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 acro ss many countries and ethnic groups. It has
been described in Africa, th e Caribbean and Latin America, and among East Asian and
Native American groups.
Related conditions in DSM-5:  Major depressive disorder, pe rsistent depressive disorder
(dysthymia), generalized anxiety disorder, pos ttraumatic stress disorder, obsessive-compul-
sive disorder, persistent complex bereavement disorder (see “Conditions for Further Study”).
Maladi moun
Maladi moun  (literally “humanly caused illness,” also referred to as “sent sickness”) is a
cultural explanation in Haitian communitie s for diverse medical and psychiatric disor-
ders. In this explanatory mode l, interpersonal envy and malice cause people to harm their
enemies by sending illnesses such as psychosis,  depression, social or academic failure, and
inability to perform activities  of daily living. The etiological model assumes that illness
may be caused by others’ envy and hatred, pr ovoked by the victim’s economic success as
evidenced by a new job or expensive purchase . One person’s gain is assumed to produce
another person’s loss, so visible success make s one vulnerable to attack. Assigning the la-
bel of sent sickness depends on mode of on set and social status more than presenting
symptoms. The acute onset of new symptoms or  an abrupt behavioral  change raises sus-
picions of a spiritual attack. Someone who is at tractive, intelligent, or wealthy is perceived
as especially vulnerable, and even young healthy children are at risk.
Related conditions in other cultural contexts:  Concerns about illness (typically, phys-