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Rossi AA, Panzeri A, Taccini F, Parola A, Mannarini S. The Rising of the Shield hero. Development of the Post-Traumatic Symptom Questionnaire (PTSQ) and Assessment of the Protective Effect of self-esteem from trauma-related Anxiety and Depression. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 17:1-19. [PMID: 36532142 PMCID: PMC9734448 DOI: 10.1007/s40653-022-00503-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Background Adverse life events such as life-threatening accidents, domestic and/or sexual violence, organic diseases (i.e., cancer), or COVID-19 can have a strong traumatic impact - generating reactions as intrusive thoughts, hyperarousal, and avoidance. Indeed, the traumatic impact of COVID-19 seems to lead individuals to experience anxiety and depression. However, the Anxiety-Buffer Hypothesis suggests that self-esteem could be considered a shield (buffer) against traumatic experiences and their outcomes (i.e., anxiety and depression). The present study has two objectives. First, to develop a measure of the impact of the traumatic event considering the aforementioned reactions. Second, to test the process - triggered by COVID19-related traumatic experience - in which self-esteem buffers the path that leads to anxiety and depression. Method In Study 1 (N = 353), the Post-Traumatic Symptom Questionnaire (PTSQ) was developed and a deep investigation of its psychometric properties was conducted. In Study 2 (N = 445), a structural equation model with latent variables was performed to assess the buffering effect of self-esteem. Results The PTSQ has excellent fit indices and psychometric properties. According to the ABH, results confirm the buffering effect of self-esteem in the relationships between traumatic symptoms and both anxiety and depression. Conclusion On the one hand, the PTSQ is a solid and reliable instrument. On the other hand, that self-esteem is a protective factor against anxiety and depression related to a traumatic experience - such as COVID-19. Targeted psychological interventions should be implemented to minimize the psychological burden of the illness while promoting adaptation and positive aspects of oneself. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00503-z.
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Affiliation(s)
- Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Anna Panzeri
- Department of General Psychology, University of Padova, Padova, Italy
| | - Federica Taccini
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
- Department of Developmental Psychology and Socialisation, University of Padova, Padova, Italy
| | - Anna Parola
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
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Bianchi D, Lonigro A, Norcia AD, Tata DD, Pompili S, Zammuto M, Cannoni E, Longobardi E, Laghi F. A model to understand COVID-19 preventive behaviors in young adults: Health locus of control and pandemic-related fear. J Health Psychol 2022; 27:3148-3163. [PMID: 35410516 PMCID: PMC9720470 DOI: 10.1177/13591053221089722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study investigated COVID-19 preventive behaviors in young adults, exploring the predictive roles of health locus of control and pandemic fear. A sample of 188 Italian young adults (Mage = 22.76, SDage = 1.95; 85% girls) completed an anonymous online survey assessing preventive behaviors, health locus of control styles (i.e. internal, chance, powerful others), and two dimensions of pandemic fear. Fear for COVID-19 consequences-but not general fear for contagion-significantly predicted prevention behaviors, and it also moderated the relationships between each health locus of control style and preventive behaviors. Our findings have relevant implications for research and social policies.
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The prevalence of insomnia in different COVID-19 policy phases: Longitudinal evidence from ITA.LI - Italian Lives. BMC Public Health 2022; 22:1657. [PMID: 36050669 PMCID: PMC9434520 DOI: 10.1186/s12889-022-14048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 08/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study investigated changes in the prevalence of insomnia in Italy during COVID-19, starting from the first lockdown period (8 March 2020). We hypothesized that lockdown precipitated increased prevalence of insomnia symptoms relative to the pre-pandemic period; b) the gradual relaxation of containment measures - post-lockdown period (Phase 2 and Phase 3) - reduced insomnia severity, leading to a relative recovery of pre-pandemic levels; and c) we tested age-related heterogeneity in sleep responses, with an expected higher increase in insomnia in younger and middle-age groups. METHODS Analyses drew on a subsample (N = 883) of respondents to ITA.LI - Italian Lives, a recently established panel study on a probability sample of individuals aged 16 + living in Italy. To estimate patterns of change in insomnia, we first fitted a random-effects ordered logistic model on the whole sample. We then added an interaction term between policy phases and the respondent age to test whether the relationship between insomnia and policy phases differed across age groups. Analyses accounted for survey non-response weights. RESULTS The fraction of respondents reporting moderate ("somewhat" + 0.159, S.E. 0.017) or severe ("very much" + 0.142, S.E. 0.030) sleep disturbances significantly increased during Phase 1. The prevalence of insomnia followed an inverted U-shaped curve across policy phases, with further increases from baseline levels ("somewhat" + 0.168, S.E. 0.015; "very much" + 0.187, S.E. 0.030) during Phase 2, followed by a relative reduction in Phase 3, although it remained significantly higher than in the pre-pandemic period ("somewhat", + 0.084, S.E. 0.016; "very much", + 0.045, S.E. 0.010). There were significant age-related differences in insomnia patterns, as the discrete change from pre-pandemic levels in the probability of not suffering from insomnia was negative and significant for the younger age group (- 0.269, S.E. 0.060) and for respondents aged 35-54 (- 0.163, S.E. 0.039). CONCLUSION There is reason to believe that the emergency policy response to the COVID-19 crisis may have had unintended and possibly scarring effects in terms of increased prevalence of insomnia. The hardest hit were young adults and, to a lesser extent, the middle-aged; however, older respondents (55 +) remained resilient, and their insomnia trajectory bounced back to pre-pandemic levels.
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Terraneo M, Lombi L, Bradby H. Depressive symptoms and perception of risk during the first wave of the COVID-19 pandemic: A web-based cross-country comparative survey. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1660-1681. [PMID: 34309032 PMCID: PMC8441873 DOI: 10.1111/1467-9566.13350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/28/2021] [Accepted: 06/22/2021] [Indexed: 05/10/2023]
Abstract
Evidence is accumulating of the negative impact of the COVID-19 pandemic and related public health measures on mental health. In this emergent field, there has been little research into the role of risk perception on depressive symptoms and the contribution of health-care resources to model risk perception and mental health. The aim of this paper is to describe the relationship between individual-level perception of risk and depression, controlling for a set of confounders and for country-level heterogeneity. A cross-sectional and observational online survey was conducted using a non-probability snowball sampling technique. We use data on 11,340 respondents, living in six European countries (Italy, Sweden, United Kingdom, France, Poland, Czech Republic) who completed survey questionnaires during the first months of the pandemic. We used a fixed-effect approach, which included individual and macro-level variables. The findings suggest that a high proportion of people suffering from depression and heightened risk perception is positively associated with reporting depressive symptoms, even if this relationship varies significantly between countries. Moreover, the association is moderated by contextual factors including health-care expenditure as a percentage of Gross Domestic Product, hospital beds for acute care, and number of medical specialists per head of population. Investment in health care offers a concrete means of protecting the mental health of a population living under pandemic restrictions.
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Affiliation(s)
- Marco Terraneo
- Department of Sociology and Social ResearchUniversità of Milano‐BicoccaMilanItaly
| | - Linda Lombi
- Department of SociologyUniversità Cattolica del Sacro CuoreMilanItaly
| | - Hannah Bradby
- Department of SociologyUppsala UniversityUppsalaSweden
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Mekhemar M, Attia S, Dörfer C, Conrad J. The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany. J Clin Med 2021; 10:1008. [PMID: 33801333 PMCID: PMC7958334 DOI: 10.3390/jcm10051008] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/24/2021] [Indexed: 12/14/2022] Open
Abstract
Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.
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Affiliation(s)
- Mohamed Mekhemar
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany; (C.D.); (J.C.)
| | - Sameh Attia
- Department of Cranio Maxillofacial Surgery, Justus-Liebig University Giessen, Klinik Str. 33, 35392 Giessen, Germany;
| | - Christof Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany; (C.D.); (J.C.)
| | - Jonas Conrad
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Kiel University, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany; (C.D.); (J.C.)
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Rossi A, Panzeri A, Pietrabissa G, Manzoni GM, Castelnuovo G, Mannarini S. The Anxiety-Buffer Hypothesis in the Time of COVID-19: When Self-Esteem Protects From the Impact of Loneliness and Fear on Anxiety and Depression. Front Psychol 2020; 11:2177. [PMID: 33240140 PMCID: PMC7683508 DOI: 10.3389/fpsyg.2020.02177] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The coronavirus (COVID-19) disease has spread worldwide, generating intense fear of infection and death that may lead to enduring anxiety. At the same time, quarantine and physical isolation can intensify feelings of dispositional loneliness that, by focusing on thoughts of disconnection from others, can trigger intense anxiety. Anxiety, generated by both fear of COVID-19 and dispositional loneliness, can activate negative expectations and thoughts of death, potentially generating alarming depressive symptoms. However, the anxiety-buffer hypothesis suggests that self-esteem acts as a shield (buffer) against mental health threats - fear and loneliness - thus hampering anxiety and depressive symptoms. OBJECTIVE This study aims to test the process - triggered by COVID-19 fear and loneliness - in which self-esteem should buffer the path leading to anxiety symptoms, then to depression. METHODS An observational research design with structural equation models was used. A sample of 1200 participants enrolled from the general population answered an online survey comprising: the fear of COVID-19 scale, the UCLA loneliness scale, the Rosenberg self-esteem scale, and the anxiety and depression scales of the Symptom Checklist-90-Revised. RESULTS Structural equation models showed the link between anxiety symptoms (mediator) with both the fear of COVID-19 and dispositional loneliness (predictors), as well as its association with consequent depressive symptomatology (outcome). In line with the anxiety-buffer hypothesis, self-esteem mediated the relationship between the predictors and their adverse psychological consequences. CONCLUSION Self-esteem represents a protective factor from the antecedents of depression. Targeted psychological interventions should be implemented to minimize the psychological burden of the disease whilst promoting adaptation and positive psychological health outcomes.
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Affiliation(s)
- Alessandro Rossi
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padua, Padua, Italy
- Interdepartmental Center for Family Research, University of Padua, Padua, Italy
| | - Anna Panzeri
- Unit of Psychology and Neuropsychology, Maugeri Scientific Institutes IRCCS, Novara, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, eCampus University, Novedrate, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS, Istituto Auxologico Italiano, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Stefania Mannarini
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padua, Padua, Italy
- Interdepartmental Center for Family Research, University of Padua, Padua, Italy
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Trumbo CW, McComas KA, Kannaovakun P. Cancer anxiety and the perception of risk in alarmed communities. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2007; 27:337-50. [PMID: 17511702 DOI: 10.1111/j.1539-6924.2007.00886.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Cancer is a significant public health topic and is frequently a factor in public reactions to environmental hazards. It may be reasonable to suggest that a unique form of health anxiety exists - one specific to cancer. In this article, we explore a measure of cancer anxiety that has applicability to risk perception in the specific context of communities that are alarmed over suspect cancer rates thought to be associated with environmental hazards. A literature search was used to identify survey questions previously used to measure cancer worry, fear, anxiety, etc. A list of 24 items was employed in a mail survey sent to 30 communities in which cancer rates were under investigation (part of a broader study). An analysis of the dataset of 1,111 responses yields two versions of a cancer anxiety scale: one an additive combination of 21 items (alpha= 0.77) and the other a two-factor model consisting of nine- and four-item subscales (alpha= 0.74 and 0.69). The resulting scales are evaluated for their ability to predict perception of risk from the environmental hazards in these cases. Controlling for age, sex, and cancer status, the scales explain between 2% and 10% of risk perception (full R(2) values ranging from 0.17 to 0.24). Given the range of concepts required to model risk perception, we conclude that this measure of cancer anxiety is sufficiently reliable and robust to be recommended for use in circumstances involving hazards associated with cancer. Other uses and further development of the measure are discussed.
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Affiliation(s)
- Craig W Trumbo
- Department of Journalism and Technical Information, Clark C-225, Colorado State University, Fort Collins, CO 80523-1785, USA.
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Greve KW, Bianchini KJ, Stickle TR, Love JM, Doane BM, Thompson MD. Effects of a community toxic release on the psychological status of children. Child Psychiatry Hum Dev 2007; 37:307-23. [PMID: 17136451 DOI: 10.1007/s10578-006-0036-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Accepted: 05/18/2006] [Indexed: 01/30/2023]
Abstract
This study sought to determine the emotional effects of a major community toxic release on children in the exposed community while controlling for the potential effects of response bias. Controlling for the response bias inherent in litigated contexts is an advance over previous studies of toxic exposure in children. A randomly selected representative sample of Exposed children (n = 31) was compared to a matched Control group (n = 28) from a nearby, unexposed community. Symptoms and complaints were assessed via interview with the children and their guardians, surveys and checklists, and well-established psychological instruments. Even when biased responding was controlled the Exposed children experienced more psychological distress, more physical symptoms, and greater general concern over their physical functioning than the Controls. The Exposed children also reported some concern about their future health and cancer risk but usually only if asked. Limitations and future research directions are discussed.
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Affiliation(s)
- Kevin W Greve
- Department of Psychology, University of New Orleans, New Orleans, LA, 70148, USA.
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Greve KW, Bianchini KJ, Doane BM, Love JM, Stickle TR. Psychological evaluation of the emotional effects of a community toxic exposure. J Occup Environ Med 2005; 47:51-9. [PMID: 15643159 DOI: 10.1097/01.jom.0000150386.33867.f9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We sought to assess the emotional effects of a major community toxic release while controlling the potential effects of response bias associated with litigation. METHODS Participants included 152 exposed adult litigants and a matched unexposed comparison group (n = 76). Psychological assessment methods included: (1) Minnesota Multiphasic Personality Inventory-2; (2) Symptom Checklist-90-Revised; and (3) Impact of Event Scale-Revised. RESULTS Ten to 40% of the exposed group demonstrated emotional distress (compared with a 5% comparison baseline) depending on indicator and cutoff score used. CONCLUSIONS The psychological consequences of a community toxic exposure were present even when exaggeration was carefully controlled. Accounting for exaggeration in the assessment of subjective psychological complaints provides a more accurate view of the subjective emotional state of persons who have experienced toxic exposure thereby facilitating appropriate clinical management of their mental health needs.
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Affiliation(s)
- Kevin W Greve
- Department of Psychology, University of New Orleans, New Orleans, Louisiana 70148, USA.
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Bornschein S, Förstl H, Zilker T. Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives. J Intern Med 2001; 250:309-21. [PMID: 11576318 DOI: 10.1046/j.1365-2796.2001.00870.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Idiopathic environmental intolerances (IEI)/multiple chemical sensitivity (MCS) is characterized by various somatic symptoms which cannot be explained organically, but are attributed to the influences of toxic environmental chemicals in low, usually harmless doses. In the absence of a widely accepted definition of IEI, contradictory aetiological hypotheses and therapeutic suggestions are discussed. Some authors doubt the existence of IEI/MCS as a disease entity of its own. The label IEI does not implicate neither a diagnosis of somatic disease nor that it is caused by an avoidable exposure. Many IEI patients suffer from psychiatric diseases. A majority of them can be diagnosed as somatoform disorders. Consequently, psychiatric therapies could be effective. This review describes the current knowledge about IEI/MCS, outlines a diagnostic algorithm and a psychotherapeutic concept for variants of IEI understood as a somatoform disorder.
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Affiliation(s)
- S Bornschein
- Department of Toxicology, II. Medical Department, Technische Universität München, Germany.
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Abstract
This review deals with diagnostic problems in DSM-III-R hypochondriasis. A first category of problems is directly connected with the definition of hypochondriasis. The following topics are discussed: the distinction between hypochondriasis and hypochondriacal attitude, the personality aspects of hypochondriasis, and the role of medical findings in the diagnosis. This is followed by a discussion of problems as to the distinction between hypochondriasis and related disorders. This concerns the status of hypochondriasis as a primary or secondary disorder in depression and the relationship with anxiety disorders (especially panic disorder and obsessive-compulsive disorder [OCD]) and the somatization disorder. The DSM-III-R classification of hypochondriasis as a somatoform disorder is disputed. A third category of problems lies in the measurement of hypochondriasis. The scope and quality of the most frequently used questionnaires for measuring hypochondriasis are poor. In research, on the basis of a single questionnaire and without due consideration of medical findings, the diagnosis of hypochondriasis is applied too soon. Finally, it is briefly indicated that the lack of diagnostic clarity affects the way in which the patient is approached in clinical practice.
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Affiliation(s)
- A J Schmidt
- Department of Medical Psychology, University of Limburg, Maastricht, The Netherlands
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Lees-Haley PR, Brown RS. Biases in perception and reporting following a perceived toxic exposure. Percept Mot Skills 1992; 75:531-44. [PMID: 1408616 DOI: 10.2466/pms.1992.75.2.531] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Reactions to chemical exposures often include fears of future illness, cancerphobia, reports of multiple chemical sensitivity, and other ill-defined complaints. Frequently, these complaints occur at levels of exposure not known to cause physiological harm. Although frequently dismissed as hysterical or hypochondriacal reactions, these complaints, along with other indefinite symptoms, may be better understood in terms of biases in perception and reporting. In this paper, we outline various sources of perceptual and response biases including prior beliefs, the media, influential others, reconstructed personal histories, self-perceptions, and the forensic environment. It is recommended that a thorough understanding of symptom-reporting and psychological distress following a chemical exposure involves consideration of these issues.
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