Cultural Competence in Mental Health Diagnosis: The DSM and its Global Applicability

Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has become the “Bible” of psychiatry since its conception in 1952, starting with the DSM-III’s skyrocket in popularity in 1980. After numerous critiques of the cross-cultural inapplicability of the DSM-III, the DSM-IV and DSM-5 made efforts to incorporate more cultural elements (e.g. incorporating cultural syndromes and idioms of distress). But, throughout the course of this paper, we argue how the DSM has limited cross-cultural applicability due to its implicit assumption of biomedical universality. We first trace the shift from psychoanalysis to the biomedical perspective in the DSM in order to discuss how the historical circumstances behind the creation of the DSM led to the theory of universality, and then we track how cultural elements have been included in the DSM over time. We also discuss the necessity of incorporating culture within the DSM, and how the DSM’s diagnostic criteria are inhibited by the underlying universalist framework.

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Funding Information: None.

Conflict of Interests: None.

Keywords: DSM, Psychiatry, Culture, Cultural Psychology, Cultural Syndromes, DSM-III, DSM-IV, DSM-5, Universality, Somatization, Individualism, Collectivism, Symptomatology, OCF, Cross-Cultural, CBS, Diagnostic and Statistical Manual of Mental Disorders, multiaxial assessment, mental health, psychology