Medical Practice in Response to a Folk Illness: The Diagnosis and Treatment of Nervios in Costa Rica

Low, Setha M.

doi:10.1007/978-94-009-2725-4_16

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Her description referred to periodic lack of energy and listlessness, loss of motivation, and feelings of helplessness following a frightening experience. The CBS symptoms outlined by the present subjects generally conform to the accounts previously recorded in the anthropological literature on the subject (Low, 1988;Paniagua, 2000;Rubel, 1985). The symptoms elicited by the individual suffering from ''falling out'' are also similar to those recently published for a related condition in Spanish-speaking cultures called ''debilidad'' (Oths, 1999) and a culture-bound disorder in Italy called ''malocchio'' (Quave and Pieroni, 2005).…”

Section: Resultssupporting

confidence: 87%

Epidemiological profile of an urban immigrant population

Halberstein

2011

International Journal of Migration, Health and Social Care

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Purpose -The health status and medical care of migrant populations is an increasingly important topic in light of the recent emergence of a number of global epidemics. This paper aims to investigate the prevalence of diseases, injuries, and other health problems in the Caribbean-American population of Miami, Florida.Design/methodology/approach -A sample of 290 Caribbean-born permanent adult residents of Miami, representing 17 different Caribbean countries of origin, was interviewed at three health clinics regarding current health problems and treatments. Demographic data were also collected.Findings -In total, 38 percent of the respondents indicated past or current health problems requiring professional medical care, while an additional 7 percent engaged in self-care. The 62 different reported conditions ranged from lung cancer to ulcers, kidney stones, clinical depression, scoliosis, and diverticulitis. The most frequently stated disorders were hypertension, asthma, diabetes, cardiovascular disease, and arthritis. Anti-hypertensives, cardiac modifiers, and analgesics accounted for the majority of the 26 reported prescription medications. A smaller number indicated the usage of chemotherapy, insulin, allergy medicines, and other individualized prescriptions. A total of 62.5 percent of the respondents employed traditional medicinal plants for preventive and therapeutic care or to supplement biomedicines in the treatment of culture-bound syndromes.Research limitations/implications -The epidemiological profile of this sample suggests a positive correlation between genetically-influenced degenerative disorders and urbanization.Originality/value -This research reveals the health profile of a previously unstudied population and hopefully will guide future treatment plans for this and similar communities.

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Section: Resultssupporting

confidence: 87%

Epidemiological profile of an urban immigrant population

Halberstein

2011

International Journal of Migration, Health and Social Care

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“…The diagnosis, treatment, and study of mental illness among Puerto Rican and other Hispanic populations are vexed by uncertainty and debate surrounding issues such as cultural patterning of symptoms and confusion/confounding/conflation of culturally normative behavior with Western (bio-medical) stipulations of symptomatic behavior (Angel & Guarnaccia, 1989; Guarnaccia, 1993; Guarnaccia & Farias, 1988; Jenkins, 1988; Lewis Fernandez & Kleinman, 1994; Mukherjee, Shukla, Woodle, Rosen & Olarte, 1983; Rogler, Cortes & Malgady, 1994; Swerdlow, 1992);the role of espiritismo in informing folk conceptions, and therefore the phenomenology, of disease etiology, symptomatology, diagnosis, and treatment within the Hispanic milieu (Gaviria & Wintrob, 1976; Harwood, 1977; Singer & Borrero, 1984;the impact on Western biomedical (differential) diagnosis of Hispanic illness conceptions, nosology, and behavior (e. g., nervios, ataques de nervios, problemas emotional, fallo mental, locura/loco) (Guarnaccia, Rubjo-Stipec & Canino, 1989; Guarnaccia, Good & Kleinman, 1990; Low, 1988); andHispanic (i. e., Puerto Rican) cultural/social structure and its roles in socioeconomic support and rehabilitation of members who are deemed seriously mentally ill (Guarnaccia, Parra, Deschamps, Milstein & Argiles,1992; Lefley, 1989; Pelto, Roman & Liriano, 1982; Schensul & Schensul, 1982; Zayas and Palleja, 1988). …”

Section: Introductionmentioning

confidence: 99%

“…the impact on Western biomedical (differential) diagnosis of Hispanic illness conceptions, nosology, and behavior (e. g., nervios, ataques de nervios, problemas emotional, fallo mental, locura/loco) (Guarnaccia, Rubjo-Stipec & Canino, 1989; Guarnaccia, Good & Kleinman, 1990; Low, 1988); and…”

Section: Introductionmentioning

confidence: 99%

An ethnographic study of vocational rehabilitation for Puerto Rican Americans with severe mental illness.

Alverson¹,

Vicente²

1998

Psychiatric Rehabilitation Journal

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“…Despite the abundant literature on CCDs in Latin America, there are few studies that systematically examine issues of stigma toward CCDs. While CCDs, such as ataque de nervios and nervios, may face less stigma because they are socially recognized and sanctioned expressions of distress (Cintro ´n et al, 2005;Low, 1988), there are also several ways that CCDs may address "what matters most" that reduce stigmatization. For example, CCDs often involve the somatization of mental distress which may reduce the stigma of mental disorders by focusing on physical ailments, particularly in collectivist societies where expressions of mental distress may place blame on social relationships (Kleinman, 1977).…”

mentioning

confidence: 99%

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

Maupin,

Driese,

Pezzia

2024

Stigma and Health

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Stigma toward psychiatric disorders is documented worldwide. While the extent of stigma may vary within and between contexts, stigma toward psychiatric conditions is frequently driven by labeling, perceptions of violence, notions of causation, and behaviors associated with different conditions. However, as stigma attacks "what matters most," interpretations of mental health may depend on sociocultural values and structures which require attention to cultural concepts of distress (CCDs). Most ethnographic studies argue that CCDs are not as stigmatized as psychiatric disorders as they represent culturally recognized and acceptable mechanisms for individuals to express experiences of suffering, critique social structures and relations, and call for social support. Yet, few studies systematically analyze stigma toward CCDs, or compare it to stigma toward psychiatric disorders. In this article, we examine factors that influence stigma toward three psychiatric disorders (alcohol use disorder [AUD], major depression, and schizophrenia) and three CCDs (ataque de nervios, nervios, and susto) among a sample of women in a Highland Guatemalan town. Using a survey design, we evaluate the impact of different factors on preferences for social distance relating to standardized vignettes for each condition. Results suggest that there is greater stigma toward AUD and schizophrenia while ataque de nervios and nervios are less stigmatized compared to a "troubled person" baseline. Notions of labeling, causation, and violence influence the significance of these differences. This study emphasizes the need to understand how CCDs and psychiatric disorders are differentiated in public perception and how sociocultural values, norms, and structures shape expressions of stigma. Clinical Impact StatementIn this study, we test the hypothesis that cultural concepts of distress are less stigmatized in Latin America than psychiatric disorders. Using a series of standardized vignettes for different conditions, we measure the factors influencing preferences for social distance. We find that some CCDs, like ataque de nervios and nervios, are less stigmatized and that factors including labeling something a mental disorder, notions of causation, and perceptions of violence influence participants' willingness for social interaction. This study contributes to the understanding of how cultural values, norms, and structure shape expressions of mental health stigma.

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Medical Practice in Response to a Folk Illness: The Diagnosis and Treatment of Nervios in Costa Rica

Cited by 6 publications

References 27 publications

Epidemiological profile of an urban immigrant population

Epidemiological profile of an urban immigrant population

An ethnographic study of vocational rehabilitation for Puerto Rican Americans with severe mental illness.

Cultural concepts of distress, psychiatric disorders, and social distance: Measuring mental health stigma in Guatemala.

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