A research about Nervios in Hispanic/Latino population. Farmworkers housing conditions as one of the factors.

1. Examining Nervios Among Immigrant Male
Farmworkers in the MICASA Study:
Sociodemographics, Housing Conditions
and Psychosocial Factors
BY DYNETTE PALLAIS

2. The Mexican Immigration to California: Agricultural Safety
and Acculturation (MICASA) Study is a prospective cohort
study of farm worker families in Mendota, CA. Mendota
was chosen as the study site because of the high proportion
of farm workers in the population, both permanent residents
and seasonal migrant laborers.
MICASA

3. Eligible participants
were 18–55 years of age, self-identified as
Mexican or
Central American, resided in Mendota at the time
of interview,
and lived with at least one household member
who
had worked in agriculture for 45 days or more in
the year prior to the interview.
467 households participated
in baseline interviews, resulting in 843 individual
interviews
(81 % participation)

4. • Substance Use Disorder
• Major Depressive Disorder
• GeneralAnxiety Disorder
• Post Traumatic Stress Disorder
• "Nervios"
There are many stressors faced by Latino immigrants that may predispose
them to negative mental health outcomes.
Prevalent mental health issues are:

5. Nervios and general mental health concerns, are pervasive in
this population of male farmworkers in California.
1.Cultures play an
important role in shaping
the psychopathology of a
variety of mental disorders
in humans.
2.Some psychiatric
problems are narrowed
down to specific cultures
and are referred to as
culture-bound syndromes.
3.Ataque de nervios
(nervous breakdown) is a
cultural bound syndrome
common among the
Hispanic population.
4.Nervios would carry
significant stigma, although
is not considered by Latinos
to be a mental illness.

6. SYMPTOMS
Nervios has been clinically
associated with symptoms of
Depression and Anxiety.
It is characterized by uncontrollable
screaming or shouting, crying,
shaking, sensations of heat rising in
the chest and head, dissociative
experiences, and verbal or physical
aggressiveness. (Richey et al., 2020).
Other symptoms of nervios are
having ‘‘too many thoughts,’’
irritability, sadness, fearfulness,
predisposition to explosive anger,
and even psychosis. (Lewis-
Fernandez et al. ,2010)

7. OTHER
SYMPTOMS
 Hopelessness, nervousness,
inability to function in
occupational roles;
 trembling, sweating,
feelings of suffocation, loss
of control, and
desperation;
 somatic symptoms
including headaches,
chest and abdominal
pains,
 high and /or low blood
pressure.

8. MEASURES
The baseline interview assessed demographic
characteristics, smoking, alcohol and drug use, work
history, acculturation, housing conditions and
psychosocial factors including Nervios, depressive
symptoms, perceived stress and family support.
The questionnaire was conducted in the participant’s
home or at the project office and required approximately
1 h to complete

9. A general question
asked if the
individual
reported ever
having nervios. In
addition, symptoms
of
nervios were
assessed
concurrent with the
general question
and included
whether
participants had
ever felt distracted
or absent-minded;
sad, depressed or
down;
irritable or angry; or
having an idea
stuck in one’s mind.
Depressive
symptoms were
assessed using the
Center for
Epidemiologic
Studies Depression
Scale (CES-D)
A short six-item Perceived Stress Scale (PSS) was derived
from the original 14-item PSS

10. ACCULTURATION
&HOUSE
CONDITION
Acculturation score was determined
using the Acculturation Rating Scale
for Mexican Americans-II (ARSMA-II),
which assesses language preference,
ethnic identity and ethnic interaction.
• Questions to examine housing conditions were
drawn from previous survey instruments and
used indicators that included
• home ownership; availability of heat in the
home;
• water damage and presence of molds; or
cockroaches

11. ANALYSIS
Statistical analysis examined the
relationships between reported nervios and
demographic and behavioral characteristics,
housing conditions and psychosocial factors
among all males and by household status
(unaccompanied vs. family male)

12. RESULTS
Latino immigrants face significant mental health risks, particularly
related to Anxiety and Depression, both clinically associated with
Nervios and with similar etiological stressors. These risks may be
exacerbated by occupational health risks, poor housing conditions,
social isolation and discrimination.

13. Latino’s Health Status and Risk Perceptions on Mental Issues
 Lack of information and persistent stigma
surrounding mental health in the
community, as discussing it,may be
considered taboo.
 Due to cultural differences, mental health
specialists may misinterpret and
misdiagnose Hispanic people.
 Lack of understanding of culture-bound
syndromes such as nervios contributes to the
creation and perpetuation of health disparities
among Latinos.

14. MISDIAGNOSES
Nervous breakdown is
frequently misdiagnosed as
illness connected to Anxiety
or Depression.
MICASA Study participants
with depressive symptoms
were seven times as likely to
report suffering from Nervios.

15. How Latino’s
Health
Status and
Risk
Perceptions
Affect the
Intervention
People from other cultures may not
perceive "ataque de nervios" (nervous
breakdown) as a mental disorder.
These misunderstandings affects
access to proper medical or
therapeutical treatment.
Traditional healers and herbalists are
used by Hispanics to treat the cultural-
bound syndrome.
Therapists should identify patients with
culturally-bound syndrome and offer
appropriate treatment.

16. Conclusion
Challenging life conditions
and hardships common to
the
immigrant farmworker
experience are positively
correlated
with an increased
prevalence of nervios,
which in turn is
associated with risk of
other mental health issues,
including
depression.
The inability to properly
support family or
administer family problems
likely contributes to the
sense among men that
family issues are a key
reason reported for their
nervios. As a result, mental
health issues among
Latino immigrants present
a potential public health
crisis
that has yet to be well
measured.
Poor understanding of this
syndrome among
healthcare providers can
lead to inappropriate
treatment.
Clinicians should be
culturally competent to
identify such syndromes
and offer appropriate
management.

17. References
O’Connor, K., Stoecklin-Marois, M., & Schenker,
M. B. (2015). Examining nervios among immigrant
male farmworkers in the MICASA study:
Sociodemographics, housing conditions and
psychosocial factors. Journal of Immigrant and
Minority Health, 17(1), 198–207. https:// doi-
org.lib.pepperdine.edu/10.1007/s10903-013-9859-8