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

Abstract

Ataque de nervios (ATQ) and padecer de nervios (PNRV) 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. ATQs are acute experiences involving both typical and atypical panic symptoms, whereas PNRV 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 ATQ/PNRV, 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 ATQ and PNRV 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 ATQ/PNRV. Study 2 explored the meanings of ATQ and PNRV among a sub-sample of respondents with positive histories of ATQ/NRV. In Study 1, survey batteries were administered to the full sample (N = 82). In Study 2, a semi-structured psychiatric interview and a qualitative interview about general beliefs of ATQ/NRV were administered to the sub-sample (n = 22). Hierarchical logistic and linear regression analyses and thematic content analysis were used. Results from Study 1 indicate that lifetime ATQ and PNRV were related experiences that were not consistently predictive of distress, with the exception of PNRV which was associated with psychological distress. Acculturation was not observed to be a statistically significant predictor of ATQ/PNRV. Results from Study 2 suggest that ATQ and PNRV are not statistically associated with psychiatric disorder. There was also no clear and consistent majority consensus on the signs, symptoms, and causes of ATQ and PNRV. Thus, ATQ and PNRV 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.