Skip to main content
SpringerLink
Log in

Psychiatric investigations among American Indians and Alaska natives: A critical review

  • Published:
Culture, Medicine and Psychiatry Aims and scope Submit manuscript

Abstract

This review of psychiatric investigations among Native Americans opens with a discussion of the dominant theoretical perspectives in psychiatric anthropology in order to provide an analytic framework with which to assess the substantive findings of researchers in the field. Studies of culture-specific disorders, service utilization and patient population studies, psychiatric epidemiological studies, and studies designed to test the validity of certain diagnostic instruments are scrutinized for evidence of the nature of the role of indigenous cultures in the manifestations of psychiatric disorders among these populations. The review reveals that a universalist theoretical perspective, which tends to obscure the role of local interpretations in the phenomenology of psychiatric illness, dominates this field of inquiry. Nonetheless, evidence has accumulated which indicates the importance of native understandings for a more reliable and valid explanation of the nature of mental disorder among these peoples. The inadequacies of our current knowledge are examined and suggestions for directions in future work are presented in the concluding section. Recommendations include the direct investigation of the local meanings of the signs, symptoms, and syndromes of Western psychiatry; the concentrated search for potentially unique and powerful local signs of distress; and the study of the culturally-constituted social processes of illness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ackerknecht, Erwin H. 1943 Psychopathology, Primitive Medicine, and Primitive Culture. Bulletin of the History of Medicine 14: 30–67.

    Google Scholar 

  • American Psychiatric Association 1980 Diagnostic and Statistical Manual of Mental Disorders, Third Edition. Washington, D.C.: APA.

    Google Scholar 

  • Bebbington, Paul E. 1978 The Epidemiology of Depressive Disorder. Culture, Medicine and Psychiatry 2: 297–341.

    Google Scholar 

  • Beeman, William O. 1985 Dimensions of Dysphoria: The View from Linguistic Anthropology. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 216–243. Berkeley: University of California Press.

    Google Scholar 

  • Beiser, Morton 1981 Mental Health of American Indian and Alaska Native Children: Some Epidemiological Perspectives. White Cloud Journal 2(2): 37–47.

    Google Scholar 

  • Beiser, Morton, J. L. Ravel, H. Collomb, et al. 1972 Assessing Psychiatric Disorder Among the Serer of Senegal. Journal of Nervous and Mental Disease 154(2): 141–151.

    Google Scholar 

  • Beiser, Morton, R. C. Benfari, H. Collomb, et al. 1976 Measuring Psychoneurotic Behaviors in Cross-Cultural Surveys. Journal of Nervous and Mental Disorders 163(1): 10–23.

    Google Scholar 

  • Blashfield, Roger K. 1984 The Classification of Psychopathology: Neo-Kraepelinian and Quantitative Approaches. New York: Plenum Press.

    Google Scholar 

  • Blashfield, Roger K. and J. G. Draguns 1976 Evaluative Criteria for Psychiatric Classification. Journal of Abnormal Psychology 85: 140–150.

    Google Scholar 

  • Boag, Thomas A. 1970 Mental Health of Native Peoples of the Arctic. Canadian Psychiatric Association Journal 15(2): 115–120.

    Google Scholar 

  • Briggs, Jean L. 1970 Never in Anger, Portrait of an Eskimo Family. Cambridge: Harvard University Press.

    Google Scholar 

  • Brown, George and Tirril Harris 1978 The Social Origins of Depression. New York: Free Press.

    Google Scholar 

  • Chance, Norman A. 1962 Conceptual and Methodological Problems in Cross-Cultural Health Research. American Journal of Public Health and the Nation's Health 52(3): 410–417.

    Google Scholar 

  • Chance, Norman A. and Dorothy A. Foster 1962 Symptom Formation and Patterns of Psychopathology in a Rapidly Changing Alaskan Eskimo Society. Anthropological Papers of the University of Alaska 11(1): 32–42.

    Google Scholar 

  • Deloria, Jr., Vine 1969 Custer Died for Your Sins. New York: Avon, Books.

    Google Scholar 

  • Devereux, George 1939 Mohave Culture and Personality. Culture and Personality 8: 91–109.

    Google Scholar 

  • Devereux, George 1961 Shamans as neurotics. American Anthropologist 63: 1088–1090.

    Google Scholar 

  • Devereux, George 1980 Basic Problems of Ethnopsychiatry. Chicago: University of Chicago Press.

    Google Scholar 

  • Ebigbo, P. O. 1982 Development of a Culture-Specific (Nigeria) Screening Scale of Somatic Complaints Indicating Psychiatric Disturbance. Culture, Medicine, and Psychiatry 6: 29–43.

    Google Scholar 

  • Foulks, Edward F. and Solomon Katz 1973 The Mental Health of Alaskan Natives. ACTA Psychiatrica Scandinavica 49: 91–96.

    Google Scholar 

  • Frake, Charles O. 1961 The Diagnosis of Disease Among the Subanun of Mindanao. American Anthropologist 63: 113–132.

    Google Scholar 

  • Freud, Sigmund 1918 Totem and Taboo. New York.

  • Fritz, W. B. 1976 Psychiatric Disorders and Natives and Non-Natives in Saskatchewan. Canadian Psychiatric Association Journal 21(6): 393–400.

    Google Scholar 

  • Fritz, W. B. 1978 Indian People and Community Psychiatry in Saskatchewan. Canadian Psychiatric Association Journal 23(1): 1–7.

    Google Scholar 

  • Good, Byron J. and Mary-Jo Delvecchio Good 1981 The Semantics of Medical Discourse. In E. Menelsohn and Y. Elkana (eds.), Sciences and Cultures: Sociology of the Sciences, Volume 5, pp. 177–212. Dordrecht: D. Reidel Publishing Company.

    Google Scholar 

  • Good, Byron J. and Mary-Jo Delvecchio Good 1982 Toward a Meaning-Centered Analysis of Popular Illness Categories: “Fright Illness” and “Heart Distress” in Iran. In Anthony J. Marsella and Geoffrey M. White (eds.), Cultural Conceptions of Mental Health and Therapy, pp. 141–166. Dordrecht: D. Reidel Publishing Company.

    Google Scholar 

  • Good, Byron J. and Arthur Kleinman 1985a Culture and Anxiety: Cross-Cultural Evidence for the Patterning of Anxiety Disorders. In A. Hussain Tuma and Jack D. Maser (eds.), Anxiety and the Anxiety Disorders, pp. 297–323. Hillsdale, NJ.: Lawrence Earlbaum Associates.

    Google Scholar 

  • Good, Byron J. and Arthur Kleinman 1985b Epilogue. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 491–506. Berkeley: University of California Press.

    Google Scholar 

  • Goodwin, Donald W. and Samuel B. Guze 1984 Psychiatric Diagnosis, Third Edition. Oxford: Oxford University Press.

    Google Scholar 

  • Hay, Thomas 1971 The Windigo Psychosis. American Anthropologist 73: 1–19.

    Google Scholar 

  • Hurd, H. M. 1916 The Institutional Care of the Insane in the United States and Canada. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Jilek-Aall, Louise, Wolfgang G. Jilek, and Frank Flynn 1978 Sex Role, Culture, and Psychotherapy: A Comparative Study of Three Ethnic Groups in Western Canada. Journal of Psychological Anthropology 1(4): 473–488.

    Google Scholar 

  • Jilek, Wolfgang G. 1971 From Crazy Witchdoctor to Auxiliary Psychotherapist: The Changing Image of the Medicine Man. Psychiatria Clinica 4: 200–220.

    Google Scholar 

  • Jilek, Wolfgang G. 1982 Indian Healing. Surrey, B.C., Canada: Hancock House.

    Google Scholar 

  • Johnson, Dale L. and Carmen A. Johnson 1965 Totally Discouraged: A Depressive Syndrome of the Dakota Sioux. Transcultural Psychiatric Research Review 2: 141–143.

    Google Scholar 

  • Kaplan, Bert and Dale L. Johnson 1974 The Social Meaning of Navaho Psychopathology and Psychotherapy. In Ari Kiev (ed.), Magic, Faith, and Healing: Studies in Primitive Psychiatry Today. pp. 203–229. New York: Free Press.

    Google Scholar 

  • Kelso, Dianne and Carolyn Attneave 1981 Bibliography of North American Indian Mental Health. Compiled by Dianne Kelso and Carolyn Attneave under the auspices of the White Cloud Center. Westport, Conn.: Greenwood Press.

    Google Scholar 

  • Kleinfeld, Judith, Joseph D. Bloom, and Virginia Weed 1982 Using Physiological Symptoms to Detect Psychological Disturbance in an Eskimo Population. White Cloud Journal 2(4): 9–17.

    Google Scholar 

  • Kleinman, Arthur 1977 Depression, Somatization, and the New Cross-Cultural Psychiatry. Social Science and Medicine 11: 3–10.

    Google Scholar 

  • Kleinman, Arthur 1978 Concepts and a Model for the Comparison of Medical Systems as Cultural Systems. Social Science and Medicine 12: 85–93.

    Google Scholar 

  • Kraus, Robert F. and Patricia A. Buffler 1979 Sociocultural Stress and the American Native in Alaska: An Analysis of Changing Patterns of Psychiatric Illness and Alcohol Abuse among Alaska Natives. Culture, Medicine, and Psychiatry 3: 111–151.

    Google Scholar 

  • Landes, Ruth 1938 The Abnormal among the Ojibwa Indians. Journal of Abnormal and Social Psychology 33: 14–33.

    Google Scholar 

  • Leff, J. 1973 Culture and the Differentiation of Emotional States. British Journal of Psychiatry 123: 299–306.

    Google Scholar 

  • Leighton, Alexander, T. Lambo, C. Hughes, et al. 1963 Psychiatric Disorder Among the Yoruba. Ithaca: Cornell University Press.

    Google Scholar 

  • Levy, Jerrold E. 1974 Navajo Suicide. Human Organization 24: 308–318.

    Google Scholar 

  • Levy, Jerrold E. and Steven J. Kunitz 1971 Indian Reservations, Anomie, and Social Pathologies. Southwestern Journal of Anthropology 27(2): 97–128.

    Google Scholar 

  • Levy, J. E., S. J. Kunitz, and E. B. Henderson 1987 “Hopi Deviance in Historical and Epidemiological Perspective.” In J. Jorgensen and L. Donald (eds.). Themes in Ethnology and Culture: Essays in Honor of David F. Aberle. Berkeley: Folklore Institute.

    Google Scholar 

  • Lewis, Thomas H. 1975 A Syndrome of Depression and Mutism in the Oglala Sioux. American Journal of Psychiatry 132(7): 753–755.

    Google Scholar 

  • Lutz, Catherine 1985 Depression and the Translation of Emotional Worlds. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 63–100. Berkeley: University of California Press.

    Google Scholar 

  • Macmillan, A. M. 1957 The Health Opinion Survey: Technique for Estimating Prevalence of Psychoneurotic and Related Types of Disorders in Communities. Psychological Reports Monograph, Supp. 7.

  • Mail, Patricia D. and David R. McDonald 1980 Tulapai to Tokay: A Bibliography of Alcohol Use and Abuse among Native Americans of North America. New Haven: HRAF Press.

    Google Scholar 

  • Manson, Spero M., James H. Shore, and Joseph D. Bloom 1985 The Depressive Experience in American Indian Communities: A Challenge for Psychiatric Theory and Diagnosis. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 331–368. Berkeley: University of California Press.

    Google Scholar 

  • Marsella, Anthony J., et al. 1985 Cross-Cultural Studies of Depressive Disorders: An Overview. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 299–330. Berkeley: University of California Press.

    Google Scholar 

  • Martin, Harry W., et al. 1968 Mental Health of Eastern Oklahoma Indians: An Exploration. Human Organization 27(4): 308–315.

    Google Scholar 

  • Matchett, William F. 1972 Repeated Hallucinatory Experiences as Part of the Mourning Process among Hopi Indian Women. Psychiatry 35: 185–194.

    Google Scholar 

  • Meketon, Melvin Jerry 1983 Indian Mental Health: An Orientation. American Journal of Orthopsychiatry 53(l): 110–115.

    Google Scholar 

  • Murphy, H. B. M. 1982 Comparative Psychiatry. Berlin: Springer-Verlag.

    Google Scholar 

  • Murphy, Jane M. and Charles C. Hughes 1965 The Use of Psychophysiological Symptoms as Indicators of Disorder among the Eskimos. In Jane M. Murphy and Alexander Leighton (eds.), Approaches to Cross-Cultural Psychiatry, pp. 108–160. Ithaca: Cornell University Press.

    Google Scholar 

  • Murphy, Jane M. and Alexander H. Leighton 1965 Native Conceptions of Psychiatric Disorder. In Jane M. Murphy and Alexander Leighton (eds.), Approaches to Cross-Cultural Psychiatry, pp. 64–107. Ithaca: Cornell University Press.

    Google Scholar 

  • Murphy, Jane M. and Alexander H. Leighton (eds.) 1965 Approaches to Cross-Cultural Psychiatry. Ithaca: Cornell University Press.

    Google Scholar 

  • Myers, Jerome K., et al. 1984 Six-Month Prevalence of Psychiatric Disorders in Three Communities. Archives of General Psychiatry 41: 959–967.

    Google Scholar 

  • Nichter, Mark 1981 Idioms of Distress, Alternatives in the Expression of Psychosocial Distress: A Case Study for South India. Culture, Medicine, and Psychiatry 5: 379–408.

    Google Scholar 

  • Noll, Richard 1983 Shamanism and Schizophrenia: A State-Specific Approach to the “Schizophrenia Metaphor” of Shamanic States. American Ethnologist 10: 443–459.

    Google Scholar 

  • Obeyesekere, Gananath 1985 Depression, Buddhism, and the Work of Culture in Sri Lanka. In Arthur Kleinman and Byron Good (eds.), Culture and Depression, pp. 134–152. Berkeley: University of California Press.

    Google Scholar 

  • Orley, John and John K. Wing 1979 Psychiatric Disorders in Two African Villages. Archives of General Psychiatry 36: 513–520.

    Google Scholar 

  • Parker, Seymour 1962 Eskimo Psychopathology in the Context of Eskimo Personality and Culture. American Anthropologist 64: 76–96.

    Google Scholar 

  • Perkins, Anne E. 1927 Psychosis of the American Indians Admitted to Gowanda State Hospital. Psychiatric Quarterly 1: 335–343.

    Google Scholar 

  • Peters, Ron 1981 Suicidal Behavior among Native Americans: An Annotated Bibliography. White Cloud Journal 2(3): 9–20.

    Google Scholar 

  • Pine, Charles 1981 Suicide in American Indian and Alaska Native Tradition. White Cloud Journal 2(3): 3–8.

    Google Scholar 

  • Pollack, David and James H. Shore 1980 Validity of the MMPI with Native Americans. American Journal of Psychiatry 137(8): 946–950.

    Google Scholar 

  • Rabinow, Paul and William M. Sullivan 1979 The Interpretive Turn: Emergence of an Approach. In Paul Rabinow and William M. Sullivan (eds.), Interpretive Social Science, pp. 1–21. Berkeley: University of California Press.

    Google Scholar 

  • Roy, Chunilal, Adjit Choudhuri and Donald Irvine 1970 The Prevalence of Mental Disorders among Saskatchewan Indians. Journal of Cross-Cultural Psychology 1(4): 383–392.

    Google Scholar 

  • Said, Edward W. 1978 Orientalism. New York: Vintage Books.

    Google Scholar 

  • Sampath, H. M. 1974 Prevalence of Psychiatric Disorders in a Southern Baffin Island Eskimo Settlement. Canadian Psychiatric Association Journal 19(4): 363–367.

    Google Scholar 

  • Sartorius, Norman, et al. 1983 Depressive Disorders in Different Cultures. Geneva: World Health Organization.

    Google Scholar 

  • Shweder, Richard A. and Edmund J. Bourne 1982 Does the Concept of the Person Vary Cross-Culturally? In Anthony J. Marsella and Geoffrey M. White (eds.), Cultural Conceptions of Mental Health and Therapy, pp. 97–137. Dordrecht: D. Reidel Publishing Company.

    Google Scholar 

  • Shore, James H., et al. 1973 Psychiatric Epidemiology of an Indian Village. Psychiatry 36: 70–81.

    Google Scholar 

  • Shore, James H. 1974 Psychiatric Epidemiology among American Indians. Psychiatric Annals 4(9): 56–66.

    Google Scholar 

  • Shore, James H. and Spero Manson 1983 American Indian Psychiatric and Social Problems. Transcultural Psychiatric Research Review 20: 159–180.

    Google Scholar 

  • Srole, L., T. S. Langner, S. T. Michael, et al. 1962 Mental Health in the Metropolis: The Midtown Manhattan Study. New York: McGraw-Hill.

    Google Scholar 

  • Steiner, Christopher B. 1986 Of Drums and Dancers. Harvard Review 1(1): 104–129.

    Google Scholar 

  • Susser, Mervyn 1967 Causes of Peptic Ulcer: A Selective Epidemiological Review. Journal of Chronic Diseases 20: 435–456.

    Google Scholar 

  • Termansen, Paul E. and Joan Ryan 1970 Health and Disease in a British Columbian Indian Community. Canadian Psychiatric Association Journal 15(2): 121–127.

    Google Scholar 

  • Trimble, Joseph E., Spero Manson, Norman G. Dinges, Beatrice Medicine 1984 American Indian Concepts of Mental Health: Reflections and Directions. In P. B. Pederson, et al. (eds.), Mental Health Services: The Cross-Cultural Context, pp. 199–220. Beverly Hills: Sage Publications.

    Google Scholar 

  • Waxler, Nancy E. 1977 Is Mental Illness Cured in Traditional Societies? A Theoretical Analysis. Culture, Medicine, and Psychiatry 1: 233–253.

    Google Scholar 

  • Weiss, Mitchell G. 1985 The Interrelationship of Tropical Disease and Mental Disorder: Conceptual Framework and Literature Review (Part I — Malaria). Culture, Medicine and Psychiatry 9(2): 121–200.

    Google Scholar 

  • Weissman, Myrna and Gerald Klerman, 1978 Epidemiology of Mental Disorders. Archives of General Psychiatry 35: 705–712.

    Google Scholar 

  • Wilson, Bryan R. 1970 Rationality. Oxford: Basil Blackwell.

    Google Scholar 

  • World Health Organization 1973 Report of the International Pilot Study of Schizophrenia. Geneva: WHO.

    Google Scholar 

  • World Health Organization 1979 Schizophrenia: An International Follow-Up Study. Geneva: WHO.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dept. of Anthropology, Harvard University, William James Hall, 02138, Cambridge, MA, U.S.A.

    Theresa D. O'Nell

Authors
  1. Theresa D. O'Nell
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

O'Nell, T.D. Psychiatric investigations among American Indians and Alaska natives: A critical review. Cult Med Psych 13, 51–87 (1989). https://doi.org/10.1007/BF00052682

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00052682

Keywords

Search

Navigation