“Deviant Deviance”: Cultural Diversity in DSM-5

The DSM-IV-TR dealt with cultural diversity in mental illness by adopting the category of culture-bound syndromes (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 4th edn, text revision [DSM-IV-TR]. American Psychiatric Association, Washington, DC, 2000). DSM-5 makes some reforms including a structured program for assessing cultural influence on mental illness (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th edn [DSM-5]. American Psychiatric Association, Washington, DC, 2013). It also drops the category of culture-bound syndrome. These are improvements, but much of the underlying logic of DSM-IV-TR remains. In particular, the DSM-5 is still prone to see Western psychology as the human norm. These changes are discussed and situated in a wider intellectual context. Recent work in the cognitive sciences and cognitive anthropology has drawn attention to the dangers inherent in taking Western psychology as the norm. However, strong claims of cultural difference may rest on questionable philosophical assumptions about the semantics of kind terms. The relevant literature is surveyed and suggestions are made for developing psychiatry along lines that take its lessons into account.