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Ataque de Nervios and History of Childhood Trauma
Authors:Daniel S. Schechter  Randall Marshall  Ester Salmán  Deborah Goetz  Sharon Davies  Michael R. Liebowitz
Affiliation:(1) New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY;(2) Division of Developmental Psychobiology, New York State Psychiatric Institute, Unit 40, 1051 Riverside Drive, New York, NY, 10032
Abstract:Objective: Ataque de nervios is a common, self-labeled Hispanic folk diagnosis. It typically describes episodic, dramatic outbursts of negative emotion in response to a stressor, sometimes involving destructive behavior. Dissociation and affective dysregulation during such episodes suggested a link to childhood trauma. We therefore assessed psychiatric diagnoses, history of ataque, and childhood trauma in treatment-seeking Hispanic outpatients (N = 70). Significantly more subjects with an anxiety or affective disorder plus ataque reported a history of physical abuse, sexual abuse, and/or or a substance-abusing caretaker than those with psychiatric disorder but no ataque. In some Hispanic individuals, ataque may represent a culturally sanctioned expression of extreme affect dysregulation associated with childhood trauma. Patients with ataque de nervios should receive a thorough traumatic history assessment.
Keywords:ataque de nervios  trauma  anxiety  cross-cultural  dissociation
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