给爱学习爱阅读的父母：Link to Journal of Child Psychology and Psychiatry

One of the most pervasive forms of context is the culture in which a child develops. Culture is used here in its broadest sense referring to the behaviours, customs, and beliefs of particular groups of people, including local variations. Several hints in the literature suggest that the extent to which symptoms are impairing may be influenced by discrete cultural factors. For example, some early research demonstrated small but interesting differences in the attitudes of parents and teachers from Thailand and America to internalising and externalising behaviours (Weisz et al., 1988). While American adults were equally likely to believe that internalising and externalising child behaviours required help, Thai adults were slightly more likely to suggest help for externalising than internalising behaviours.

Some specific work in this area has focussed on symptoms of social anxiety disorder such as social withdrawal. In a model of the development of social anxiety disorder, Rapee and Spence (2004) argued that varying degrees of acceptance of socially withdrawn behaviours by different cultures will affect the extent to which these behaviours impair the individual’s life and hence affect rates of the clinical diagnosis. In support of this suggestion, data have shown that socially withdrawn behaviours are more impairing in Western-influenced than Eastern-influenced groups. For example, in a comparison of 228 Chinese Canadian and 367 European Canadian children aged 9–13 years, shyness was related more strongly to peer rejection and victimisation among the European than the Chinese background children (Chen & Tse, 2008). Similar results were reported in a study of over 1,500 children in grades 5 and 6 from four different countries (Chen et al., 2004). Among Chinese children, shyness was positively related to academic achievement and was unrelated to perceived social competence, whereas shyness was negatively related to perceived social competence among Canadian and Brazilian children and was unrelated to academic achievement among Canadian and Italian children. A more direct examination of functional impairment related to symptoms of social anxiety in a young adult sample demonstrated a significantly lower correlation between symptoms of social anxiety and life impairment among students from East Asian countries than students from Western countries (Rapee et al., 2011). Further, in response to hypothetical descriptions of people showing characteristically reticent versus outgoing behaviours, students from East Asian countries predicted less impact and impairment from reticent behaviours on social and career functioning than did the Western students.