Chapter 3. Culture and Mental Illness: Social Context and Explanatory Models

  1. Ihsan M. Salloum Professor of Psychiatry Director4,5 and
  2. Juan E. Mezzich Professor of Psychiatry Director Past President6,7
  1. Laurence J. Kirmayer Professor Director1 and
  2. Dinesh Bhugra Professor President2,3

Published Online: 11 MAY 2009

DOI: 10.1002/9780470743485.ch3

Psychiatric Diagnosis: Challenges and Prospects

Psychiatric Diagnosis: Challenges and Prospects

How to Cite

Kirmayer, L. J. and Bhugra, D. (2009) Culture and Mental Illness: Social Context and Explanatory Models, in Psychiatric Diagnosis: Challenges and Prospects (eds I. M. Salloum and J. E. Mezzich), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470743485.ch3

Editor Information

  1. 4

    Division of Alcohol and Substance Abuse: Treatment and Research, University of Miami Miller School of Medicine, FL, USA

  2. 5

    Section on Classification, Diagnostic Assessment and Nomenclature, World Psychiatric Association, FL, USA

  3. 6

    International Center for Mental Health and Division of Psychiatric Epidemiology, Mount Sinai School of Medicine, New York University, NY, USA

  4. 7

    World Psychiatric Association, USA

Author Information

  1. 1

    Division of Social & Transcultural Psychiatry, McGill University, Culture & Mental Health Research Unit, Sir Mortimer B Davis–Jewish General Hospital, Montreal, Quebec, Canada

  2. 2

    Institute of Psychiatry, London, UK

  3. 3

    Royal College of Psychiatrists, UK

Publication History

  1. Published Online: 11 MAY 2009
  2. Published Print: 27 MAR 2009

Book Series:

  1. World Psychiatric Association Evidence and Experience in Psychiatry Series

Book Series Editors:

  1. Helen Herrman

Series Editor Information

  1. WPA Secretary for Publications, University of Melbourne, Australia

ISBN Information

Print ISBN: 9780470725696

Online ISBN: 9780470743485



  • culture and mental illness - social context and explanatory models;
  • cultural models - how individuals interpret signs and symptoms of illness, and psychiatric disorders;
  • explanatory models - target of research, clinical assessment, and intervention;
  • Kleinman's view of explanatory models - emphasizing parallels with clinicians' biomedical models of disease;
  • Weiss's Explanatory Model Interview Catalogue (EMIC);
  • Short Explanatory Model Interview (SEMI) in epidemiological studies;
  • notion of explanatory models - based on problematic theory of knowledge and action;
  • how reasons become causes - a typology of looping effects;
  • individuals' self-representations and self-esteem - shaped by cultural norms and values contributing to vulnerability or resistance to depression;
  • culture, context and meaning in psychiatric nosology - cultural meanings in psychological or social loops and vicious circles


This chapter contains sections titled:

  • Introduction

  • Understanding and Eliciting Explanatory Models

  • Culture, Context and Explanation

  • How Reasons Become Causes: Explanations and Looping Effects

  • Conclusion: Culture, Context and Meaning in Psychiatric Nosology

  • References