31 Psychosocial aspects of Anthropology

Ajeet Jaiswal

Contents

1. Introduction

2. Psychosocial approach

3. A psychosocial aspect of Anthropology

4. Psychological Anthropology

5. Social psychology

6. Psychosocial Aspects of Occupational Therapy

7. Psychosocial Aspects of Disease

8. Psychosocial aspects of obesity

9. Psychosocial Aspects of Chronic Disease

10. Psychosocial Aspects of People Living with HIV/AIDS

11. Anthropology of Psychosocial responses

12. Psychosocial assessment and intervention

13. Psychosocial aspects of depression and the role of psychotherapy

14. Psychosocial adaptation

15. Summary

Learning Objectives:

The course provides an introduction to the field of Psychosocial aspects of Anthropology.
It includes the Basic Concept of Concepts of Psychological Anthropology, Social psychology and psychosocial adaptation.
The study of this module enables the students at postgraduate level to understand the Psychosocial Aspects of Occupational Therapy, Disease, obesity, Chronic Disease and Psychosocial aspects of depression and the role of psychotherapy

1. Introduction

People may not be fully aware of the relationship between their mental and emotional wellbeing and the environment. It was first commonly used by psychologist Erik Erikson in his description of the stages of psychosocial development. Mary Richmond, pioneer of American social work regarded there to be a linear relationship between cause and effect in a diagnostic process. In 1941 Gordon Hamilton renamed the 1917 concept of “social diagnosis” as “psychosocial study”.

Psychosocial study was further developed by Hollis in 1964 with emphasis in treatment model. It is contrasted with diverse social psychology, which attempts to explain social patterns within the individual. Problems that occur in one’s psychosocial functioning can be referred to as “psychosocial dysfunction” or “psychosocial morbidity.” This refers to the lack of development or diverse atrophy of the psychosocial self, often occurring alongside other dysfunctions that may be physical, emotional, or cognitive in nature.

Scholarly societies in this field bring together researchers, academics and practitioners who are interested in contributing to the development of this inter/trans-disciplinary field of study. There are organizations such as Transcultural Psychosocial Organization (United Nations High Commissioner for Refugees), Association for Psychosocial Studies, etc.

2. Psychosocial approach

The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is used in a broad range of helping professions in health and social care settings as well as by medical and social science researchers (Woodward, 2015).

3. A psychosocial aspect of Anthropology

A psychosocial aspect of Anthropology is the study of psychological topics using anthropological concepts and methods. Among the areas of interest are personal identity, selfhood, subjectivity, memory, consciousness, emotion, motivation, cognition, madness, and mental health. Considered thus, there is hardly a topic in the anthropological mainstream that does not offer grist for the analytical mill. Like economic or political anthropology, psychological anthropology can be seen as a perspective on the social as well as being a subfield of the broader discipline. The overlap in subject matter with the related discipline of psychology is obvious, but the approach, grounded in ethnographic fieldwork and comparativism, is usually quite different. Moreover, as a reflexive endeavor, psychological anthropology shines a light not only on the cultural vehicles of thought (language, symbolism, the body) but on the concepts we use to think about those means.

Psychosocial or Psychological anthropologists are concerned, for example, not merely with emotional practices in diverse cultures (what angers people? how do they express it?), but in the shape and cross-cultural validity of the concept of emotion. To the ethnographic question, “How do the Nuaulu classify animals?” they add, “How is their classification structured and what does that structure reveal about broader processes of cognition?” Some of the basic categories of psychology—self, mind, emotion— turn out, in cross-cultural perspective, to be less self-evident, less transparently objective than expected. While rough equivalents can often be found in other linguistic traditions, the scholar soon finds that English (or French or Malay) is not a neutral inventory of psychological universals. Comparison can be corrosive of confidence. And perhaps more than in other subfields, in psychosocial or psychological anthropology there is a full spectrum from the hard scientific to the soft interpretive.

Indeed, a divergence between a scientific, positivist psychology—confident in its categories and methods, bent on universals —and a relativist, meaning-oriented, often doubt-ridden constructionism is one of the productive tensions that animate enquiry. Until recently, the subfield has fared very differently on either side of the Atlantic. With some exceptions, anthropologists in Britain and France until at least the 1960s pursued strongly sociological or structuralist agendas unsympathetic to psychological anthropology. American anthropologists, with their broader conception of culture and interest in individual experience, led the way with culture and personality studies, a diverse body of work that has a recent reinvention in person-centered anthropology. Parallel endeavors in psychoanalytic anthropology and cognitive anthropology drew on different intellectual traditions. These complementary, sometimes rival, approaches span and crosscut in surprising ways the scientific-humanistic division that characterizes anthropology generally (Andrew, 2013).

4. Psychological Anthropology

Psychological anthropology is an interdisciplinary subfield of anthropology that studies the interaction of cultural and mental processes. This subfield tends to focus on ways in which humans’ development and enculturation within a particular cultural group—with its own history, language, practices, and conceptual categories—shape processes of human cognition, emotion, perception, motivation, and mental health. It also examines how the understanding of cognition, emotion, motivation, and similar psychological processes inform or constrain our models of cultural and social processes. Each school within psychological anthropology has its own approach (D’Andrade, 1995; Schwartz, and White, 1992).

5. Social psychology

Social psychology is the study of the manner in which the personality, attitudes, motivations, and behavior of the individual influence and are influenced by social groups.

Social psychology is the scientific study of how people’s thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others (Allport, 1985). In this definition, scientific refers to the empirical method of investigation. The terms thoughts, feelings, and behaviors include all psychological variables that are measurable in a human being. The statement that others’ presence may be imagined or implied suggests that we are prone to social influence even when no other people are present, such as when watching television, or following internalized cultural norms. Social psychologists typically explain human behavior as a result of the interaction of mental states and immediate social situations. Social psychologists therefore deal with the factors that lead us to behave in a given way in the presence of others, and look at the conditions under which certain behavior/actions and feelings occur. Social psychology is concerned with the way these feelings, thoughts, beliefs, intentions and goals are constructed and how such psychological factors, in turn, influence our interactions with others.

Social psychology is a discipline that had traditionally bridged the gap between psychology, anthropology and sociology. During the years immediately following World War II there was frequent collaboration between psychologists and anthropologist (Sewell, 1989). However, the two disciplines have become increasingly specialized and isolated from each other in recent years, with anthropologist sociologists focusing on “micro as well as macro variables” (e.g., social structure) to a much greater extent.

Nevertheless, anthropological to social psychology remains an important counterpart to psychological research in this area.

6. Psychosocial Aspects of Occupational Therapy

Psychosocial dimensions of human performance are fundamental to all aspects of occupation and occupational therapy, with every client, and across all practice settings. Occupation is defined as “activities of everyday life, named, organized, and given meaning by individuals and a culture” (Law, Polatajko, Baptiste, and Townsend, 1977). A key tenet of occupational therapy is that the loss of valued occupations may adversely affect an individual’s sense of self and agency in the world. An individual’s sense of self is influenced by the social, cultural, personal, psychological, and spiritual contexts in which these occupations occur (Kannenberg & Greene, 2003).

Psychosocial is defined as pertaining to intrapersonal, interpersonal, and social experiences and interactions that influence occupational behavior and development (Mosey, 1996). While there is no one uniformly accepted definition of the term psychosocial, it is often used in a manner that includes psychological, cognitive, social, cultural, and spiritual aspects of occupation.

Some key concepts in the psychosocial area of occupation include meaning, purpose, motivation, symbolic aspects of occupation, relationships, roles, and unconscious dynamics that may influence occupational behavior. Aspects of personality, temperament, energy, and drive also affect how people perform their meaningful daily life activities (AOTA, 2002).

7. Psychosocial Aspects of Disease

An understanding of the psychosocial aspects of physical illness is one of the most important contributions that behavioral sciences can make to medicine. A conceptual framework for the clinical study of these aspects is presented. The determinants and the manifold components of psychological reactions to disease and disability are discussed. The determinants fall into four classes of variables:

the personality of the patient and his life history,
the state of the patient’s current interpersonal relationships,
characteristics of his non-human environment, and
the nature and characteristics of the pathological process or injury.

The resulting psychological reactions include three components: the intrapsychic, the behavioral, and the social. To understand how the patient experiences his illlness and copes with it one has to know what all aspects of his disease mean to him and what responses to his complaints he obtains from other persons, including health professionals. Psychosocial factors influence the course and outcome of every illness, and it is imperative that their evaluation should be a part of medical diagnosis and management (Psychosocial Aspects of Disease, 1969).

8. Psychosocial aspects of obesity

Obese patients have many physical limitations and much psychiatric burden to overcome. Several studies have shown that the prevalence of psychiatric morbidity in the obese is similar to those with normal weight. However, in obese patients seeking treatment there is an increased prevalence (40-60%) of psychiatric morbidity, most commonly depression. It is difficult to separate the effects of depression on obesity and, on the contrary, the neuroendocrine changes associated with stress and depression may cause metabolic changes that predispose and perpetuate obesity. The stigma associated with obesity causes bullying in school as well as childhood psychiatric morbidity. Prejudice is not limited to the general public but exists among health professionals too. This section discusses the treatment of depression in obesity and the psychiatric evaluation of the pre-bariatric surgery patient.

Education of society, starting with schools and including healthcare professionals will reduce bias and stigma as well as assist this vulnerable group of patients to seek help for their obesity and the many problems that come with it. Given that by the year 2025 obesity will be the world’s number one health problem with the US leading the way, it is very important that we pursue preventive measures as well as encourage research for treatments of obesity (Vaidya, 2006).

9. Psychosocial Aspects of Chronic Disease

Psychosocial issues are an understudied yet important concern in the overall health of patients. Stress is a concomitant of chronic illness and its treatment, and may have meaningful influences on psychological and medical outcomes. There is a direct influences of psychopathology, social support, family issues, culture, and socioeconomic status on patients treated. Depressive affect and decreased perception of social support have been linked with mortality in several studies of patients. Decreased marital satisfaction, disturbances in family dynamics, and lower socioeconomic status have been associated with poorer health outcomes and can affect patients’ perception of social support and depressive affect. Chronically ill patients who undergo treatment with constant interaction and observation by medical staff are potentially an ideal group for evaluation of the effects of stress and psychosocial factors on outcomes in those with chronic disease, as well as an excellent patient population for intervention to reduce morbidity and mortality. These interactions between potentially modifiable psychosocial risk factors for disease and medical aspects of illness form a paradigm for the study of interventions related to adjustment to chronic illness in the ill or patient population (Daniel et.al, 2007).

10. Psychosocial Aspects of People Living with HIV/AIDS

Psycho-social aspects of people living with HIV/AIDS and their responses shows that, Besides identifying particular issues like fear, loss, grief, hopelessness and helplessness syndrome, guilt and self-esteem, anxiety and depression, denial, anger, aggression and suicide attempts are also identified. The objective is also to analyze the spiritual needs, discrimination and stigmatization of HIV positive people. Special remark is directed towards children, as a most vulnerable group, especially in the situation when they are orphaned and need to cope with the dead and dying.

Discussion on HIV/AIDS is in many third-world countries still accompanied by taboo, misunderstandings, shame, guilt and rejection. Culturally conditioned silence about sexuality, sexual behaviour conceals risky sexual behaviour and sexual abuse and especially sexual abuse of children. Due to cultural, religious and legal aspects of the topic is HIV/AIDS, death, sexuality, the discussion is led only by a small group of experts. Rejection or lack of awareness about HIV/AIDS significantly limits the ability of effective and decent care for HIV-positive people and their families. It is very important to speak about HIV/AIDS loudly, to speak about the feelings and reactions of people living with HIV/AIDS (Lenka, 2016).

11. Anthropology of Psychosocial responses

People living with disease or disorder feel uncertainty and they have to cope with the situation. Feelings of insecurity have its origin in the fear from the upcoming future and the people focus on their families and their fob. They feel even more uncertain and are more concerned because of the quality of life and life expectancy as well the treatment´s outcome and the reaction of the society. All concerns are unpredictable, and therefore they should be discussed. Above all, positive thinking and faith of is recommended. The situation is very special for children, who have lost their family and home. The disease or disorder child must react to this uncertainty and make several decisions to adapt to the current situation. Even if it seems, that the child does not react at all, it can be the very adaptation to the illness by denying it. People begin their adaptation process from the day they learnt about it. Their daily life reflects the tension between uncertainty and coping with the situation. It is the tension, which raises a lot of psychosocial responses of bigger and smaller intensity (Lenka, 2016).

12. Psychosocial assessment and intervention

Psychosocial assessment considers several key areas related to psychological and social functioning and the availability of supports. It is a systematic inquiry that arises from the introduction of dynamic interaction; it is an ongoing process that continues throughout a treatment, and is characterized by the circularity of cause-effect/effect-cause. In assessment the clinician/health care professional identifies the problem with the client, takes stock of the resources that are available for dealing with it, and considers the ways in which it might be solved from an educated hypothesis formed by data collection. This hypothesis is tentative in nature and goes through a process of elimination, refinement, or reconstruction in the light of newly obtained data (Mary and Florence, 1999).

There are five internal steps in assessment:

I. Data collection (relevant and current) of the problem presented.

II. Integrating collected facts with relevant theories.

III. Formulating a hypothesis (case theory) that gives the presented problem more clarity.

IV. Hypothesis substantiation through exploration of the problem: life history of the client, etiology, personality, environment, stigmas, etc.

V. Further integration of newer facts identified in the treatment period and preparing a psychosocial report for psychosocial intervention.

Assessment includes psychiatric, psychological and social functioning, risks posed to the individual and others, problems required to address from any co-morbidity, personal circumstances including family or other careers. Other factors are the person’s housing, financial and occupational status and physical needs (Steve and Nicola, 2017). Assessments when categorized, it particularly includes Life history of the client that include data collection of living situation and finances, social history and supports, family history, coping skills, religious/cultural factors, trauma from systemic issues or abuse and medico-legal factors (assessment of the client’s awareness of legal documents, surrogate decision-making, power of attorney and consent).

Components include: in resource assessment of the client include psycho-spiritual strengths; substance abuse; coping mechanisms, styles and patterns (individual, family level, workplace, and use of social support systems); sleeping pattern; needs and impacts of the problem etc. Advanced clinicians incorporate individual scales, batteries and testing instruments in their assessments. In the late 1980s Hans Eysenck, in an issue of Psychological Inquiry, raised controversies on then assessment methods and it gave way to comprehensive Bio-Psycho-Social assessment. This theoretical model sees behavior as a function of biological factors, psychological issues and the social context. Qualified healthcare professionals conduct the physiological part of these assessments. This thrust on biology expands the field of approach for the client with the client through the interaction of these disciplines and in a domain that mental illnesses are also physical, just as physical conditions have mental components. Likewise, the emotional is both psychological and physical.

The clinician’s comprehension and set of judgments about the client’s situation, the assessment through a theory of each case, predicts the intervention. Hence a good psychosocial assessment leads to a good psychosocial intervention that aims to reduce complaints and improve functioning related to mental disorders and/or social problems (e.g., problems with personal relationships, work, or school) by addressing the different psychological and social factors influencing the individual. For example, a psychosocial intervention for an older adult client with a mental disorder might include psychotherapy and a referral to a psychiatrist while also addressing the caregiver’s needs in an effort to reduce stress for the entire family system as a method of improving the client’s quality of life (Cummings and Kropf, 2013). Treatment for psychosocial disorders in a medical model usually only involve using drugs and talk therapy (Pallassana, 2000).

13. Psychosocial aspects of depression and the role of psychotherapy

The psychosocial aspects of depression are considered with respect to psychological factors (i.e., thinking, personality, coping style) and social factors (i.e., family, relationships, employment, life events). Etiologic/mechanistic controversies are only acknowledged, as the purpose of this review is to underscore the wide variety of psychosocial complications that can occur during a depressive episode. The potential roles of psychotherapy in the treatment of mood disorders are considered. Results regarding the efficacy of behavioral therapy, cognitive therapy, and interpersonal psychotherapy in the treatment of unipolar, nonpsychotic, adult depressed outpatients are helpful and considerable (Jarrett, 1990).

14. Psychosocial adaptation

Psychosocial adaptation is a process, a person experiences in order to achieve good fitness in person-environment congruence known as adjustment, a state of wisdom oriented activities and psychosocial equilibrium (Elizabeth and Julie, 2009). Psychosocial support is the provision of psychological and social resources to a person by a supporter intended for the benefit of the receiver’s ability to cope with problems faced (Elizabeth and Julie, 2009). The allocentric principle within social relationships that promote health and well-being moves individual’s to aid victims of terminal illness, disaster, war, catastrophe or violence to foster resilience of communities and individuals. It aims at easing resumption of normal life, acilitating affected people’s participation to their convalescence and preventing pathological consequences of potentially traumatic situations. This might extend in forms of informational and instrumental support.

15. Summary

People may not be fully aware of the relationship between their mental and emotional wellbeing and the environment.
It was first commonly used by psychologist Erik Erikson in his description of the stages of psychosocial development.
Mary Richmond, pioneer of American social work regarded there to be a linear relationship between cause and effect in a diagnostic process.
In 1941 Gordon Hamilton renamed the 1917 concept of “social diagnosis” as “psychosocial study”.
Psychosocial study was further developed by Hollis in 1964 with emphasis in treatment model.
The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function.
A psychosocial aspect of Anthropology is the study of psychological topics using anthropological concepts and methods.
Psychosocial or Psychological anthropologists are concerned, for example, not merely with emotional practices in diverse cultures, but in the shape and cross-cultural validity of the concept of emotion.
Psychological anthropology Psychological anthropology is an interdisciplinary subfield of anthropology that studies the interaction of cultural and mental processes.
Social psychology is the study of the manner in which the personality, attitudes, motivations, and behavior of the individual influence and are influenced by social groups.
Social psychology is the scientific study of how people’s thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others
Psychosocial dimensions of human performance are fundamental to all aspects of occupation and occupational therapy, with every client, and across all practice settings.
Occupation is defined as “activities of everyday life, named, organized, and given meaning by individuals and a culture”
An understanding of the psychosocial aspects of physical illness is one of the most important contributions that behavioral sciences can make to medicine.
Obese patients have many physical limitations and much psychiatric burden to overcome.
Psychosocial issues are an understudied yet important concern in the overall health of patients.
Stress is a concomitant of chronic illness and its treatment, and may have meaningful influences on psychological and medical outcomes.
Psycho-social aspects of people living with HIV/AIDS and their responses shows that, Besides identifying particular issues like fear, loss, grief, hopelessness and helplessness syndrome, guilt and self-esteem, anxiety and depression, denial, anger, aggression and suicide attempts are also identified.
People living with disease or disorder feel uncertainty and they have to cope with the situation.
Psychosocial assessment considers several key areas related to psychological and social functioning and the availability of supports.
The clinician’s comprehension and set of judgments about the client’s situation, the assessment through a theory of each case, predicts the intervention.
The psychosocial aspects of depression are considered with respect to psychological factors and social factors.
Psychosocial adaptation is a process, a person experiences in order to achieve good fitness in person-environment congruence known as adjustment, a state of wisdom oriented activities and psychosocial equilibrium.

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GLOSSARY

Psychosocial approach

A psychosocial aspect of Anthropology

Psychological anthropology

Social psychology

Social psychology is the study of the manner in which the personality, attitudes, motivations, and behavior of the individual influence and are influenced by social groups

Psychosocial adaptation

Interesting facts

People may not be fully aware of the relationship between their mental and emotional wellbeing and the environment.
It was first commonly used by psychologist Erik Erikson in his description of the stages of psychosocial development.
Mary Richmond, pioneer of American social work regarded there to be a linear relationship between cause and effect in a diagnostic process.
In 1941 Gordon Hamilton renamed the 1917 concept of “social diagnosis” as “psychosocial study”.
Psychosocial study was further developed by Hollis in 1964 with emphasis in treatment model.
The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function.
A psychosocial aspect of Anthropology is the study of psychological topics using anthropological concepts and methods.
Psychosocial or Psychological anthropologists are concerned, for example, not merely with emotional practices in diverse cultures, but in the shape and cross-cultural validity of the concept of emotion.
Psychological anthropology Psychological anthropology is an interdisciplinary subfield of anthropology that studies the interaction of cultural and mental processes.
Social psychology is the study of the manner in which the personality, attitudes, motivations, and behavior of the individual influence and are influenced by social groups.
Social psychology is the scientific study of how people’s thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others
Psychosocial dimensions of human performance are fundamental to all aspects of occupation and occupational therapy, with every client, and across all practice settings.
Occupation is defined as “activities of everyday life, named, organized, and given meaning by individuals and a culture”
An understanding of the psychosocial aspects of physical illness is one of the most important contributions that behavioral sciences can make to medicine.
Obese patients have many physical limitations and much psychiatric burden to overcome.
Psychosocial issues are an understudied yet important concern in the overall health of patients.
Stress is a concomitant of chronic illness and its treatment, and may have meaningful influences on psychological and medical outcomes.
Psycho-social aspects of people living with HIV/AIDS and their responses shows that, Besides identifying particular issues like fear, loss, grief, hopelessness and helplessness syndrome, guilt and self-esteem, anxiety and depression, denial, anger, aggression and suicide attempts are also identified.
People living with disease or disorder feel uncertainty and they have to cope with the situation.
Psychosocial assessment considers several key areas related to psychological and social functioning and the availability of supports.
The clinician’s comprehension and set of judgments about the client’s situation, the assessment through a theory of each case, predicts the intervention.
The psychosocial aspects of depression are considered with respect to psychological factors and social factors.
Psychosocial adaptation is a process, a person experiences in order to achieve good fitness in person-environment congruence known as adjustment, a state of wisdom oriented activities and psychosocial equilibrium.

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