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J Nerv Ment Dis. 1975 Jun;160(6):409-21.

Cultural conceptions and mental illness. A controlled comparison of Germany and America.


This study attempts to test, in a bicultural, controlled comparison, two sociological theories of mental disorders. The first of these theories proposes that the stereotypes of mental illness profoundly shape the symptoms of mental illness in America. The second theory maintains that the requirements and needs of the mental hospital largely determine the "symptoms" of the chronic mental patient. To test these theories, matched samples of 100 mental patients in Germany and America were subjected to in-depth interviews and were administered semantic differentials. Patients were divided into groups according to length of confinement in order to investigate the thesis that the institution conditions chronic patient roles. The results revealed statistically significant differences between the two nationalities. German patients generally agreed that mental illness is a biologically determined, and rather incurable condition. In contrast, American patients generally believed that the individual is partially responsible for his condition and with the proper motivation and help, he can improve. Patients' statements about themselves and about proper behavior in the hospital were consistent with these national differences. It was concluded that institutionalization consists more in conditioning the patient to accept his status than in convincing him that he is insane.

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