Dissociation, Childhood Trauma, and<i>Ataque De Nervios</i>Among Puerto Rican Psychiatric Outpatients

Lewis‐Fernández, Roberto; Garrido-Castillo, Pedro; Bennasar, Mari Carmen; Parrilla, Elsie M.; Laria, Amaro J.; Ma, Guoguang; Petkova, Eva

doi:10.1176/appi.ajp.159.9.1603

Cited by 78 publications

(62 citation statements)

References 9 publications

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“…Ataque phenomenology may contribute to the salience in Caribbean Latinos of trembling, uncontrollable crying and/or screaming, aggressive or suicidal behavior, and depersonalization/derealization symptoms, during acute anxiety episodes that meet PA criteria. [25,36,38] Finally, feelings of heat in specific parts of the body (head, chest, neck) are common across several cultural groups during PAs and are not well captured by the phrase "hot flushes," which suggest full body heat sensations. [26,30] Fifty-three percent of ataques, for example, are characterized by "a sense of heat rising in the chest."…”

Section: Panic Attackmentioning

confidence: 99%

“…In many cultures, PAs are expected after traumatic exposures, reducing the likelihood that these attacks would meet PD criteria, as they would be attributed to the traumatic experience. [26,38] Postattack negative sequelae of at least one month duration: In one study, 80% of Caribbean Latino psychiatric outpatients with ataques de nervios endorsed at least one of the three postattack sequelae included in PD criterion A2, [36] suggesting that this criterion adequately captures the consequences of a panic-like episode in this cultural group. However, more research is necessary on its cross-cultural validity.…”

Section: What Is the Cross-cultural Validity Of Existing Panic Disordmentioning

confidence: 99%

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Culture and the Anxiety Disorders: Recommendations for DSM-V

Lewis‐Fernández¹,

Hinton²,

Laria³

et al. 2011

FOC

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Background-The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent "over-specification" of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria.

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Section: Panic Attackmentioning

confidence: 99%

Section: What Is the Cross-cultural Validity Of Existing Panic Disordmentioning

confidence: 99%

Culture and the Anxiety Disorders: Recommendations for DSM-V

Lewis‐Fernández¹,

Hinton²,

Laria³

et al. 2011

FOC

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“…That is, a Puerto Rican patient may experience dissociation in this culturally specific form. One recent study [Lewis-Fernández et al, 2002] of 29 Puerto Rican patients found the severity of dissociation (as assessed by the Dissociative Experiences Scale [DES]) to be significantly associated with the lifetime frequency of ataque de nervios.…”

Section: Introductionmentioning

confidence: 99%

Ataque de nervios: relationship to anxiety sensitivity and dissociation predisposition

et al. 2008

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We investigated the relative importance of "fear of arousal symptoms" (i.e., anxiety sensitivity) and "dissociation tendency" in generating ataque de nervios. Puerto Rican patients attending an outpatient psychiatric clinic were assessed for ataque de nervios frequency in the previous month, and they completed the Anxiety Sensitivity Index (ASI) and the Dissociation Experiences Scale (DES). ASI scores were especially high in the ataque-positive group (M=41.6, SD=12.8) as compared with the ataque-negative group (M=27.2, SD=11.7), t(2, 68)=4.6, P<.001. Among the whole sample (N=70), in a logistic regression analysis, the ASI significantly predicted (odds ratio=2.6) the presence of ataque de nervios, but the DES did not. In a linear regression analysis, ataque severity was significantly predicted by both the ASI (beta=.46) and the DES (beta=.29). The theoretical and clinical implications of the strong relationship of the ASI to ataque severity are discussed.

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“…The idea is to emphasize the fragmentation of identity, memory, and consciousness but to add several features: the disruptive effect of such symptoms on consciousness and a broader definition of symptoms (including examples from non-Western cultures, such as possession; Dell, 2002;Korol, 2008;Lewis-Fernandez et al, 2002). Amnesia would continue to be a diagnostic requirement.…”

Section: Spiegelmentioning

confidence: 99%