# The Cultural Perception of Abuse in a Multicultural Context and Its Impact on Mental Health: A Case Report

## TL;DR

A Botswana woman's mental health struggles highlight how cultural norms around corporal punishment can impact psychiatric care in a multicultural context.

## Contribution

This case report emphasizes the need for culturally sensitive trauma-informed psychiatric care for migrant patients.

## Key findings

- The patient showed improvement with lamotrigine, Adderall XR, and trauma-informed therapy.
- Sleep hygiene and alcohol consumption remained persistent challenges.
- Cultural perceptions of abuse significantly influenced the patient's mental health outcomes.

## Abstract

This case report reviews the psychiatric difficulties of a 27-year-old female patient from Botswana with symptoms fitting for posttraumatic stress disorder (PTSD), cluster B personality traits, and attention-deficit/hyperactivity disorder (ADHD). Her case illustrates how corporal punishment, an accepted practice in Botswana, remains in stark contrast to the standards of American society and the psychological consequences that may emerge from such practices. The patient presented with mood instability, anxiety, and recurrent depressive episodes, which were worsened by poor coping mechanisms including binge drinking and emotional dissociation. The patient’s interviews confirmed the presence of PTSD, ADHD, and personality disorder per diagnostic criteria in the DSM-5. She was treated with lamotrigine and Adderall XR, with trauma-informed group therapy and psychoeducation about cultural perceptions of abuse. The patient showed improvement in emotional regulation and investment in the treatment; however, she continued to have difficulties with sleep hygiene and alcohol consumption. This case underlines the importance of culturally sensitive psychiatric care and emphasizes that osteopathic practitioners should further work within the framework of the trauma-informed approach with consideration of cultural influence when managing patients, especially those of migrant backgrounds.