title: Culture and personality disorder: from a fragmented literature to a contextually grounded alternative.
abstract: OBJECTIVE
  The aim of this review is twofold: to review recent literature on personality disorders, published in 2013 and the first half of 2014; and to use recent theoretical work to argue for a contextually grounded approach to culture and personality disorder.
  
  
  RESULTS
  Recent large-sample studies suggest that U.S. ethnoracial groups differ in personality disorder diagnostic rates, but also that minority groups are less likely to receive treatment for personality disorder. Most of these studies do not test explanations for these differences. However, two studies demonstrate that socioeconomic status partly explains group differences between African-Americans and European Americans. Several new studies test the psychometric properties of instruments relevant to personality disorder research in various non-Western samples. Ongoing theoretical work advocates much more attention to cultural context. Recent investigations of hikikomori, a Japanese social isolation syndrome with similarities to some aspects of personality disorder, are used to demonstrate approaches to contextually grounded personality disorder research.
  
  
  CONCLUSIONS
  Studies of personality disorder must understand patients in sociocultural context considering the dynamic interactions between personality traits, developmental histories of adversity and current social context. Research examining these interactions can guide contextually grounded clinical work with patients with personality disorder.
authors.affiliation: aDepartment of Psychology and Centre for Clinical Research in Health, Concordia University bCulture and Mental Health Research Unit, Jewish General Hospital cDivision of Social & Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Ryder
authors.forename: Momoka
authors.initials: M
authors.lastname: Sunohara
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Kirmayer
mesh_terms: D003469:Culture; D006801:Humans; D010554:Personality Disorders / Q000175:diagnosis / Q000209:etiology*; D011594:Psychometrics; D012307:Risk Factors; D012931:Social Environment