Do <italic>ataque de nervios</italic> and <italic> padecer de nervios</italic> function as culture-bound syndromes and markers of distress among Mexican immigrant mothers? A mixed-method analysis.

Abstract

<italic>Ataque de nervios (ATQ) and padecer de nervios (PNRV)</italic> are considered culture-bound syndromes with overlapping symptoms of anxiety, depression, and dissociation that are popularly endorsed among Latina/os from Latin America and the Caribbean. <italic>ATQs</italic> are acute experiences involving both typical and atypical panic symptoms, whereas <italic>PNRV</italic> appears to be a diffuse descriptor of nonspecific distress. These affective illnesses have inconsistent associations with mood and anxiety disorders, and vary in function and phenomenology by Latina/o ethnic group. Some researchers suggest that level of acculturation may be the most significant indicator of a tendency to present with <italic>ATQ/PNRV,</italic> but few empirical studies test this hypothesis. Through the use of mixed methods (i.e., integration of quantitative and qualitative methods), this two-study dissertation explores the extent to which <italic>ATQ</italic> and <italic>PNRV</italic> are culture-bound syndromes with identifiable signs and symptoms that are reliably associated with psychopathology and distress among a community sample of Mexican immigrant mothers. Study 1 examined the relationships between acculturative stress, U.S. American/Latino acculturation, anxious predispositions, psychological distress, and lifetime history of <italic>ATQ/PNRV.</italic> Study 2 explored the meanings of <italic>ATQ</italic> and <italic>PNRV</italic> among a sub-sample of respondents with positive histories of <italic>ATQ/NRV.</italic><super></super> In Study 1, survey batteries were administered to the full sample (<italic> N</italic> = 82). In Study 2, a semi-structured psychiatric interview and a qualitative interview about general beliefs of <italic>ATQ/NRV</italic> were administered to the sub-sample (<italic>n</italic> = 22). Hierarchical logistic and linear regression analyses and thematic content analysis were used. Results from Study 1 indicate that lifetime <italic>ATQ</italic> and <italic> PNRV</italic> were related experiences that were not consistently predictive of distress, with the exception of <italic>PNRV</italic> which was associated with psychological distress. Acculturation was not observed to be a statistically significant predictor of <italic>ATQ/PNRV.</italic> Results from Study 2 suggest that <italic>ATQ</italic> and <italic>PNRV</italic> are not statistically associated with psychiatric disorder. There was also no clear and consistent majority consensus on the signs, symptoms, and causes of <italic>ATQ</italic> and <italic>PNRV.</italic> Thus, <italic>ATQ</italic> and <italic>PNRV</italic> are better conceptualized as interrelated idioms of distress rather than patterned and culturally-bounded experiences of psychopathology. Implications for the study of culture-bound syndromes and psychiatric nosology are discussed.