SYMPTOM ATTRIBUTION IN CULTURAL-PERSPECTIVE

The explanatory model perspective of medical anthropology emphasizes t he cultural shaping of individuals' efforts to make sense of their sym ptoms and suffering. Causal attribution is a pivotal cognitive process in this personal and social construction of meaning. Cultural variati ons in symptom attribution affect the pathogenesis, course, clinical p resentation and outcome of psychiatric disorders. Research suggests th at styles of attribution for common somatic symptoms may influence pat ients' tendency to somatize or psychologize psychiatric disorders in p rimary care. At the same time, symptom attributions are used to negoti ate the sociomoral implications of illness. Recent work in social psyc hology and medical anthropology emphasizes the roots of attributional processes in bodily and social processes that are highly context-depen dent, and hence, must be understood as part of the construction of a l ocal world of meaning. Symptom attributions then may be understood as forms of positioning with both cognitive and social consequences relev ant to psychiatric assessment and intervention.