Moderne Gesundheitssorgen und ihre Beziehung zu umweltbezogenen Beschwerden

Modern health worries and annoyance from environmental factors are largely unrelated to smoking, alcohol consumption, and physical activity

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.

Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation

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.

Prospective study of nocebo effects related to symptoms of idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF)

The exact causes of Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields (IEI-EMF, i.e., experience of somatic symptoms attributed to low-level electromagnetic fields) are still unknown. Psychological causation such as nocebo effects seem plausible. This study aimed to experimentally induce a nocebo effect for somatic symptom perception and examined whether it was reproducible after one week. We also examined whether these effects were associated with increased sympathetic activity and whether interoceptive accuracy (IAcc) moderated these relationships. Participants were recruited from the general population and instructed that electromagnetic exposure can enhance somatosensory perception. They participated twice in a cued exposure experiment with tactile stimulation and sham WiFi exposure in 50% of trials. The two sessions were scheduled one week apart (session 1: N = 65, session 2: N = 63). Before session 1, participants watched either a 6-min film on adverse health effects of EMF or a neutral film on trade of mobile phones. IAcc was assessed with the heartbeat detection paradigm. Electrodermal activity served as a measure of sympathetic activation. Evidence for a nocebo effect (i.e., increased self-reported intensity and aversiveness and electrodermal activity) during sham WiFi exposure was observed in both sessions. IAcc moderated the nocebo effect, depending on stimulus intensity. Contrary to previous findings, no difference emerged between the health-related EMF and the neutral films. Based on negative instructions, somatic perception and physiological responding can be altered. This is consistent with the assumption that IEI-EMF could be due to nocebo effects, suggesting an important role for psychological interventions.

Modern health worries: A systematic review

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.

Modern health worries: Deriving two measurement invariant short scales for cross-cultural research with Ant Colony Optimization

Worries about possible harmful effects of new technologies (modern health worries) have intensely been investigated in the last decade. However, the comparability of translated self-report measures across countries is often problematic. This study aimed to overcome this problem by developing psychometrically sound brief versions of the widely used 25-item Modern Health Worries Scale (MHWS) suitable for multi-country use. Based on data of overall 5,176 individuals from four European countries (England, Germany, Hungary, Sweden), Ant Colony Optimization was used to identify the indicators that optimize model fit and measurement invariance across countries. Two scales were developed. A short (12-item) version of the MHWS that represents the four-factor structure of the original version and an ultra-short (4-item) scale that only measures the general construct. Both scales show that overall levels of health worries were highest in England and Hungary, but that the main reason for concern (e.g. electromagnetic radiation or food related fears) differs considerably between these countries. This study also shows that even if measurement invariance of translated self-report instruments across countries is problematic, it can be optimized by using adequate item selection procedures. Differences of modern health worries across countries and recommendations for cross-cultural research are discussed.

Modern health worries, somatosensory amplification and subjective symptoms: a longitudinal study : a longitudinal study

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.

Assessing modern health worries: Dimensionality and factorial invariance across age and sex of the Modern Health Worries Scale in a general population sample

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.

Modern health worries and idiopathic environmental intolerance

OBJECTIVE

We conducted two studies to test whether modern health worries (MHWs) were associated with central features of a condition called idiopathic environmental intolerance (IEI) and medical care utilization.

METHODS

In Study 1, 474 Internet users completed an Internet-based questionnaire that assessed MHWs, IEI features, and medical care utilization. In Study 2, the diagnostic specificity of MHWs was investigated by comparing the level of MHWs of three diagnostic groups: 46 people with IEI, 38 people with somatoform disorder but without IEI, and 46 people with neither IEI nor somatoform disorder.

RESULTS

The good psychometric properties of the MHW scale were confirmed. MHWs were related to various features of IEI, and people who met IEI case criteria showed consistently higher levels of MHWs compared with people without IEI. The link between MHWs and number of doctor visits was mediated by perceived IEI complaints. In Study 2, the MHW scale effectively discriminated the IEI group from the non-IEI groups.

CONCLUSIONS

These results suggest that MHWs may contribute to the development of IEI. However, only prospective longitudinal studies will enable us to determine the predictive importance of MHWs for later development of IEI.