Ludwig A M
Am J Psychother. 1982 Jul;36(3):350-7. doi: 10.1176/appi.psychotherapy.1982.36.3.350.
"Nerves" represents a common complaint among individuals from Appalachia. It appears to be a conglomerate term to encompass chronic anxiety without panic, mild depression without despair, neurasthenia without malaise, a smattering hypochondriasis and a surfeit of illness behavior, all superimposed on passive, dependent individuals with borderline normal intelligence and exposed to profound sociocultural deprivation. Definitive treatment of this disorder entails major changes or modifications in almost every aspect of their lives, including family structure, education, vocational training, and basic value systems. This may eliminate "nerves" but will not prevent the development of the more conventional psychiatric disorders to which more educated, middle-class individuals are vulnerable.
“神经问题”是阿巴拉契亚地区居民的常见主诉。它似乎是一个综合术语,涵盖了无惊恐发作的慢性焦虑、无绝望情绪的轻度抑郁、无不适症状的神经衰弱、些许疑病症以及过度的疾病行为,所有这些都叠加在智力接近正常、消极依赖且遭受严重社会文化剥夺的个体身上。对这种疾病的彻底治疗几乎需要在他们生活的方方面面进行重大改变或调整,包括家庭结构、教育、职业培训和基本价值体系。这或许能消除“神经问题”,但无法预防更有文化的中产阶级个体易患的更为常见的精神疾病的发生。