Is Dissociative Amnesia a Culture-Bound Syndrome?

Review of Harrison, G., Poliakoff, M., Parker, M., Boynes, M. & Hudson, J. (2007) “Is dissociative amnesia a culture-bound syndrome?” Psychological Medicine 27(2), 225- 233.

Culture-bound syndromes (CBS) present some of the most interesting pathology of contemporary mental disorders.  DSM-IV-TR lists 24 of them at Appendix I p. 897.  A CBS primarily considers “the role of cultural context in the expression and evaluation of symptoms and dysfunction.”  This includes the predominant idioms of distress through which symptoms are communicated, such as possessing spirits, somatic complaints or inexplicable misfortune.  DSM-IV-TR conceives CBS as being spatially dispersed but temporally concurrent, that is, although CBS occur in different parts of the world all of them occur now.  There are however many interesting previous CBS including “hysteria” (a common diagnosis in fin de siècle Vienna) and drapetomania (a mental disorder causing slaves to free captivity).

This article considers whether dissociative amnesia (DA) is a CBS, .  DA is defined at DSM-IV-TR 300.12 as “an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness.”  The authors canvassed respondents in three languages and on 30 Internet web sites and discussion groups.  While they identified numerous examples of ordinary forgetfulness they were unable to document any instances of DA occurring anywhere in the world prior to 1800.  They reasoned that if DA was a natural psychological phenomenon then it should have some prevalence.  Since there was none they concluded DA was a CBS.

In my opinion there were several confounds to the study, including lack of contemporary documentation and (ironically) a dense veil of cultural interpretation that may have obscured the symptoms even then.  Nonetheless this article is an interesting study of a relatively unexplored area of psychological research using a non-experimental design method.