Pica

Pica is categorized as an eating disorder. It includes the practice of repeatedly ingesting nonnutritive substances. Although it most often is seen in children between the age of 18 months and 2 years, it is also seen in adults (though very rarely). In fact, it is sometimes seen in pregnant women, often indicating some sort of nutrient deficiency. It is not always a threat to the individual’s health but depending on the substances being ingested, it can be life-threatening and very dangerous. Some substances that the person may ingest include, but are not limited to, dirt, fingernails, hair, cigarette butts, feces, or even needles. As addressed by Medscape, what makes this a culture bound syndrome is the view that culture holds on ingesting nonnutritive substances. If the act is viewed as a part of normal practice (aka culturally sanctioned) then it is not a disorder. It becomes a syndrome when the act is viewed as strange and unacceptable. Another important qualification is that the behavior must be inappropriate to the developmental level of the individual. For example, if an American baby puts sand in his/her mouth, we do not categorize that as a disorder but rather a normal mistake that babies make. If that same individual ate sand habitually at the age of 23, we would then start to categorize it as a disorder.

Pica is not always associated with biological causes. If that is the case, it is not considered severe and may not be addressed medically. When paired with mental retardation or another disorder, it is considered more detrimental. It also must last over a month to be considered. Treatment includes addressing nutrient deficiencies, mild aversion therapy and positive reinforcement, and even medication in cases where therapy is not a possibility (such as when paired with mental disorders).

Sources:

http://emedicine.medscape.com/article/914765-overview

http://health.nytimes.com/health/guides/disease/pica/overview.html

4 thoughts on “Pica

  1. When I began reading this post, my initial thought was that this is not a Culture Bound Syndrome, as interesting as it is. Giving that its something that occurs in varying societies & cultures, to varying people, led me to this conclusion. However, reading the qualifications given from the article, makes it harder to determine. Unfortunately, just because something has cultural significance in a society & therefore makes it a CBS, is not enough for me to be convinced that something many others experience throughout the world should be classified as culture bound. So, even though I was torn upon reading that, I’d still have to say Pica should not be a CBS (in my opinion).
    As far as treatment in ethnomedical systems, I believe it should be treated in the professional sector with biomedical treatments, and some therapy as discussed; yet in other systems, I assume one would see a shaman or other non-western healer, to rid them of spirits causing them to uncontrollably eat random objects.

  2. Initially I was skeptical, but after reading your post, I agree with your summary of Pica and classification of the condition as a culturally bound syndrome. To say that that Pica is not a culturally bound syndrome, but rather a classical illness is to disgrace many cultural practices around the world such as those found in some parts of Africa and Haiti where eating clay and mud is acceptable. The advantages of regarding Pica as a culturally bound syndrome include above all else, in my opinion, allowing for respect of other cultural practices and rituals. Perhaps in other cultures it is considered sacred or good luck to consume mud or other non-food items and by classifying Pica as a standard illness our culture would be discrediting theirs, deeming their practices as ignorantly unhealthy. A disadvantage of regarding Pica as a culturally bound syndrome includes the possibility of individuals therefore not fully considering all of the implications or not fully considering it a real condition. It is a paradox in this way, in that to regard it as a culturally bound syndrome protects the integrity of foreign cultural practices but also lessens the perceived severity or seriousness of the disease for many individuals. Thus, leaving the possibility of complete skepticism even, in which some individuals could regard the condition as not really a condition at all. In a different ethnomedical system or culture, Pica might be explained as a normal cultural practice and therefore not as an illness. For example, in the United States people continue to expose themselves to high levels of UV radiation via artificial tanning facilities despite known detrimental effects to skin it is merely a cultural practice.

  3. I also read an article about pica, but more specifically kaolin ingesting or chalk eating. Though the reading did say that pica satisfied the conditions of a cultural bound syndrome, it was difficult for me to decide. Like others have mentioned different cultures have different rituals and practices that to them are normal. However, I feel that in the United States consuming things like dirt and chalk are out of the ordinary and is not culturally sanctioned. Elsewhere it may be very acceptable. When it comes to whether or not it is inappropriate to the developmental level of the individual, I think you were spot on. If a parent sees there small child eating dirt, they would probably tell them to stop but not think there was something wrong with them. As the kid gets older and becomes an adult that’s when it can be viewed as abnormal. In the case of chalk eating, there were no ties to other psychological problems. One major issue with pica was overindulgence. That’s when more serious problems can occur with the body. As you have stated treatment is available to those in need. An interesting fact from the study done in the article I read was that of 21 people interviewed who consumed chalk only one was male. This leads me to believe that young boys with pica are rid of the habit by the time they get older. All in all I would have to say this should be categorized as a cultural bound syndrome

  4. As mentioned in the post, when consuming a non-nutritional substance is culturally acceptable or sanctioned this act is not labeled. Only when this act is viewed as abnormal is it labeled as syndrome, more specifically a culture-bound syndrome, or CBS. One disadvantage that comes with labeling Pica as a culture-bound syndrome is that individuals afflicted with this syndrome seem to be looked at from a negative perspective because they are viewed as being strange or abnormal. This could add additional emotional/psychological stress that may increase the intensity of the behavior since they don’t really know what is causing Pica anyways. This label seems to imply that this syndrome is only found within this culture, therefore by labeling this syndrome as a culture bound syndrome not only will the individual be viewed as abnormal, but the culture as a whole may also suffer from negative stereotypes related to this syndrome.

    It was not specifically addressed in this post where this syndrome occurs or what ethnomedical system it is being viewed by. However, if this syndrome were being viewed solely by a biomedical ethnomedical system, the causes of this syndrome would not be attributed to anything culturally-specific, but rather based on the individual’s biology. For example, there are documented cases of individuals consuming chalk. Biomedical doctors have related this behavior to a nutritional deficiency. In this example, the consumption of chalk was attributed to the individual’s iron deficiency.

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