Cross-cultural differences in the presentation of depression : Chinese somatization and western psychologization

The expectation that Chinese individuals tend to present distress in a somatic way, through physical symptoms, has been a major prediction of cultural psychopathology. Numerous theoretical papers have been written in an attempt to explain this phenomenon, but empirical research on this subject remains scarce. The present paper begins by reviewing literature indicating low depression rates in China along with high rates of a syndrome, most often translated using the archaic term Neurasthenia, which shares many physical symptoms with depression. Then, research is discussed pertaining to underlying processes of symptom presentation, most often referred to as somatization and psychologization. This review accounts for the influence of sociocultural and historical forces, arguing that sufficient work on these factors has now been done to allow for carefully constructed empirical research using the methods of clinical and cultural psychology. To this end, two studies are presented, the first a questionnaire study of Chinese, Chinese-Canadian, and Euro-Canadian students and the second a multimethod study using Chinese and Euro-Canadian psychiatric outpatients. Results suggest that Chinese somatization, and Western psychologization, only emerge when sufficient psychosocial distress is present and, when this is the case, can be detected regardless of the assessment method used. At the same time, neither mode of symptom presentation is culturally unique. A number of possible explanations are explored, suggesting a role for cultural differences in the emphasis on emotional life. The paper concludes by integrating these findings into the existing literature and by noting the ways in which cultural psychopathology can be informed by clinical and cultural psychology.Arts, Faculty ofPsychology, Department ofGraduat