- Culture can lead to different views on what is abnormal e.g. homosexuality is illegal in Russia but not in the UK
Bias in the diagnostic tools:- Ebigno (1986), symptoms in the west for depression include feelings of worthlessness and hopelessness whereas in Nigeria they include burning and crawling sensations in the body e.g.Koro
Bias in the person doing the diagnosing:- Louis (1990), asked 139 psychiatrists to judge a case study and say whether an individual (white/black) should recieve drug treatment or should undergo criminal proceedings. Found that they are more likely to recommend both drugs and criminal proceedings for a black person. Lacks mundane realism.
Stress of being an ethnic minority/immigrant: - Littlewood (1980), understandable actions of an immigrant may be seen as insane by some people.- Littlewood and Lipsedge (1989), however this doesn't explain why the bias is only to black people because the majority of immigrants in the UK are white.
- Robins et al (1984), men are more likely to be diagnosed with alcohol abuse whereas women are more likely to be diagnosed with severe depression or a phobia. However, it may be because women are more open about their emotions and men hide it with alcohol- therefore symptoms may be different.
- Walker (1994), women are two to six times more likely to be diagnosed with depression than men. However there is no gender bias for bi-polar or schzophrenia.
- Cochrane (1995), in the earlier twentieth century men were more likely to be treated admitted to hospital than women. However, it doesn't tell us whether they actually suffer from more types of mental illness or whether they just get diagnosed more often.
- Worell and Remer (1992), environmental factors e.g. giving birth or more hormones makes women more susceptible to depression. Bias in the person doing the diagnosing, women are seen as emotional and men physical. However, this is just a stereotype.
- Broverman et al (1981) asked psychiatrists to define a healthy person, man and woman. Found that the definition of person and man were similar e.g. assertive, independent and decisive, whereas womens was different e.g. dependent, emotional and submissive. This also implies that diagnosis is unfair on women because mental health is male dominated.
- Psychologists often blame the high level of depression in women on their hormone fluctuations e.g. monthly cycle, childbirth and menopause
- However Weissman (1971) claims that despite the hormones being partially responsible, they don't account for the whole difference between men and women.
- If the bias was solely in the diagnostic tools e.g. DSM, we would expect there to be large differences in all mental illnesses but there is no difference in bi-polar and schizophrenia.