Personality Disorders in the Indian Culture: Reconsidering Self-Perceptions, Traditional Society and Values

摘要

Until recently, personality disorder research in India has been a largely neglected area. A small body of epidemiological research reveals lower prevalence rates for personality disorders in India than seen globally. The present study aims to examine personality disorders within the lens of family of origin and values, thereby providing a culturally relevant framework to understand this heterogeneous and complex clinical condition. The participants were recruited over a 2-year time period and comprised of 20 adults with personality disorders who, using a matched case-control design, were compared with 20 participants from the community. A total of three focus groups were conducted to develop themes for an in-depth interview that highlighted four context specific themes relevant to personality disorders (mood states that impact the self, significant life experiences, impact of family of origin and procreation, and value organization). The study revealed several key findings. Like previous studies, borderline and avoidant personality disorders were more common. Interestingly, participants were brought to the clinical setting in their late twenties. Internalized emotional reactions were predominant. The family acted as both a source of stress, abuse and support, with ties being maintained with extended family such as grandparents, siblings and spouse. Dissonance between individual values and existing pluralistic Indian cultural belief system was experienced. The findings highlight the requirement for expanding on cultural models of personality disorders in South Asian settings and integrating them into mainstream psychosocial assessment and interventions.