Ataque de Nervious
Cult Med Psychiatry (2010) 34:219–243
DOI 10.1007/s11013-010-9177-8
ORIGINAL PAPER
Association of Trauma-Related Disorders and Dissociation with Four Idioms of Distress
Among Latino Psychiatric Outpatients
´
Roberto Lewis-Fernandez • Magdaliz Gorritz •
´
Greer A. Raggio • Clara Pelaez • Henian Chen •
Peter J. Guarnaccia
Published online: 23 April 2010
Ó Springer Science+Business Media, LLC 2010
Abstract Past research on idioms of distress among U.S. Latinos has revealed that ataque de nervios and altered perceptions, such as hearing and seeing things when alone, are independent markers of higher morbidity and mental health utilization despite having no one-to-one relationships with any single psychiatric diagnosis.
It has been proposed that the idioms exert this effect because they are signs of distressing dissociative capacity associated with traumatic exposure. This study examines the relationships in an ethnically diverse Latino psychiatric outpatient sample (N = 230) among interpersonal trauma, posttraumatic stress disorder
(PTSD), major depressive disorder, dissociative capacity and four cultural idioms of distress associated with the popular overall category of nervios. We particularly explore how these relationships change with varied measures of traumatic exposure, including trauma severity and timing or persistence of trauma. A series of adjusted bivariate regressions assessed the matrix of associations between the idioms and the clinical variables. In this highly traumatized population, we identified a strong
‘nexus’ of associations between dissociation and three of the idioms: currently being
´
R. Lewis-Fernandez (&) Á M. Gorritz Á G. A. Raggio
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA e-mail: rlewis@nyspi.cpmc.columbia.edu
´
R. Lewis-Fernandez
Department of Psychiatry, Columbia College of Physicians & Surgeons, New York, NY, USA
´
C. Pelaez
Hospital Puerta de Hierro,
DOI 10.1007/s11013-010-9177-8
ORIGINAL PAPER
Association of Trauma-Related Disorders and Dissociation with Four Idioms of Distress
Among Latino Psychiatric Outpatients
´
Roberto Lewis-Fernandez • Magdaliz Gorritz •
´
Greer A. Raggio • Clara Pelaez • Henian Chen •
Peter J. Guarnaccia
Published online: 23 April 2010
Ó Springer Science+Business Media, LLC 2010
Abstract Past research on idioms of distress among U.S. Latinos has revealed that ataque de nervios and altered perceptions, such as hearing and seeing things when alone, are independent markers of higher morbidity and mental health utilization despite having no one-to-one relationships with any single psychiatric diagnosis.
It has been proposed that the idioms exert this effect because they are signs of distressing dissociative capacity associated with traumatic exposure. This study examines the relationships in an ethnically diverse Latino psychiatric outpatient sample (N = 230) among interpersonal trauma, posttraumatic stress disorder
(PTSD), major depressive disorder, dissociative capacity and four cultural idioms of distress associated with the popular overall category of nervios. We particularly explore how these relationships change with varied measures of traumatic exposure, including trauma severity and timing or persistence of trauma. A series of adjusted bivariate regressions assessed the matrix of associations between the idioms and the clinical variables. In this highly traumatized population, we identified a strong
‘nexus’ of associations between dissociation and three of the idioms: currently being
´
R. Lewis-Fernandez (&) Á M. Gorritz Á G. A. Raggio
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA e-mail: rlewis@nyspi.cpmc.columbia.edu
´
R. Lewis-Fernandez
Department of Psychiatry, Columbia College of Physicians & Surgeons, New York, NY, USA
´
C. Pelaez
Hospital Puerta de Hierro,