The article I found was related to a research into treatment of patients suffering from the culture bound syndrome ‘Hwa-Byung’, which seems to afflict middle aged Korean women with low socioeconomic status and low education levels. The title of the article was “The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients”. The authors introduce the paper by talking about how mental stress is connected to cardiovascular diseases, including arthrosclerosis, and its negative side effects can lead to atherosclerotic cardiovascular disease. As an association had been made between stress and atherosclerosis, the authors felt is was important to investigate appropriate coping strategies to reduce/minimize the cardiovascular health risks.
The article discusses how Hwa-Byung patients displayed somatic and psychological symptoms such as depression, anxiety, chest tightness etc. The symptoms of Hwa-Byung patients overlap cardiovascular symptoms, confusing diagnosis. The low economic status was also deemed to be associated with the risk factors of cardiovascular disease among Hwa-Byung sufferers. The authors indicate that previous studies on the coping mechanisms of Hwa-Byung patients suggest that such people use ineffective coping strategies such as “active forgetting, accommodation, fatalism, emotional pacification and emotional support seeking”. They also tended to utilize negative passive mechanisms such as withdrawal and self-criticism.
The research was conducted on 50 patients who felt that they had Hwa-Byung syndrome. They were also assessed using a Ways of Coping Checklist (WOCC). Blood cholesterol samples were taken from fasting participants, as cholesterol is a risk factor for atherosclerosis. The results indicated that coping skills wee inversely related to social support seeking patients. The article then clarifies that the core concept of Hw-Byung is considered to have originated from a Korean cultural emotion “Hahn” which is a concoction of sorrow and anger feelings. This emotion is connected to psychosocial stress of family and economic discords. As Korean culture implies suppression of anger, the pathogenesis of Hwa-Byung may be considered a maladaptive coping mechanism for stress. The authors however acknowledge that in western medicine, the culture bound syndrome would be related to somatic disorders such as anxiety and depression.
The article concluded that social isolation is a predictor for atherosclerotic progression. Interestingly, the authors also suggest that in a catch 22, those who feel that they have Hwa-Byung syndrome may be isolating themselves by suggesting that they have the culture bound syndrome.
The article concludes by suggesting that coping styles and strategies are associated with cardiovascular issues and health education and improved adaptive coping strategies may help reduce the risk in patients with Hwa-Byung disease.
Lee, Yu Jin, Kyung Won Baek, Kyu Wol Yun, and Weonjeong Lim. “The Associations of Coping Mechanism with Arterial Stiffness in Hwa-Byung Patients.” Psychiatry Investigation 6, no. 4 (December 2009). Accessed July 17, 2013. http://dx.doi.org/10.4306/pi.2009.6.4.241.