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FPR-UCLA 4th Interdisciplinary Conference - Summaries
Session 1 Summary: Current Neuroscientific, Clinical, Cultural, and Historical Perspectives on Psychiatric Disorder
Session 2 Summary: Cultural and Biological Contexts of Autism
Session 3 Summary: Beyond Categories: Dimensions, Thresholds, Contexts, and Trajectories in Mental Health and Illness
Session 4 Summary: Cultural and Biological Contexts of Bipolar Disorder
Session 5 Summary: Cultural and Biological Contexts of Schizophrenia
Session 6 Summary: Cultural and Biological Contexts of Anxiety-Related Conditions
Session 7 Summary: Integrating Biology into DSM-V
Session 8 Summary: Integrating Culture into DSM-V
Session One Summary
The fourth FPR-UCLA interdisciplinary conference was held at UCLA on January 22–24, 2010. The basic aim of this series is to create, nourish, and sustain connections among scientists from anthropology, psychiatry, the neurosciences, and related fields in order to address topics of fundamental social or clinical concern.
In her opening remarks, UCLA’s Vice-Chancellor of Graduate Studies Claudia Mitchell-Kernan noted the timeliness of the conference, which focuses on the cultural and biological contexts of psychiatric disorder and precedes publication of the DSM-V in 2013. “I think a good deal is at stake,” Dr. Mitchell-Kerman said. “The diagnostic criteria established in the fifth edition will in many ways establish how society views various forms of emotional and psychological conditions, and, just as important, what kind of treatment is available and what kind of access insurance programs will offer.”
“The current focus on culture, the brain, and mental illness,” FPR founder and UCLA anthropologist Robert Lemelson said in his opening remarks, “is one that is certainly close to my interests and my heart. I’ve been studying this topic for the last two decades in Indonesia, [and it’s one in which] biology, culture, history, and political economy all play central roles.” One of the objectives of the conference, he continued, is to highlight the intersection of culture, biology (particularly neurobiology) and social and political ecologies in the origin, presentation, and outcome of mental illness. He quoted from a critical article that appeared in the New York Times Magazine; the article by Ethan Watters is based on his book, Crazy Like Us, and concerns the export of a DSM-based framework for categorizing and treating mental disorders across the globe. Although, based on his fieldwork in Indonesia, Dr. Lemelson has found that such a biologically based model can be useful at times in dispelling “prescientific myths and harmful stigma,” he noted the extent to which (directly quoting from Ethan Watters) “in the process of teaching the rest of the world to think like us, we’ve been exporting our own western symptom repertoire as well.” (This theme recurs throughout the conference and is highlighted in particular in the last roundtable session on Day 3.)
Interdisciplinary Foundations
Introductory remarks to the first session of this conference were presented by UCLA’s department of neurobiology chair, Marie-Françoise Chesselet, who studies the basal ganglia, with special focus on Parkinson’s disease. “When we were trying to conceptually frame this conference,” she said, “a discussion erupted about the broadness of psychiatric illnesses versus the more focused definition people have of neurological disorders.” During that discussion, as well as in her opening remarks, Dr. Chesselet used Parkinson’s as an example of a neurological disease for which there was a very "reductive" (in the positive sense) explanation, what biological psychiatry now strives for vis-à-vis mental disorders. In the case of Parkinson’s, the disease is best conceptualized as a complex, multi-dimensional condition. (As will be highlighted in later sessions, most of the mental disorders are now presumed to have similarly complex neurobiological etiologies.) Long considered to be a disease of the dopaminergic neurons with a well-defined set of motor disorders, she explained, Parkinson’s is now understood to involve almost every area of the brain, as well as the peripheral nervous system, and to affect many aspects of psychological functioning. “Now that we know that all those other brain regions are affected and that rather than being a disease of cell death, it is a disease of dysfunction of many circuits in the brain,” she said, “neurologists [have become] a lot more attuned to the patients’ predicament which goes well beyond the narrow list of symptoms that were used to recognize and treat.” Although psychiatric symptoms are now considered to be a major component of the disorder, culture has yet to be integrated, just as culture has yet to be considered a major component in western psychiatric nosology.
