analyses showed that the four Southeast Asian refugee groups
did not express distress in three separate factors as devised
in the original measure. Instead, a single robust factor
emerged. The single factor comprised items from the
depression, anxiety, somatic, and psychosocial dysfunction
subscales. The items that made up the single factor strongly
resemble the construct for the diagnosis of neurasthenia.

Researchers have found neurasthenia to be a culturally
sanctioned Asian cultural idiom of distress. The findings
strongly suggested that this Southeast Asian refugee
population expressed distress in a pattern of symptoms more
consistent with Asian nosology. The clinical and research
implications of the results of this exploratory study are also

Chung RC, Singer MK

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