Modern health worries and idiopathic environmental intolerance.

Abstract 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 we…

Abnormalities in cognitive-emotional information processing in idiopathic environmental intolerance and somatoform disorders

Idiopathic environmental intolerance (IEI) represents a functional somatic syndrome marked by diverse bodily complaints attributed to various substances in the environment. Evidence for abnormalities in affective information processing similar to somatoform disorders (SFD) has recently been found in people with IEI. In order to further investigate these cognitive-emotional abnormalities, we compared people with IEI (n=49), SFD only (n=43), and non-somatoform controls (n=54) with respect to their performance in the extrinsic affective Simon task (EAST). This task allowed us to dissociate indicators of automatic affective associations and emotional intrusion effects of both bodily complaints …

Cough is dangerous : neural correlates of implicit body symptoms associations

The negative interpretation of body sensations (e.g., as sign of a severe illness) is a crucial cognitive process in pathological health anxiety (HA). However, little is known about the nature and the degree of automaticity of this interpretation bias. We applied an implicit association test (IAT) in 20 subjects during functional magnetic resonance imaging (fMRI) to investigate behavioral and neural correlates of implicit attitudes towards symptom words. On the behavioral level, body symptom words elicited strong negative implicit association effects, as indexed by slowed reaction times when symptom words were paired with the attribute harmless (incongruent condition) relative to a control …

Vorschläge zur Evaluation regulärer Psychotherapien an Hochschulambulanzen im Sinne der Phase-IV-Therapieforschung

Zusammenfassung. Durch den Aufbau psychotherapeutischer Hochschulambulanzen an Universitätsinstituten ist in den letzten Jahren ein enormes Potenzial für die naturalistische Phase-IV-Therapieforschung entstanden. Viele Ambulanzen haben ein System zur kontinuierlichen Evaluation der Behandlungen eingeführt. Das methodische Vorgehen dabei ist jedoch heterogen und erscheint mehr von den lokalen Möglichkeiten als von übergeordneten wissenschaftlichen Überlegungen bestimmt. Dies betrifft die Organisation der Datenerhebung, die Definition des „Produkts Psychotherapie” sowie die Auswertung und Präsentation der Daten. Ein Vergleich zwischen den Ambulanzen und die Zusammenführung von Datensätzen zu…

Health anxiety and hypochondriasis in the light of DSM-5.

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD.Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals.Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired,…

Elektronische Tagebücher optimieren die Kognitive Verhaltenstherapie bei Krankheitsängsten : eine randomisiert-kontrollierte Studie

Zentrale Komponenten in kognitiv-behavioralen Erklärungsmodellen der Hypochondrie und den daraus abgeleiteten Behandlungen sind eine selektive Aufmerksamkeitslenkung auf körperliche Empfindungen und ein katastrophisierender Symptominterpretationsbias. Wir untersuchten, ob sich die Effektivität einer störungsspezifischen Kognitiven Verhaltenstherapie (KVT) für Patienten mit Hypochondrie durch ein zusätzliches zweiwöchiges elektronisches Tagebuchtraining (TBT), das auf eine Korrektur der Symptominterpretationen abzielt, verbessern lässt. Zu diesem Zweck wurden 35 Patienten mit Hypochondrie randomisiert zwei Interventionsformen zugewiesen: Gruppe 1 (N = 16) erhielt vor der KVT (16 Einzelsitzu…

Sucht und Folgestörungen

Reaction time paradigms in subjects at risk for schizophrenia.

Abstract Deviant response patterns in experimental reaction time paradigms in schizophrenic probands are well documented. Although simple reaction times are strongly influenced by the current psychopathological status of the proband (e.g. florid psychotic patients versus remitted patients) these influences are less clear for measures obtained from more complex reaction time paradigms. These include the crossover paradigm (reaction time to stimuli presented after constant preparatory intervals in comparison to reaction time to stimuli presented after irregular preparatory intervals) and the modality shift paradigm (reaction time to a stimulus (light or tone) when the modality of the stimulus…

Neuronal and Behavioral Correlates of Health Anxiety: Results of an Illness-Related Emotional Stroop Task

<b><i>Background:</i></b> Health anxiety (HA) is defined as the objectively unfounded fear or conviction of suffering from a severe illness. Predominant attention allocation to illness-related information is regarded as a central process in the development and maintenance of HA, yet little is known about the neuronal correlates of this attentional bias. <b><i>Methods:</i></b> An emotional Stroop task with body symptom, illness, and neutral words was employed to elicit emotional interference in healthy participants with high (HA+, n = 12) and low (HA–, n = 12) HA during functional magnetic resonance imaging. <b><i>Results:</i>…

Neuropsychological indicators of the vulnerability to schizophrenia

Schizophrenia is associated with enduring deficits in neuropsychological functioning. It is widely undecided if the various aspects of neuropsychological impairment are a consequence of the disorder or if they are also present premorbidly and in populations at increased risk for schizophrenia (vulnerability markers). Neuropsychological deficits in healthy relatives of schizophrenic patients who are at an elevated risk for schizophrenia and who did not yet pass the period of risk would indicate that these deficits are vulnerability markers. This hypothesis was tested for three neuropsychological paradigms which have been proven to distinguish schizophrenic patients from controls. 33 siblings…

Cognitive Biases in Pathological Health Anxiety

Pathological health anxiety refers to the medically unfounded fear of suffering from a severe illness. Differences in cognitive processes related to attention, memory, and evaluation of health threat have been hypothesized to underlie pathological health anxiety. In no study, however, have researchers systematically and simultaneously assessed different cognitive biases. On the basis of the idea that multiple cognitive biases simultaneously contribute to psychopathology (the combined-cognitive-bias hypothesis), we compared 88 patients with pathological health anxiety, 52 patients with depressive disorder, and 52 healthy participants on their performance in several cognitive tasks involving…

Neural correlates of an attentional bias to health-threatening stimuli in individuals with pathological health anxiety

Background: An attentional bias to health-threat stimuli is assumed to represent the primary pathogenetic factor for the development and maintenance of pathological health anxiety (PHA; formerly termed “hypochondriasis”). However, little is known about the neural basis of this attentional bias in individuals with PHA.Methods: A group of patients with PHA, a group of depressed patients and a healthy control group completed an emotional Stroop task with health-threat (body symptom and illness) words and neutral control words while undergoing functional MRI.Results: We included 33 patients with PHA, 28 depressed patients and 31 controls in our analyses. As reflected in reaction times, patients…

Evidence for a specific link between the personality trait of absorption and idiopathic environmental intolerance.

Absorption as a personality trait refers to the predisposition to get deeply immersed in sensory (e.g., smells, sounds, pictures) or mystical experiences, that is, to experience altered states of consciousness. Absorption is markedly related to constructs openness to experiences, hypnotic suggestibility, imagination, and dissociation. Although absorption was hypothesized to be a risk factor for medically unexplained symptoms (MUS), the construct has yet not been investigated in individually suffering from idiopathic environmental intolerance (IEI), formerly better known as multiple chemical sensitivity (MCS). IEI is a complex condition marked by MUS, which patients attribute to various chem…