Comparative Phenomenology of Ataques de Nervios,Panic Attacks,and Panic Disorder |
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Authors: | Lewis-Fernández Roberto Guarnaccia Peter J Martínez Igda E Salmán Ester Schmidt Andrew Liebowitz Michael |
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Institution: | (1) New York State Psychiatric Institute, Unit 69, 1051 Riverside Drive, New York, NY, 10032 |
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Abstract: | This article examines a clinicalsample of 66 Dominican and Puerto Ricansubjects who reported ataques de nerviosand also psychiatric disorder, and disentanglesthe phenomenological experiences of ataquede nervios, panic attacks, and panic disorder. In-depth cultural interviews assessed thesymptomatic phenomenology of ataqueepisodes from the local perspective as well asin terms of key panic features, such asrecurrence, rapid peaking of symptoms, and lackof provocation. Independent diagnosticassessments of panic attacks and disorder werealso used to establish the phenomenologicaloverlap between ataque and panic. Ourfindings indicate that 36 percent ofataques de nervios fulfill criteria for panicattacks and between 17 percent and 33 percentfor panic disorder, depending on the overlapmethod used. The main features distinguishingataques that fulfill panic criteria fromataques that do not include whether theepisodes were provoked by an upsetting event inthe person's life and the rapidity of crescendoof the actual attack. A key finding is thatataques often share individualphenomenological features with panic episodes,but that these features usually do not ``runtogether' during the ataque experience.This confirms previous findings thatataque is a more inclusive construct thanpanic disorder. The importance of thesefindings for the clinical diagnosis andtreatment of persons with ataques isdiscussed. |
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Keywords: | ataque de nervios cultural psychiatry Latinos panic disorder popular syndromes psychiatric phenomenology |
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