The Folk Illness Called Susto

Abstract

There is growing concern over the extent to which current paradigms of scientific biomedicine have the capability to explain folk or culture-bound illness. This work tests a hypothesis that the folk illness susto afflicts individuals who consider themselves as inadequately performing crucial social roles. The research was conduced in three culturally distinct municipios of Oaxaca, Mexico. Susto is widespread throughout Latin America. It is reported from Mexico, Venezuela, Argentina, Colombia, Brazil, Peru, Guatemala, and among Spanish-speaking groups of the United Staes. Symptoms are (1) restlessness during sleep, (2) loss of appetite, (3) loss of weight, (4) introversion, (5) lack of motivation to accomplish ordinary tasks. A sample of sick individuals over 18 years of age was developed. One-half of the patients include susto in their complaints (the experimentals), the other half (the controls) complain of illness, but do not include susto as contributory to it. Each experimental asustado is matched with an ill control by gender, age, and municipio of residence. The two samples are tested for levels and severity of biological disease, stress associated with social role performance, and amount of psycho-emotional distress. The results support the predicted association between self-perceived social role inadequacy and the presence of susto. Asustados also suffer significantly more biological disease than the controls, but are not more psycho-emotionally ill. Finally, after a seven year period, eight deaths among the asustados, but no death among the controls. This significantly higher mortality shows that whereas the entire sample of these rural Mexicans is plagued by the ``diseases of poverty'', the added burden among the asustados of a perceived failure to meet critical social roles ``tips the scales'' towards an early death.