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Nervios'
Nervios is a common idiom of distress among Latinos in Latin America and the United States. Other ethnic groups have related to this idiom. Ideas of "nerves" have been found in other cultures, such as nerva found in Greeks in North America. Nervios refers both to a state of vulnerability due to stressful life experiences and, also, to a syndrome brought on by difficult life circumstances. While some may refer to nervios simply as stress. The term nervios refers to a wide range of somatic disturbances, symptoms of emotional distress, and the inability to function.

Further Defining
Ataque de nervios ("attack of nerves") is an illness category used frequently by Hispanic individuals to describe one or more particular symptom complexes. A review of the literature on ataque suggested some overlap with panic disorder. This study investigated the overlap with panic disorder as well as other DSM-III-R axis I disorders.

Causes of Nervios
Causes of nervios by gender may be head pain (headache), despair, desperation, facial pain, trembling, anger, anxiety, twitching, stomach pain, high blood pressure, body pain, sensations of itching, insomnia, violence, loud noises, leg and arm pain, low blood pressure, breathing issues, nausea, and numbness.

Nervios is a culture-bound syndrome disorder and is specific to a culture. As the United States has increased in cultural plurality, culture-bound syndromes are more relevant to the mental health fields and demand more attention from mental health professionals and clinicians. Individual Psychology conceptualizes psychopathology from a teleological, socially embedded, and singular perspective where social interest and the lifestyle are relevant constructs. Social interest explains the manner in which a person belongs and describes the nature of his or her contributions to the group and humanity. The lifestyle sets the tone for the life tasks and exposes a person's singular approach toward living. Both constructs are relevant to address culture and the psychiatric syndromes included within its parameters. The authors describe culture-bound syndromes as the merge between psychology, psychiatry, and anthropology. To illustrate the merge among the aforementioned disciplines, the authors describe the case of a woman who suffered from ataque de nervios. [3]

Latin America
Nervios: (Latin America) Idiom of distress, refers to a general state of vulnerability to stressful life experiences and to a syndrome brought on by such stresses. Symptoms may be very broad, but commonly include emotional distress, headaches, irritability, stomach disturbances, sleep disturbances, nervousness, easy tearfulness, inability to concentrate, tingling sensations, and dizziness. Similar to nevra (Greece).

Ataque de nervios (“attack of nerves”) is a culturally defined Latino syndrome usually triggered by acute stress and typically characterized by paroxysms of uncontrollable shouting and crying, trembling, palpitations, and aggressiveness (1, 2). Although it has a prevalence of 13.8% in Puerto Rico and is considered normal by many Latinos, ataque is often associated with mood and anxiety disorders (1). Case reports suggesting that dissociative symptoms are a primary feature of ataque have never been investigated systematically. These symptoms include depersonalization, amnesia, identity alteration, and trancelike states (2). In addition, although ataque has been linked to childhood trauma (3), the relationship between exposure to trauma and dissociation among ataque sufferers has not been explored.

Case Reports
Although there have been detailed descriptions of nervios from case reports and from specific regions, few attempts have been made to compare descriptions of the illness across cultures. Nervios is often glossed as “nervousness” or “anxiety” (Trotter 1982), although it is not synonymous with formal definitions of anxiety, nor is it generally recognized by biomedical practitioners. Low (1985) attempted to compare published descriptions of nervios in different populations, but found that methodological differences in how individual studies were conducted made generalizations difficult. She suggested, however, that the similarity between nervios and susto (a folk illness glossed as fright or shock) might mean that they were both expressions of distress, but labeled differently by different segments of the population. As such, unresolved issues include whether the term nervios means the same thing in different cultural contexts, and the extent to which nervios and susto represent similar or distinct illness entities.

Not simply part of the exotica of different cultures, folk illnesses have been linked to morbidity and mortality. Susto is associated with an increased risk of comorbidities and a higher mortality rate (Baer and Bustillo 1993; Baer and Penzell 1993; Rubel et al. 1984) and nervios is now noted in the DSM-IV (American Psychiatric Association 1994: Appendix 1). The study of these folk illnesses in relation to physiological symptoms has not been for the purpose of reducing the folk illnesses to their biomedical equivalents, but rather to understand the meaning of these ethnomedical diagnoses for increasing risk of morbidity and mortality.

Susto has been linked with increased morbidity (Baer and Penzell 1993) and mortality (Rubel et al. 1984), therefore if nervios and susto are really just different names for the same problem, nervios sufferers may similarly be at increased health risk.

A study investigated the overlap with panic disorder as well as other DSM-III-R axis I disorders.

METHOD: Hispanic subjects seeking treatment at an anxiety disorders clinic (N = 156) were assessed with a specially designed questionnaire for self-report of ataque de nervios and panic symptoms and with structured or semistructured psychiatric interviews for axis I disorders.

RESULTS: Seventy percent of the subjects reported at least one ataque de nervios; 80% of these were female, whereas 57% of the group without these attacks were female. There were no differences in DSM-III-R diagnoses between the groups with and without ataque de nervios. Ataque was frequently associated with one or more anxiety and affective disorders, including panic disorder, generalized anxiety disorder, recurrent major depression, and anxiety not otherwise specified. Of the subjects with both ataque de nervios and primary panic disorder, 80% appeared to have labeled panic disorder as ataque. Liebowitz, MR, Salman, E, Jusino, CM, Garfinkel, R, Street, L, Cardenas, DL, Silvestre, J, Fyer, AJ, Carrasco, JL, Davies, S Ataque de nervios and panic disorder Am J Psychiatry 1994 151: 871-875 45

PHENOMENOLOGIES OF ATAQUES DE NERVIOS, PANIC ATTACKS, AND PANIC DISORDER
In order to carry out a valid comparison with ataque, it is important to distinguish at the outset between panic attacks and panic disorder, sin''ce these two psychiatric entities are likely to bear different relationships to ataque de nervios''. A separate category for panic attacks was first established in DSM-IV (American Psychiatric Association 1994), based on the recognition that these episodes can occur in the context of several psychiatric diagnoses, not just panic disorder (Liebowitz 1996). For example, persons suffering from social phobia often experience panic attacks when confronted with a dreaded social situation, such as public speaking. Because these panic attacks are not unexpected in that person, they are considered “cued,” and do not merit a separate panic disorder diagnosis. Likewise, sudden episodes of acute anxiety that correspond to the clinical phenomenology of panic attacks and that occur in situations which would be frightening to anyone (e.g., military combat) are still labeled panic attacks, but because they are not considered unexpected, they also would not be diagnosed as panic disorder. Thus, the first criterion of panic disorder as defined in DSM-IV is the presence of panic attacks that arise recurrently and unexpectedly, that is, in more than one unexpected situation. The notion is of a bodily danger signal gone wrong, like a “fire alarm when there is no fire”; this definition demarcates panic disorder from other psychiatric diagnoses and also highlights the presumed biological nature of the disorder.

Ataque, on the other hand, is paradigmatically a reaction to a stressful situation, such as family conflict or some other very troubling event, and therefore typically “cued,” and thus conceptually distinct from panic disorder. The similarity to panic attacks, however, does not hinge on the issue of whether the episode is unexpected, but rather on the phenomenological relationship between the two categories. That is, from an empirical standpoint, how well do ataques meet the other formal characteristics of panic attacks, such as rapid peaking of symptoms (“crescendo”) or displaying a minimum of four symptoms out of a predefined list of thirteen? The empirical overlap between ataque de nervios and panic attacks and disorder is what we set out to discover in the study discussed in this article. First, however, we turn to the results of previous studies on the panic-ataque relationship.

'Ataque de nervios'' has also been defined as a sudden episode of crying, uncontrollable shouting, heat in the chest rising to the head, verbal and physical aggression, and trembling, generally precipitated by a stressful situation. Ataque de nervious is a sense of being out of control. The syndrome is specific to,. ..