Special Issue: CBS & Idioms of Distress (Weaver) Neighborhood characteristics and ataque de nervios: the role of neighborhood violence Shir Lerman Ginzburg 1 , Stephenie C. Lemon 2 and Milagros Rosal 2 Abstract Ataque de nervios is a Latina/o idiom of distress that may occur as a culturally sanctioned response to acute stressful experiences, particularly relating to grief, threat, family conflict, and a breakdown in social networks. The contextual factors associated with ataque de nervios have received little attention in research. This study examined the association between neighborhood factors and the experience of ataque de nervios among a sample of Latinas/os participating in the Latino Health and Well-Being Project in the northeastern United States. We examined the association between neigh- borhood cohesion, safety, trust, and violence and ataque de nervios. In multivariate logistic regression models, neigh- borhood violence was associated with ataque de nervios (p ¼ .02), with each unit increase in the neighborhood violence scale being associated with 1.36 times greater odds of experiencing ataque de nervios. None of the other neighborhood variables were significantly associated with ataque de nervios. The positive association between neighborhood violence and the experience of ataque de nervios makes a further case for policy efforts and other investments to reduce neighborhood violence. Keywords ataque de nervios, idioms of distress, Latinas/os, neighborhood violence Introduction Idioms of distress, defined as “particular ways in which members of sociocultural groups express affliction” (Hinton & Lewis-Ferna´ ndez, 2010, p. 210), have received increased attention in the past four decades due to the growing overall awareness of cultural differ- ences in mental health outcomes, both in the US and internationally (Keys, Kaiser, Kohrt, Khoury, & Brewster, 2012; Nichter, 1981; Parsons & Wakeley, 1991). Examples of idioms of distress include Han (a Korean expression of regret or resentment), Hozun (a Darfuri expression of deep sadness), and sıkıntı (a Turkish expression of trouble or oppression) (Borra, 2011; Rasmussen, Katoni, Keller, & Wilkinson, 2017; Saint Arnault & Kim, 2008). Research on these idioms of distress suggests that they are used by indi- viduals responding to stressful situations, such as war- fare or immigration to a new country (Borra, 2011; Hinton & Lewis-Ferna´ndez, 2010; Lewis-Ferna´ndez et al., 2005; Rasmussen et al., 2017). Parsons (1984) found that idioms of distress in Tonga were adaptive coping mechanisms against personally or culturally stressful experiences, while Desai and Chaturvedi (2017) found that Indian idioms of distress, such as Dhat (anxiety and weakness associated with semen dis- charge), arose from interpersonal and cultural conflicts and were layered with both personal and cultural meaning. Idioms of distress were thus understood as culturally sanctioned responses to various stressors, such as abuse and the loss of loved ones, which bind people together in times of stress and permit individu- als to share their distressful experiences without fear of social isolation (Hinton & Lewis-Ferna´ ndez, 2010; Vazquez, Sandler, Interian, & Feldman, 2017). 1 UConn Health 2 University of Massachusetts Medical School Corresponding author: Shir Lerman Ginzburg, UConn Health, 263 Farmington Ave, Farmington, CT 06030, USA. Email: sginzburg@uchc.edu Transcultural Psychiatry 0(0) 1–10 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1363461520935674 journals.sagepub.com/home/tps