U.S. Clinicians’ Recognition and Diagnosis of Cultural Concepts of Distress

Bibliographic Data

ID21696222
AuthorsYunjung Lisa Chung (Virginia Commonwealth University), Shea Wenzler (0000-0002-1981-8721, Virginia Commonwealth University), Emma Headley (Virginia Commonwealth University), Gabriella Scalzo (Virginia Commonwealth University), Waverley Vesely (Virginia Commonwealth University), Jared W Keeley (0000-0002-1437-5810, Virginia Commonwealth University, corresponding author)
Year2026
Volume63
Issue4
Pages13634615261446922-13634615261446922
Publication date2026-07-09
Open AccessYes
TypeARTICLE
VenueTranscultural Psychiatry (JOURNAL)
Journal identifiersISSN: 1363-4615 • E-ISSN: 1461-7471
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/13634615261446922
PMID42423559
OpenAlexW7167802688
LanguageEN
References cited27

In an increasingly diverse world, it is important for mental health professionals to be familiar with symptom presentations from a variety of cultures, including cultural concepts of distress. This study aimed to evaluate how U.S. clinicians diagnosed two cultural concepts of distress— hwa-byung and ataque de nervios —and whether the clinicians’ cultural values or competence influenced their diagnosis. A sample of 84 mental health professionals viewed three case vignettes in random order depicting hwa-byung, ataque de nervios, and Generalized Anxiety Disorder. The clinicians provided an unprompted free-response diagnosis and a forced-choice diagnosis from a predetermined list for each vignette. Clinicians provided a wide range of diagnoses for the hwa-byung and ataque de nervios vignettes, with only a minority of participants correctly labeling the cultural concepts of distress. Prompting diagnoses by providing a list of options improved the likelihood of selecting a cultural syndrome. The most common mental health diagnoses selected did not adequately capture the symptom profiles of the cultural concepts of distress. Clinicians appeared to be more familiar with Latinx cultural presentations than East Asian. U.S. clinicians could likely benefit from additional training and exposure to varying cultural presentations of psychopathology. Labeling a cultural syndrome with a psychiatric diagnosis may lead to decreased rapport and insufficient or ineffective treatment options

Anxiety · Categorization · Cultural competence · Cultural diversity · Distress · Help-seeking · Medical diagnosis · Mental health · Cultural Differences and Values · Mental Health and Psychiatry · Mental Health Treatment and Access

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