Culture-Bound Syndromes: Racial/Ethnic Differences in the Experience and Expression of Ataques de nervios

摘要

Culture-bound syndromes have proven to be significant indicators for social and psychiatric vulnerability for specific racial/ethnic minorities. However, the diagnostic criteria for these syndromes often fail to adequately address important historical and social circumstances that influence immigrant health. While culture plays a significant role in influencing the etiology and the symptom expression of certain disorders, the immigrant context is also an important indicator of mental health outcomes. In particular, factors such as English proficiency, generational status, and age at time of immigration can influence how they experience and express mental illness. The present study used logistic regression to assess the relationships among ethnicity and immigration-integration characteristics on the outcome of culture-bound syndromes from the National Latino and Asian American Study (NLAAS, n = 4528). Differences in racial/ethnic groups and immigration-integration factors were found. Compared to Filipinos and other Asians, Latinos had higher odds of reporting ataques de nervios. There were associations between ataques de nervios with age of immigration, generation, and English proficiency. Further, there was effect modification between English proficiency and ethnicity: Filipinos with limited English proficiency were associated with greater odds of reporting ataques de nervios as compared to Latinos and other Asians. Filipinos with excellent or good English proficiency were associated with decreased odds of reporting ataques de nervios as compared to Latinos and other Asians. The Latinos in our sample demonstrated an inverse relationship to Filipinos in their reports of ataques de nervios, while all other Asians reported similar levels of ataques de nervios at both levels of English proficiency. Culture-bound syndromes can serve as helpful indicators for identifying mental health needs in marginalized populations, but should be considered in the context of important historical, cultural, and social factors.