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Association of trauma-related disorders and dissociation with four idioms of distress among Latino psychiatric outpatients.
Cult Med Psychiatry. 2010 Jun; 34(2):219-43.CM

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 ill with nerves, ataque de nervios and altered perceptions. These idioms were largely independent from PTSD and depression and were associated with trauma persistence and severity. A fourth idiom, being nervous since childhood, was not associated with any other variable and may represent a personality trait rather than a diagnosable condition. Our results validate the clinical utility of the construct of nervios as a set of specific idioms associated with dissociation that are useful markers of mental health need among Latinos independently of their association with clinical diagnoses.

Authors+Show Affiliations

New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA. rlewis@nyspi.cpmc.columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20414799

Citation

Lewis-Fernández, Roberto, et al. "Association of Trauma-related Disorders and Dissociation With Four Idioms of Distress Among Latino Psychiatric Outpatients." Culture, Medicine and Psychiatry, vol. 34, no. 2, 2010, pp. 219-43.
Lewis-Fernández R, Gorritz M, Raggio GA, et al. Association of trauma-related disorders and dissociation with four idioms of distress among Latino psychiatric outpatients. Cult Med Psychiatry. 2010;34(2):219-43.
Lewis-Fernández, R., Gorritz, M., Raggio, G. A., Peláez, C., Chen, H., & Guarnaccia, P. J. (2010). Association of trauma-related disorders and dissociation with four idioms of distress among Latino psychiatric outpatients. Culture, Medicine and Psychiatry, 34(2), 219-43. https://doi.org/10.1007/s11013-010-9177-8
Lewis-Fernández R, et al. Association of Trauma-related Disorders and Dissociation With Four Idioms of Distress Among Latino Psychiatric Outpatients. Cult Med Psychiatry. 2010;34(2):219-43. PubMed PMID: 20414799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of trauma-related disorders and dissociation with four idioms of distress among Latino psychiatric outpatients. AU - Lewis-Fernández,Roberto, AU - Gorritz,Magdaliz, AU - Raggio,Greer A, AU - Peláez,Clara, AU - Chen,Henian, AU - Guarnaccia,Peter J, PY - 2010/4/24/entrez PY - 2010/4/24/pubmed PY - 2010/9/3/medline SP - 219 EP - 43 JF - Culture, medicine and psychiatry JO - Cult Med Psychiatry VL - 34 IS - 2 N2 - 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 ill with nerves, ataque de nervios and altered perceptions. These idioms were largely independent from PTSD and depression and were associated with trauma persistence and severity. A fourth idiom, being nervous since childhood, was not associated with any other variable and may represent a personality trait rather than a diagnosable condition. Our results validate the clinical utility of the construct of nervios as a set of specific idioms associated with dissociation that are useful markers of mental health need among Latinos independently of their association with clinical diagnoses. SN - 1573-076X UR - https://www.unboundmedicine.com/medline/citation/20414799/Association_of_trauma_related_disorders_and_dissociation_with_four_idioms_of_distress_among_Latino_psychiatric_outpatients_ L2 - https://doi.org/10.1007/s11013-010-9177-8 DB - PRIME DP - Unbound Medicine ER -