The Psychiatric clinics of North America
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Psychiatr. Clin. North Am. · Sep 1995
ReviewCultural aspects of substance abuse and alcoholism. Assessment and management.
Cultures and ethnic groups within cultures prescribe, proscribe, or tolerate use of various psychoactive substances for social or personal purposes. In the United States, these ethnic strictures and practices vary widely. ⋯ In addition, they should be culturally sensitive to those aspects of treatment that can impede or augment successful outcomes. Finally, any and all attempts at primary prevention, early recognition and intervention, and rehabilitation should reflect the complex cultural, political, economic, and religious factors that influence substance use and abuse.
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Psychiatr. Clin. North Am. · Sep 1995
Review Case ReportsThe cultural context of anxiety disorders.
About a century ago, George Crile, a surgeon and experimental physiologist, suggested that the meaning of pain could be discovered in the context of evolution. Pain is a signal of a physical injury that would be otherwise ignored by the individual, a form of ignorance that would ultimately have mortal consequences. Crile believed that pain has a second purpose, that has important implications for how psychiatry now understands the emotions, specifically fear and anxiety. ⋯ Anxiety is not a vector directed toward a threatening object or event in the environment but is situated in the person's own bodily experience, the workings of the mind, the Cartesian theater of self-representation. As an experience and event located entirely within the psyche, to be mastered by asserting a strong ego, reflections on anxiety became one of the self-constituting experiences of the Western concept of the person. In contemporary psychiatry, the constellation of injury, pain, fear, anxiety, memory, and imagination would seem to live on mainly in the context of traumatogenic anxiety and PTSD.(ABSTRACT TRUNCATED AT 400 WORDS)