Critically questioning an African perspective on psychopathology : a systematic literature review

Abstract

This study aimed to collate and analyse academic literature with regards to possible African perspectives on psychological distress. The purpose of conducting the literature review was to explore thirty years of critical arguments supporting and refuting an African perspective on psychopathology. Literature (e.g. Bhugra&Bhui, 1997) appeared to suggest that some of the relatively recent views regarding psychopathology fail to adequately address psychological distress as it presents in Africa. A systematic literature review was selected as the methodology for this study, and the specific method of the review was research synthesis (Gough, 2004; Popay, 2005). Reviewed literature was sourced between the years 1980 and 2010. The theoretical point of departure was integrative theory, thus falling within the postpostmodern framework. As such, literature regarding psychological theory formed a substantial part of the research, including literature relating to psychodynamic theory, cognitive-behavioural theory, postmodernism, phenomenology, existentialism, critical theory, and systemic patterning (Becvar&Becvar, 1996). These theories formed part of the analysis, thereby allowing contextual analysis as the interpretive method. The review’s themes highlighted the following outcomes: current psychiatric nosology employed a universalistic approach to diagnosis and intervention, thus limiting cultural conceptions of mental illness; holistic intervention requires the inclusion of traditional epistemological tenets; collaboration between modern practitioners and traditional healers would probably better meet the patient’s needs; and that culture-fit assessment and treatment often indicated improved prognosis. The outcomes evidenced the operation of an African perspective on psychopathology. In fact, much of the reviewed literature also suggested culture-contextual perspectives on psychopathology. Furthermore, the way in which lack of cultural coherence appears to exist between patients and some clinicians suggested that diagnostic flaws may be a relatively frequent occurrence. Potential benefits of the investigation include increased awareness that culture-related conceptualisation be further explored in the clinical field; that future researchers use the current review as a foundational reference for primary investigations; that contemporary clinical classificatory systems be reviewed in terms of cultural applicability; and that clinicians reconsider the diagnostic process in terms of culture-fit manifestations of psychopathology.