Culture and Cognitive Theory : Toward a Reformulation

14
Culture and Cognitive
Theory: Toward a
Reformulation
Jo Thakker and Russil Durrant
In a provocative and important recent article Anthony Marsella (1998) makes an
eloquent plea for the forging of a new metadiscipline of psychology that he labels
global-community psychology. Marsella argues that we need a radical rethinking of
the fundamental premises of psychology, rooted as they are in Western cultural
traditions. Features of an emergent global-community psychology include an
emphasis on multicultural and multidisciplinary approaches to human behavior
that draw attention to the importance of context and meaning in human lives.
Marsella's call for a global-community psychology reflects, in part, a growing
body of literature that demonstrates the importance of cultural factors in a diver-
sity of psychological domains such as cognition, emotion, social behavior, and
psychopathology.
The relationship between culture and cognition, for example, has been
explored in some detail by both psychologists (e.g., Semin & Zweir, 1997;
Serpell & Boykin, 1994), and anthropologists (e.g., Bloch, 1998; D'Andrade,
1995). Bartlett's (1932) seminal work on the nature of human memory demon-
strated the ways in which cultural knowledge, embodied in schemas, can affect
the pattern and process of memory reconstruction. More contemporary research
attests to the way cultural factors can impinge on various aspects of cognition,
including memory and reasoning (D'Andrade, 1995), attribution style (Morris &
Peng, 1994; Semin & Zweir, 1997; Triandis, 1989), knowledge structures,
(Serpell & Boykin, 1994), and value hierarchies (Smith & Schwartz, 1997).

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The importance of attending to cultural variables in understanding the nature of
mental disorders is also becoming increasingly apparent (Tanaka-Matsumi &
Draguns, 1997; Thakker & Ward, 1998). For example, the underlying philosophy
of the universalist approach to the classification of psychopathology offered by
the DSM-IV has been called into question. More specifically, the view
entrenched in the biomedical model, that mental disorders are the same across
cultures, cannot be sustained (Thakker & Ward, 1998). Presentation of major dis-
orders such as depression and schizophrenia have been shown to vary signifi-
cantly across cultures (see for example, Draguns, 1995; Kleinman, 1988;
Westermeyer, 1989). Furthermore, the existence of a range of culture bound dis-
orders (although diagnostically somewhat controversial), suggests that a satis-
factory understanding of mental disorder must take into account the significance
of cultural particulars (Kirmayer, 1991). Because cognitive factors often are
viewed as central to the understanding of the diagnosis, etiology, and treatment
of many mental disorders (e.g., Teasdale & Barnard, 1993; Williams, Watts,
MacLeod, & Matthews, 1997), there is much scope for an exploration of the var-
ious relations that occur between culture, cognition, and psychopathology, as
contributors to this volume demonstrate.
In this chapter, we aim to draw on and extend the implications of the body of
research, briefly outlined above, in the context of a dynamic model of mental dis-
order; one that attempts to do justice to the rich interplay between cognitive, cul-
tural, and biological variables. First, we outline a theoretical perspective of the
relations between culture, cognition, and biology presented in the context of a
domain specific view of human cognitive architecture. Second, we illustrate the
relationship between culture, cognition, and biology in the domain of psy-
chopathology, drawing on the example of anxiety disorder. Third, we present a
model of mental disorder developed by Thakker, Ward, & Strongman (in press)
that addresses the relationships between culture, cognition, and biology in the
context of psychopathology. We conclude with some thoughts on the role of
interdisciplinary integration in the domain of psychopathology.
THE RELATIONSHIPS BETWEEN
CULTURE, COGNITION, AND BIOLOGY
"What we are is very much a matter of what culture has made us" suggests the
philosopher Daniel Dennett (1995, p. 340) in his recent book Darwin's Dangerous
Idea. It is clear, as Dennett indicates, that people are influenced in a myriad of
ways by the culture in which they are embedded. Belief systems or worldviews
vary considerably across cultures, with potentially profound implications for
human thought and behavior. The striking pattern of within-culture similarities
and between-culture differences in human behavior is testimony to the role of
culturally acquired patterns of beliefs, desires, and values. However, it is also
clear that there are substantial degrees of similarity between peoples of different
cultures, regardless of the specific patterns of beliefs and values that occur.
Indeed, it has been argued that anthropologists and crosscultural psychologists

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Culture and Cognitive Theory: Toward a Reformulation 215
have focused predominantly on patterns of differences between cultures while
neglecting relevant underlying similarities (Brown, 1991).
The question of the nature and degree of crosscultural differences and, more
generally, the extent or role that culture plays in human development, have been
perennial themes in psychology, anthropology, and sociology. The well-worn
distinctions between universalism and relativism and between culture and nature
reflect this enduring interest. Focusing more specifically on the relations between
culture and cognition we can make a distinction between weak and strong for-
mulations of cultural cognition. The weak version of the relationship between
culture and cognition concedes that the contents of cognition are often highly
variable across different cultures, however, the processes that underlie these vari-
ations are themselves crossculturally invariant.
Thus, for example, although language varies in its surface features in different
cultures, this variety is underpinned by universal psychological mechanisms that
generate universal grammars (Chomsky, 1975; Pinker, 1994). Empirical support
for this weak version of cultural cognition is provided by various lines of
research. For example, living-kind classification, the natural taxonomies of flora
and fauna, shows strong commonalties across all cultures although the specific
contents of the classification scheme are naturally variable (Berlin, 1978; Atran,
1990). Specifically, there is a crosscultural tendency to classify living-kind entities
in a hierarchical fashion and to treat biological species in essentialist terms. Of
course, the specific animals and plants that people in different cultures treat in
such fashions will be determined by local biogeographical features.
In contrast to the weak version of cultural cognition, advocates of the strong
version maintain that not only does the content of cognition vary across cultures,
but so too does the very nature of cognitive processes. Culture here can be seen to
radically affect the basic nature of cognitive and neural architecture. As the psy-
chologist Merlin Donald (1991, p. 14) suggests, "Cultures restructure the human
mind, not only in terms of its specific contents, which are obviously culture
bound, but also in terms of its fundamental neurological organization." An exam-
ple of such culture-based effects on neural organization is provided by
Jovanovski (1995). According to Jovanovski, people raised in urban areas
respond differently to visual tests than people who have grown up in rural areas.
The former respond more readily to angular and structured stimuli whereas the
latter show more sensitivity to less regular and perhaps more natural configura-
tions. This finding is explained as the result of differential deterioration of specific
clusters of cells in the neural cortex during development. Jovanovski (1995)
concludes on the basis of this research that " if cultural standards, impressions,
and experiences can influence no less than our visual tendencies, then, indeed,
we could hardly convincingly deny that those same social characteristics can and
do give rise to context-identifiable ideas, interpretations, worries, phobias and
obsessions" (p. 295).
How are we to reconcile these two versions of cultural cognition? Should we
accept the idea that cultures have the power to radically restructure the funda-
mental organization of the human mind, or is the influence of culture on

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cognition a more moderate one? This issue is crucial in the present context, for it
lies at the heart of understanding how we should adequately conceptualize the
importance of cultural factors in understanding the nature of mental disorder. We
will argue that a richer understanding of the relationship between culture and
cognition can be fruitfully obtained by adopting a domain specific or modular
view of human cognition. Moreover, we argue that a consideration of biological
factors, specifically evolutionary considerations, can further our understanding
of the culture-cognition interface. Finally, we suggest that we must adopt an
approach to human cognition that fully realizes the dynamic reciprocal relation-
ship between mind and world. These three themes reflect important general
trends in cognitive theory. In what follows we address each of these points in
turn, before combining the central ideas in a way that helps us further our under-
standing of both cognitive universality and cultural diversity.
THE DECLINE OF INDIVIDUALISM IN PSYCHOLOGY
In a comprehensive review of historical developments in cognitive theory,
Bechtel, Abrahamsen, and Graham (1998), note an increasing shift away from
approaches to cognition that limit themselves to addressing information pro-
cessing within the mind, toward a recognition of the importance of the envi-
ronmental embeddedness of human cognitive systems. For a considerable
period of time, mainstream cognitive psychologists have directed their intel -
lectual labors toward elucidating the internal systems of information process-
ing within the human mind via often highly artificial experimental protocols.
This approach, by itself, however, has led to an impoverished view of the
human mind; one that has failed to do full justice to the real-world nature of
human cognition.
This individualist research program in cognitive psychology, which has been
labeled methodological solipsism by the philosopher Jerry Fodor (1980), has
drawn a variety of criticisms from a diverse range of sources. Philosophers of
various theoretical persuasions (e.g., Burge, 1986; Kitcher, 1985; Millikan,
1993) have convincingly argued that the nature of mental states can only be fully
understood by reference to the external environment. In a similar vein,
researchers in cognitive psychology and artificial intelligence have begun to
direct their attention to the situated nature of human cognition (e.g., Clark, 1997)
as it occurs in real-world environments (see Hutchins, 1995).
Cognitive anthropologists (e.g., D'Andrade, 1995) have also drawn attention
to the way in which environmental factors, specifically those related to the cul-
tural environment, can exert important influences on the nature of cognition.
D'Andrade (1995) emphasizes that we should conceptualize the relationship
between culture and cognition as essentially reciprocal in nature: the psyche is
influenced by cultural representations, which themselves are selected and modi-
fied in terms of the capacities of the human cognitive system.

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Culture and Cognitive Theory: Toward a Reformulation
217
THE MODULARITY OF MIND
Another important development in cognitive theory is the growing acceptance of
some version of the modularity thesis of human cognitive architecture
(Appelbaum, 1998). Made popular in part by Fodor (1983), proponents of the
modularity thesis argue that human cognition can be best characterized as con-
taining many distinct subsystems that are dedicated to specific functions.
Modular, or domain specific, approaches to the mind reject the view that knowl-
edge acquisition is driven by a few content-independent domain general
processes. Instead, the human mind is replete with a multiplicity of content specific
mechanisms dedicated to processing specific classes of information.
The modularity thesis has received a growing body of empirical support.
Specifically, there is evidence for modular mechanisms dedicated to various cog-
nitive domains such as language (Chomsky, 1975; Pinker, 1994), biological clas-
sification (Atran, 1990; Berlin, 1978), mental state attribution (Baron-Cohen,
1995; Leslie, 1987), object perception (Spelke, 1988), and numeracy (Wynn,
1992), among others (see Hirschfeld & Gelman, 1994, for a good review).
However, there still remains considerable debate over many aspects of modularity.
It is unclear just how many modules humans possess, how best to characterize
them, what their relationships are to one another, and so forth (see
Karmiloff-Smith, 1992, and Samuels, 1998, for interesting alternatives). We will not
address these issues here. However, it is likely that the range of domain specific
mechanisms that humans possess is likely to be supplemented by some more
domain general processes, and that there are rich connections between different
modules (conceptual ones at least) that give rise to the creative and flexible
nature of human cognition.
THE ROLE OF EVOLUTIONARY THEORY
The importance of evolutionary theory for understanding the nature of human
mentation and behavior has also received renewed interest in recent times (e.g.,
Barkow, Cosmides, & Tooby, 1992; Buss, 1995; Pinker, 1997). Evolutionary
psychologists argue that to understand how the mind works we must pay due
attention to the problems that the mind has been designed to solve. The mind, it is
suggested, is as much a product of evolution as is the body, and should be studied
using similar methods. Although we reject the claim that evolutionary psychology
provides a revolutionary new paradigm for psychological science (e.g., Buss, 1995),
we would argue that questions of evolutionary origin are certainly relevant to our
understanding of human cognition and its relation to culture.
An evolutionary approach naturally meshes with both a domain specific view of
mind and an anti-individualist approach to human cognition. Evolutionary
psychologists (e.g., Cosmides & Tooby, 1994; Pinker, 1997) argue that cognitive
modules are best characterized as evolved mechanisms with distinct

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phylogenetic histories. A general purpose view of cognition, it is argued, is bio-
logically unfeasible, because what counts as adaptive behavior differs signifi-
cantly across different domains. Moreover, there must be some way in which
learning is framed, or constrained, in order to direct the organism toward the nar-
row envelope of contextually relevant behavior. Furthermore, from an evolu-
tionary point of view, cognition must be embedded in the real world. That is, for
adaptive behavior to be generated there must be rich, reciprocal relations
between the mind and the environment, including the social environment,
EXPLAINING CULTURAL DIVERSITY
At first glance, a modular theory of mind, coupled with an evolutionary per-
spective, may seem unable to do justice to an understanding of the role of culture in
cognition, and the generation of cultural diversity. However, if we accept the
thoroughly epigenetic character of human cognitive development, cultural diversity
can be viewed as a natural consequence of an evolved, domain specific mind
embedded in a rich social and cultural environment. Cultural learning, according to
this perspective, is not a passive domain general affair (cultures do not entirely
determine the nature of thought), but rather is best thought of as active, directed,
and domain specific in character. The view we adopt here is nicely summarized by
E. 0. Wilson (1998) in his recent book Consilience:
Culture is created by the communal mind, and each mind in turn is the product of the
genetically structured human brain. Genes and culture are therefore inseverably linked.
But the linkage is flexible, to a degree still mostly unmeasured. The linkage is also tortuous:
Genes prescribe epigenetic rules, which are the neural pathways and regularities in cognitive
development by which the individual mind assembles itself. The mind grows from birth
to death by absorbing parts of the existing culture available to it, with selections guided
through the epigenetic rules inherited by the individual brain. (p. 127)
To understand how cultural diversity is generated from this perspective, it is
useful to consider the important distinctions made by the cognitive anthropologist
Dan Sperber (1996) between proper and actual domains. The proper domain of
some conceptual module is all the information in the organism's environment that it
is the module's biological function to process; the actual domain is all the
information that satisfies the module's input conditions. For example, the
living-kind module alluded to earlier has been designed to process information
about biological species that one encounters in the environment. However, the
actual domain of this module will include information about all sorts of other
entities such as dinosaurs and dragons, which we have had no direct experience
with at all. In a similar fashion, our theory-of-mind module, designed to generate
causal explanations of human behavior in terms of intentional states (beliefs,
desires, and so forth), is employed to explain the behavior of other animals, and
even nonbiological entities such as weather systems and automobiles. In these cases,

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Culture and Cognitive Theory: Toward a Reformulation
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what remains invariant across individuals are the underlying cognitive opera -
tions, while content is free to change depending on specific local details.
Cultural cognition, therefore, can be seen to be generated from an active
process of domain specific learning across varying cultural contexts. Although
innate knowledge structures guide the organisms to certain classes of informa-
tion in the environment, culture strongly influences the subsequent form that the
acquired knowledge will take. As Gardner (1983, 1985) has argued, modules
undergo lengthy developmental constructions and thus are open to potentially
strong influences from social and cultural factors.
The perspective on the human mind we have presented in this section thus far
suggests that the weak version of the cultural cognition hypothesis is both true
and potentially highly relevant in understanding human behavior. Although
learning, including cultural learning, is likely to some extent to be constrained
along domain specific lines, there are substantial degrees of freedom available
for the generation of culturally unique patterns of representations. Moreover, the
way various systems of information are integrated in the mind provides further
avenues for cultural differentiation. We remain agnostic, however, on the strong
version of cultural cognition. Although it is unlikely that cultures radically alter
fundamental cognitive processes within domains, there is still room for substantial
cognitive reorganization on the basis of specific patterns of development. In
evaluating the plausibility of the strong hypothesis on cultural cognition, it is best to
proceed on a case-by-case basis.
In the next section we explore some of the implications of the framework pre-
sented above in the context of psychopathology. More specifically, we demon-
strate the interplay of cognitive, cultural, and biological variables in the context
of anxiety disorders.
CULTURE AND COGNITION IN THE CONTEXT OF
PSYCHOPATHOLOGY: ANXIETY DISORDERS
Anxiety disorders provide a potentially fruitful example for illustrating the
interrelationships that occur between cognitive, cultural, and evolutionary factors
in the context of mental disorder. Research on anxiety disorders has often
directed attention to the role of cognitive processing mechanisms (e.g., Beck &
Emery, 1985; Eysenck, 1997; Mathews & MacLeod, 1994; Williams et al., 1997)
as well as invoking the potentially functional or adaptive role that anxiety has to
play (e.g., Beck & Emery, 1985; Marks, 1987; Marks & Nesse, 1994).
Crosscultural investigations have also revealed considerable cultural patterning
in the manifestation of anxiety disorders, as well as the occurrence of specific
culture bound instances of anxiety related disturbances (e.g., Al-Issa & Oudji,
1998; Kirmayer, 1991; Levine & Gaw, 1995).
Many important approaches to anxiety have adopted a cognitive perspective.
For example, Beck and Emery (1985) have argued that cognitive factors are

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central to the etiology and maintenance of a wide range of anxiety disorders.
Beck and Emery emphasize the role that schemata—cognitive structures that
influence a person's appraisals and interpretations of experiences—have to play
in relevant information processing tasks. Schemata direct processing resources
toward certain aspects of the situation that they are congruent with. The schemata
of anxious individuals are characterized by themes of danger, vulnerability, and
threat. Thus a range of cognitive distortions and biases are generated in anxious
individuals that influence how they experience events and that feed back into
their cognitive and emotional states.
Other important theoretical approaches to anxiety (e.g., Eysenck, 1997;
Williams et al., 1997) have also adopted a cognitive perspective. Although to
some extent similar to the approach pursued by Beck and Emery (1985), both
Eysenck and Williams et al. have extended the work of Beck and Emery by high-
lighting the importance of attending to multiple levels of processing in the con-
text of anxiety disorders. The distinction between perceptual and conceptual
processing favored by Williams et al. (1997), for example, is helpful in under-
standing the nature of unconscious attentional mechanisms that appear to be rel-
evant in the generation of anxiety states. What all the cognitive approaches to
anxiety disorders emphasize, however, is the importance of examining the nature
of specific attentional and interpretive biases.
The occurrence of such processing biases in anxious individuals has received
considerable empirical support from a diverse range of experimental studies (for
reviews see Mathews & MacLeod, 1994; Mineka & Gilboa, 1998; Mineka &
Sutton, 1992). The general finding from this body of literature is that anxiety is
closely associated with typically automatic preconscious biases for threatening
information. Some kind of attentional biases seem to exist in all anxiety disorders.
Cognitive biases and distortions have been found in patients with social phobia
(Foa, Franklin, Perry & Herbert, 1996; Wells & Clark, 1997), panic disorder
(Khawaja & Oei, 1998), post-traumatic stress disorder (Cassidy, McNally &
Zeitlin, 1992), and specific phobias (Watts, McKenna, Sharrock & Trezise, 1986).
Such biases have been shown to occur entirely unconsciously (e.g., Ohman &
Soares, 1994), although for some anxiety disorders, such as social phobia, con-
scious cognitive distortions are also implicated (Wells & Clark, 1997).
The specific pattern of attentional and interpretative biases found in anxiety
disorders, along with the nature of the stimuli that elicit them, has led a number of
researchers to adopt an evolutionary framework (e.g., Baumeister & Tice,
1990; Beck & Emery, 1985; Marks, 1987; Marks & Nesse, 1994). Broadly
speaking, advocates of evolutionary approaches suggest that anxiety in general is
adaptive, because it directs cognitive resources and motivates behavior in a manner
that is likely to reduce the possibility of harm and hence increase reproductive
success. Anxiety disorders, from this perspective, simply reflect exaggerations of
various subtypes of normal anxiety (Marks & Nesse, 1994). Marks and Nesse
stress the relative domain specificity of anxiety responses; subtypes of anxiety
evolved to give selective advantages to particular kinds of danger. These

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Culture and Cognitive Theory: 7bward a Reformulation
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subtypes, however, are only partly differentiated because different threats often
co-occur, and similar responses to diverse stimuli are sometimes indicated.
The early work of Marks (1969) and Seligman (1970) on the development of
phobias had implicated the role of evolutionarily prepared biases in both atten-
tion and learning. Marks argued that humans are more likely to attend to phylo-
genetically relevant stimuli in the world, a phenomenon he labeled prepotency. In
a similar fashion, Seligman argued that humans are more likely to learn fear
associations to some classes of stimuli but not to others; that is, humans are pre-
pared to develop fears to objects and events in the world that have important con-
sequences for survival and reproduction. This approach to the development of fears
and phobias helps to explain the nonrandom distribution of such fears. As Marks
(1987) suggests, humans are more likely to develop phobias to objects and events
that would have posed specific threats to reproductive success in ancestral
environments. Thus fear of spiders, snakes, heights, social situations,
enclosed spaces, and so forth are more prevalent than are fears of dangerous but
novel stimuli such as cars and electric outlets. An evolutionary approach also
helps to explain the ontogenetic development of such fears and phobias. For
example, a fear of heights appears in infants immediately prior to the average age
that they begin crawling and intensifies with crawling experience. Similarly, a
fear of animals emerges at about age two—an age when infants begin to explore
further afield (see Ost, 1987, for details of the ages when different phobias typically
emerge). To summarize, evolutionary approaches to anxiety disorders emphasize the
role of innate domain specific mechanisms that direct attention (often
preconsciously—see Ohman, 1997) toward certain kinds of stimuli in the world:
ones that have phylogenetic relevance.
Evolutionary approaches to anxiety disorders, however, have not gone without
criticism (e.g., Davey, 1995; McNally, 1987; Merckelbach & de Jong, 1997).
Questions have been asked regarding the putative adaptive advantages of spe-
cific phobias, such as blood injury phobia (Page, 1994), and their have been cri-
tiques of more general approaches such as Seligman's preparedness theory
(McNally, 1987; Davey, 1995). The details of these criticisms will not concern us
here, however. What emerges as prominent in the challenges to evolutionary
approaches is the role that cultural factors have to play in the nature of anxiety
disorders. Both Davey (1995) and Merckelbach and de Jong (1997) argue that
variations in social taboos, culturally variable patterns of beliefs, locally relevant
information about potential dangers, and so forth, exert potentially powerful effects
on the development of specific fears. Cultural schemata are conceptualized as
providing strong top-down influences on the cognitive mechanisms that direct
attention toward relevant stimuli in the environment. Hence it is suggested that it
may be cultural, rather than evolutionary, factors that generate expectancy biases
regarding the sorts of objects and situations toward which people develop fears and
phobias.
Crosscultural approaches to anxiety disorders suggest that they are a universal
phenomenon. However, the events that precipitate anxiety are strongly

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influenced by a diverse range of cultural factors (Aderibigbe & Pandurangi,
1995; Al-Issa & Oudji, 1998; Levine & Gaw, 1995). Al-Issa and Oudji (1998, p.
144), for example, in a recent review of culture and anxiety, conclude:
"Epidemiological data suggests [sic] that anxiety disorders are universal.
However, the meaning of the concept of anxiety and of its manifestations seem[s] to
vary from one culture to another." The existence of a number of culture bound
anxiety syndromes serves to underscore this conclusion. Some examples of such
culture bound disorders include ataque de nervios, dhat, kayak angst, brain fog,
koro, and taijin kyofusho (Levine & Gaw, 1995).
Koro, to take one example, provides an instructive illustration of the role that
cultural beliefs have to play in the manifestation of anxiety. Koro occurs in a
diverse range of cultures but is most prominent in India, Southeast Asia, and
China (Aderibigbe & Pandurangi, 1995). Koro is characterized by an extreme
fear that the penis is retracting into the abdomen and will eventually cause death.
Individuals with this fear experience extreme panic and terror, often accompa-
nied with heart palpitations, outbursts of sweating, and catastrophic cognitions
relating to sexual functioning and the sexual organs (Levine & Gaw, 1995). Koro
appears to be associated with a specific pattern of beliefs regarding the existence of
koro itself, as well as more general beliefs and values centered on micturation,
masturbation, and sexual functioning. The role of beliefs in koro itself in the eti-
ology of this disorder is clearly illustrated in the incidence of koro epidemics,
such as the one that occurred in Guangdong, China (Tseng, Mo, Jing, Li, Ou,
Chen & Jiang, 1988). Koro has, however, been reported in individuals with no prior
knowledge of the disorder. For example, Chowdhury & Rajbhandri (1995) report a
case of koro in a Nepali patient, which in the absence of any preexisting beliefs
about koro, seemed to be related to more specific beliefs about the fear of semen
depletion and guilt associated with masturbation. A general model of koro proposed
by Simons (1985) suggests that endemic beliefs about koro (and general beliefs
about sexual functions, seminal fluid, and so forth) lead to a greater monitoring and
awareness of penile states, which leads in turn to anxiety if the penis appears to be
smaller than usual. This anxiety, by reducing blood flow to the penis, increases
penile shrinkage, leading to a feedback loop of mounting anxiety. This feedback
loop is exacerbated when a koro epidemic is believed to be occurring.
The example of koro and other such culture bound disorders seems to be prob-
lematic from an evolutionary perspective. It is hard to see how catastrophic cog-
nitions and attentional biases directed at penile states is likely to further
reproductive goals (although no doubt some such story could be concocted).
Moreover, the culture specific nature of koro seems to implicate the role of more
general and culturally idiosyncratic patterns of belief. However, we argue that
the adaptive nature of anxiety has both more general and specific characteristics (see
Marks & Nesse, 1994, for a similar perspective), and nicely illustrates the
complementary role of evolutionary and cultural factors. Because what is harmful
and threatening in the environment is, in some cases, specific to given times

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