The Experience of Asthma, Panic, and Ataques de Nervios Among Latinos
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Abstract
Introduction: Various studies have reported a wide range of psychiatric comorbidity with the culture-bound syndrome ataques de nervios. Ataques de nervios has been described as an idiom of distress primarily among Latinos from the Caribbean, and are often compared to panic disorder throughout the psychiatric literature. Latinos from the Caribbean and Puerto Ricans in particular, additionally exhibit high rates of asthma. Asthma and panic disorder co-occur at greater rates than would be expected from chance. Methods: Given the high comorbidity and overlapping symptomotology of asthma, panic, and ataques de nervios , the present study qualitatively assessed the experience of all three disorders among a sample of 20 Latino adults. Five focus groups were conducted and data were analyzed for themes of the experience of ataques de nervios among Latinos with asthma and panic. Participants additionally engaged in a baseline session to assess severity of asthma and panic. Results: Theory generation suggested that a) the sense of loss of control manifests physically in panic disorder and emotionally in ataques within this population of Latinos with asthma and panic disorder b) a difference in the experience of emotional and behavioral symptoms exists between more and less acculturated individuals, whereby more highly acculturated individuals experience anger as central to ataques while less acculturated individuals endorse experiencing dissociative symptoms and c) the symptoms of ataques are likely not confused with asthma in the same way as panic disorder. Discussion: Results suggest that ataques de nervios is experienced by Latinos with asthma and panic as an experience distinct from both asthma and panic. Several differentiating factors including anger, dissociation, urges to escape, and loss of control are addressed. These differences in the conceptualization and experience of ataques may signify a shift in conceptualization of the presentation of ataques as Latinos become increasingly acculturated.