Ataque de nervios

Despite comparisons to panic attacks, investigators have identified as a separate syndrome with measured differences in anxiety sensitivity, and types of attacks. Marlene Steinberg, an Associate Research Scientist at Yale University stated that because it is similar to Dissociative Identity Disorder, some Hispanics may be misdiagnosed with an syndrome instead. In Steinberg's case study of a 40-year old divorced Hispanic woman, she hypothesizes that the subject's varied presentations of dissociative symptoms throughout her ongoing treatment amounted to a way for her to manage past sexual, emotional, and psychological abuse at the hands of family members. Patricia Gherovici, psychoanalyst in private practice and founding member and director of the Philadelphia Lacan Study Group and Seminar, stated that the classification of the psychological disorder as Puerto Rican is considered derogatory given that individuals under study or afflicted by this condition feel stigmatized and unwillingly made part of a group by this terminology solely based on race, ethnicity, and geographical region. This classification may very well exacerbate the perception of this condition as pathological, rendering individual Puerto Rican individuals unable to bring themselves to rest. The Freudian approach posits that, given the cultural context, this syndrome is a subconscious manifestation of the individual's reliance, for self-identification, on a hypothetical observer that embodies authority and entitlement in society. Gherovici advocated for a cultural perspective in this syndrome's classification that sheds light on how the diverse histories of racial and class oppression manifest themselves. ==Symptoms==

Reported aspects of the syndrome include uncontrollable screaming or shouting, crying, trembling, sensations of heat rising in the chest and head, dissociative experiences, and verbal or physical aggression. There are also many similarities and differences between the syndrome's pattern of symptoms and those seen in panic disorder. Ataque impersonates features at varying degrees commonly seen in these other psychiatric disorders, such as accelerated heart rate, difficulty breathing and dizziness. This syndrome is broad and all-embracing in its features of other conditions whereas panic disorder, for instance, is more exclusive in its makeup. It does not involve intense fear. == History ==

Ataque de nervios was first mentioned after studies were conducted by US medical officers who focused on healthcare for Hispanic populations, particularly soldiers who were Puerto Rican and involved in the Korean War. The symptoms defining this diagnosis resembled hysteria, the form most commonly known for hundreds of years. Given that the psychiatric illness is bound to a particular geographical region, US psychiatrists categorized these symptoms "Puerto Rican syndrome." But, this unique designation transformed an otherwise everyday experience for Puerto Ricans. This problematic classification sheds light on the ethnocentric and stigmatizing nature of medical and health practices of the military complex, showing how US colonial powers exact control over marginalized populations. The military community has had an overwhelming influence on how mental disorders are named and classified in APA Diagnostic and Statistical Manuals (DSM), which demonstrates how its psychiatric practices have impacted the public sector. == Literary references ==

In Part 3 of Justin Torres' Blackouts, a main character by the name of Juan Gay recounts being diagnosed with "Puerto Rican syndrome." The 2023-nationally acclaimed investigative novel explores queer identity, the violent suppression and institutional violence against the LGBTQ+ community through the relationship between Juan, an old man who is battling illness in a remote dwelling called The Palace and an unnamed narrator--who Juan affectionately refers to by the Spanish nickname "Nene." Both met when they were admitted to a psychiatric hospital 10 years ago. Broken up into 6 parts, the narrative is interspersed with various multimedia elements, including historical photographs, documents, illustrations, as well as redacted excerpts from the 1941 medical book Sex Variants: A Study of Homosexual Patterns with varying degrees of connection to the story. Part 3 begins with an epigraph, directly quoting from Patricia Gherovici's book of cultural studies and psychoanalysis The Puerto Rican Syndrome. This section is intertwined with excerpts from articles, military medical reports on the condition that provide historical context that also shed light on the personal and social impact of the syndrome. We learn that Juan's condition was common to his family and may have led to him being committed to a psychiatric hospital as an adolescent. Torres' character shares more specific details that address the social stressors that led to his eldest sister's violent tremors, expressing his wish that their parents show him the same quality of attention in caring for their daughter. Both Juan and the unnamed narrator discuss the connection between the Sex Variants study and the psychopathological studies done on the syndrome, entertaining the theory that both were forms of retaliation against the LGBTQ+ community and the growing migration of Puerto Ricans to the US mainland in the 1950s. == Works ==

• Women on the Verge of a Nervous Breakdown, Spain, 1988 • Blackouts (novel), United States, 2023 ==See also==