Related conditions in other cultural contexts: koro in Southeast Asia, particularly Sin- gapore and shen-k'uei (”kidney deficiency”) in China.
Related conditions in DSM-S: Major depressive disorder, persistent depressive disor- der (dysthymia), generalized anxiety disorder, somatic symptom disorder, illness anxiety disorder, erectile disorder, early (premature) ejaculation, other specified or unspecified sexual dysfunction, academic problem.
"Khyfil attacks” (khyzil cap), or "wind attacks,” is a syndrome found among Cambodians in the United States and Cambodia. Common symptoms include those of panic attacks, such as dizziness, palpitations, shortness of breath, and cold extremities, as well as other symp- toms of anxiety and autonomic arousal (e.g., tinnitus and neck soreness). Khyfil attacks in- clude catastrophic cognitions centered on the concern that khyril (a windlike substance) may rise in the body—along with blood—and cause a range of serious effects (e.g., com- pressing the lungs to cause shortness of breath and asphyxia; entering the cranium to cause tinnitus, dizziness, blurry vision, and a fatal syncope). Khyzil attacks may occur with- out warning, but are frequently brought about by triggers such as worrisome thoughts, standing up (i.e., orthostasis), specific odors with negative associations, and agoraphobic- type cues like going to crowded spaces or riding in a car. Khyfil attacks usually meet panic attack criteria and may shape the experience of other anxiety and trauma- and stressor- related disorders. Khyfil attacks may be associated with considerable disability.
Related conditions in other cultural contexts: Laos (pen lom), Tibet (srog rlung gz' nud),
Sri Lanka (vate), and Korea (hwu byung).
Related conditions in DSM-S: Panic attack, panic disorder, generalized anxiety disor- der, agoraphobia, posttraumatic stress disorder, illness anxiety disorder.
Kufungisisu ("thinking too much” in Shona) is an idiom of distress and a cultural explana- tion among the Shona of Zimbabwe. As an explanation, it is considered to be causative of anxiety, depression, and somatic problems (e.g., ”my heart is painful because I think too much"). As an idiom of psychosocial distress, it is indicative of interpersonal and social difficulties (e.g., marital problems, having no money to take care of children). Kufungisisu involves ruminating on upsetting thoughts, particularly worries.
Kufungisisa is associated with a range of psychopathology, including anxiety symp- toms, excessive worry, panic attacks, depressive symptoms, and irritability. In a study of a random community sample, two—thirds of the cases identified by a general psychopathol- ogy measure were of this complaint.
In many cultures, "thinking too much” is considered to be damaging to the mind and body and to cause specific symptoms like headache and dizziness. ”Thinking too much” may also be a key component of cultural syndromes such as “brain fag” in Nigeria. In the case of brain fag, “thinking too much” is primarily attributed to excessive study, which is considered to damage the brain in particular, with symptoms including feelings of heat or crawling sensations in the head.
Glossary of Cultural Concepts of Distress 835
Related conditions in other cultural contexts: ”Thinking too much" is a common id- iom of distress and cultural explanation across many countries and ethnic groups. It has been described in Africa, the Caribbean and Latin America, and among East Asian and
Native American groups.
Related conditions in DSM-5: Major depressive disorder, persistent depressive disorder (dysthymia), generalized anxiety disorder, posttraumatic stress disorder, obsessive—compul— sive disorder, persistent complex bereavement disorder (see ”Conditions for Further Study").