Academic journal article Advances in Mental Health

Coraje, Nervios, and Susto: Culture-Bound Syndromes and Mental Health among Mexican Migrants in the United States

Academic journal article Advances in Mental Health

Coraje, Nervios, and Susto: Culture-Bound Syndromes and Mental Health among Mexican Migrants in the United States

Article excerpt

INTRODUCTION

The DSM-IV-TR [Diagnostic and Statistical Manual of Mental Disorders, IV (i.e. Fourth Edition) Text Revision] (APA, 2000), in the Glossary of Cultural-Bound Syndromes, states 'the term culture-bound syndrome denotes recurrent, locality-specific patterns of aberrant behavior and troubling experience that may or may not be linked to a particular DSM-IV diagnostic category [and] are generally limited to specific societies or culture areas' (p. 898). This diagnostic consideration has significant implications for multicultural societies worldwide. In the United States (US) for example, Hispanics or Latinos comprise 48.4 million or 15.8% of the total US population, making them the largest ethnic minority group in the US (US Census Bureau, 2010). About 31.7 million or 65.5% of Latinos come from Mexican origins; of these, about 11.4 million were Mexican-born, which accounted for 29.6% of foreign-born residents in the US No other country in the world has as many total immigrants from all countries, as the United States has immigrants from Mexico alone (United Nations, 2009). Mexico is the country of origin of the vast majority of foreign-born residents in the US, with migrant communities from the Philippines and India a distant second and third at 1.7 million and 1.6 million residents respectively. More than half (55%) of the Mexicanborn residing in the US are present without legal authorisation, and on average Mexican migrants have lower levels of education and income, as well as higher poverty rates than other groups (Pew Hispanic Center, 2009).

Mexican migrants in the US are subject to the acculturative stressors that most migrants experience in their new environments, but they encounter additional stressors that accumulate to make them more vulnerable to mental distress (Finch, Frank, & Vega, 2004). In addition to their lack of education, material resources, and legal authorisation to be in the US, they also confront on a daily basis widespread expressions of anti-Mexican sentiment in the popular mass media and in everyday interactions (Caldwell, Couture, & Nowotny, 2008; Finch et al., 2004; Mines, Nichols, & Runsten, 2010). Taken together, these factors make Mexican migrants very susceptible to depression and other forms of mental distress (Alderete, Vega, Kolody, & Aguilar-Gaxiola, 1999; Caldwell, et al., 2008; Finch, et al., 2004; Mines, et al., 2010).

Research, however, shows great disparities in mental health service utilization by the Mexicanorigin and especially the Mexican-born population (Aguilar-Gaxiola, et al., 2002; Surgeon General, 2001; Caldwell, et al., 2008; Vega, Kolody, Aguilar-Gaxiola, & Catalano, 1999). Some research accounts for these disparities by asserting that the protective strength of Mexican extended family bonds, often referred to as familismo (familism) may account for their low utilization of mental health services (Baer, 1996; Caldwell et al., 2008). Other research suggests that Mexican migrants experience mental health problems in a different manner than the mainstream US population, as their cultural background can influence every aspect of the illness experience, from linguistic construction to the content of delusions (Alegria, 2004; Bade, 2004; Baer, 1996). Mexican migrants may present symptoms, which are not part of the mainstream nosology, and that may only partially overlap the diagnostic construct being assessed. For example, nervios is an idiom of distress prominent among Mexican migrants, which may be strongly related to clinical depression. A recent development that adds to the complexity of understanding how Mexican migrants conceptualise mental and emotional distress is that since the 1980s, the number and diversity of migrants entering the US from southern Mexico who are of Indigenous origin has rapidly increased (Aguirre International, 2005; Fox & Rivera-Salgado, 2004; Gabbard, Kissam, et al., 2008; Holmes, 2006; Huizar Murillo & Cerda, 2004; Mines et al. …

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