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Anthropologists have critiqued cultural competence programs in medical settings while introducing mental health clinicians to social theories on culture for practice. We explore how patients articulated narratives about themselves and how clinicians responded to such narratives through an intervention known as the Cultural Formulation Interview that anthropologists have helped develop. We conducted over 500 hours of fieldwork from 2014 to 2019 at an outpatient clinic in New York, analyzing multiple data (participant observation, medical records, patient–clinician sessions, and individual debriefing interviews) in a trial joining clinical and ethnographic methods. Our study enrolled 45 patients and six clinicians, yielding 117 patient–clinician appointments and 98 debriefing interviews. Most patients differed in how they presented their identities through demographic forms and discussed them in sessions with their clinicians. Two‐thirds of the patients drew connections between their personal identities and experiences of mental illness. These results reveal why cultural identities should not be taken for granted in clinical settings. [ABSTRACT FROM AUTHOR]

This article presents analyses of a representative sample of U.S. Latinos (N = 2,540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggest a significant association between family cohesion and lower psychological distress, and the combination of strong family cohesion with presence of family cultural conflict is associated with higher psychological distress. However, this association differs by Latino groups. In this study, no association for Puerto Ricans is seen; Cuban results are similar to the aggregate group, family cultural conflict in Mexicans is associated with higher psychological distress whereas family cohesion in other Latinos is associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups. (Contains 2 tables.)

This article provides a profile of a range of important variables for assessing diversity among different Latino groups from the National Latino and Asian American Study (NLAAS). The NLAAS is a nationally representative study of the mental health needs and mental health services use of the Latino population of the United States. The NLAAS employs a stratified area probability sampling design. There are 2,554 respondents in the Latino portion of the NLAAS. The article demonstrates through a detailed presentation of a wide range of variables the diverse experiences of Latino groups in their encounters with U.S. culture. Language use and migration experiences show considerable variability within and across Latino groups and are promising areas for analysis of their mental health consequences. (Contains 5 tables.)

The authors present a quantitative analysis and assessment of the symptoms of "ataque de nervios." A sample of 121 individuals living in Puerto Rico provided qualitative and structured data on "ataques de nervios" and psychiatric correlates. A total of 77 participants reported having an "ataque de nervios" during their lifetimes. Their reports of symptoms associated with the "ataque" episode were analyzed using factor analysis. Two dimensions emerged from the analysis, representing respectively internalizing and externalizing experiences. Results sustained the heterogeneity of "ataque de nervios" with a marked anxiety component. The authors discuss results in the context of classification and understanding of "ataques de nervios" and a model for studying cultural variance among cultural syndromes. (Contains 3 tables and 3 notes.)

Objective: To provide the first empirical analysis of a cultural syndrome in children by examining the prevalence and psychiatric correlates of ataques de nervios in an epidemiological study of the mental health of children in Puerto Rico. Method: Probability samples of caretakers of children 4-17 years old in the community (N = 1,892; response rate: 90%) and in clinical services (N = 761; response rate 72%) were administered structured interviews to assess the presence and correlates of ataques de nervios. Results: Nine percent of children in the community sample and 26% of children in the clinical sample had a reported history of an ataque de nervios. In contrast to the overall community and clinical samples, which had more boys in them, the ataque de nervios groups in both samples had more girls in them. Family history of ataques de nervios was associated with ataques de nervios in children in both samples. Across a wide range of depression, anxiety, and disruptive disorders, children who reported an ataque de nervios were more likely to meet research criteria for psychiatric disorder in both samples. Conclusions: Ataques de nervios are a frequently reported cultural syndrome among children in Puerto Rico. Adolescent girls are more likely to report this experience. Ataques de nervios have a significant relationship with psychiatric disorder and impairment in Puerto Rican children.

Background: This article presents the first epidemiological portrait of ataques de nervios among Latinos in the mainland United States. Much of the previous literature has focused on Puerto Ricans in Puerto Rico and New York City. Aims: This study examines the social and psychiatric correlates of ataque de nervios in a nationally representative sample of Latinos in the United States. Methods: This study employs data from the Latino sample (N = 2554) of the National Latino and Asian American Study (NLAAS). Analyses examined the associations between ataques de nervios and a range of social and migration variables, as well as psychiatric diagnoses and measures of mental health need. Results: Ataques de nervios were reported by 7_15% of the different Latino groups, with Puerto Ricans reporting the highest frequency. Ataques de nervios were more frequent in women, those with disrupted marital status, and those more acculturated to the US. The frequency of those who met criteria for affective, anxiety and substance abuse disorders was higher among those reporting an ataque de nervios. Conclusion: Ataque de nervios can serve as an important indicator of social and psychiatric vulnerability in future epidemiological and clinical studies with Latino populations.

This article presents analyses of a representative sample of U.S. Latinos (N = 2,540) to investigate whether family cohesion moderates the effects of cultural conflict on psychological distress. The results for the aggregated Latino group suggest a significant association between family cohesion and lower psychological distress, and the combination of strong family cohesion with presence of family cultural conflict is associated with higher psychological distress. However, this association differs by Latino groups. In this study, no association for Puerto Ricans is seen; Cuban results are similar to the aggregate group, family cultural conflict in Mexicans is associated with higher psychological distress whereas family cohesion in other Latinos is associated with higher psychological distress. Implications of these findings are discussed to unravel the differences in family dynamics across Latino subethnic groups. Keywords: family cohesion; family conflict; psychological distress; Latino ethnic groups

This article provides a profile of a range of important variables for assessing diversity among different Latino groups from the National Latino and Asian American Study (NLAAS). The NLAAS is a nationally representative study of the mental health needs and mental health services use of the Latino population of the United States. The NLAAS employs a stratified area probability sampling design. There are 2,554 respondents in the Latino portion of the NLAAS. The article demonstrates through a detailed presentation of a wide range of variables the diverse experiences of Latino groups in their encounters with U.S. culture. Language use and migration experiences show considerable variability within and across Latino groups and are promising areas for analysis of their mental health consequences. Keywords: diversity; Latinos; mental health; acculturation; NLAAS