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Transcultural Psychiatry

DOI: 10.1177/1363461501038004052001; 38; 474TRANSCULT PSYCHIATRY

Curtis C. Hsia and David H. BarlowDisorders

On the Nature of Culturally Bound Syndromes in the Nosology of Mental

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474

On the Nature ofCulturally Bound Syndromes in

the Nosology ofMental Disorders

CURTISC.HSIA ANDDAVIDH.BARLOWBoston University

The unique and creative research into kyol goeuby Hinton and colleaguesis important on several levels. It provides clinicians with valuable infor-

mation focused on a syndrome commonly seen among a population aboutwhom we have li ttle information,while also providing insight into how thecategorization of culturally bound syndromes is limited.

Hinton and his coauthors noted that many of the Khmer they inter-viewed were affected by kyol goeu either directly or indirectly, and thus itstands to reason that clinicians who work with Khmer refugees and theirfamilies need to be aware of this syndrome. Kyol goeuis perhaps bestdescribed as a culturally influenced variant of panic disorder. As with Asiansin general, and Southeast Asians in particular (Tung, 1985), it is likely that

Khmer underutilize mental health facilities but may seek help within theirown community (e.g., herbalists, Eastern doctors and monks) or frommedical settings such as hospitals. To better serve this and other popu-lations, Hinton et al. have taken very important first steps by providingservices to the Khmer, and by thoroughly documenting the symptomologyofkyol goeu.

Perhaps just as importantly,Hinton et al. comparekyol goeu with ataquede nervios, noting that the physiological symptoms and cognitions aresimilar. In reviewing other culturally bound syndromes with anxietysymptoms listed in DSM-IV (American Psychiatric Association, 1994),one

Vol 38(4): 474476[13634615(200112)38:4;474476;020114]Copyright 2001 McGill University

t ranscul turalpsychiatry

COMMENTARY

December2001

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Barlow, D. H. (in press). Anxiety and its disorders: The nature and treatment ofanxiety and panic (2nd ed). New York: Guilford Press.

Barlow, D. H., & Craske, M. G. (2000). Mastery of your anxiety and panic: Clientworkbook for anxiety and panic(3rd ed.). San Antonio, TX: Graywind Publi-cations/Psychological Corporation.

Tung, T. M. (1985). Psychiatr ic care for Southeast Asians: How different isdifferent? In T.Owan (Ed.), Southeast Asian mental health: Treatment, preven-tion, services, training and research. Washington, DC: U.S. Department ofHealth and Human Services.

Uba, L. (1994). Asian Americans. New York: Guilford Press.

CURTISC. HSIA received his PhD from Hofstra University in 2000 and is currentlya postdoctoral fellow at the Center for Anxiety and Related Disorders at Boston

University. He has previously worked at UCLA with Ivar Lovaas, and at the Bio-Behavioral Institute in New York. His research interests include anxiety disorders,cross-cultural psychology and diversity issues in psychology.He is also the currentpresident of the Cross-Cultural Behavioral Therapy Special Interest Group at theAssociation for the Advancement of Behavior Therapy.Address:Center for Anxietyand Related Disorders, Boston University, 648 Beacon Street, 6th Floor, Boston,MA 02215,USA. [E-mail: chsia@bu.edu]

DAVID H. BARLOW received his PhD from the University of Vermont in 1969 andhas published over 400 articles and chapters and over 20 books. His major inter-ests over the past 30 years have been the study of anxiety and its disorders, anddeveloping new psychological procedure for practice settings. Prior to his currentposition as Director of the Center for Anxiety and Related Disorders at BostonUniversity,he founded clinical psychology internships at Brown University and theUniversity of Mississippi Medical Center. He is the recipient of the 2000 Ameri-can Psychological Association Distinguished Scientific Award for the Applicationsof Psychology. Other awards include the Career Contribution Award from theMassachusetts Psychological Association, and a MERIT award from the NationalInsti tute of Mental Health for long-term contributions to the clinical research

effort. He is Past-President of the Division of Clinical Psychology of the AmericanPsychological Association. He is also a Diplomat in Clinical Psychology of theAmerican Board of Professional Psychology and maintains a private practice.

Transcult ur al Psych iat ry 38(4)

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