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Transcultural Psychiatry
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A Qualitative Study of Clinicians’ Use of the Cultural Formulation Model in Assessing Posttraumatic Stress Disorder

Lisa R. Fortuna

University of Massachusetts Medical School, lisa.fortuna{at}umassmed.edu

Michelle V. Porche

Wellesley Centers for Women, Wellesley College

Margarita Alegría

Cambridge Health Alliance and Harvard Medical School

The Cultural Formulation (CF) of the Diagnostic and Statistical Manual (DSM) provides a potential framework for improving the diagnostic assessment of Posttraumatic Stress Disorder (PTSD) in culturally diverse patients. We analyzed data from the Patient-Provider Encounter Study, a multi-site study that examines the process of diagnosis and clinical decision-making during an initial clinical intake session, in order to examine use of CF for PTSD diagnosis. We find that while the CF is generally used inconsistently or underutilized in routine community settings, when employed appropriately it may assist the formulation and interpretation of traumatic experiences. We discuss the implications for improving the assessment of PTSD in the time-limited setting of the clinical intake encounter and across race/ethnicity.

Key Words: clinical decision making • cross-cultural diagnosis • cultural formulation model • posttraumatic stress disorder • trauma

Transcultural Psychiatry, Vol. 46, No. 3, 429-450 (2009)
DOI: 10.1177/1363461509342948
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