magazine issue 10 2009 / Issue 10

Culture and Health Psychology: Insights from a Socio-Cultural Perspective

• written by Ayse K. Uskul & David Sherman
• edited by Selin Kesebir

In individualistic cultures, such as the United Kingdom or the United States, the dominant model of the self is an independent self characterized by self-defining attributes which serve to fulfil personal autonomy and self-expression (Hofstede, 1980; Kim & Sherman, 2007; Markus & Kitayama, 1991; Oyserman, Coon, & Kemmelmeier, 2002; Triandis, 1995). People are seen as agentic and thus responsible for their own decisions and actions. Moreover, in cultures shaped by individualism, individuals favour not missing chances over not making mistakes, focusing on the positive outcomes they hope to approach rather than the negative outcomes they hope to avoid (e.g., Lee, Aaker, & Gardner, 2000). Relationships are seen as freely chosen and relatively easy to enter and exit (Adams, 2005).

By contrast, in collectivistic cultures, such as many East Asian cultures, the dominant model is an interdependent self embedded within the social context and defined by social relations and memberships in groups (e.g., Markus & Kitayama, 1991;Triandis, 1995). People are seen as relational or communal and their decisions and actions are seen as heavily influenced by social, mutual obligations and the fulfilment of in-group expectations (e.g., Hofstede, 1980; Oyserman et al., 2002; Triandis, 1995). In such cultures, individuals tend to be motivated to fit in with their group and maintain social harmony; they focus on their responsibilities and obligations while trying to avoid behaviours that might cause social disruptions or disappoint significant others (Markus & Kitayama, 1991). They favour not making mistakes over not missing chances, focusing on the negative outcomes they hope to avoid rather than the positive outcomes they hope to achieve (Elliot, Chirkov, Kim & Sheldon, 2001; Lee et al. , 2000; Lockwood, Marshall, & Sadler, 2005). Relationships are seen as less voluntary and are relatively more difficult to leave (Adams, 2005).

It should be noted that individualism and collectivism are two of many constructs researchers use to understand cultural differences in psychological functioning and research using these constructs, by no means, captures the breadth of the growing body of research on culture, health, and illness. Other important constructs that distinguish cultures include uncertainty avoidance, masculinity, and power distance (Hofstede, 1980), tightness versus looseness (Triandis, 1995), and survival versus self-expression (Inglehart, 1997). For the current piece, however, we focus on the link between individualism/collectivism and health and illness. In particular, we discuss a few select examples of our own and other recent research that implicitly or explicitly uses an individualism-collectivism framework to cross-culturally test models of health communication and social support seeking.