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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EDue to the increasing cultural and ethnic diversity of clients, psychiatric nurses must be culturally competent to be good clinical providers. This article discusses results from research in the fields of cultural neuroscience and ethnopsychopharmacology, demonstrating how cultural differences influence the neurobiological foundations of key issues in psychiatric nursing.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Epsychopharmacology\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EIn a presentation focused on science-based interactions between culture and biology, Jason F. Earle, PhD, PMHNP-BC, Wheaton Franciscan Healthcare, Racine, Wisconsin, USA, discussed results from research in the fields of cultural neuroscience and ethnopsychopharmacology, demonstrating how cultural differences influence the neurobiological foundations of key issues in psychiatric nursing.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EDue to the increasing cultural and ethnic diversity of clients, Dr Earle emphasized that psychiatric nurses must be culturally competent to be good clinical providers. He encouraged the audience to consider emerging data from studies in the fields of cultural neuroscience and ethnopsychopharmacology to help improve patient outcomes in psychiatric nursing.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\u003Ch2 class=\u0022\u0022\u003ECULTURAL NEUROSCIENCE\u003C\/h2\u003E\u003Cp id=\u0022p-4\u0022\u003EHistorically, psychiatric research has centered on the influence of neurobiology, genetics, and brain functioning, on different aspects of human behavior (culture). Cultural neuroscience, by contrast, explores the influence of culture on neurobiology and the influence of neurobiology on culture. Cultural neuroscience studies have demonstrated differences in brain functioning between people from Western and East Asian cultures. Dr Earle focused on cultural neuroscience findings\u2014psychopathology, the self, emotion, and cognition\u2014that might be relevant to psychiatric nurses.\u003C\/p\u003E\u003Cdiv id=\u0022sec-3\u0022 class=\u0022subsection\u0022\u003E\u003Ch3\u003EPsychopathology\u003C\/h3\u003E\u003Cp id=\u0022p-5\u0022\u003EDr Earle discussed a large study that examined polymorphisms of the serotonin uptake transporter (5-HTTLPR) gene in people in 29 countries [Chiao JY, Blizinsky KD. \u003Cem\u003EProc Biol Sci.\u003C\/em\u003E 2010]. The short allele of this gene has been associated with an increased risk of mood and anxiety disorders. The study authors found a high frequency of the short allele in countries from East Asia but a low prevalence of mood and anxiety disorders. Conversely, people from Euro-American nations had a reduced frequency of this allele but a higher prevalence of mood and anxiety disorders. In explaining this discrepancy, the study authors also investigated the differences in dominant cultural values and their influence on mood and anxiety disorder prevalence. While individualistic values (independence, uniqueness, self-expression, and individual goals) are more common in Western cultures, collectivist values (connection, other focusedness, duties and obligations to others, and group goals) dominate in East Asian cultures. A statistical procedure from this study called a \u003Cem\u003Emediation analysis\u003C\/em\u003E suggested that the collectivist values in East Asian cultures helped to buffer these people from developing mood and anxiety disorders.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EDr Earle emphasized research that suggests an intriguing relationship among brain plasticity, culture, and psychopathology, mentioning a study that showed an increase in the prevalence of major depressive disorder in Chinese people who migrated from a collectivist culture in Taiwan into an individualistic culture such as the United States.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv id=\u0022sec-4\u0022 class=\u0022subsection\u0022\u003E\u003Ch3\u003EThe Self\u003C\/h3\u003E\u003Cp id=\u0022p-7\u0022\u003EPast research in cultural psychology found 2 predominant kinds of self-construal: independent and interdependent. Western cultures tend to promote an independent self, which is autonomous, unique, the same across contexts, and driven by individual traits such as curiosity or strength. In East Asian cultures, the interdependent self is more common. It emphasizes connection, one\u0027s role within a social group, less differentiation from others, and the self\u0027s changing from one context to another.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EDr Earle discussed a study [Zhu Y et al. \u003Cem\u003ENeuroimage.\u003C\/em\u003E 2007] that examined the neural activation patterns of Western and Chinese people when they were thinking about their own self, someone close to them (mother), and someone distant (a celebrity). The results appeared to support the idea that East Asian cultures have an interdependent self and Westerners have an independent self. Chinese subjects activated the same brain structure, the medial prefrontal cortex, for both the self and the mother. By contrast, Western subjects activated one structure for the self, the medial prefrontal cortex, and a separate brain structure for the mother, the anterior cingulate cortex (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/5\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The Influence of Culture on Brain Activation Patterns\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-750036938\u0022 data-figure-caption=\u0022The Influence of Culture on Brain Activation Patterns\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/5\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/5\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/44\/5\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15156\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EThe Influence of Culture on Brain Activation Patterns\u003C\/p\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from JF Earle, PhD, PMHNP-BC.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EDr Earle presented research that suggests a relationship among brain plasticity, culture, and the self. A study found that the brain activation patterns related to the self can change in people who intentionally migrate from an interdependent East Asian culture to an independent Western culture such as the United States [Chen PHA et al. \u003Cem\u003ECult Brain.\u003C\/em\u003E 2013].\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv id=\u0022sec-5\u0022 class=\u0022subsection\u0022\u003E\u003Ch3\u003EEmotion\u003C\/h3\u003E\u003Cp id=\u0022p-11\u0022\u003ECultural neuroscience research has compared the neural processing of emotion in Westerners and East Asians. One study examined how Koreans and North Americans respond to scenes of emotional pain, finding that although both groups activated the same region of the emotional pain matrix, Koreans activated the region to a greater degree. The researchers demonstrated that this was related to the collectivist cultural values of the Korean subjects, which emphasizes other focusedness [Cheon BK et al. \u003Cem\u003ENeuropsychologia.\u003C\/em\u003E 2013].\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv id=\u0022sec-6\u0022 class=\u0022subsection\u0022\u003E\u003Ch3\u003ECognition\u003C\/h3\u003E\u003Cp id=\u0022p-12\u0022\u003EPast cultural psychology research found that Western and East Asian cultures have different cognitive styles. Western cultures tend to be analytic, focusing on objects in the foreground and their features, whereas East Asian cultures are holistic. A holistic cognitive style focuses on background and its relationship with foreground objects. Cultural neuroscience research has consistently found different neural processing by East Asian and Western subjects that supports the idea that individuals from these cultures have different cognitive styles. For example, a study that employed eye-tracking technology [Goh JO et al. \u003Cem\u003EPLoS One.\u003C\/em\u003E 2009] found that East Asians and Westerners had different visual attention patterns when observing pictures with changing foregrounds and backgrounds. East Asians shifted their gaze between the background and foreground, whereas Westerners\u0027 eye patterns focused more on changes to foreground objects.\u003C\/p\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-7\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EETHNOPSYCHOPHARMACOLOGY\u003C\/h2\u003E\u003Cp id=\u0022p-13\u0022\u003EEthnopsychopharmacology research has demonstrated that cultural and ethnic groups have varying responses to psychiatric medication. Dr Earle highlighted this by discussing results from studies investigating polymorphisms of the serotonin uptake transporter gene and CYP450 enzymes.\u003C\/p\u003E\u003Cp id=\u0022p-14\u0022\u003EIn one study, for example, Caucasians with 2 long alleles of the serotonin uptake transporter gene responded better to escitalopram than did Koreans [Ng C et al. \u003Cem\u003EHum Psychopharmacol.\u003C\/em\u003E 2013]. Other studies have shown that Caucasians with the long allele responded better to antidepressants, whereas East Asians with the short allele responded better to antidepressants.\u003C\/p\u003E\u003Cp id=\u0022p-15\u0022\u003EResearch has identified cultural and ethnic differences with respect to specific polymorphisms in the cytochrome P450 enzymes, which are involved in metabolizing many psychiatric medications. One of these enzymes, CYP2D6, is involved in metabolizing antidepressants such as fluoxetine, paroxetine, duloxetine, trazodone, and mirtazapine and antipsychotics such as risperidone, aripiprazole, and olanzapine. Ethnopsychopharmacologic research has found 80 CYP2D6 polymorphisms. For example, CYP2D6*10 and CYP2D6*17 are more prevalent in East Asians and sub-Saharan Africans. These 2 polymorphisms are associated with lower enzyme activity and, consequently, lower doses of some antidepressants and antipsychotics to achieve a therapeutic response in these ethnic groups.\u003C\/p\u003E\u003Cp id=\u0022p-16\u0022\u003ESome studies have shown that the diets of different cultural or ethnic groups can interact with CYP450 enzymes to influence metabolism. Dr Earle discussed a study in which individuals from Asia and Sudan who ate traditional ethnic foods in their home countries experienced slower metabolism of clomipramine. However, after immigrating to England and adopting new dietary habits, their metabolism of clomipramine increased to a level similar to that of English individuals.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-8\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EHOW DO THESE DATA INFLUENCE PSYCHIATRIC NURSING?\u003C\/h2\u003E\u003Cp id=\u0022p-17\u0022\u003EIn summarizing, Dr Earle noted that research in cultural neuroscience and ethnopsychopharmacology demonstrates how culture and ethnicity can shape the collective neurobiological functioning of large groups of individuals. This research also suggests more neurobiological variability than was previously imagined. A growing number of scholars have argued that this variability emerged from culture and genes jointly contributing to evolution, which is referred to as \u003Cem\u003Eculturegene coevolution.\u003C\/em\u003E Ultimately, incorporating the findings from these disciplines into clinical practice can help psychiatric nurses be more culturally competent when working with diverse client populations.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/44\/5.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzluhq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzluhq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}