Culture, Medicine and Psychiatry

, Volume 27, Issue 3, pp 339–366

Toward a Puerto Rican Popular Nosology: Nervios and Ataque de Nervios


  • Peter J. Guarnaccia
    • Institute for Health, Health Care Policy, and Aging ResearchRutgers University
  • Roberto Lewis-Fernández
    • Anxiety Disorders Clinic and Hispanic Treatment ProgramNew York State Psychiatric Institute and Columbia University
  • Melissa Rivera Marano
    • Graduate School of Applied and Professional Psychology, and, Institute for Health, Health Care Policy, and Aging ResearchRutgers University

DOI: 10.1023/A:1025303315932

Cite this article as:
Guarnaccia, P.J., Lewis-Fernández, R. & Marano, M.R. Cult Med Psychiatry (2003) 27: 339. doi:10.1023/A:1025303315932


This paper is about naming illnesses—about who determines what categories are used and the implications of these determinations. The central concerns of medical/psychiatric anthropology have been to understand popular categories of and systems for classification of illness, to examine the relationship of illness categories to cultural understandings of the body, and to interpret the role of categories of illness in mediating between the personal and social spheres. At the same time, the paper also discusses the interplay of popular categories and psychiatric diagnoses. This paper examines the multiple experiences of nervios among Puerto Ricans in Puerto Rico and New York City. Our contention is that nervios is more than a diffuse idiom of distress, and that there are different categories and experiences of nervios which provide insights into how distress is experienced and expressed by Puerto Ricans and point to different social sources of suffering. The data in this paper come from the responses to a series of open-ended questions which tapped into people's general conceptions of nervios and ataques de nervios. These questions were incorporated into follow-up interviews to an epidemiological study of the mental health of adults in Puerto Rico. The results suggest ways to incorporate these different categories of nervios into future research and clinical work with different Latino groups in the United States and in their home countries.

ataques de nervios culture and diagnosis nervios Puerto Ricans social sources of suffering

Copyright information

© Kluwer Academic Publishers 2003