Chapter 4. Cross-Cultural Aspects of Addiction

Nady el-Guebaly, M.D., D.Psych., D.P.H.
DOI: 10.1176/appi.books.9781585623440.345154



In our ever-shrinking global village, the need for cross-cultural sensitivity and clinical competence increases as the pace of our contact with people from other cultures accelerates, either through travel or permanent resettlement. Clinical cultural competence is a lifelong journey. This chapter focuses on identifying the clinically relevant variables of culture and their implications for assessment and management. Most of the recent scientific literature in English addresses culture in the context of our modern multiethnic societies in the United States, Great Britain, Canada, and Australia.

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FIGURE 4–1. Cultural dynamics in clinical assessment.
Table Reference Number

Culturally sensitive clinical care is required for individuals from different cultures.

The impact of ethnicity is moderated by both risk and protective factors.

A cultural assessment provides a better understanding of the patient's subjective views.

Nosological classifications are influenced by culture.

Culturally sensitive care can be delivered either through separated services, a consultation model, or a sensitized melting pot approach.


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CME Activity

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Sample questions:
In multiethnic societies, a number of cross-cultural terms are used to define important concepts. Which of the following is a definition of acculturation?
It is crucial to control, as much as possible, sociodemographic variables so that differences in substance use rates among various cultures may be taken into account. Which of the following statements related to sociodemographic variables or migration is true?
Through a cultural assessment, the clinician can gather a better understanding of the patient's subjective view of the world, the meaning of the illness to the patient, and his or her expected recovery process. DSM-IV-TR outlines assessment categories to develop a cultural assessment. Which of the following is not one of the assessment categories?
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