The role of cultural explanations in 'somatization' and 'psychologization'

Ethnographic and clinical research has described Chinese views of psycho-social distress as characterized by the 'somatization' of illness complaints and the 'underutilization' of mental health services. The hypothesis which states that such observed differences in American and Chinese illness behavior, including health-care decisions, derive in part from cultural modes of explaining illness and social behavior is termed the 'interpretative hypothesis'. The 'interpretive hypothesis' is explored by eliciting causal inferences about illness and behavioral difficulties from samples of (Caucasian) American and Hong Kong Chinese students at the University of Hawaii. Explicit procedures are developed for the reliable identification of elements of meaning in explanations given by the two groups. Comparative analysis gives limited support to the 'interpretive hypothesis' in showing a more 'psychologized' American model of illness in comparison with the 'situational' explanations given by the Hong Kong Chinese. The contrasts in common sense explanations offered by each sample suggest that these differences are related to implicit cultural modes of interpreting social behavior which have been characterized by other researchers with oppositions such as 'individual-centered' vs 'situation-centered', and 'internal' vs 'external' locus of control. These speculations, however, are tempered by the finding that the Hong Kong Chinese respondents make relatively greater use of personality attributions (a kind of psychological construct) in explaining interpersonal problems. This result indicates that global characterizations of explanatory modes should be limited to specific domains of discourse.