Culture and Panic Disorder

By Devon E. Hinton; Byron J. Good | Go to book overview

6
Comparative Phenomenology of 'Ataques de
Nervios,' Panic Attacks, and Panic Disorder

Roberto Lewis-Fernández, Peter J. Guarnaccia, Igda E. Martínez, Ester Salmán, Andrew B. Schmidt, and Michael Liebowitz

THIS VOLUME PRESENTS an opportunity to use anthropological research on panic-like episodes to expand psychiatric understandings of panic disorder and to raise issues concerning the cross-cultural applicability of Diagnostic and Statistical Manual (DSM) diagnoses. The tension between psychiatric universalism and cultural specificity has been only partially examined for the anxiety disorders. Good and Kleinman's 1985 chapter “Culture and Anxiety” sets out the issues with which we grapple today: “The cross-cultural research … makes it abundantly clear that anxiety and disorders of anxiety are universally present in human societies. It makes equally clear that the phenomenology of such disorders, the meaningful forms through which distress is articulated and constituted as social reality varies in quite significant ways across cultures” (Good and Kleinman 1985:298).

Since we began our research on ataques de nervios, the question of the relationship between ataques and panic have both informed and haunted our efforts. One of the issues we have explored both epidemiologically and clinically is the relationship between experiencing an ataque de nervios and meeting the criteria for panic disorder (along with other psychiatric diagnoses). At the same time, since the beginning of our work and continuing to the present, many investigators and clinicians have assumed that ataques de nervios are just a cultural label that Puerto Ricans and other Latinos use for panic attacks, often with the assumption that Latinos are misinformed about their own experience when they use the term ataque de nervios.

Our research benefits from a close working relationship with Dr. Byron Good, coeditor of this volume. The work of this chapter's two senior authors on the

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