Somatic presentations of distress in China.
OBJECTIVE
Somatic presentations of distress are common cross-culturally and are thought to predominate in Asian cultures such as that of China. From an etic perspective, researchers utilizing empirically validated standardized assessment measures find that somatic symptoms are no more common in individuals of Chinese descent than they are in individuals of European descent. In contrast, patient presentations are heavily influenced by culture and are associated with patterns of illness behavior. The objective of the current review is to determine the culture-specific factors contributing to somatic presentations and descriptions of distress in China.


METHODS
The current review was based on a literature search of PubMed and PsychInfo using the terms 'China,' 'Asia,' 'somatoform,' 'somatization,' and 'psychogenic.'


RESULTS
Factors contributing to somatic presentations of distress in China include stigma and help-seeking behavior, and assessment approaches that ignore culture-specific patterns of symptom reporting, fail to incorporate somatic metaphor and Chinese conceptualizations of distress that emphasize bodily sensation, and ignore the role that culture-specific normative data and culture specific response patterns may produce on assessment results.


CONCLUSIONS
From an emic perspective, there are numerous factors contributing to the appearance of a predominantly somatic presentation of distress in China. Implications for clinical practice are discussed.
Department of Psychology, University of Macau, Taipa, Macao. charleszaroff@umac.mo
Charles M
CM
Zaroff
J Mark
JM
Davis
Pit Hoi
PH
Chio
Deepak
D
Madhavan
D044466:Asian People / Q000523:psychology*; D002681:China; D003469:Culture; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D057545:Social Stigma; D013001:Somatoform Disorders / Q000208:ethnology*; D013315:Stress, Psychological / Q000208:ethnology* / Q000503:physiopathology