U.S. Clinicians' Recognition and Diagnosis of Cultural Concepts of Distress

In an increasingly diverse world, it is important for mental health professionals to be familiar with symptom presentations from a variety of cultures, including cultural concepts of distress. This study aimed to evaluate how U.S. clinicians diagnosed two cultural concepts of distress-hwa-byung and ataque de nervios-and whether the clinicians' cultural values or competence influenced their diagnosis. A sample of 84 mental health professionals viewed three case vignettes in random order depicting hwa-byung, ataque de nervios, and Generalized Anxiety Disorder. The clinicians provided an unprompted free-response diagnosis and a forced-choice diagnosis from a predetermined list for each vignette. Clinicians provided a wide range of diagnoses for the hwa-byung and ataque de nervios vignettes, with only a minority of participants correctly labeling the cultural concepts of distress. Prompting diagnoses by providing a list of options improved the likelihood of selecting a cultural syndrome. The most common mental health diagnoses selected did not adequately capture the symptom profiles of the cultural concepts of distress. Clinicians appeared to be more familiar with Latinx cultural presentations than East Asian. U.S. clinicians could likely benefit from additional training and exposure to varying cultural presentations of psychopathology. Labeling a cultural syndrome with a psychiatric diagnosis may lead to decreased rapport and insufficient or ineffective treatment options.