title: Interpreting suffering from illness: The role of culture and repressive suffering construal.
abstract: Mental and physical illnesses are among the most prominent forms of suffering. Cultural worldviews provide tools for making sense of and coping with suffering. In this research, we examine how culture influences both experts' and laypeople's interpretation of suffering from illness.
  
  
  
  We focus on one type of interpretation of suffering- repressive suffering construal-an interpretation that frames suffering both as the result of immorality on the part of the sufferer and as having the function of maintaining social order by curtailing deviance. We sought to test whether this type of suffering interpretation is more common in cultural ecologies (e.g., urban vs. rural; higher vs. lower status) traditionally associated with collectivist values.
  
  
  
  Study 1 used data from the General Social Survey to examine variation in suffering interpretation in a representative sample of the U.S.
  
  
  
  Study 2 examined variation in suffering interpretation with a survey completed by a subsample of Chinese health-care professionals.
  
  
  
  Study 1 found that U.S. citizens living in a rural environment are more likely to interpret illnesses as being the fault of the sufferer. Study 2 found that those from a lower-SES background are more likely to interpret illnesses in a repressive fashion. In these studies, family size mediates the effect of ecological conditions on RSC.
  
  
  
  Our research highlights how ecological variables associated with collectivism may bias both laypeople and professionals to interpret suffering from illness in a more repressive way.
authors.affiliation: Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Columbia Business School, Columbia University, USA.
authors.forename: Shi
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Psychology, University of Arizona, 1503 E. University Blvd., P.O. Box 210068, Tucson, AZ 85721, USA. Electronic address: swolf22@email.arizona.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sullivan
authors.affiliation: The Second Affiliated Hospital of Zhejiang University School of Medicine, China.
authors.forename: Shengdong
authors.initials: S
authors.lastname: Pan
mesh_terms: D000328:Adult; D002681:China; D017281:Cost of Illness; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012649:Self Concept; D012923:Social Class; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Culture; Mental illness; Repressive suffering construal; Suffering