SCHIZOPHRENIA AMONG PRIMITIVES
Authors: N. J. DEMERATH
Journal: American Journal of Psychiatry (1942)

A survey of the literature reveals that the present state of our knowledge of the schizophrenic reaction in non-literate societies is as inadequate as our knowledge of comparative psychopathology in general. This inadequacy becomes apparent when one considers what should be known about the psychopathologies of a wide range of societies. Ideally, answers to the following questions would seem to be called for in the case of each society investigated. (1) What mental disorders are found, and how do the symptom pictures differ from, or resemble those of Euro-American society? (2) To what extent are psychopathological behaviors defined as such in terms of Euro-American values, to what extent are they defined relative to the values of the culture investigated, and to what extent do they represent deviations from universal social norms (e. g. mutism, extreme negativism, homicidal mania, etc.)? (3) Which personality and temperament types enjoy the greater opportunities for expression, for drive and wish fulfillment, and in what social spheres do these opportunities exist? (4) What are the adjustment hazards figuring in the histories of individuals ultimately declared abnormal? How are they related to the social organization on the one hand, and to the biology of the individual on the other; and in what ways do they resemble or differ from the adjustment problems of the mentally ill in various Euro-American groups? (5) To what extent do the psychotic productions— language, thought and other behavior in the psychosis—reflect inter- and intra-institutional conflicts; and to what extent do they reflect conflict between social and individual expectations? (6) In what ways may the incidence of mental disorder in the society in question be said to be associated with the "advance" of material culture and civilization? The students of schizophrenia among primitives have devoted themselves almost exclusively to the question, Where is schizophrenia found? Seligman and Fans report an absence of the disorder in societies which remain largely isolated from white influences, but one may not attach great importance to their findings inasmuch as the data are limited, and methodological assumptions and research operations are veiled and suspect. Yet, in view of the fact that wherever schizophrenia has been reported the society in question has been in process of acculturation, a sociological hypothesis involving the concepts of culture conflict, marginality and shock appears tenable. Laubscher, Hummer, Dhunjiboy, Shaw, Kraepelin, Lopez, and Mend found schizophrenia among peoples who, though frequently classed as primitive—even by the investigators in some cases—are actually in the throes of acculturation. However, the rarity or absence of schizophrenia among truly primitive peoples generally has simply not been established, in spite of Devereux's overoptimistic conclusion that it has Moreover, it would seem that the definitive answers to the research questions previously formulated will come only from a body of facts that is at present almost wholly non-existent. That is to say, any satisfactory understanding of comparative psychopathology, either among primitive or civilized societies, must be predicated (1) on reliable diagnoses (and derived statistics of incidence) made by psychiatrists who are willing to honestly entertain sociological hypotheses; and (2) on the interpretation of detailed life histories by psychiatrically oriented sociologists, or preferably, by psychologists and sociologists in collaboration. Unfortunately, such knowledge remains as conspicuous by its absence today as it was seven years ago when Hallowell called attention to our need of it, and the task of the travelling field-worker is considerably complicated by wars and rumors of wars.