Am J Psychiatry. 2002 Sep; 159(9): 1603-5.

Dissociation, childhood trauma, and ataque de nervios among Puerto Rican psychiatric outpatients.

Lewis-FernÃ¡ndez R, Garrido-Castillo P, Bennasar MC, Parrilla EM, Laria AJ, Ma G, Petkova E.

Anxiety Disorders Clinic, New York State Psychiatric Institute, NY 10032, USA. rlewis@nyspi.cpmc.columbia.edu

OBJECTIVE: This study examined the relationships of dissociation and childhood trauma with ataque de nervios. METHOD: Forty Puerto Rican psychiatric outpatients were evaluated for frequency of ataque de nervios, dissociative symptoms, exposure to trauma, and mood and anxiety psychopathology. Blind conditions were maintained across assessments. Data for 29 female patients were analyzed. RESULTS: Among these 29 patients, clinician-rated dissociative symptoms increased with frequency of ataque de nervios. Dissociative Experiences Scale scores and diagnoses of panic disorder and dissociative disorders were also associated with ataque frequency, before corrections were made for multiple comparisons. The rate of childhood trauma was uniformly high among the patients and showed no relationship to dissociative symptoms and disorder or number of ataques. CONCLUSIONS: Frequent ataques de nervios may, in part, be a marker for psychiatric disorders characterized by dissociative symptoms. Childhood trauma per se did not account for ataque status in this group of female outpatients.