Culture and mental distress: Causal attributions and pathways to seeking help

This thesis examines differences and similarities in the causal attributions of mental distress and attitudes towards seeking help tor mental distress of Western and non- Western cultural groups. In doing so, it stresses the importance of culture in the conceptualisations of mental distress. At the same time, it emphasises the necessity for a balanced consideration of cultural factors in the diversity of cultural groupings in the present day. The first chapter argues for a shift in research from the emphasis on notions of cultural homogeneity suggested by the anthropological viewpoint of the 'new' cross-cultural psychology. The second chapter focuses on the impact of culture by considering differences in Western and non-Western cultural concepts and explanatory models of mental distress. The third chapter provides the methodological framework of this research. Three studies examine the relationship between culture, causal attributions of mental distress and attitudes associated with seeking help for mental distress. The first study investigates causal attributions and associated attitudes underlying seeking help for mental distress of lay populations, in three cultural samples, British Pakistanis, Britons and Pakistanis. The second study examines the relationship between causal attributions, levels of mental distress and attitudes towards help-seeking pathways, in three samples, British Pakistanis, Britons and Pakistanis. The third study examines the relationship between causal attributions, psychological and somatic distress and the choice of one help-seeking pathway, i.e. GP consultation, between two groups, British Asians and Britons. Findings indicate differences and similarities between all three groups in the causal attributions as well as in associated attitudes towards seeking help for mental distress. While these differences cannot be dichotomised as Western and non-Western, some cultural themes emerge as being significant in the concepts of mental distress. Results demonstrate a relationship between causal attributions of mental distress and attitudes towards seeking help for mental distress. However, the generalisation of these findings is limited due to the unrepresentative and heterogenous nature of the samples investigated in the three studies. Further limitations of this research are discussed and suggestions for future studies are considered