title: From culture to symptom: Testing a structural model of "Chinese somatization".
abstract: "Chinese somatization" has been frequently discussed over the past three decades of cultural psychiatry, and has more recently been demonstrated in cross-national comparisons. Empirical studies of potential explanations are lacking, however. Ryder and Chentsova-Dutton (2012) proposed that Chinese somatization can be understood as a cultural script for depression, noting that the literature is divided on whether this script primarily involves felt bodily experience or a stigma-avoiding communication strategy. Two samples from Hunan province, China-one of undergraduate students (n = 213) and one of depressed psychiatric outpatients (n = 281)-completed the same set of self-report questionnaires, including a somatization questionnaire developed in Chinese. Confirmatory factor analysis demonstrated that Chinese somatization could be understood as two correlated factors: one focusing on the experience and expression of distress, the other on its conceptualization and communication. Structural equation modeling demonstrated that traditional Chinese cultural values are associated with both of these factors, but only bodily experience is associated with somatic depressive symptoms. This study takes a first step towards directly evaluating explanations for Chinese somatization, pointing the way to future multimethod investigations of this cultural script.
authors.affiliation: Shanghai Normal University.
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Hunan Normal University pengyunshi@163.com andrew.ryder@concordia.ca.
authors.forename: Yunshi
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Central South University.
authors.forename: Xiongzhao
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Central South University.
authors.forename: Shuqiao
authors.initials: S
authors.lastname: Yao
authors.affiliation: University of Toronto Scarborough.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dere
authors.affiliation: Georgetown University.
authors.forename: Yulia E
authors.initials: YE
authors.lastname: Chentsova-Dutton
authors.affiliation: Concordia UniversityJewish General Hospital.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Ryder
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000523:psychology*; D002681:China; D003469:Culture; D003863:Depression / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D010555:Personality Inventory; D057566:Self Report; D057545:Social Stigma; D013001:Somatoform Disorders / Q000523:psychology*; D055815:Young Adult
keywords: cultural scripts; culture; depression; somatization; symptoms; values