Open Access Open Access  Restricted Access Subscription or Fee Access

Experimental induction of psychogenic illness in the context of a medical event and media exposure

Joan E. Broderick, PhD, Evonne Kaplan-Liss, MD, MPH, Elizabeth Bass, MPH

Abstract


Objectives: Mass psychogenic illness can be a significant problem for triage and hospital surge in disasters; however, research has been largely limited to posthoc observational reports. Reports on the impact of public media during a disaster have suggested both salutary as well as iatrogenic psychological effects. This study was designed to determine if psychogenic illness can be evoked and if media will exacerbate it in a plausible, controlled experiment among healthy community adults.
Methods: A randomized controlled experiment used a simulated biological threat and elements of social contagion—essential precipitants of mass psychogenic illness. Participants were randomly assigned to one of three groups: no-intervention control group, psychogenic illness induction group, or psychogenic illness induction plus media group. Measures included three assessments of symptom intensity, heart rate, blood pressure, as well as questionnaires to measure potential psychogenic illness risk factors.
Results: The two psychogenic induction groups experienced 11 times more symptoms than the control group. Psychogenic illness was observed in both men and women at rates that were not significantly different. Higher rates of lifetime history of traumatic events and depression were associated with greater induction of illness. Media was not found to exacerbate symptom onset.
Conclusions: Psychogenic illness relevant to public health disasters can be evoked in an experimental setting. This sets the stage for further research on psychogenic illness and strategies for mitigation.


Keywords


disaster medicine, mass media, psychogenic illness, trauma, psychosomatic

Full Text:

PDF

References


Drazen JM: SARS—Looking back over the first 100 days. N Engl J Med. 2003; 349(4): 319-320.

Johnson NP, Mueller J: Updating the accounts: Global mortality of the 1918-1920 “Spanish” influenza pandemic. Bull Hist Med. 2002; 76(1): 105-115.

Jones TF, Craig AS, Hoy D, et al.: Mass psychogenic illness attributed to toxic exposure at a high school. N Engl J Med. 2000; 342(2): 96-100.

Knudson GB: Nuclear, biological, and chemical training in the U.S. Army Reserves: Mitigating psychological consequences of weapons of mass destruction. Mil Med. 2001; 166(12 Suppl): 63-65.

Clements CJ: Mass psychogenic illness after vaccination. Drug Saf. 2003; 26(9): 599-604.

Boss LP: Epidemic hysteria: A review of the published literature. Epidemiol Rev. 1997; 19(2): 233-243.

Bartholomew RE: Rethinking the dancing mania. The Committee for Skeptical Inquiry. Vol. 24.4, July/August 2000. Available at http://www.csicop.org/si/show/rethinking_the_dancing_mania. Accessed September 28, 2010.

Pastel RH, Mulvaney J: Fear of radiation in U.S. military medical personnel. Mil Med. 2001; 166(12 Suppl): 80-82.

White PD, Moorey S: Psychosomatic illnesses are not “all in the mind”. J Psychosom Res. 1997; 42(4): 329-332.

Kharabsheh S, Al-Otoum H, Clements J, et al.: Mass psychogenic illness following tetanus-diphtheria toxoid vaccination in Jordan. Bull World Health Organ. 2001; 79(8): 764-770.

Hefez A: The role of the press and the medical community in the epidemic of “mysterious gas poisoning” in the Jordan West Bank. Am J Psychiatry. 1985; 142(7): 833-837.

Page LA, Petrie KJ,Wessely SC: Psychosocial responses to environmental incidents: A review and a proposed typology. J Psychosom Res. 2006; 60(4): 413-422.

Winters W, Devriese S, Van Diest I, et al.: Media warnings about environmental pollution facilitate the acquisition of symptoms in response to chemical substances. Psychosom Med. 2003; 65(3): 332-338.

Yzermans CJ, Donker GA,Kerssens JJ, et al.: Health problems of victims before and after disaster: A longitudinal study in general practice. Int J Epidemiol. 2005; 34(4): 820-826.

ten Veen PM, Morren M, Yzermans CJ: The influence of news events on health after disaster: A longitudinal study in general practice. J Trauma Stress. 2009; 22(6): 505-515.

Smithson A: Rethinking the lessons of Tokyo. In Smithson A, Levy L (eds.): Ataxia:The Chemical and Biological Terrorism Threat and the US Response.Washington, DC: The Henry Stimson Center, 2000: 71–111.

Bootsma MCJ, Ferguson NM: The effect of public health measures on the 1918 influenza pandemic in U.S. cities. Proc Natl Acad Sci USA. 2007; 104(18): 7588-7593.

Hatchett RJ, Mecher CE, Lipsitch M: Public health interventions and epidemic intensity during the 1918 influenza pandemic. Proc Natl Acad Sci USA. 2007; 104(18): 7582-7587.

Lindberg MA: The role of suggestions and personality characteristics in producing illness reports and desires for suing the responsible party. J Psychol. 2002; 136(2): 125-140.

Lorber W, Mazzoni G, Kirsch I: Illness by suggestion: Expectancy, modeling, and gender in the production of psychosomatic symptoms. Ann Behav Med. 2007; 33(1): 112-116.

Mazzoni G, Foan L, Hyland ME, et al.: The effects of observation and gender on psychogenic symptoms. Health Psychol. 2010; 29(2): 181-185.

Lange LJ, Piette JD: Perceived health status and perceived diabetes control: Psychological indicators and accuracy. J Psychosom Res. 2005; 58(2): 129-137.

Schuster MA, Stein BD, Jaycox LH, et al.: A national survey of stress reactions after the September 11, 2001, terrorist attacks. N Engl J Med. 2001; 345(20): 1507-1512.

Schlenger WE, Caddell JM, Ebert L, et al.: Psychological reactions to terrorist attacks: Findings from the National Study of Americans’ Reactions to September 11. JAMA. 2002; 288(5): 581-588.

Barsky AJ, Borus JF: Functional somatic syndromes. Ann Int Med. 1999; 130(11): 910-921.

Barsky AJ, Orav EJ, Bates DW: Distinctive patterns of medical care utilization in patients who somatize. Med Care. 2006; 44(9): 803-811.

Kroenke K, Spitzer RL,Williams JBW, et al.: Physical symptoms in primary care: Predictors of psychiatric disorders and functional impairment. Arch Fam Med. 1994; 3(9): 774-779.

Watson D, Clark LA: Negative affectivity: The disposition to experience aversive emotional states. Psychol Bull. 1984; 96(3): 465-490.

Craig T, Boardman A, Mills K, et al.: The South London Somatisation Study. I. Longitudinal course and the influence of early life experiences. Br J Psychiatry. 1993; 163(5): 579-588.

Escobar JI, Burnam MA, Karno M, et al.: Somatization in the community. Arch Gen Psychiatry. 1987; 44(8): 713-718.

Swartz M, Blazer D, George L, et al.: Somatization disorder in a community population. Am J Psychiatry. 1986; 143(11): 1403-1408.

Kroenke K, Spitzer RL: Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998; 60(2): 150-155.

Ware JE, Kosinski M, Dewey JE: How to Score Version 2 of the SF-36 Health Survey. Lincoln, RI: QualityMetric, Incorporated, 2000.

Pennebaker JW: The Psychology of Physical Symptoms. New York: Springer-Verlag, 1982.

Costa PT, McCrae RR: The NEO Personality Inventory Manual. Odessa, FL: Psychological Assessment Resources, 1985.

Watson D, Pennebaker JW: Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol Rev. 1989; 96(2): 234-254.

Hultsch DF, Hertzog C, Dixon RA, et al.: Memory Change in the Aged. Cambridge, England: Cambridge University Press, 1998.

Walker E, Katon W, Hansom J, et al.: Medical and psychiatric symptoms in women with childhood sexual abuse. Psychosom Med. 1992; 54(6): 658-664.

McCauley J, Kern D, Kolodner K, et al.: Relation of low-severity violence to women’s health. J Gen Intern Med. 1998; 13(10): 687-691.

Kubany ES, Leisen MB, Kaplan AS, et al.: Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The Traumatic Life Events Questionnaire. Psycholog Assess. 2000; 12(2): 210-224.

Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385-396.

Cohen S,Williamson GM: Perceived stress in a probability sample of the United States. In Spacapan S, Oskamp S (eds.): The Social Psychology of Health: The Claremont Symposium on Applied Social Psychology. Newbury Park, CA: Sage Publications, 1988: 31–67.

Derogatis LR: SCL-90-R: Symptom checklist-90-R: Administration, Scoring and Procedures Manual. 3rd ed. Minneapolis, MN: National Computer Systems, Inc., 1994.

Serlie AW, Erdman RA, Passchier J, et al.: Psychological aspects of non-cardiac chest pain. Psychother Psychosom. 1995; 64(2): 62-73.

Schachter S, Singer JE: Cognitive, social, and physiological determinants of emotional state. Psychol Rev. 1962; 69: 379-399.

Leventhal H, Meyer D, Nerenz D: The common sense representation of illness danger. In Rachman S (ed.): Contributions to Medical Psychology. New York: Pergamon Press, 1980: 7-30.

Gallay A, Van Loock F, Demarest S, et al.: Belgian coca-cola-related outbreak: Intoxication, mass sociogenic illness, or both? Am J Epidemiol. 2002; 155(2): 140-147.

Waugh CE, Panage S, Mendes WB, et al.: Cardiovascular and affective recovery from anticipatory threat. Biol Psychol. 2010; 84(2): 169-175.

Schwerdtfeger A: Trait anxiety and autonomic indicators of the processing of threatening information: A cued S1-S2 paradigm. Biol Psychol. 2006; 72(1): 59-66.

Vasterman P, Yzermans CJ, Dirkzwager AJE: The role of the media and media hypes in the aftermath of disasters. Epidemiol Rev. 2005; 27(1): 107-114.

Njenga FG, Nyamai C, Kigamwa P: Terrorist bombing at the USA Embassy in Nairobi: The media response. East Afr Med J. 2003; 80(3): 159-164.




DOI: https://doi.org/10.5055/ajdm.2011.0056

Refbacks

  • There are currently no refbacks.