Guarnaccia Peter J, Lewis-Fernández Roberto, Marano Melissa Rivera
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ 08901-1293, USA.
Cult Med Psychiatry. 2003 Sep;27(3):339-66. 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.
本文围绕疾病命名展开——探讨由谁决定使用何种分类方式以及这些决定所带来的影响。医学/精神病学人类学的核心关注点在于理解疾病的通俗分类及其分类体系，审视疾病分类与身体的文化认知之间的关系，阐释疾病分类在个人与社会领域之间所起的中介作用。同时，本文还讨论了通俗分类与精神病诊断之间的相互作用。本文考察了波多黎各以及纽约市的波多黎各人对神经过敏（nervios）的多样体验。我们的观点是，神经过敏不止是一种宽泛的痛苦表述方式，而且存在不同类型和体验的神经过敏，这能让我们深入了解波多黎各人如何体验和表达痛苦，并指向不同的痛苦社会根源。本文的数据来自对一系列开放式问题的回答，这些问题涉及人们对神经过敏和神经发作（ataques de nervios）的总体认知。这些问题被纳入对波多黎各成年人心理健康进行的一项流行病学研究的后续访谈中。研究结果为如何将这些不同类型的神经过敏纳入未来针对美国及他们祖国不同拉丁裔群体的研究和临床工作提供了思路。
