ABSTRACT
In 1994, the American Psychiatric Association (APA) made a major decision regarding the importance of considering cultural variables in the assessment and diagnosis of psychiatric or mental disorders. This decision resulted in the inclusion of many cultural variables across most (but not all) psychiatric disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV) (Paniagua, 2000; Paniagua, Tan, & Lew, 1996). In 2000, the APA published a text revision of the DSM–IV, and although nothing new was added regarding cultural variables across mental disorders, cultural variations continued to be a critical addition in the DSM–IV. The DSM–IV, however, is only a preliminary step in the application of culturally sensitive strategies to minimize biases and prejudices in the assessment and diagnosis of mental disorders among clients from the four major racial/ethnic groups in mental health services, namely, African Americans, American Indians, Asians, and Hispanics (Cuellar & Paniagua, 2000; Paniagua, 2000; Santiago-Rivera, Arredondo, & Gallardo-Cooper, 2002). Examples of additional steps clinicians should consider in the present context include:
Clinician’s self-assessment of potential biases and prejudices.
An assessment of the potential impact of acculturation on both assessment and diagnosis of mental disorders.
The role of racism and cultural identity of the client in assessment and diagnostic practices.
Selection of culturally appropriate psychological tests to assess intellectual functioning and psychopathology.
Formulation of culturally appropriate questions.
Use of the mental status in a cultural context.
Selecting the least biased assessment strategy.
Distinguishing culture-bound syndromes from cultural variations.
Guidelines for the cultural formulation.
