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Köteles F, Nordin S. Do somatic symptom distress and attribution predict symptoms associated with environmental factors? J Psychosom Res 2024; 179:111637. [PMID: 38442536 DOI: 10.1016/j.jpsychores.2024.111637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Not much is known on the development of symptoms associated with environmental factors (SAEF), also known as (idiopathic) environmental intolerances. Findings from qualitative studies suggest that appearance of symptoms might be the first step, followed by the acquisition of a specific attribution. The current study investigated cross-sectional and longitudinal (three years) associations between attribution and symptoms with respect to symptoms associated with chemical substances, certain indoor environments (buildings), sounds, and electromagnetic fields (EMFs). METHODS We used data from the first two waves of the population-based Västerbotten Environmental Health Study (n = 2336). Participants completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Environmental Symptom-Attribution Scale, and answered single questions on the four aforementioned SAEFs. RESULTS Using binary logistic regression analyses, all four SAEFs showed significant cross-sectional associations with somatic symptom distress and the respective attribution. In the longitudinal analysis, development of SAEF-Sound and SAEF-Chemicals were predicted by both somatic symptom distress and attribution. SAEF-EMFs was predicted only by attribution, whereas neither somatic symptom distress nor attribution forecasted SAEF-Buildings. CONCLUSION Overall, these findings suggest that attribution (i.e., a specific expectation) plays a substantial role in the development and maintenance of many SAEFs.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Köteles F, Nordin S, Claeson AS. Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms. J Psychosom Res 2023; 173:111476. [PMID: 37643562 DOI: 10.1016/j.jpsychores.2023.111476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The objective of the present study was to investigate the associations between somatosensory amplification, modern health worries (MHWs), and symptoms among patients with building-related symptoms (BRS). METHODS Patients with self-reported and medically confirmed BRS (n = 83) were included in this cross-sectional study. The Somatosensory Amplification Scale (SSAS) was used to quantify the tendency to amplify somatic sensations and perceive them as unpleasant and dangerous. Concerns about harmful effects of modern technologies were assessed with the Modern Health Worries Scale (MHWS). Symptoms commonly found in different forms of environmental intolerance were assessed with the Environmental Hypersensitivity Symptom Inventory (EHSI). RESULTS Patients with BRS were characterized by more frequent and more severe environmental hypersensitivity symptoms compared to a reference population. Females and those with co-morbid self-reported chemical intolerance reported even more symptoms. MHWS and SSAS scores showed weak to moderate associations with symptoms, even after adjusting for socio-economic variables. However, neither the mean MHWS score or the SSAS score of our sample differed from normative scores. CONCLUSION Patients with BRS are not characterized by elevated levels of MHWs and somatosensory amplification, thus other, psychosocial and/or environmental, factors may have contributed to the development of the condition. However, the associations between severity of symptoms and MHWs and somatosensory amplification suggest that psychosocial characteristics may substantially influence symptom experience in this group.
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Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Köteles F, Szemerszky R, Petrie K, Nordin S. Modern health worries and annoyance from environmental factors are largely unrelated to smoking, alcohol consumption, and physical activity. J Psychosom Res 2023; 172:111417. [PMID: 37331267 DOI: 10.1016/j.jpsychores.2023.111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Modern health worries, as well as environmental annoyance from chemical agents, noise, and electromagnetic exposure are associated with symptom reporting and marked affective-behavioural changes. As promotion and protection of health is a primary characteristic of these conditions, it can be expected that they will be related to less risk behaviour (smoking and alcohol consumption) and more health behaviour (physical activity), both cross-sectionally and longitudinally. METHODS Hypotheses were tested in a sample of 2336 individuals participating in T1 and T2 data collection (3 years apart) of the Västerbotten Environmental Health Study, Sweden. Health-related behaviours were assessed using single self-report questions. Smoking was measured on a binary (yes-or-no) scale; frequency of alcohol consumption and physical activity was measured on a 5-point and a 4-point scale, respectively. RESULTS Modern health worries showed no cross-sectional association with the three behaviours, whereas annoyance was typically inversely, very weakly, related to smoking and alcohol consumption. Physical activity was significantly positively associated only with chemical annoyance. None of the variables significantly predicted change of behaviours at T2 after controlling for the respective T1 value and demographic variables. CONCLUSIONS Individuals with high levels of modern health worries and annoyance from various environmental agents are not clearly characterized by a healthier lifestyle. Perhaps they focus on the alleviation of their existing symptoms; alternatively, somatic symptom distress decreases their cognitive-affective resources necessary for a long-term life style change.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Renáta Szemerszky
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Keith Petrie
- Department of Psychological Medicine, University of Auckland, New Zealand.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Speck MJ, Witthöft M. Symptoms of Idiopathic Environmental Intolerance associated with chemicals (IEI-C) are positively associated with perceptual anomalies. J Psychosom Res 2022; 157:110808. [PMID: 35421699 DOI: 10.1016/j.jpsychores.2022.110808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Idiopathic Environmental Intolerance (IEI; i.e. the experience of somatic symptoms attributed to environmental agents) represents a functional somatic syndrome of unclear aetiology. Based on previous findings that suggest an association between IEI and perceptual anomalies, this study aimed to investigate the relationship between symptoms of IEI associated with chemicals (IEI-C) and facets of the schizotypy spectrum. METHODS A cross-sectional study design was used with N = 410 (78.3% female) persons responding to an online survey in which chemical odor sensitivity (COS) and modern health worries (MHW) that are associated with IEI-C, as well as schizotypal personality traits (SPQ), hallucination proneness (LSHS) and delusional ideation (PDI) as core components of the schizotypy spectrum were assessed. RESULTS Schizotypal traits were found to be significantly positively associated with MHWs (r = 0.20, p = .01), COS (r = 0.23, p = .01), and showed significant positive associations with hallucination proneness. Magical thinking was found to exhibit a significant positive relationship with both MHW (r = 0.17, p = .01) and COS (r = 0.21, p = .01). These small associations between IEI-C and facets of the psychosis spectrum remained significant even after statistically controlling for individual levels of trait anxiety and depression. CONCLUSION Schizotypal personality traits, particularly magical thinking, and hallucination proneness, appear positively related to facets of IEI-C. The findings are of relevance for the advancement of theoretical models of IEI.
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Affiliation(s)
- M J Speck
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany.
| | - M Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany
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Zucco GM, Doty RL. Multiple Chemical Sensitivity. Brain Sci 2021; 12:46. [PMID: 35053790 PMCID: PMC8773480 DOI: 10.3390/brainsci12010046] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 01/09/2023] Open
Abstract
Multiple Chemical Sensitivity (MCS), a condition also known as Chemical Sensitivity (CS), Chemical Intolerance (CI), Idiopathic Environmental Illness (IEI) and Toxicant Induced Loss of Tolerance (TILT), is an acquired multifactorial syndrome characterized by a recurrent set of debilitating symptoms. The symptoms of this controversial disorder are reported to be induced by environmental chemicals at doses far below those usually harmful to most persons. They involve a large spectrum of organ systems and typically disappear when the environmental chemicals are removed. However, no clear link has emerged among self-reported MCS symptoms and widely accepted objective measures of physiological dysfunction, and no clear dose-response relationship between exposure and symptom reactions has been observed. In addition, the underlying etiology and pathogenic processes of the disorder remain unknown and disputed, although biologic and psychologic hypotheses abound. It is currently debated whether MCS should be considered a clinical entity at all. Nevertheless, in the last few decades MCS has received considerable scientific and governmental attention in light of the many persons reporting this illness. In this review, we provide a general overview of the history, definition, demographics, prevalence, and etiologic challenges in defining and understanding MCS.
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Affiliation(s)
- Gesualdo M Zucco
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35100 Padova, Italy
| | - Richard L Doty
- Smell and Taste Center, Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Szemerszky R, Dömötör Z, Witthöft M, Köteles F. Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation. J Psychosom Res 2021; 146:110501. [PMID: 33930739 DOI: 10.1016/j.jpsychores.2021.110501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Paranoid ideation is assumed to characterize worries about possible harmful effects of modern technologies (MHWs) and idiopathic environmental intolerances (IEIs), such as IEI attributed to electromagnetic fields (IEI-EMF). Empirical evidence on these associations is scarce. METHODS In a cross-sectional on-line survey, participants of a community sample (n = 700; mean age: 28.4 ± 12.0; 434 females) completed the Somatosensory Amplification Scale, the Modern Health Worries Scale, and the Paranoid Ideation scale of the Symptom Checklist 90 Revised. They were considered IEI-EMF if (1) they categorized themselves so, (2) they had experienced symptoms that they attributed to the exposure to electromagnetic fields, and (3) the condition impacted their everyday functioning. RESULTS Paranoid ideation was significantly positively associated with MHWs (standardized β = 0.150, p < .001) even after controlling for socio-demographic variables and somatosensory amplification tendency, an indicator of somatic symptom distress. Also, paranoid ideation explained significant variability in IEI-EMF (OR = 1.090, 95% CI: 1.006-1.180, p = .035) even after statistically controlling for socio-demographic variables and somatosensory amplification. CONCLUSIONS Paranoid ideation was found to be associated with MHWs and IEI-EMF. This association appears independent of general somatic symptom distress in both cases. This might partly explain the temporal stability of these constructs.
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Affiliation(s)
- Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
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Furnham A. Modern Health Worries and the Personality Disorders: Two Studies Using Different Measures. Health (London) 2021. [DOI: 10.4236/health.2021.133019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Köteles F, Szemerszky R, Witthöft M, Nordin S. No evidence for interactions between modern health worries, negative affect, and somatic symptom distress in general populations. Psychol Health 2020; 36:1384-1396. [DOI: 10.1080/08870446.2020.1841761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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9
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Association between somatic symptoms and modern health worries. J Psychosom Res 2020; 135:110163. [PMID: 32559520 DOI: 10.1016/j.jpsychores.2020.110163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 05/11/2020] [Accepted: 05/26/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Modern health worries (MHWs) refer to perceived risk to personal health from technological changes and features of modern life, and is associated with health outcomes. The present objective was to test the hypotheses of (i) associations between MHWs and a global measure of typical somatization symptoms, referred to as somatic symptom distress, and (ii) associations between MHWs and a broad range of specific typical somatization symptoms and eye/skin and airway symptoms. METHODS Cross-sectional population-based data were used. Validated instruments were used to assess MHWs (Modern Health Worries Scale), typical somatization symptoms (Patient Health Questionnaire 15-item Somatic Symptom Severity Scale, PHQ-15), eye/skin and airway symptoms (Environmental Hypersensitivity Symptom Inventory), depression and anxiety (Hospital Anxiety and Depression Scale). Multivariate linear regression analyses were conducted with MHWs as dependent variable, symptoms as independent variables, and background variables, anxiety and depression as confounding variables. RESULTS When controlled for background variables, MHWs were statistically significantly, but only very weakly, associated with global PHQ-15 score, most of the specific typical somatization symptoms, and eye/skin and airway symptoms. When controlled also for depression and anxiety, the associations were statistically significant, but even more weakly associated with global PHQ-15 score and most of the specific symptoms. CONCLUSIONS The results suggest a very small increased risk of somatic symptom distress and related specific symptoms in MHW, and that depression and anxiety are confounding variables in these associations.
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10
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Nordin S. Mechanisms underlying nontoxic indoor air health problems: A review. Int J Hyg Environ Health 2020; 226:113489. [DOI: 10.1016/j.ijheh.2020.113489] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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Selinheimo S, Vuokko A, Hublin C, Järnefelt H, Karvala K, Sainio M, Suojalehto H, Paunio T. Psychosocial treatments for employees with non-specific and persistent physical symptoms associated with indoor air: A randomised controlled trial with a one-year follow-up. J Psychosom Res 2020; 131:109962. [PMID: 32078837 DOI: 10.1016/j.jpsychores.2020.109962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Persistent physical symptoms (PPS) associated with indoor air without an adequate pathophysiological- or environmental-related explanation may lead to work disability and decreased health-related quality of life (HRQoL). We attempted to assess the effect of cognitive behavioural therapy (CBT) for PPS and also psychoeducation (PE) on these symptoms involving disability. METHOD The intention-to-treat (ITT) sample included 52 employees recruited from an occupational healthcare service randomised as either controls undergoing treatment as usual (TAU) or TAU enhanced with CBT or PE. The primary outcome was HRQoL measuring the severity of symptoms and restrictions in everyday life caused by them. Secondary outcomes included depressive, anxiety and insomnia symptoms, and intolerance to environmental factors, assessed at baseline and at 3-, 6- and 12-month follow-ups. RESULTS At the 12-month follow-up assessment point, no statistically significant differences between treatments emerged following adjustment for gender, age, and HRQoL before the waiting period in the ITT analysis [F(2,46)=2.89, p=.07]. The secondary analysis revealed a significant improvement in HRQoL in the combined intervention group as compared with controls [F(1,47)=5.06, p=.03, g=0.41]. In total, 15% of participants dropped out during follow-up. CONCLUSIONS The results suggest that CBT for PPS or PE might not have a robust effect on HRQoL in PPS associated with indoor air, but the study did not achieve the planned power. Despite difficulties during the recruitment process, the final dropout rates remained low, and participants positively evaluated CBT, suggesting that it represents an acceptable treatment to them. Trial status This study was registered at the ClinicalTrials.gov registry (NCT02069002).
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Affiliation(s)
- Sanna Selinheimo
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
| | - Aki Vuokko
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Heli Järnefelt
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, Helsinki, Finland; Insurance Medicine and Rehabilitation Unit, Keva, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | | | - Tiina Paunio
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry and the SleepWell Research Program, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Haanes JV, Nordin S, Hillert L, Witthöft M, van Kamp I, van Thriel C, Van den Bergh O. "Symptoms associated with environmental factors" (SAEF) - Towards a paradigm shift regarding "idiopathic environmental intolerance" and related phenomena. J Psychosom Res 2020; 131:109955. [PMID: 32058864 DOI: 10.1016/j.jpsychores.2020.109955] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/13/2020] [Accepted: 02/05/2020] [Indexed: 02/07/2023]
Abstract
Health conditions characterized by symptoms associated with chemical, physical and biological environmental factors unrelated to objectifiable pathophysiological mechanisms are often labelled by the general term "idiopathic environmental intolerances". More specific, exposure-related terms are also used, e.g. "multiple chemical sensitivities", "electromagnetic hypersensitivity" and "candidiasis hypersensitivity". The prevalence of the conditions varies from a few up to more than 50%, depending on definitions and populations. Based on evolving knowledge within this field, we provide arguments for a paradigm shift from terms focusing on exposure and intolerance/(hyper-)sensitivity towards a term more in line with the perceptual elements that seem to underlie these phenomena. Symptoms caused by established pathophysiologic mechanisms should not be included, e.g. allergic or toxicological conditions, lactose intolerance or infections. We discuss different alternatives for a new term/concept and end up proposing an open and descriptive term, "symptoms associated with environmental factors" (SAEF), including a definition. "Symptoms associated with environmental factors" both is in line with the current knowledge and acknowledge the experiences of the afflicted persons. Thus, the proposed concept is likely to facilitate therapy and communication between health professionals and afflicted persons, and to provide a base for better understanding of such phenomena in healthcare, society and science.
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Affiliation(s)
- Jan Vilis Haanes
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, NO-9038 Tromsø, Norway; Department of Community Medicine, University of Tromsø, NO-9037 Tromsø, Norway.
| | - Steven Nordin
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | - Lena Hillert
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University, DE-55122 Mainz, Germany.
| | - Irene van Kamp
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands.
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors, TU Dort-mund University, DE-44139 Dortmund, Germany.
| | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, BE-3000, Belgium.
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Dömötör Z, Nordin S, Witthöft M, Köteles F. Modern health worries: A systematic review. J Psychosom Res 2019; 124:109781. [PMID: 31443819 DOI: 10.1016/j.jpsychores.2019.109781] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Modern health worries (MHWs) refer to people's concerns about possible harmful effects of modern technologies, and are widespread in the developed countries. The aim of the present work was to provide comprehensive, yet integrated understanding for MHWs and associated factors. METHODS Following the PRISMA guideline, a systematic review was conducted based on 48 empirical articles published between 2001 and 2018 (Prospero registration number: CRD42018103756). All empirical studies were included that (1) were published between 2001 and 2018 in peer-reviewed scientific journals in English, German, or Hungarian, (2) used the Modern Health Worries Scale or any of its sub-scales, and (3) assessed associations between MHWs and other constructs and/or compared criterion groups (i.e. purely psychometric studies were excluded). RESULTS The results from the review suggest that female gender, age, somatic symptom distress and idiopathic environmental intolerances, holistic thinking, and paranoid beliefs are positively associated with MHWs, whereas educational qualification and the five major dimensions of personality appear not to be. CONCLUSION Scientific inquiry on the MHWs phenomenon is still in its descriptive-explorative phase; more rigorously designed studies are needed. The presented theoretical framework integrates illness-related and holistic thinking-related aspects of MHWs as a starting point to guide further research in this area.
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Affiliation(s)
- Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
| | | | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Germany.
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Hungary.
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Vuokko A, Karvala K, Suojalehto H, Lindholm H, Selinheimo S, Heinonen-Guzejev M, Leppämäki S, Cederström S, Hublin C, Tuisku K, Sainio M. Clinical Characteristics of Disability in Patients with Indoor Air-Related Environmental Intolerance. Saf Health Work 2019; 10:362-369. [PMID: 31497334 PMCID: PMC6717934 DOI: 10.1016/j.shaw.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 11/28/2022] Open
Abstract
Background Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
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Affiliation(s)
- Aki Vuokko
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | | | - Marja Heinonen-Guzejev
- University of Helsinki, Department of Public Health, Faculty of Medicine, Helsinki, Finland
| | - Sami Leppämäki
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Sebastian Cederström
- Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Katinka Tuisku
- Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland
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Claeson AS, Palmquist E, Nordin S. Physical and chemical trigger factors in environmental intolerance. Int J Hyg Environ Health 2018. [DOI: 10.1016/j.ijheh.2018.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Katoh T. [Multiple Chemical Sensitivity (MCS): History, Epidemiology and Mechanism]. Nihon Eiseigaku Zasshi 2018; 73:1-8. [PMID: 29386440 DOI: 10.1265/jjh.73.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multiple chemical sensitivity (MCS), also known as idiopathic environmental intolerance, has been described as a chronic acquired disorder characterized by nonspecific symptoms in multiple organ systems and is associated with exposure to low-level chemicals. The name was established by Cullen, in 1987, although the name and diagnostic criteria are still under debate even now. A number of hypotheses concering the etiology and pathogenesis of MCS have been proposed, including impairmens of neurological, immunological and psychological systems. However, research on the possible mechanisms underlying MCS is far from complete. The name and diagnostic criteria of its history as well as theoretical and experimental mechanisms underlying MCS are reviewed here.
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Affiliation(s)
- Takahiko Katoh
- Department of Public Health, Faculty of Life Sciences, Kumamoto University
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Vuokko A, Karvala K, Lampi J, Keski-Nisula L, Pasanen M, Voutilainen R, Pekkanen J, Sainio M. Environmental Intolerance, Symptoms and Disability Among Fertile-Aged Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020293. [PMID: 29419757 PMCID: PMC5858362 DOI: 10.3390/ijerph15020293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/04/2018] [Accepted: 02/06/2018] [Indexed: 12/12/2022]
Abstract
The purpose was to study the prevalence of environmental intolerance (EI) and its different manifestations, including behavioral changes and disability. Fertile-aged women (n = 680) of the Kuopio Birth Cohort Study were asked about annoyance to 12 environmental factors, symptoms and behavioral changes. We asked how much the intolerance had disrupted their work, household responsibilities or social life. We chose intolerance attributed to chemicals, indoor molds, and electromagnetic fields to represent typical intolerance entities. Of the respondents, 46% reported annoyance to chemicals, molds, or electromagnetic fields. Thirty-three percent reported symptoms relating to at least one of these three EIs, 18% reported symptoms that included central nervous system symptoms, and 15% reported behavioral changes. Indicating disability, 8.4% reported their experience relating to any of the three EIs as at least “somewhat difficult”, 2.2% “very difficult” or “extremely difficult”, and 0.9% “extremely difficult”. Of the latter 2.2%, all attributed their intolerance to indoor molds, and two thirds also to chemicals. As the number of difficulties increased, the number of organ systems, behavioral changes and overlaps of the three EIs also grew. EI is a heterogeneous phenomenon and its prevalence depends on its definition. The manifestations of EI form a continuum, ranging from annoyance to severe disability.
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Affiliation(s)
- Aki Vuokko
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
| | - Jussi Lampi
- Environmental Health, National Institute for Health and Welfare, P.O. Box 95, 70701 Kuopio, Finland.
- Social and Health Services, 70701 Kuopio, Finland.
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynecology, Kuopio University Hospital, P.O. Box 100, 70029 KYS Kuopio, Finland.
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, P.O Box 1627, 70211 Kuopio, Finland.
| | - Markku Pasanen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.
| | - Raimo Voutilainen
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, P.O Box 1627, 70211 Kuopio, Finland.
- Department of Pediatrics, Kuopio University Hospital, P.O. Box 100, 70029 KYS Kuopio, Finland.
| | - Juha Pekkanen
- Environmental Health, National Institute for Health and Welfare, P.O. Box 95, 70701 Kuopio, Finland.
- Department of Public Health, University of Helsinki, P.O. Box 20, 00014 Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, P.O. Box 40, 00032 Helsinki, Finland.
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Karvala K, Sainio M, Palmquist E, Nyback MH, Nordin S. Prevalence of various environmental intolerances in a Swedish and Finnish general population. ENVIRONMENTAL RESEARCH 2018; 161:220-228. [PMID: 29161654 DOI: 10.1016/j.envres.2017.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/27/2017] [Accepted: 11/08/2017] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To determine the prevalence of various environmental intolerances (EIs), using several criteria in a Swedish and a Finnish general population. Ill-health attributed to low-level environmental exposures is a commonly encountered challenge in occupational and environmental medicine. METHODS In population-based questionnaire surveys, the Västerbotten Environmental Health Study (Sweden) and the Österbotten Environmental Health Study (Finland), EI was inquired by one-item questions on symptom attribution to chemicals, certain buildings, or electromagnetic fields (EMFs), and difficulties tolerating sounds. The respondents were asked whether they react with central nervous system (CNS) symptoms or have a physician-diagnosed EI attributed to the corresponding exposures. Prevalence rates were determined for different age and sex groups and the Swedish and Finnish samples in general. RESULTS In the Swedish sample (n = 3406), 12.2% had self-reported intolerance to chemicals, 4.8% to certain buildings, 2.7% to EMFs, and 9.2% to sounds. The prevalence rates for the Finnish sample (n = 1535) were 15.2%, 7.2%, 1.6%, and 5.4%, respectively, differing statistically significantly from the Swedish. EI to chemicals and certain buildings was more prevalent in Finland, while EI to EMFs and sounds more prevalent in Sweden. The prevalence rates for EI with CNS-symptoms were lower and physician-diagnosed EIs considerably lower than self-reported EIs. Women reported EI more often than men and the young (18-39 years) to a lesser degree than middle-aged and elderly. CONCLUSIONS The findings reflect the heterogeneous nature of EI. The differences in EI prevalence between the countries might reflect disparities concerning which exposures people perceive harmful and focus their attention to.
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Affiliation(s)
- Kirsi Karvala
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, 00250 Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, 00250 Helsinki, Finland.
| | - Eva Palmquist
- Department of Psychology, Umeå University, SE-90187 Umeå, Sweden.
| | - Maj-Helen Nyback
- Novia University of Applied Sciences, PO BOX 6, 65201 Vaasa, Finland.
| | - Steven Nordin
- Department of Psychology, Umeå University, SE-90187 Umeå, Sweden.
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Lahrach Y, Furnham A. Are modern health worries associated with medical conspiracy theories? J Psychosom Res 2017; 99:89-94. [PMID: 28712435 DOI: 10.1016/j.jpsychores.2017.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
This study was concerned with whether Medical Conspiracy Theories (MCTs), along with other variables (demographics, ideology and health perceptions) are associated with Modern Health Worries (MHWs). MCTs were significantly associated with MHWs over and above all other variables. Older individuals, with more religious and right-wing beliefs had higher MHWs. In addition, those who used Complementary and Alternative Medicine (CAM) and individuals who perceived their mental health as worse than their peers were also more likely to display higher MHWs. Implications for helping health professions understand their patients' health-related beliefs and choices were discussed.
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Affiliation(s)
- Y Lahrach
- Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
| | - A Furnham
- Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom; Norwegian Business School (BI), Nydalveien, Olso, Norway.
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Witthöft M, Freitag I, Nußbaum C, Bräscher AK, Jasper F, Bailer J, Rubin GJ. On the origin of worries about modern health hazards: Experimental evidence for a conjoint influence of media reports and personality traits. Psychol Health 2017; 33:361-380. [DOI: 10.1080/08870446.2017.1357814] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Ina Freitag
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Christiane Nußbaum
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Fabian Jasper
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Josef Bailer
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
| | - G. James Rubin
- Department of Psychological Medicine, King’s College London, London, UK
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Szemerszky R, Dömötör Z, Berkes T, Köteles F. Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms. Int J Behav Med 2016; 23:204-13. [PMID: 26420517 DOI: 10.1007/s12529-015-9511-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution. PURPOSE The current study aimed to find empirical evidence supporting this theory. METHOD Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed. RESULTS No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables. CONCLUSIONS An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.
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Affiliation(s)
- Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary
| | - Zsuzsanna Dömötör
- Doctoral School of Psychology and Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Tímea Berkes
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University, Bogdánfy Ödön u. 10., Budapest, 1117, Hungary.
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Palmquist E, Petrie KJ, Nordin S. Psychometric Properties and Normative Data for a Swedish Version of the Modern Health Worries Scale. Int J Behav Med 2016; 24:54-65. [PMID: 27324490 DOI: 10.1007/s12529-016-9576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Köteles F, Simor P, Czető M, Sárog N, Szemerszky R. Modern health worries - the dark side of spirituality? Scand J Psychol 2016; 57:313-20. [DOI: 10.1111/sjop.12297] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences; Eötvös Loránd University; Budapest Hungary
| | - Péter Simor
- Department of Cognitive Sciences; Budapest University of Technology and Economics; Hungary
- Nyírő Gyula Hospital National Institute of Psychiatry and Addictions; Hungary
| | | | - Noémi Sárog
- Institute of Psychology; Eötvös Loránd University; Hungary
| | - Renáta Szemerszky
- Institute of Health Promotion and Sport Sciences; Eötvös Loránd University; Budapest Hungary
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Gibson PR, Lockaby SD, Bryant JM. Experiences of persons with multiple chemical sensitivity with mental health providers. J Multidiscip Healthc 2016; 9:163-72. [PMID: 27103817 PMCID: PMC4827900 DOI: 10.2147/jmdh.s100688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In this paper, we summarize the results of an online survey of persons in the United States with chemical intolerance/multiple chemical sensitivity who sought help from mental health providers, including counselors, psychologists, psychiatrists, and others. Respondents reported on their most recent contact with a provider, describing reasons for the contact, accommodations requested and received, and suggestions for how the experience could be more helpful. Overall, though clients were accommodated in small ways, some received no accommodation, and many felt that the providers needed to be more knowledgeable regarding chemical intolerance. Results are discussed in terms of the importance of providers becoming more aware of multiple chemical sensitivity and more willing to make their services accessible to these clients.
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
| | - Sharon D Lockaby
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
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Dömötör Z, Doering BK, Köteles F. Dispositional aspects of body focus and idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). Scand J Psychol 2016; 57:136-43. [DOI: 10.1111/sjop.12271] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/02/2015] [Indexed: 11/29/2022]
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Mindfulness-based cognitive therapy (MBCT) for multiple chemical sensitivity (MCS): Results from a randomized controlled trial with 1 year follow-up. J Psychosom Res 2015; 79:628-34. [PMID: 26311155 DOI: 10.1016/j.jpsychores.2015.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by symptoms from multiple organ systems following the perception of common odorants. The condition can cause severe functional impairment for afflicted individuals. The aim of this study was to assess the effects of mindfulness-based cognitive therapy (MBCT) for individuals with MCS. METHODS The intention-to-treat sample (ITT) included 69 individuals who had been randomized to either MBCT or treatment as usual (TAU). The primary outcome measure was the Quick Environmental Exposure and Sensitivity Inventory (QEESI), which measures the following aspects of MCS impact of MCS on daily life, symptoms, and reactions following chemical exposures. Secondary outcome measures included the Brief Illness Perception Questionnaire (BIPQ) and the anxiety and depression subscales of the symptom checklist 92 (SCL-92). Participants were assessed at baseline and post treatment, and at follow-up periods of 6- and 12-months. RESULTS We found no effect of MBCT on the primary outcome, nor did we find an effect on levels of depression or anxiety. We did, however, find positive changes in illness perceptions, which were sustained at 12-month follow-up. Dropout rates were low, suggesting MBCT was well received and regarded as an acceptable intervention by individuals with MCS. CONCLUSIONS Overall, these results suggest that MBCT does not change overall illness status in individuals with MCS, but that MBCT positively changes emotional and cognitive representations. Possible explanations for these results are discussed.
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The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data. J Psychosom Res 2015; 79:355-61. [PMID: 26526308 DOI: 10.1016/j.jpsychores.2015.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The present study investigates the association of modern health worries (MHW) with self-reported as well as general practitioner (GP)-registered non-specific physical symptoms (NSPS), medication use, alternative therapy consultations, sleep quality and quality of life. The interrelation between MHW, general environmental sensitivity and the aforementioned outcomes is also explored. METHODS Self-reported questionnaires and data from electronic medical records from 21 general practices in The Netherlands were combined in a sample of 5933 adult participants. RESULTS The majority of the participants reported increased worries about potential health effects from environmental exposures. The highest worry scores were reported by people who perceived themselves as more vulnerable to environmental stressors. After adjustment for socio-demographic characteristics and diagnosed psychiatric morbidity, higher MHW were significantly associated with increased self-reported prevalence and duration of NSPS, symptom-related healthcare utilization, GP-registered NSPS, alternative therapy consultations and lower sleep quality and quality of life. These associations were statistically mediated by perceived environmental sensitivity. No association was observed between worries and GP-registered medication prescriptions. CONCLUSION Modern health worries are very common in the general population. They are associated with self-reported as well as clinically defined NSPS and as such might play a key role in the process of developing and maintaining environmental sensitivities and related symptoms. A large cross-cultural longitudinal study would help to determine important aspects such as temporal precedence and stability of MHW and the relevant psychosocial context within which symptomatic conditions occur.
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Köteles F, Simor P. Somatic symptoms and holistic thinking as major dimensions behind modern health worries. Int J Behav Med 2015; 21:869-76. [PMID: 24136400 DOI: 10.1007/s12529-013-9363-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Modern health worries (MHWs) were related to somatic symptoms and to preference of holistic healing methods in previous studies. PURPOSE The study aimed to investigate the contribution of symptom-related and holism-related factors to MHWs. METHODS Participants (visitors of an Internet news portal; N = 16152; 64.1 % males) completed a questionnaire assessing MHWs, somatosensory amplification, somatic symptoms, positive and negative affect, spirituality, holistic health beliefs, and various aspects of health care utilization (both conventional and alternative). RESULTS Exploratory factor analysis with oblique rotation revealed two independent dimensions ("Somatic symptom distress" and "Holism") MHWs were involved with factor loadings of 0.294 and 0.417, respectively. The existence of two factors was supported by the results of confirmatory factor analysis. No practically significant interaction between the two factors was found in binary logistic regression analysis. Positive and negative affect, somatosensory amplification, spirituality, and holistic health beliefs were positively connected, while self-rated health status was negatively connected to MHWs even after controlling for socio-demographic and treatment-related variables. CONCLUSIONS Holistic thinking and symptom-related behavioral and psychological factors are independently associated with MHWs. Modern health worries can be conceptualized as symptom-related by-products of a holistic-spiritual worldview.
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Affiliation(s)
- Ferenc Köteles
- Faculty of Education and Psychology, Institute for Health Promotion and Sport Sciences, Eötvös Loránd University, Budapest, Bogdánfy Ödön u. 10., 1117, Hungary,
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Vuokko A, Selinheimo S, Sainio M, Suojalehto H, Järnefelt H, Virtanen M, Kallio E, Hublin C, Karvala K. Decreased work ability associated to indoor air problems--An intervention (RCT) to promote health behavior. Neurotoxicology 2015; 49:59-67. [PMID: 26014487 DOI: 10.1016/j.neuro.2015.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Indoor air problems may induce respiratory irritation and inflammation. In occupational settings, long-lasting non-specific building-related symptomatology, not fully medically explained, is encountered. The symptomatology may lead to illness, avoidance behavior and decreased work ability. In Finland, investigations of workers suspected of occupational asthma have revealed excess disability. There are no well-established clinical practices for the condition. OBJECTIVE The aim was to develop a clinical intervention for patients with non-specific indoor air-related symptoms and decreased work ability. METHODS A randomized controlled trial including psychoeducation and promotion of health behavior was carried out in 55 patients investigated for causal relationship between work-related respiratory symptoms and moisture damaged workplaces. Inclusion criteria for disability was the work ability score (WAS)≤7 (scale 0-10) and indoor air-related sick leave ≥14 days the preceding year. After medical evaluation and the 3-session counseling intervention, follow-up at 6-months was assessed using self-evaluated work-ability, sick leave days, quality of life, and illness worries as outcome measures. RESULTS The mean symptom history was 55.5 months. 82% (45 out of 55) had asthma with normal lung function tests in most cases, although reporting abundant asthma symptoms. 81% of patients (39/48) had symptomatology from multiple organ systems without biomedical explanation, despite environmental improvements at work place. At the psychological counseling sessions, 15 (60%) patients of the intervention (INT, n=25) group showed concerns of a serious disease and in 5 (20%), concerns and fears had led to avoidance and restricted personal life. In the 6-month follow-up, the outcomes in the INT group did not differ from the treatment as usual group. CONCLUSION No intervention effects were found. Patients shared features with medically unexplained symptoms and sick building syndrome or idiopathic environmental intolerance. Long environment-attributed non-specific symptom history and disability may require more intensive interventions. There is a need for improved recognition and early measures to prevent indoor-associated disability. TRIAL REGISTRATION NUMBER Single-center randomized controlled trial (ISRCTN33165676).
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Affiliation(s)
- Aki Vuokko
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Sanna Selinheimo
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Hille Suojalehto
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Heli Järnefelt
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Marianna Virtanen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Eila Kallio
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland
| | - Christer Hublin
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, 00250 Helsinki, Finland.
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Skovbjerg S, Christensen KB, Ebstrup JF, Linneberg A, Zachariae R, Elberling J. Negative affect is associated with development and persistence of chemical intolerance: a prospective population-based study. J Psychosom Res 2015; 78:509-514. [PMID: 25758214 DOI: 10.1016/j.jpsychores.2015.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Chemical intolerance (CI) is characterised by negative health effects attributed to a heightened responsiveness to common airborne chemicals. This longitudinal study explored the hypothesised role of negative affect in the development and persistence of CI in a general population. METHODS A general population sample aged 19 to 72 years was examined in 2006-2008 and again in 2011-2012. Longitudinal data on CI were analysed with the purpose of examining baseline negative affect as a risk factor for having developed CI at 5-year follow-up and for reporting persistent CI. Participants were classified as reporting no signs of CI, having symptoms of CI and as being a likely CI case based on self-reported reactions to 11 common chemical exposures, symptoms related to chemical exposures and daily life adjustments attributed to reactions when exposed to chemicals. RESULTS A total of 69.4% of the participants who had reported CI at baseline also reported CI at follow-up. In participants with no baseline CI, 15.5% reported CI at follow-up and 18.1% reported symptoms related to chemicals but no daily life adjustments. Baseline negative affect was positively and statistically significantly associated with both development and persistence of CI. CONCLUSIONS Initial reports of CI were found to be persistent over time, and a considerable proportion of the participants with no CI at baseline reported having developed CI after 5 years. The positive association between negative affect and CI at the 5-year follow-up supports negative affect as a possible risk factor for CI.
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Affiliation(s)
- Sine Skovbjerg
- The Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark.
| | - Karl Bang Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Denmark
| | | | - Allan Linneberg
- The Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark; Department of Clinical Experimental Research, Copenhagen University Hospital Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Elberling
- The Allergy Clinic, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
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Janssens T, Brepoels S, Dupont L, Van den Bergh O. The impact of harmfulness information on citric acid induced cough and urge-to-cough. Pulm Pharmacol Ther 2015; 31:9-14. [DOI: 10.1016/j.pupt.2015.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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Szemerszky R, Gubányi M, Árvai D, Dömötör Z, Köteles F. Is There a Connection Between Electrosensitivity and Electrosensibility? A Replication Study. Int J Behav Med 2015; 22:755-63. [DOI: 10.1007/s12529-015-9477-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nordin S, Neely G, Olsson D, Sandström M. Odor and noise intolerance in persons with self-reported electromagnetic hypersensitivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8794-805. [PMID: 25166918 PMCID: PMC4198991 DOI: 10.3390/ijerph110908794] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 08/10/2014] [Accepted: 08/19/2014] [Indexed: 11/16/2022]
Abstract
Lack of confirmation of symptoms attributed to electromagnetic fields (EMF) and triggered by EMF exposure has highlighted the role of individual factors. Prior observations indicate intolerance to other types of environmental exposures among persons with electromagnetic hypersensitivity (EHS). This study assessed differences in odor and noise intolerance between persons with EHS and healthy controls by use of subscales and global measures of the Chemical Sensitivity Scale (CSS) and the Noise Sensitivity Scale (NSS). The EHS group scored significantly higher than the controls on all CSS and NSS scales. Correlation coefficients between CSS and NSS scores ranged from 0.60 to 0.65 across measures. The findings suggest an association between EHS and odor and noise intolerance, encouraging further investigation of individual factors for understanding EMF-related symptoms.
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Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | - Gregory Neely
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | - David Olsson
- Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden.
| | - Monica Sandström
- Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden.
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Köteles F, Simor P. Modern health worries, somatosensory amplification and subjective symptoms: a longitudinal study : a longitudinal study. Int J Behav Med 2014; 20:38-41. [PMID: 22207442 DOI: 10.1007/s12529-011-9217-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Modern health worries (MHWs; i.e., concerns about possibly harmful features of modern life) have been associated with somatic symptoms and somatosensory amplification in previous cross-sectional studies. Causal relationship among these variables is yet to be discovered. PURPOSE The study investigates the temporal association among subjective symptoms, somatosensory amplification (SSA), and modern health worries (MHWs). METHOD Baseline and follow-up questionnaires (somatic symptoms--PHQ-15, somatosensory amplification scale--SSAS, modern health worries scale--MHW, PANAS negative affect scale-NA) were completed by 366 undergraduate students in a 2-month longitudinal study. RESULTS MHWs were predicted by baseline MHWs (β = 0.721, p < 0.001) and by somatic symptoms (β = 0.084, p < 0.05). Somatic symptoms were predicted by baseline symptoms (β = 0.610, p < 0.001), NA (β = 0.104, p < 0.05), and SSAS scores (β = 0.089, p < 0.05). The only predictor of SSA was baseline SSAS score (β = 0.628, p < 0.001). CONCLUSION Based on the results, a linear model (proneness to somatosensory amplification leads to subjective symptoms which lead to MHWs) was proposed, where MHWs serve as explanations of physical symptoms or as possible environmental threats to avoid.
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Affiliation(s)
- Ferenc Köteles
- Institute for Health Promotion and Sport Sciences, Faculty of Education and Psychology, Eötvös Loránd University, Bogdánfy u. 10, 1117, Budapest, Hungary.
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Tseng MCM, Lin YP, Hu FC, Cheng TJ. Risks perception of electromagnetic fields in Taiwan: the influence of psychopathology and the degree of sensitivity to electromagnetic fields. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2013; 33:2002-2012. [PMID: 23551091 DOI: 10.1111/risa.12041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Little is known about the perceived health risks of electromagnetic fields (EMFs) and factors associated with risk perception in non-Western countries. Psychological conditions and risk perception have been postulated as factors that facilitate the attribution of health complaints to environmental factors. This study investigated people's perceived risks of EMFs and other environmental sources, as well as the relationships between risk perception, psychopathology, and the degree of self-reported sensitivity to EMFs. A total of 1,251 adults selected from a nationwide telephone interviewing system database responded to a telephone survey about the relationships between environmental sources and human health. The interview included questions assessing participants' psychiatric conditions and the presence and degree of sensitivity to EMFs. One hundred and seventy participants were self-identified as having sensitivity to EMFs, and 141 met the criteria for psychiatric conditions without EMF sensitivity. More than half of the survey respondents considered power lines and mobile phone base stations to affect people's health to a big extent. Higher sensitivity to EMFs, psychopathology, being female, being married, more years of education, and having a catastrophic illness had positive associations with perceived risks of EMF-related environmental sources as well as for all environmental sources combined. We observed no moderating effect of psychopathology on the association between degree of sensitivity to EMF and risk perception. Thus, psychopathology had influence on general people's risk perception without having influence on the relationship between people's degree of sensitivity to EMF and risk perception. The plausible explanations are discussed in the text.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate, Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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Tran MTD, Elberling J, Skovbjerg S, Berg ND, Søsted H, Johansen JD, Lysdal SH. Chemical intolerance among hairdressers in Denmark. PLoS One 2013; 8:e71241. [PMID: 23951117 PMCID: PMC3741293 DOI: 10.1371/journal.pone.0071241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/28/2013] [Indexed: 12/04/2022] Open
Abstract
Objectives To investigate the prevalence and the severity of fragrance-related symptoms among hairdressers in Denmark compared with the Danish general population. Further, to characterize former hairdressers who are severely chemically intolerant to fragranced products in relation to sex, age and health- and work-related reasons for leaving the hairdressing profession. Methods The study population consisted of all hairdressers who graduated from the public vocational schools in Denmark during 1985 and 2007 (n = 7840) and a random sample of individuals from the Danish general population (n = 6000). Both populations received a postal questionnaire on symptoms from inhalation of fragranced products and the resultant behavioural consequences. All former hairdressers also answered additional questions on health- and work-related reasons for leaving the profession. Results No differences were found in the prevalence (OR = 1.0, CI = 0.89–1.14) or the severity (OR = 1.1, CI = 0.80–1.51) of symptoms from inhalation of fragranced products in hairdressers compared with the general population. Among hairdressers, however, experience of fragrance-related symptoms (OR = 1.2, CI = 1.01–1.31) and adjustments of social (OR = 1.8, CI = 1.12–2.80) and occupational conditions (OR = 2.8, CI = 1.84–4.25) were reported significantly more often by former hairdressers than current hairdressers. Conclusions The prevalence and the severity of fragrance-related symptoms were similar in hairdressers and the general population. Former hairdressers were more affected by fragranced products than current hairdressers were. Although fragrance-related symptoms did not seem to be more frequent among hairdressers, the hairdressing profession might pose a problem for those who are chemically intolerant.
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Gentofte, Denmark.
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Palmquist E, Claeson AS, Neely G, Stenberg B, Nordin S. Overlap in prevalence between various types of environmental intolerance. Int J Hyg Environ Health 2013; 217:427-34. [PMID: 24029726 DOI: 10.1016/j.ijheh.2013.08.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 11/17/2022]
Abstract
Environmental intolerance (EI) is characterized by attribution of several, multisystem symptoms to specific environmental exposures, such as exposure to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs) and everyday sounds. The symptoms are medically unexplained, non-specific and the symptoms overlap between different types of EI. To approach the issue of underlying mechanisms the matter of overlap in prevalence between intolerances can provide valuable information. The aim of the study was to examine if the overlap between intolerance to odorous/pungent chemicals, certain buildings, EMFs and sounds is larger than the expected overlap if no association would exist between them. The study was using cross-sectional data from the Västerbotten Environmental Health Study in Sweden; a large questionnaire-based survey. 8520 adults (18-79 years) were randomly selected after stratification for age and sex, of whom 3406 (40%) participated. Individuals with the four types of intolerance were identified either through self-report, or by having been physician-diagnosed with a specific EI. The overlaps between the four EIs were greater than predictions based on coincidence for both self-reported and diagnosed cases (except for the overlap between diagnosed intolerance to sounds and EMFs). The results raise the question whether different types of EI share similar underlying mechanisms, or at least that the sufferers of EI share some predisposition to acquire the conditions.
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Affiliation(s)
- Eva Palmquist
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | | | - Gregory Neely
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden
| | - Berndt Stenberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Steven Nordin
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden
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Nordin S, Claeson AS, Andersson M, Sommar L, Andrée J, Lundqvist K, Andersson L. Impact of Health-Risk Perception on Odor Perception and Cognitive Performance. CHEMOSENS PERCEPT 2013. [DOI: 10.1007/s12078-013-9153-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Spangenberg L, Zenger M, Rief W, Brähler E, Glaesmer H. Assessing modern health worries: Dimensionality and factorial invariance across age and sex of the Modern Health Worries Scale in a general population sample. J Health Psychol 2013; 19:1302-8. [DOI: 10.1177/1359105313488980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Previous work suggests a four-factor structure of the Modern Health Worries Scale. This study is the first to investigate its dimensionality and factorial invariance across age and sex in a representative population sample ( N = 2524) using confirmatory factor analysis. The proposed four-factor model failed to achieve good model fit. Model fit was optimized by allowing correlating error terms resulting in acceptable model fit. Multi-group analysis revealed invariance across age and sex. Our study proved the proposed four-factor structure across age and sex. Consequently, the Modern Health Worries Scale can be applied in general population surveys using subscale scores.
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Greenberg MI, Curtis JA, Vearrier D. The perception of odor is not a surrogate marker for chemical exposure: a review of factors influencing human odor perception. Clin Toxicol (Phila) 2013; 51:70-6. [PMID: 23387344 DOI: 10.3109/15563650.2013.767908] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Clinical toxicologists perform risk assessments and clinical evaluations for patients with potential exposure to airborne toxicants in which the patient's self-reported perception of odor may be the only indicator that an exposure may have taken place. OBJECTIVE To review the factors that may affect the human ability to perceive chemical odors and relate those odors to specific chemical exposures. METHODS The medical literature, from 1950 through 2012, was searched using the OVID database and the PUBMED database. The searches returned 238 articles, of which 113 involved human studies and were published in the English language. Of these 113 articles, 40 articles discussed odor issues and thus were chosen as specifically relevant to the topic. Bibliographies of all articles were also searched for other relevant references and this found six additional articles, making a total of 46. FACTORS THAT MAY AFFECT OLFACTION AND THE ABILITY TO PERCEIVE ODOR: Genetic/population: Ethnic background is associated with widely differing odor detection abilities and thresholds. A significant genetic influence for the ability to smell and perceive odor has been reported. Gender: Women are superior to men in their ability to identify odors. Age. Increasing age is correlated with higher odor detection thresholds. Medical conditions: A variety of medical conditions have been associated with deficits in olfaction, including diseases of the nose and sinuses, multiple sclerosis, and schizophrenia. Alcoholism and smoking: Abuse of alcohol results in impaired olfactory sense, and smoking tobacco products alters odor detection threshold in a dose-related manner. Occupational and environmental factors: Repeated inhalation of any chemical results in olfactory fatigue over relatively short time frames that leads to a decreased ability to accurately detect and identify an odor. Recent exposure to relatively high concentrations of a chemical has been shown to affect sensitivity to that particular odorant, altering subsequent detection thresholds by up to three orders of magnitude. Applicability of proposed odor thresholds: Humans are only able to identify three to four components of complex olfactory mixtures and the odorants present in the mixture affect which individual components are detected. Odorants present in suprathreshold concentrations in a mixture may effectively mask the presence of odorants present in perithreshold concentrations. Self-rating of olfactory function may not correlate with actual olfactory ability. It is even more difficult to accurately determine intensity of an odor in a quantifiable way. For example, under conditions of constant stimulation with hydrogen sulfide, perceptual intensity was reported to decrease exponentially with time of stimulation. Concomitant visual stimulation also affects odor intensity. Some chemicals, such as hydrogen sulfide, may induce reactions in humans related solely to their odor, even when they are present in concentrations substantially lower than those levels usually associated with the development of adverse clinical effects. There is a wealth of literature suggesting that the intensity of perceived odor, the degree of irritation, and the reported health effects of exposure to an odorant chemical are affected by psychological state and bias. Multiple theories have been proposed to explain the cognitive basis for perceived illness in association with the perception of odor. The concept of odor has been reported to be intrinsically and cognitively associated with illness rather than with health. Assigning negative bias to an odor prior to an exposure results in the reporting of significantly more health-related symptoms following exposure. This suggests that those symptoms are not mediated by the odor directly, but rather by an individual's cognitive associations between odor and health. CONCLUSIONS Attempts to verify exposure intensity based on the report of a perceived odor is unreliable and has no useful application in legitimate exposure assessment paradigms. Detection of an odor does not imply a medically significant exposure to a toxicant and, due to subject bias and the difficulty of detecting individual odorants in mixtures, may not constitute an exposure to the purported substance.
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Affiliation(s)
- Michael I Greenberg
- Division of Medical Toxicology, Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
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Freyler A, Kőhegyi Z, Köteles F, Kökönyei G, Bárdos G. Modern health worries, subjective somatic symptoms, somatosensory amplification, and health anxiety in adolescents. J Health Psychol 2013; 18:773-81. [DOI: 10.1177/1359105313479629] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The cross-sectional study aimed at the psychometric evaluation of the Modern Health Worries Scale in adolescents and the exploration of the relationship among modern health worries, somatosensory amplification, health anxiety, and somatic symptoms. A total of 480 secondary school students (aged between 14 and 19 years) completed a set of questionnaires. Four-factor structure of the scale was confirmed by confirmatory factor analysis. Modern health worries were connected to somatosensory amplification and health anxiety, and somatosensory amplification and health anxiety were partial mediators of the connection between modern health worries and somatic symptoms. Perceived vulnerability (conceptualized as somatosensory amplification and health anxiety) appears to build a “social-cognitive-emotional bridge” between symptoms and modern health worries.
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The feasibility of aromatherapy massage to reduce symptoms of Idiopathic Environmental Intolerance: a pilot study. Complement Ther Med 2012; 20:400-8. [PMID: 23131370 DOI: 10.1016/j.ctim.2012.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/23/2012] [Accepted: 07/26/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Idiopathic Environmental Intolerance (IEI) is an acquired disorder with multiple recurrent symptoms, which is associated with diverse environmental factors that are tolerated by the majority of people. IEI is an illness of uncertain aetiology, making it difficult to treat using conventional medicine. Therefore, there is a need for novel therapies to control the symptoms of IEI. The objective of this study was to evaluate the feasibility and impact of aromatherapy massage for individuals with IEI. DESIGN Non-blinded crossover trial. SETTING IEI patients who attended a clinic in Sapporo city were recruited, and sixteen patients were enrolled. Participants were clinically examined by an experienced medical doctor and met the criteria included in the working definition of IEI disorder. INTERVENTIONS During the active period, participants received four one-hour aromatherapy massage sessions every two weeks. During the control period, the participants did not receive any massages. MAIN OUTCOME MEASUREMENTS Scores on the IEI-scales trigger checklist, symptoms, life impact, and the State Anxiety Inventory were assessed before and after each period. Short-term mood enhancement was evaluated using the Profiles of Mood Status (POMS) before and after sessions. RESULTS Due to period effects, evaluation of the results had to be restricted to the first period, and the result showed no effect of intervention. All six sub-scales of the POMS improved after each session (mean score differences: 4.89-1.33, P<0.05). CONCLUSIONS Aromatherapy was well tolerated by subjects with IEI; however, aromatherapy, as applied in this study, did not suggest any specific effects on IEI condition.
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Indregard AMR, Ihlebæk CM, Eriksen HR. Modern Health Worries, Subjective Health Complaints, Health Care Utilization, and Sick Leave in the Norwegian Working Population. Int J Behav Med 2012; 20:371-7. [DOI: 10.1007/s12529-012-9246-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rief W, Glaesmer H, Baehr V, Broadbent E, Brähler E, Petrie KJ. The relationship of modern health worries to depression, symptom reporting and quality of life in a general population survey. J Psychosom Res 2012; 72:318-20. [PMID: 22405228 DOI: 10.1016/j.jpsychores.2011.11.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 11/17/2011] [Accepted: 11/22/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Worries about the risk to personal health from new technology and features of modern life have been shown to be associated with the use of health care services, health behaviours, mood and reporting of physical symptoms. We examined the frequency and nature of these concerns in a large national sample and the relationship of modern health worries to demographic factors, depression, symptom reporting and health-related quality of life. METHODS A representative sample of the German population (n=2485) completed a face-to-face survey which included demographic information, the Modern Health Worries Scale, as well as measures of depression, symptom reporting, and health-related quality of life. RESULTS The majority of the population reports high or extremely high concerns about aspects of modernity affecting their personal health, while only six percent reported no concerns at all. Higher levels of modern health worries were found in females but were not associated with income or age. Higher levels of modern health worries were significantly associated with depression, symptom reporting and lower health-related quality of life. We found the relationship between modern health worries and both symptom reporting and health-related quality of life was only partially explained by depression for most outcome variables, while the association between MHW and physical component (SF-12) was fully mediated by depression. CONCLUSIONS Concerns about aspects of modernity affecting health are common in a general population sample and associated with depression, symptom reporting and quality of life.
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Affiliation(s)
- Winfried Rief
- Department of Psychology, University of Marburg, Germany.
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KÖTELES FERENC, BÁRÁNY ESZTER, VARSÁNYI PÉTER, BÁRDOS GYÖRGY. Are modern health worries associated with somatosensory amplification, environmental attribution style, and commitment to complementary and alternative medicine? Scand J Psychol 2011; 53:144-9. [DOI: 10.1111/j.1467-9450.2011.00908.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ozakinci G, Boratav HB, Mora PA. Modern health worries, health care utilization, and symptom reporting: a cross-cultural comparison. Behav Med 2011; 37:35-41. [PMID: 21660770 DOI: 10.1080/08964289.2011.552925] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Perception of risk to personal health from features of modern life and technology is increasing across the globe. We investigated whether these concerns exist in the Turkish setting in the same degree and whether symptom reports mediate the relationship between modern health worries (MHWs) and health care utilization in the UK and Turkish settings. A total of 506 University of St Andrews students and a total of 424 Turkish university students in Istanbul Bilgi University participated in the study. The factor structure of the MHW scale was similar in both samples and previous literature with the addition of a new factor, "ingested toxins." Turkish sample had higher scores on all items compared to the UK sample. We also tested a moderated mediational hypothesis in both samples which showed that subjective health complaints mediated the relationship between MHWs and health care utilization in both samples.
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Affiliation(s)
- Gozde Ozakinci
- University of St Andrews, School of Medicine, Fife, Scotland, UK.
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Jeswani M, Furnham A. Are modern health worries, environmental concerns, or paranormal beliefs associated with perceptions of the effectiveness of complementary and alternative medicine? Br J Health Psychol 2010; 15:599-609. [DOI: 10.1348/135910709x477511] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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48
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KÖTELES FERENC, SZEMERSZKY RENÁTA, FREYLER ANETT, BÁRDOS GYÖRGY. Somatosensory amplification as a possible source of subjective symptoms behind modern health worries. Scand J Psychol 2010; 52:174-8. [DOI: 10.1111/j.1467-9450.2010.00846.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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49
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Factors associated with prospective development of environmental annoyance. J Psychosom Res 2010; 69:9-15. [PMID: 20630258 DOI: 10.1016/j.jpsychores.2009.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 11/24/2009] [Accepted: 12/01/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Idiopathic environmental intolerance (IEI) has in cross-sectional studies been associated with emotional problems and psychiatric disorders. However, in the absence of prospective studies it has not been possible to determine whether emotional problems precede the onset of IEI, or are a consequence of IEI. The purpose of this study was to address this issue in a prospective panel study design. METHODS The study sample (n=10 275) responded to a postal survey that included five questions regarding annoyance from environmental factors, at baseline and at follow-up five years later. Associations between a number of self-rating scales of stress, subjective health, and working conditions at baseline on one hand, and development of environmental annoyance from baseline to follow-up on the other, were examined. RESULTS Participants having developed environmental annoyance between baseline and follow-up had at baseline reported more subjective health complaints, higher levels of stress, strain, and lack of recovery, more dissatisfaction with their work situation, and lower personal social support, compared to participants not developing environmental annoyance. CONCLUSION Elevated subjective health complaints, high stress in daily life and a strained work situation, all possible signs of sustained arousal, increase the risk of developing annoyance to environmental factors. The results fit the hypothesis that reduced subjective health, over the course of time, may be attributed to environmental factors.
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