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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 and IEI-trigger words. Negative association effects toward IEI-trigger words were strongest for IEI participants. Emotional intrusion effects of symptom words were larger both in IEI and SFD than in controls. The results of enhanced negative automatic evaluations of IEI-trigger words and greater attention allocation to symptom words support cognitive models of IEI.

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.

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 chemical substances that are typically detectable by their odor (e.g., exhaust emissions, cigarette smoke). The current study investigated whether IEI was related to the personality trait of absorption. In a longitudinal study, 54 subjects with IEI were compared to 44 subjects with a somatoform disorder (SFD), but without IEI, and 54 subjects with neither SFD nor IEI (control group, CG). Self-report measures of somatic symptoms, severity of IEI, and level of absorption were collected both at a first examination and 32 mo later. On both assessments, subjects with IEI and individuals with SFD reported similar highly elevated levels of MUS, compared to CG. In contrast to SFD, IEI was specifically related to elevated absorption scores. IEI was specifically associated with a tendency to experience self-altering states of consciousness. Since absorption is related to both openness to unusual experiences and elevated imaginative involvement, absorption might contribute to IEI via two routes by (1) enhancing the susceptibility for IEI-specific convictions and (2) fostering classical conditioning processes of MUS via enhanced cognitive-imaginative representations of assumed IEI triggers.

Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity (MCS), is defined as a chronic polysymptomatic condition that cannot be explained by an organic disease. Previous studies suggest that IEI may be a variant of somatoform disorders (SFD), because both disorders overlap with respect to symptoms and psychological features of somatization. However, little is known about the short- and medium-term outcome of IEI and psychological outcome predictors. Two clinical groups (IEI and SFD) and a comparison group (CG) were followed through 32 mo to assess both the outcome, and the extent to which trait anxiety and somatic symptom attribution (assessed at first examination) predict outcome presented 12 and 32 mo later. Outcome measures were the number of self-reported IEI symptoms, IEI triggers, IEI-associated functional impairments, and the number of somatoform symptoms. In addition, the course of the 2 syndromes over the 32-mo follow-up period was investigated with standardized screening scales. The 3 diagnostic groups consisted of 46 subjects with IEI, 38 subjects with SFD but without IEI, and 46 subjects (CG) with neither IEI nor SFD. Syndrome stability was high over the 32-mo follow-up period, and at both follow-ups IEI and non-IEI subjects differed on all IEI outcome measures (symptoms, triggers, functional impairments). Both trait anxiety and somatic attribution (the tendency to attribute common somatic complaints to an illness) predicted outcome. In addition, somatic attribution was found to partially mediate the effect of trait anxiety on outcome in the IEI group. In conclusion, these results suggest that IEI is a chronic and disabling condition and that trait anxiety contributes to the maintenance of the disorder via somatic attributions.

Objective: Results from previous studies suggest that past trauma experience increases the risk for medically unexplained somatic symptoms and somatoform disorders (SFD). This cross-sectional study examined the link between various lifetime traumas, idiopathic environmental intolerance (IEI), and SFD., Methods: Two clinical groups of 54 subjects with IEI and 44 subjects with SFD were compared to 54 subjects (comparison group, CG) free from both IEI and SFD regarding self-reported traumas. The subjects were mainly recruited via advertisements in local newspapers. From 970 individuals screened for IEI and multiple somatic symptoms, 152 were included through a two-step selection procedure consisting of screening questionnaires, a medical examination, and structured interviews for IEI and mental disorders., Results: In all three groups at least one potential traumatic event was reported rather frequently (CG: 70%; IEI: 82%; SFD: 73%). But contrary to our expectation, significant group differences were neither found in regard to the proportion of subjects with any trauma, nor traumas fulfilling DSM-IV criteria (CG: 41%; IEI: 48%; SFD: 59%), nor multiple traumas (CG: 43%, IEI: 56%, SFD: 39%). Only two trauma categories were endorsed more frequently by the two clinical groups than by the CG: the unspecified 'other' category (IEI, SFD>CG) and 'life-threatening illness' (IEI>CG)., Conclusion: No clear evidence was found for increased rates of trauma experience in IEI and SFD. However, the results of this exploratory study should be considered as preliminary. Comparing larger IEI and SFD groups with a representative population-based sample may yield different results.

Objective: The objective of this study was to examine the psychometric qualities of a brief screening measure for idiopathic environmental intolerance (IEI), the Chemical Odor Sensitivity Scale (COSS)., Methodology: The COSS was administered together with other measures of environmental sensitivity, IEI, and symptom scales in large samples (students, individuals with IEI, and individuals without IEI)., Results: The COSS achieved high internal consistency (.88 < or = Cronbach's alpha < or = .96) and good factorial, convergent, and discriminant validity across diverse samples. In a longitudinal sample, the COSS and other IEI features were stable across time. According to receiver operating characteristic analyses, the COSS performs adequately in screening individuals likely to meet case criteria for IEI., Conclusions: The favorable psychometric qualities of the COSS recommend the scale as a useful tool both for assessing self-reported chemical odor sensitivity as a vulnerability marker and for screening for IEI.

Objective: Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity, is a chronic, polysymptomatic condition that cannot be explained by an organic disease. Physical and psychological complaints are believed to be sustained by low levels of chemically unrelated substances in the environment. At present, it is unclear whether IEI is an environmental illness or a variant of somatoform disorders (SFD). This study examined whether IEI can be distinguished from SFD with respect to self-reported symptoms, trait anxiety, body-related cognitions, and symptom attributions., Methods: We compared 54 subjects with IEI, 54 subjects with SFD but without IEI, and 44 subjects with neither IEI nor SFD on symptom scales, psychological questionnaires, and structured interviews for IEI, depression, anxiety, and SFD., Results: More than half of the IEI subjects met Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria of SFD. This group shared both symptoms and psychological features of somatization with the SFD group. IEI subjects who did not fulfill criteria for a specific SFD were less impaired by their chemical sensitivity but differed nevertheless from nonsomatoform controls by significantly higher symptom scores, higher trait anxiety, a focus on autonomic sensations, and more pronounced somatic symptom attributions. These psychological features were significantly associated with the burden of somatic symptoms in both SFD and IEI. Furthermore, self-reported allergy but not total immunoglobulin E correlated with symptom burden in the total sample., Conclusions: The similarity of IEI and SFD regarding symptoms and psychological features of somatization support the hypothesis that IEI is a variant of SFD.

Multiple Chemical Sensitivity (MCS) -- also known as Idiopathic Environmental Intolerances (IEI) -- is defined as a disorder with multiple somatic and psychological symptoms attributed to low levels of various, chemically unrelated substances in the environment. Self-reported chemical odor sensitivity is an important feature of MCS. We describe the construction and the reliability and validity properties of a short questionnaire for the assessment of chemical odor sensitivity (COSS). The 11 items of the COSS were factor analytically derived from the Questionnaire of Chemical and General Environmental Sensitivity (CGES). Test statistical properties of the COSS were examined in college students, unselected community members, environmental medicine outpatients and chemically sensitive subjects. The COSS achieved good internal consistency in all samples (Cronbach's alpha = 0.89 - 0.93). Women and subjects from samples with higher MCS risk showed elevated COSS scores. The scale showed adequate construct validity and proved useful as an economic screening instrument for persons at risk for MCS.

Objective:Worries about health threatening effects of potential health hazards of modern life (e.g. electric devices and pollution) represent a growing phenomenon in Western countries. Yet, little is known about the causes of this growing special case of affective risk perceptions termed Modern Health Worries (MHW). The purpose of this study is to examine a possible role of biased media reports in the formation of MHW. Design:In two experiments, we investigated whether typical television reports affect MHW. In Study 1, 130 participants were randomly assigned to a film on idiopathic environmental intolerance (IEI) or a control film about cystic fibrosis. In Study 2, 82 participants were randomly assigned to either a film on the dangers of electromagnetic fields or a control condition. Main outcome measures:Increases in MHW after sensational media reports. Results:In Study 1, only participants high on the personality trait of absorption revealed increased MHW after watching the IEI film. In Study 2, specifically worries about radiation were found to be elevated after watching the film on the dangers of electromagnetic fields compared to the control film. Conclusion:The results of both studies reveal a significant and specific influence of sensational short mass media reports on MHW. The influence of potential moderators such as absorption remains to be clarified. [ABSTRACT FROM AUTHOR]

Idiopathic environmental intolerance (IEI) refers to a polysymptomatic condition, similar to somatoform disorders. Various processes seem to contribute to its yet unknown etiology. Attention and memory for somatic symptom and IEI-trigger words was compared among participants with IEI (n = 54), somatoform disorders (SFD; n = 44) and control participants (n = 54). Groups did not differ in a dot-probe task. However, in an emotional Stroop task, attention was biased in WI and SFD groups toward symptom words but not toward IEI-trigger words. Only the IEI group rated trigger words as more unpleasant and more arousing, and participants remembered them better in a recognition task. These implicit and explicit cognitive abnormalities in WI and SFD may maintain processes of somatosensory amplification. [ABSTRACT FROM AUTHOR]

Objective: Cross-sectional investigation of associations between psychosocial and periodontal parameters. Methods: One hundred and ten patients 18–76 years of age were examined clinically and 57 radiographically at the Department of Conservative Dentistry of the University Hospital of Heidelberg: probing depths (PDs) and attachment level (PAL-V) were obtained at six sites per tooth. Inter-proximal bone loss was assessed in 57 patients on panoramic radiographs. Further chemical and general environmental sensitivity, somatization, and smoking status were assessed by several questionnaires. Results: Significant correlations between severe bone loss and age ( r=0.38, p=0.004) were observed. PAL-V and PD also correlated with age ( r=0.45, p<0.001; r=0.37, p<0.001) and pack years ( r=0.21, p=0.031; r=0.3, p=0.002). After adjustment for age, smoking, and sex a negative correlation between chemical odour sensitivity and bone loss, PD=4 mm as well as PAL-V=4 mm was observed. Further, a negative correlation was observed between gastrointestinal sensitivity and PAL-V=4 mm. Psychological stress correlated positively with bone loss. Conclusion: The results give evidence for associations of psychosocial factors and periodontal disease. Some environmental traits seem to be related to more favourable periodontal status. [ABSTRACT FROM AUTHOR]

Abstract: Multiple chemical sensitivity (MCS) is defined as a syndrome with multiple medically unexplained symptoms attributed to low levels of chemically unrelated substances in the environment. The etiology of this syndrome is still unclear. As MCS may be conceptualized as an atypical type of somatoform disorder, the purpose of the study was to examine whether MCS subjects show symptom patterns, personality traits, and perceptual and cognitive styles as typically found in somatoform patients. Nonsensitive controls () were compared to subjects with moderate () and high () MCS intensity with self-report psychological questionnaires and structured interviews for depression and somatoform disorders. The high MCS group scored significantly higher than the other two groups on self-report scales for somatoform symptoms and depression. Moreover, high MCS was strongly associated with the diagnosis of somatoform disorder, and weaker but still significantly with depression. In a stepwise multiple regression analysis, cognitions about environmental threat, trait anxiety, focus on autonomic sensations, and general environmental sensitivity predicted MCS symptoms in the total sample, explaining 53% of the variance. These results support the hypothesis that trait negativity and mechanisms of symptom perception and symptom amplification contribute to the enhanced symptom reports of MCS individuals. [Copyright &y& Elsevier]