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Idiopathic Environmental Intolerance

Part 2: A Causation Analysis Applying Bradford Hill’s Criteria to the Psychogenic Theory

  • Review Article
  • Published:
Toxicological Reviews

Abstract

Toxicogenic and psychogenic theories have been proposed to explain idiopathic environmental intolerance (IEI). Part 2 of this article is an evidence-based causality analysis of the psychogenic theory using an extended version of Bradford Hill’s criteria. The psychogenic theory meets all of the criteria directly or indirectly and is characterised by a progressive research programme including double-blind, placebo-controlled provocation challenge studies. We conclude that IEI is a belief characterised by an overvalued idea of toxic attribution of symptoms and disability, fulfilling criteria for a somatoform disorder and a functional somatic syndrome. A neurobiological diathesis similar to anxiety, specifically panic disorder, is a neurobiologically plausible mechanism to explain triggered reactions to ambient doses of environmental agents, real or perceived. In addition, there is a cognitively mediated fear response mechanism characterised by vigilance for perceived exposures and bodily sensations that are subsequently amplified in the process of learned sensitivity. Implications for the assessment and treatment of patients are presented.

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References

  1. Staudenmayer H, Binkley KE, Leznoff A, et al. Idiopathic environmental intolerance: part 1 — a causation analysis applying Bradford Hill’s criteria to the toxicogenic theory. Toxicol Rev 2003; 22(3): 235–46

    Article  PubMed  CAS  Google Scholar 

  2. McKenna PJ. Disorders with overvalued ideas. Br J Psychiatry 1984; 145: 579–85

    Article  PubMed  CAS  Google Scholar 

  3. Ross SE. ‘Memes’ as infectious agents in psychosomatic illness. Ann Intern Med 1999; 131: 867–71

    PubMed  CAS  Google Scholar 

  4. Staudenmayer H. Environmental illness: myth and reality. Boca Raton (FL): CRC/Lewis Publishers, 1999

    Google Scholar 

  5. Staudenmayer H. Idiopathic environmental intolerances (IEI): myth and reality. Toxicol Lett 2001; 120: 333–42

    Article  PubMed  CAS  Google Scholar 

  6. Black DW. The relationship of mental disorders and idiopathic environmental intolerance. Occup Med 2000; 15: 557–70

    PubMed  CAS  Google Scholar 

  7. Sparks PJ. Idiopathic environmental intolerances: overview. Occup Med 2000; 15: 497–510

    PubMed  CAS  Google Scholar 

  8. Bornschein S, Forstl H, Zilker T. Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives. J Intern Med 2001; 250: 309–21

    Article  PubMed  CAS  Google Scholar 

  9. Gothe CJ, Molin CM, Nilsson CG. The environmental somatization syndrome. Psychosomatics 1995; 36: 1–11

    Article  PubMed  CAS  Google Scholar 

  10. Boss LP. Epidemic hysteria: a review of the published literature. Epidemiol Rev 1997; 19: 232–43

    Article  Google Scholar 

  11. Bartholomew RE, Wessely S. Protean nature of mass sociogenic illness. Br J Psychiatry 2002; 180: 300–4

    Article  PubMed  Google Scholar 

  12. Dodes JE. The amalgam controversy: an evidence-based analysis. J Am Dent Assoc 2001; 132: 348–56

    PubMed  CAS  Google Scholar 

  13. Selner JC, Staudenmayer H. Food allergy: psychological considerations. In: Metcalfe DD, Sampson HA, Simon RA, editors. Food allergy: adverse reactions to foods and food additives. 2nd ed. Cambridge (MA): Blackwell Science, 1997: 519–28

    Google Scholar 

  14. Staudenmayer H, Selner JC. Psychological manifestations in idiopathic environmental intolerance (foods). In: Frieri M, Kettelhut B, editors. Food hypersensitivity and adverse reactions. New York: Marcel Dekker, 1999: 347–80

    Google Scholar 

  15. Levallois P. Hypersensitivity of human subjects to environmental electric and magnetic field exposure: a review of the literature. Environ Health Perspect 2002; 110Suppl. 4: 613–8

    Article  PubMed  Google Scholar 

  16. Tarlo SM, Poonai N, Binkley K. Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorder. Environ Health Perspect 2002; 110Suppl. 4: 669–71

    Article  PubMed  Google Scholar 

  17. Meggs WJ. RADS and RUDS: the toxic induction of asthma and rhinitis. Clin Toxicol 1994; 32: 487–501

    Article  CAS  Google Scholar 

  18. Bell IR, Hardin EE, Baldwin CM, et al. Increased limbic system symptomatology and sensitizability of young adults with chemical and noise sensitivities. Environ Res 1995; 70: 84–97

    Article  PubMed  CAS  Google Scholar 

  19. Ziem GE, Davidoff LL. Illness from chemical ‘odors’: is the health significance understood? Arch Environ Health 1992; 47: 88–91

    Article  PubMed  CAS  Google Scholar 

  20. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV). 4th ed. Washington, DC: American Psychiatric Press, 1994

    Google Scholar 

  21. Simon GE, Daniell W, Stockbridge H, et al. Immunologic, psychological and neuropsychological factors in multiple chemical sensitivity. Ann Intern Med 1993; 19: 97–103

    Google Scholar 

  22. Black DW, Rathe A, Goldstein RB. Environmental illness: a controlled study of 26 subjects with ‘20th century disease.’ JAMA 1990; 264: 3166–70

    Article  PubMed  CAS  Google Scholar 

  23. Black DW, Rathe A, Goldstein RB. Measures of distress in 26 ‘environmentally ill’ subjects. Psychosomatics 1993; 34: 131–8

    Article  PubMed  CAS  Google Scholar 

  24. Hausteiner C, Bornschein S, Bickel H, et al. Psychiatric morbidity and low selfattentiveness in patients with environmental illness. J Nerv Ment Dis 2003; 191: 50–5

    Article  PubMed  Google Scholar 

  25. Brewin CR. Cognitive theories of motivation. In: Eysenck H, Martin I, editors. Theoretical foundations of behavior therapy. New York: Plenum, 1987: 277–93

    Google Scholar 

  26. Shedler J, Mayman M, Manis M. The illusion of mental health. Am Psychol 1993; 48: 1117–31

    Article  PubMed  CAS  Google Scholar 

  27. Fiedler N, Maccia C, Kipen H. Evaluation of chemically sensitive patients. J Occup Med 1992; 34: 529–38

    Article  PubMed  CAS  Google Scholar 

  28. Staudenmayer H, Selner JC. Failure to assess psychopathology in patients presenting with chemical sensitivities. J Occup Med 1995; 37: 704–9

    Article  CAS  Google Scholar 

  29. Terr AI. Environmental illness: a clinical review of 50 cases. Arch Intern Med 1986; 146: 145–9

    Article  PubMed  CAS  Google Scholar 

  30. Hill AB. The environment and disease: association or causation. Proc R Soc Med 1965; 58: 295–300

    PubMed  CAS  Google Scholar 

  31. Hammond EC. Some preliminary findings on physical complaints from a prospective study of 1,064,004 men and women. Am J Public Health 1964; 54: 11–23

    CAS  Google Scholar 

  32. Simon GE, VonKorff M, Piccinelli M, et al. An international study of the relation between somatic symptoms and depression. N Engl J Med 1999; 341: 1329–35

    Article  PubMed  CAS  Google Scholar 

  33. Leznoff A. Provocative challenges in patients with multiple chemical sensitivity. J Allergy Clin Immunol 1997; 99: 438–42

    Article  PubMed  CAS  Google Scholar 

  34. Simon GE, VonKorff M. Somatization and psychiatric disorder in the NIMH epidemiologic catchment area study. Am J Psychiatry 1991; 148: 1494–500

    PubMed  CAS  Google Scholar 

  35. Selner JC, Staudenmayer H. The relationship of the environment and food to allergic and psychiatric illness. In: Young SH, Rubin JM, Daman HR, editors. Psychophysiological aspects of allergic disorders. New York: Praeger, 1986: 102–46

    Google Scholar 

  36. Bornschein S, Hausteiner C, Zilker T, et al. Psychiatric and somatic disorders and multiple chemical sensitivity (MCS) in 264 ‘environmental patients’. Psychol Med 2002; 32: 1387–94

    Article  PubMed  CAS  Google Scholar 

  37. Moorhead JF, Suruda AJ. Occipital lobe meningioma in a patient with multiple chemical sensitivities. Am J Ind Med 2000; 37: 443–6

    Article  PubMed  CAS  Google Scholar 

  38. Escobar JI, Hoyos-Nervi C, Gara M. Medically unexplained physical symptoms in medical practice: a psychiatric perspective. Eniron Health Perspect 2002; 110Suppl. 4: 631–6

    Article  Google Scholar 

  39. Bass C, Benjamin S. The management of chronic somatization. Br J Psychiatry 1993; 162: 472–80

    Article  PubMed  CAS  Google Scholar 

  40. Kellner R. Somatization theories and research. J Nerv Ment Dis 1990; 178: 150–60

    Article  PubMed  CAS  Google Scholar 

  41. Pennebaker JW. Psychological bases of symptom reporting: perceptual and emotional aspects of chemical sensitivity. Toxicol Ind Health 1994; 10: 497–511

    PubMed  CAS  Google Scholar 

  42. Barsky AJ, Klerman GL. Overview: hypochondriasis, bodily complaints, and somatic styles. Am J Psychiatry 1983; 140: 273–83

    PubMed  CAS  Google Scholar 

  43. Barsky AJ, Borus JF. Somatization and medicalization in the era of managed care. JAMA 1995; 274: 1931–4

    Article  PubMed  CAS  Google Scholar 

  44. Stewart DE. The changing faces of somatization. Psychosomatics 1990; 31: 153–8

    Article  PubMed  CAS  Google Scholar 

  45. Shorter E. From paralysis to fatigue: a history of psychosomatic illness in the modern era. New York: Free Press/Macmillan, 1992

    Google Scholar 

  46. Wessely S. Old wine in new bottles: neurasthenia and ‘ME’. Psychol Med 1990; 20: 35–53

    Article  PubMed  CAS  Google Scholar 

  47. Wessely S. Chronic fatigue syndrome: a 20th century illness. Scand J Work Environ Health 1997; 23Suppl. 3: 17–34

    PubMed  Google Scholar 

  48. Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med 1999; 130: 910–21

    PubMed  CAS  Google Scholar 

  49. Hadler NM. Fibromyalgia, chronic fatigue, and other iatrogenic diagnostic algorithms. Postgrad Med 1997; 102: 161–7

    Article  PubMed  CAS  Google Scholar 

  50. Buchwald D, Garrity D. Comparison of patients with chronic fatigue syndrome, fibromyalgia, and multiple1 chemical sensitivities. Arch Intern Med 1994; 154: 2049–53

    Article  PubMed  CAS  Google Scholar 

  51. Rea WJ. Chemical sensitivity: clinical manifestations of pollutant overload. Vol. 3. Boca Raton (FL): Lewis Publishers/CRC Press, 1995

    Google Scholar 

  52. Schaumburg HH, Spencer PS, Ludolph AC, editors. Experimental and clinical neurotoxicology. 2nd ed. New York: Oxford University Press, 2000

    Google Scholar 

  53. Rosenberg NL, editor. Occupational and environmental neurology. Newton (MA): Butterworth-Heineman, 1995

    Google Scholar 

  54. Bardana EJ. Sick building syndrome: a wolf in sheep’s clothing. Ann Allergy Asthma Immunol 1997; 79: 283–93

    Article  PubMed  Google Scholar 

  55. Ooi PL, Goh KT. Sick building syndrome: an emerging stress-related disorder. Int J Epidemiol 1997; 26: 1243–9

    Article  PubMed  CAS  Google Scholar 

  56. Hodgson MJ. Indoor environmental exposures and symptoms. Environ Health Perspect 2002; 110Suppl. 4: 663–7

    Article  PubMed  CAS  Google Scholar 

  57. Christopher KL, Wood RP, Eckert RC, et al. Vocal-cord dysfunction presenting as asthma. N Engl J Med 1983; 308: 1566–70

    Article  PubMed  CAS  Google Scholar 

  58. Selner JC, Staudenmayer H, Koepke JW, et al. Vocal cord dysfunction: the importance of psychologic factors and provocation challenge testing. J Allergy Clin Immunol 1987; 79: 726–33

    Article  PubMed  CAS  Google Scholar 

  59. Perkner JJ, Fennelly KP, Balkissoon R, et al. Irritant-associated vocal cord dysfunction. J Occup Environ Med 1998; 40: 136–43

    Article  PubMed  CAS  Google Scholar 

  60. Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposures. Chest 1985; 88: 376–84

    Article  PubMed  CAS  Google Scholar 

  61. Brooks SM, Hammad Y, Richards I, et al. The spectrum of irritant-induced asthma: sudden and not-so-sudden onset and the role of allergy. Chest 1998; 113: 42–9

    Article  PubMed  CAS  Google Scholar 

  62. Bardana EJ. Reactive airways dysfunction syndrome (RADS): guidelines for diagnosis and treatment and insight into likely prognosis. Ann Asthma Allergy Immunol 1999; 83: 583–6

    Article  CAS  Google Scholar 

  63. Ross PM, Whysner J, Covello VT, et al. Olfaction and symptoms in multiple chemical sensitivities syndrome. Prev Med 1999; 28: 467–80

    Article  PubMed  CAS  Google Scholar 

  64. Meggs WJ. Neurogenic inflammation and sensitivity to environmental chemicals. Environ Health Perspect 1993; 101: 234–8

    Article  PubMed  CAS  Google Scholar 

  65. Demitrack MA, Abbey SE. Chronic fatigue syndrome: an interactive approach to evaluation and treatment. New York: Guilford Press, 1996

    Google Scholar 

  66. Natelson BH, Lange G. A status report on chronic fatigue syndrome. Environ Health Perspect 2002; 110Suppl. 4: 673–7

    Article  PubMed  Google Scholar 

  67. Epstein SA, Kay G, Clauw D, et al. Psychiatric disorders in patients with fibromyalgia: a multicenter investigation. Psychosomatics 1999; 40: 57–63

    Article  PubMed  CAS  Google Scholar 

  68. Winfield JB. Pain in fibromyalgia. Rheumatol Clin North Am 1999; 25: 55–79

    Article  CAS  Google Scholar 

  69. Drossman DA, Leserman J, Nachman G, et al. Sexual and physical abuse in women with functional or organic gastrointestinal disorders. Ann Intern Med 1990; 113:828–33

    PubMed  CAS  Google Scholar 

  70. Drossman DA, McKee DC, Sandler RS, et al. Psychosocial factors in the irritable bowel syndrome: a multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology 1988; 95: 701–8

    PubMed  CAS  Google Scholar 

  71. Kroenke K, Koslowe P, Roy M. Symptoms in 18,495 Persian Gulf war veterans. J Occup Environ Med 1998; 40: 520–8

    Article  PubMed  CAS  Google Scholar 

  72. Roy MJ. Environmental influences on illnesses in Persian Gulf war veterans. In: Lundberg A, editor. The environment and mental health. Hillsdale (NJ): Lawrence Erlbaum, 1998: 67–82

    Google Scholar 

  73. Black DW, Doebbeling BN, Voelker MD, et al. Multiple chemical sensitivity: symptom prevalence and risk factors in a military population. Arch Intern Med 2000; 160: 1169–76

    Article  PubMed  CAS  Google Scholar 

  74. Skapinakis P, Lewis G, Venetsanos M. Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalized anxiety. Am J Psychiatry 2003; 160: 785–7

    Article  PubMed  Google Scholar 

  75. Stewart DE, Raskin J. Psychiatric assessment of patients with ‘20th century disease’ (‘total allergy syndrome’). CMAJ 1985; 133: 1001–6

    PubMed  CAS  Google Scholar 

  76. Simon GE, Katon WJ, Sparks PJ. Allergic to life: psychological factors in environmental illness. Am J Psychiatry 1990; 147: 901–6

    PubMed  CAS  Google Scholar 

  77. Fiedler N, Kipen H. Chemical sensitivity: the scientific literature. Environ Health Perspect 1997; 105Suppl. 2: 409–15

    PubMed  Google Scholar 

  78. Selner JC. Chamber challenges: the necessity of objective observation. Reg Toxicol Pharmacol 1996; 24: S87

    Article  CAS  Google Scholar 

  79. Weiss B. Experimental strategies for research on multiple chemical sensitivity. Environ Health Perspect 1997; 105Suppl. 2: 487–94

    PubMed  Google Scholar 

  80. International Programme on Chemical Safety/World Health Organization (IPCS/WHO). Conclusions and recommendations of a workshop on multiple chemical sensitivities (MCS). Reg Toxicol Pharmacol 1996; 24: S188

    Article  Google Scholar 

  81. Graveling RA, Pilkington A, George JP. A review of multiple chemical sensitivity. Occup Environ Med 1999; 56: 73–85

    Article  PubMed  CAS  Google Scholar 

  82. Pearson DJ, Rix KJ, Bentley SJ. Food allergy: how much in the mind?: a clinical and psychiatric study of suspected food hypersensitivity. Lancet 1983; I(8336): 1259–61

    Article  Google Scholar 

  83. Rix KJ, Pearson DJ, Bentley SJ. A psychiatric study of patients with supposed food allergy. Br J Psychiatry 1984; 145: 121–6

    Article  PubMed  CAS  Google Scholar 

  84. Parker SL, Leznoff A, Sussman GL, et al. Characteristics of patients with food-related complaints. J Allergy Clin Immunol 1990; 86: 503–11

    Article  PubMed  CAS  Google Scholar 

  85. Jewett DL, Fein G, Greenberg MH. A double-blind study of symptom provocation to determine food sensitivity. N Engl J Med 1990; 323: 429–33

    Article  PubMed  CAS  Google Scholar 

  86. Staudenmayer H, Selner JC, Buhr M. Double-blind provocation challenges in 20 patients presenting with ‘multiple chemical sensitivity’. Reg Toxicol Pharmacol 1993; 18: 44–53

    Article  CAS  Google Scholar 

  87. Hummel T, Roscher S, Jaumann MP, et al. Intranasal chemoreception in patients with multiple chemical sensitivity: a double-blind investigation. Reg Toxicol Pharmacol 1996; 24: S79

    Article  CAS  Google Scholar 

  88. Dalton P. Cognitive influences on health symptoms from acute chemical exposure. Health Psychol 1999; 18: 579–90

    Article  PubMed  CAS  Google Scholar 

  89. Dalton P, Hummel T. Chemosensory function and response in idiopathic environmental intolerance. Occup Med 2000; 15: 539–56

    PubMed  CAS  Google Scholar 

  90. Andersson B, Berg M, Arnetz BB, et al. A cognitive-behavioral treatment of patients suffering from ‘electric hypersensitivity’. J Occup Environ Med 1996; 38: 752–8

    Article  PubMed  CAS  Google Scholar 

  91. Flodin U, Seneby A, Tegenfeldt C. Provocation of electrical hypersensitivity under everyday conditions. Scand J Work Environ Health 2000; 26: 93–8

    Article  PubMed  CAS  Google Scholar 

  92. Bolla-Wilson K, Wilson RJ, Bleeker ML. Conditioning of physical symptoms after neurotoxic exposure. J Occup Med 1988; 30: 684–6

    PubMed  CAS  Google Scholar 

  93. Spyker DA. Multiple chemical sensitivities: syndrome and solution. Clin Toxicol 1995; 33: 95–9

    Article  CAS  Google Scholar 

  94. Giardino ND, Lehrer PM. Behavioral conditioning and idiopathic environmental intolerance. Occup Med 2000; 15: 519–28

    PubMed  CAS  Google Scholar 

  95. Sullivan Jr JB, Krieger GR. Hazardous materials toxicology: clinical principles of environmental health. Baltimore (MD): Williams & Wilkins, 1992

    Google Scholar 

  96. Binkley KE, Kutcher S. Panic response to sodium lactate infusion in patients with multiple chemical sensitivity syndrome. J Allergy Clin Immunol 1997; 99: 570–4

    Article  PubMed  CAS  Google Scholar 

  97. Poonai N, Anthony MM, Binkley KE, et al. Carbon dioxide inhalation challenges in idiopathic environmental intolerance. J Allergy Clin Immunol 2000; 105: 358–63

    Article  PubMed  CAS  Google Scholar 

  98. Sinha S, Papp LA, Gorman JM. How study of respiratory physiology aided our understanding of abnormal brain function in panic disorder. J Affect Disord 2000; 61: 191–200

    Article  PubMed  CAS  Google Scholar 

  99. Selner JC, Staudenmayer H. Neuropsychophysiologic observations in patients presenting with environmental illness. Toxicol Ind Health 1992; 8: 145–55

    PubMed  CAS  Google Scholar 

  100. Rosenberg SJ, Freedman MR, Schmaling KG, et al. Personality styles of patients asserting environmental illness. J Occup Med 1990; 32: 678–81

    PubMed  CAS  Google Scholar 

  101. Schmidt LA, Fox NA, Schulkin J, et al. Behavioral and psychophysiological correlates of self-presentation in temperamentally shy children. Dev Psychobiol 1999; 35: 119–35

    Article  PubMed  CAS  Google Scholar 

  102. Arbelle S, Benjamin J, Golin M, et al. Relation of shyness in grade school children to the genotype for the long form of the serotonin transporter promoter region polymorphism. Am J Psychiatry 2003; 160: 671–6

    Article  PubMed  Google Scholar 

  103. Bell IR. Neuropsychiatric aspects of sensitivity to low-level chemicals: a neural sensitization model. Toxicol Ind Health 1994; 10: 277–312

    PubMed  CAS  Google Scholar 

  104. Binkley K, King N, Poonai N, et al. Idiopathic environmental intolerance; Increased prevalence of panic disorder-associated cholecystokinin B receptor allele 7. J Allergy Clin Immunol 2001; 107: 887–90

    Article  PubMed  CAS  Google Scholar 

  105. Knutson JF. Physical and sexual abuse of children. In: Rauth DK, editor. Handbook of pediatric psychology. New York: Guilford, 1988: 32–70

    Google Scholar 

  106. Green AH. Physical and sexual abuse of children. In: Kaplan HI, Sadeck BI, editors. Comprehensive textbook of psychiatry. Vol 2. 5th ed. Baltimore (MD): Williams and Wilkins, 1989: 1962–70

    Google Scholar 

  107. Shengold L. Soul murder: the effects of childhood abuse and deprivation. New York: Ballantine Books, 1989

    Google Scholar 

  108. Loewenstein RJ. Somatoform disorders in victims of incest and child abuse. In: Kluft RP, editor. Incest related syndromes of adult psychopathology. Washington, DC: American Psychiatric Press, 1990: 75–111

    Google Scholar 

  109. Briere J. Medical symptoms, health risk, and history of childhood sexual abuse. Mayo Clin Proc 1992; 67: 527–32

    Article  Google Scholar 

  110. Benjamin S, Eminson DM. Abnormal illness behavior: childhood experiences and long-term consequences. Int Rev Psychiatry 1992; 4: 55–70

    Article  Google Scholar 

  111. Norris FH. Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. J Consult Clin Psychol 1992; 60: 409–18

    Article  PubMed  CAS  Google Scholar 

  112. Springs FE, Friedrich WN. Health risk behaviors and medical sequelae of childhood sexual abuse. Mayo Clin Proc 1992; 67: 527–33

    Article  PubMed  CAS  Google Scholar 

  113. DeBellis MD, Putman FW. The psychobiology of childhood maltreatment. Child Adolesc Psychiatric Clin North Am 1994; 3: 663–78

    Google Scholar 

  114. Schwarz ED, Perry BD. The post-traumatic response in children and adolescents. Psychiatr Clin North Am 1994; 17: 311–26

    PubMed  CAS  Google Scholar 

  115. Silk KR, editor. Biological and neurobehavioral studies of borderline personality disorder. Washington, DC: American Psychiatric Press, 1994

    Google Scholar 

  116. Dancu CV, Riggs DS, Hearst-Ikeda DE, et al. Dissociative experiences and posttraumatic stress disorder among female victims of criminal assault and rape. J Trauma Stress 1996; 9: 253–67

    Article  PubMed  CAS  Google Scholar 

  117. Draijer N, Langeland W. Childhood trauma and perceived parental dysfunction in the etiology of dissociative symptoms in psychiatric patients. Am J Psychiatry 1999; 156: 379–85

    PubMed  CAS  Google Scholar 

  118. Heim C, Newport DH, Heit S, et al. Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA 2000; 284: 592–7

    Article  PubMed  CAS  Google Scholar 

  119. MacMillan HL, Fleming JE, Streiner DL, et al. Childhood abuse and lifetime psychopathology in a community sample. Am J Psychiatry 2001; 158: 1878–83

    Article  PubMed  CAS  Google Scholar 

  120. Arnow BA, Hart S, Scott C, et al. Childhood sexual abuse, psychological distress, and medical use among women. Psychosom Med 1999; 61: 762–70

    PubMed  CAS  Google Scholar 

  121. Felitti VJ, Anda RF, Nordenberg DF, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14: 248–58

    Article  Google Scholar 

  122. Edwards VJ, Holden GW, Felitti VJ, et al. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the Adverse Childhood Experiences Study. Am J Psychiatry 2003; 160: 1453–60

    Article  PubMed  Google Scholar 

  123. Vythilingam M, Heim C, Newport J, et al. Childhood trauma associated with smaller hippocampal volume in women with major depression. Am J Psychiatry 2002; 159: 2072–80

    Article  PubMed  Google Scholar 

  124. Pribor EF, Yurzy SH, Dean JT, et al. Briquet’s syndrome, dissociation, and abuse. Am J Psychiatry 1993; 150: 1507–11

    PubMed  CAS  Google Scholar 

  125. Barsky AJ, Wool C, Barnett MC, et al. Histories of childhood trauma in adult hypochondriacal patients. Am J Psychoanal 1994; 151: 397–401

    CAS  Google Scholar 

  126. Morrison J. Childhood sexual histories of women with somatization disorder. Am J Psychiatry 1989; 146: 239–41

    PubMed  CAS  Google Scholar 

  127. Walker E, Katon WJ, Hanson J, et al. Psychiatric diagnoses and sexual victimization in women with chronic pelvic pain. Psychosomatics 1995; 36: 531–40

    Article  PubMed  CAS  Google Scholar 

  128. Blair JA, Blair RS, Rueckert P. Pre-injury emotional trauma and chronic back pain. Spine 1994; 19: 1144–7

    Article  PubMed  CAS  Google Scholar 

  129. Drossman DA. Physical and sexual abuse and gastrointestinal illness: what is the link? Am J Med 1994; 97: 105–7

    Article  PubMed  CAS  Google Scholar 

  130. Scarinci IC, McDonald-Haile J, Bradley LA, et al. Altered pain perception and psychosocial features among women with gastrointestinal disorders and history of abuse: a preliminary model. Am J Med 1994; 97: 108–18

    Article  PubMed  CAS  Google Scholar 

  131. Hudson JL, Pope Jr HG. Does childhood sexual abuse cause fibromyalgia? Arthritis Rheum 1995; 38: 161–3

    Article  PubMed  CAS  Google Scholar 

  132. Aaron LA, Bradley LA, Alarcon GS, et al. Perceived physical and emotional trauma as precipitating events in fibromyalgia: associations with health care and disability status but not pain severity. Arthritis Rheum 1997; 40: 453–60

    Article  PubMed  CAS  Google Scholar 

  133. Staudenmayer H, Selner ME, Selner JC. Adult sequelae of childhood abuse presenting as environmental illness. Ann Allergy 1993; 71: 538–46

    PubMed  CAS  Google Scholar 

  134. Brown TM, Merritt WD, Evans DL. Psychogenic vocal cord dysfunction masquerading as asthma. J Nerv Ment Dis 1988; 176: 308–10

    Article  PubMed  CAS  Google Scholar 

  135. Freedman MR, Rosenberg SJ, Schmaling KB. Childhood sexual abuse in patients with paradoxical vocal cord dysfunction. J Nerv Ment Dis 1991; 179: 295–8

    Article  PubMed  CAS  Google Scholar 

  136. True WR, Rice J, Eisen SA, et al. A twin study of genetic and environmental contributions to liability for posttraumatic stress symptoms. Arch Gen Psychiatry 1993; 50: 257–64

    Article  PubMed  CAS  Google Scholar 

  137. Stein MB, Jang KL, Taylor S, et al. Genetic and environmental influences of trauma exposure and posttraumatic stress disorder symptoms. Am J Psychiatry 2002; 159: 1675–81

    Article  PubMed  Google Scholar 

  138. Lyons MJ, Goldberg J, Eisen SA, et al. Do genes influence exposure to trauma: a twin study of combat. Am J Med Genet 1993; 48: 22–7

    Article  PubMed  CAS  Google Scholar 

  139. Koenen KC, Harley R, Lyons MJ, et al. A twin registry study of familial and individual risk factors for trauma exposure and posttraumatic stress disorder. J Nerv Ment Dis 2002; 190: 209–18

    Article  PubMed  Google Scholar 

  140. Green BL, Grace MC, Lindy JD, et al. Risk factors for PTSD and other diagnoses in a general sample of Vietnam veterans. Am J Psychiatry 1990; 147: 729–33

    PubMed  CAS  Google Scholar 

  141. Goldberg J, True WR, Eisen SA, et al. A twin study of the effects of the Vietnam War on posttraumatic stress disorder. JAMA 1990; 263: 1227–32

    Article  PubMed  CAS  Google Scholar 

  142. King DW, King LA, Foy D, et al. Posttraumatic stress disorder in a national sample of female and male Vietnam veterans; risk factors, war-zone Stressors, and resilience-recovery variables. J Abnorm Psychol 2000; 108: 164–70

    Article  Google Scholar 

  143. Wolfe J, Erickson DJH, Sharkansky EJ, et al. Course and predictors of posttraumatic stress disorder among Gulf War veterans: a prospective analysis. J Consult Clin Psychol 2000; 67: 520–8

    Google Scholar 

  144. Prigerson HG, Maciejewski PK, Rosenheck RA. Combat trauma: trauma with highest risk of delayed onset and unresolved posttraumatic stress disorder symptoms, unemployment, and abuse among men. J Nerv Ment Dis 2001; 189: 99–108

    Article  PubMed  CAS  Google Scholar 

  145. Bromet E, Sonnega A, Kessler RC. Risk factors for DSM-III-R posttraumatic stress disorder: findings from the National Comorbidity Survey. Am J Epidemiol 1998; 147: 353–61

    Article  PubMed  CAS  Google Scholar 

  146. Breslau N, Kessler RC, Chilcoat HD, et al. Trauma and posttraumatic stress disorder in the community. Arch Gen Psychiatry 1998; 55: 626–32

    Article  PubMed  CAS  Google Scholar 

  147. Creamer M, Burgess P, McFarlane AC. Posttraumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-Being. Psychol Med 2001; 31: 1237–47

    Article  PubMed  CAS  Google Scholar 

  148. Christenson RM, Walker JI, Ross DR, et al. Reactivation of traumatic conflicts. Am J Psychiatry 1981; 138: 984–5

    PubMed  CAS  Google Scholar 

  149. Resnick HS, Yehuda R, Pitman RK, et al. Effect of previous trauma on acute plasma cortisol level following rape. Am J Psychiatry 1995; 152: 1675–7

    PubMed  CAS  Google Scholar 

  150. Bremner JD, Vythilingam M, Vermetten E, et al. MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. Am J Psychiatry 2003; 160: 924–32

    Article  PubMed  Google Scholar 

  151. Frodl T, Meisenzahl EM, Zetzsche T, et al. Hippocampal changes in patients with a first episode of major depression. Am J Psychiatry 2002; 159: 1112–8

    Article  PubMed  Google Scholar 

  152. Shusterman D, Balmes J, Cone J. Behavioral sensitization to irritants/odorants after acute over exposures. J Occup Med 1988; 30: 565–7

    PubMed  CAS  Google Scholar 

  153. Van den Bergh O, Stegen K, Van de Woestijne KP. Learning to have psychosomatic complaints: conditioning of respiratory behavior and somatic complaints in psychosomatic patients. Psychosom Med 1997; 59: 13–23

    PubMed  Google Scholar 

  154. Van den Bergh O, Stegen K, Van Dest I, et al. Acquisition and extinction of somatic symptoms in response to odors: a Pavlovian paradigm relevant to multiple chemical sensitivity. Occup Environ Med 1999; 56: 295–301

    Article  PubMed  Google Scholar 

  155. Devriese S, Winters W, Stegen K, et al. Generalization of acquired somatic symptoms in response to odors: a Pavlovian perspective on multiple chemical sensitivity. Psychosom Med 2000; 62: 751–9

    PubMed  CAS  Google Scholar 

  156. Rescorla RA. Pavlovian conditioning: it is not what you think it is. Am Psychol 1988; 43: 151–60

    Article  PubMed  CAS  Google Scholar 

  157. Staudenmayer H. Multiple chemical sensitivities or idiopathic environmental intolerances (EI): psychophysiological foundation of knowledge for a psychogenic explanation. J Allergy Clin Immunol 1997; 99: 434–7

    Article  PubMed  CAS  Google Scholar 

  158. Kandel ER, Hawkins RD. The biological basis of learning and individuality. Sci Am 1992 Sep; 267(3): 79–86

    Article  Google Scholar 

  159. Stegen K, De Brunye K, Rasschaert W, et al. Fear-relevant images as conditioned stimuli for somatic complaints, respiratory behavior, and reduced end-tidal pCO2. J Abnorm Psychol 1999; 108: 143–52

    Article  PubMed  CAS  Google Scholar 

  160. Van den Bergh O, Devriese S, Winters W, et al. Acquiring symptoms in response to odors: a learning perspective on multiple chemical sensitivity. Ann N Y Acad Sci 2001; 933: 278–90

    Article  PubMed  Google Scholar 

  161. Jones TF, Graig AS, Hoy D, et al. Mass psychogenic illness attributed to toxic exposure at a high school. N Engl J Med 2000; 342: 96–100

    Article  PubMed  CAS  Google Scholar 

  162. Hodgson MJ, Frohliger J, Permar E, et al. Symptoms and microenvironmental measures in non-problem buildings. J Occup Med 1991; 33: 527–33

    PubMed  CAS  Google Scholar 

  163. Cahill L, Prins B, Weber M, et al. Beta-adrenergic activation and memory for emotional events. Nature 1994; 371: 702–4

    Article  PubMed  CAS  Google Scholar 

  164. Kolb LC. Neurophysiological hypothesis explaining posttraumatic stress disorder. Am J Psychiatry 1987; 144: 989–95

    PubMed  CAS  Google Scholar 

  165. Liotti M, Sava D, Rizzolatti G, et al. Differential hemispheric asymmetries in depression and anxiety: a reaction time study. Biol Psychiatry 1991; 29: 887–99

    Article  PubMed  CAS  Google Scholar 

  166. Cohen RA, O’Donnell BF. Physiological substrates of attention. In: Cohen RA, editor. The neuropsychology of attention. New York: Plenum, 1993: 115–44

    Google Scholar 

  167. Guidano VF, Liotti G. Cognitive processes and emotional disorders. New York: Guilford Press, 1983

    Google Scholar 

  168. Mayberg HS, Liotti M, Brannan SK, et al. Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999; 156: 675–82

    PubMed  CAS  Google Scholar 

  169. Brewin CR, Andrews B, Gotlib IH. Psychopathology and early experience: a reappraisal of retrospective reports. Psychol Bull 1993; 113: 82–98

    Article  PubMed  CAS  Google Scholar 

  170. Halligan SL, Michael T, Clark M, et al. Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals. J Consul Clin Psychol 2003; 71: 419–31

    Article  Google Scholar 

  171. Van der Kolk BA. The body keeps score. In: van der Kolk BA, McFarlane AC, Weisaeth L, editors. Traumatic stress. New York: Guilford Press, 1996: 279–302

    Google Scholar 

  172. Terr LC. What happens to early memories of trauma. J Am Acad Child Adolescent Psychiatry 1988; 1: 96–104

    Article  Google Scholar 

  173. Teicher MH, Ito Y, Glod CA, et al. Early abuse, limbic system dysfunction, and borderline personality disorder. In: Silk KR, editor. Biological and neurobehavioral studies of borderline personality disorder. Washington, DC: American Psychiatric Press, 1994: 177–207

    Google Scholar 

  174. Van der Kolk BA. The body keeps score: approaches to the psychobiology of posttraumatic stress disorder. In: van der Kolk B A, McFarlane AC, Weisaeth L, editors. Traumatic stress. New York: Guilford Press, 1996: 214–41

    Google Scholar 

  175. Shusterman D. Critical review: the health significance of environmental odor pollution. Arch Environ Health 1992; 47: 76–87

    Article  PubMed  CAS  Google Scholar 

  176. Shusterman D. Review of the upper airway, including olfaction, as mediator of symptoms. Environ Health Perspect 2002; 110Suppl. 4: 649–53

    Article  PubMed  Google Scholar 

  177. Shusterman D, Dager S. Prevention of psychological disability after occupational respiratory exposures. Occup Med 1991; 6: 11–27

    PubMed  CAS  Google Scholar 

  178. Shusterman D, Lipscomb J, Neutra R, et al. Symptom prevalence and odor-worry interaction near hazardous waste sites. Environ Health Perspect 1991; 94: 25–30

    Article  PubMed  CAS  Google Scholar 

  179. Larkin M. Sniffing out memories of holidays past. Lancet 1999; 354: 2142

    Article  PubMed  CAS  Google Scholar 

  180. Van der Kolk BA. The trauma spectrum: the interaction of biological and social events in genesis of the trauma response. J Trauma Stress 1988; 1: 273–90

    Article  Google Scholar 

  181. Chrousos GP, Gold PW. The concepts of stress and stress system disorders: overview of physical and behavioral homeostasis. JAMA 1992; 267: 1244–52

    Article  PubMed  CAS  Google Scholar 

  182. Sapolsky RM, Krey LC, McEwen BS. The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocr Rev 1986; 7: 284–301

    Article  PubMed  CAS  Google Scholar 

  183. Sapolsky RM. Stress, the aging brain, and the mechanisms of neuron death. Cambridge (MA): MIT Press, 1992

    Google Scholar 

  184. Sapolsky RM. Why stress is bad for your brain. Science 1996; 273: 749–50

    Article  PubMed  CAS  Google Scholar 

  185. Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry 2000; 57: 925–35

    Article  PubMed  CAS  Google Scholar 

  186. Rutter M. Psychopathology and development: I. childhood antecedents of adult psychiatric disorder. Aust N Z J Psychiatry 1984; 18: 225–34

    Article  PubMed  CAS  Google Scholar 

  187. Blanchard EB, Kolb LC, Pallmeyer TP, et al. A psychophysiological study of post traumatic stress disorder in Vietnam veterans. Psychiatr Q 1982; 54: 220–9

    Article  PubMed  CAS  Google Scholar 

  188. Pitman RK, Orr SP, Forgue DF, et al. Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. Arch Gen Psychiatry 1987; 44: 970–5

    Article  PubMed  CAS  Google Scholar 

  189. Lautenbacher S, Spernal J, Schreiber W, et al. Relationship between clinical pain complaints and pain sensitivity in patients with depression and panic disorder. Psychosom Med 1999; 61: 822–7

    PubMed  CAS  Google Scholar 

  190. Clauw DJ, Chrousos GP. Chronic pain and fatigue syndromes: overlapping clinical an neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation 1997; 4: 134–53

    PubMed  CAS  Google Scholar 

  191. Chrousos GP. The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 1995; 332: 1351–62

    Article  PubMed  CAS  Google Scholar 

  192. Jewett DL. Diagnosis and treatment of hypersensitivity syndrome. Toxicol Ind Health 1992; 8: 111–23

    PubMed  CAS  Google Scholar 

  193. Yehuda R. Stress and glucocorticoids. Science 1997; 275: 1662

    Article  PubMed  CAS  Google Scholar 

  194. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993; 50: 975–90

    Article  PubMed  CAS  Google Scholar 

  195. Bowlby J. The making and breaking of affectional bonds: aetiology and psychopathology in the light of attachment theory. Br J Psychiatry 1977; 130: 201–10

    Article  PubMed  CAS  Google Scholar 

  196. Schore AN. Affect regulation and the origin of the self: the neurobiology of emotional development. Englewood Cliffs (NJ): Lawrence Earlbaum, 1994

    Google Scholar 

  197. Krystal JH, Bennett AL, Bremner JD, et al. Toward a cognitive science of dissociation and altered mental function in posttraumatic stress disorder. In: Friedman MJ, Charney DS, Deutch AY, editors. Neurobiological and clinical consequences of stress: from normal adaptation to post-traumatic stress disorder. Hagerstown (MD): Lipincott-Raven, 1995: 239–69

    Google Scholar 

  198. Widom CS. Posttraumatic stress disorder in abused and neglected children grown up. Am J Psychiatry 1999; 156: 1223–9

    PubMed  CAS  Google Scholar 

  199. Yehuda R, McFarlane AC, editors. Psychobiology of posttraumatic stress disorder. Ann N Y Acad Sci 1997, 821

  200. Shors TJ. Stress and memory. In: Squire LR, editor. Encyclopedia of learning and memory. New York: Macmillan, 1992: 608–10

    Google Scholar 

  201. McEwen B, Sapolsky R. Stress and cognitive function. Curr Opin Neurobiol 1995; 5: 205–11

    Article  PubMed  CAS  Google Scholar 

  202. McEwen BS. Effects of adverse experiences for brain structure and function. Biol Psychiatry 2000; 48: 721–31

    Article  PubMed  CAS  Google Scholar 

  203. Hull AM. Neuroimaging findings in post-traumatic stress disorder. Br J Psychiatry 2002; 181: 102–10

    Article  PubMed  Google Scholar 

  204. Staudenmayer H. Psychological treatment of psychogenic idiopathic environmental intolerance (IEI). Occup Med 2000; 15: 627–46

    PubMed  CAS  Google Scholar 

  205. Bolla KI. Neurobehavioral performance in multiple chemical sensitivities. Reg Toxicol Pharmacol 1996; 24: S52

    Article  CAS  Google Scholar 

  206. Fiedler N, Kipen HM, Deluca J, et al. A controlled comparison of multiple chemical sensitivities and chronic fatigue syndrome. Psychosom Med 1996; 58: 38–49

    PubMed  CAS  Google Scholar 

  207. Brown-DeGagne AM, McGlone J. Multiple chemical sensitivity: a test of the olfactory-limbic model. J Occup Environ Med 1999; 41: 366–77

    Article  PubMed  CAS  Google Scholar 

  208. Bolla KI. Use of neuropsychological testing in idiopathic environmental testing. Occup Med 2000; 15: 617–25

    PubMed  CAS  Google Scholar 

  209. Lees-Haley PR, Brown RS. Biases in perception and reporting following a perceived toxic exposure. Perceptual Motor Skills 1992; 75: 531–44

    Article  CAS  Google Scholar 

  210. Poonai NP, Antony MM, Binkley KE, et al. Psychological features of patients with idiopathic environmental intolerance. J Psychosom Res 2001; 51: 537–41

    Article  PubMed  CAS  Google Scholar 

  211. Stenn PG, Binkley K. Multiple chemical sensitivity. Psychosomatics 1998; 39: 393–4

    Article  PubMed  CAS  Google Scholar 

  212. Staudenmayer H, Kramer RE. Psychogenic chemical sensitivity: psychogenic pseudoseizures elicited by provocation challenges with fragrances. J Psychosom Res 1999; 47: 185–90

    Article  PubMed  CAS  Google Scholar 

  213. Haller E. Successful management of patients with ‘multiple chemical sensitivity’ on an inpatient psychiatric unit. J Clin Psychiatry 1993; 54: 196–9

    PubMed  CAS  Google Scholar 

  214. Amundsen MA, Hanson NP, Bruce BK, et al. Odor aversion of multiple chemical sensitivities: recommendation for a name change and description of successful behavioral medicine treatment. Reg Toxicol Pharmacol 1996; 24: S116

    Article  CAS  Google Scholar 

  215. Guglielmi RS, Cox DJ, Spyker DA. Behavioral treatment of phobic avoidance in multiple chemical sensitivity. J Behav Ther Exp Psychiatry 1994; 25: 197–209

    Article  PubMed  CAS  Google Scholar 

  216. Binkley KE, Stenn PG. ‘Specialized’ psychiatric referral: improved outcome in patients with multiple chemical sensitivity. J Allergy Clin Immunol 1998; 101 Suppl.: 587

    Article  Google Scholar 

  217. Stenn P, Binkley K. Successful outcome in a patient with chemical sensitivity: treatment with psychological desensitization and selective serotonin reuptake inhibitor. Psychosomatics 1998; 39: 547–50

    Article  PubMed  CAS  Google Scholar 

  218. Hillert L, Kolmodin HB, Dolling BF, et al. Cognitive behavioral therapy for patients with electric sensitivity: a multidisciplinary approach in a controlled study. Psychother Psychosom 1998; 67: 302–10

    Article  PubMed  CAS  Google Scholar 

  219. Gomez R, Schvaneveldt RW, Staudenmayer H. Assessing beliefs about ‘environmental illness/multiple chemical sensitivity’. J Health Psychol 1996; 1: 107–23

    Article  PubMed  CAS  Google Scholar 

  220. Black DW, Sparks PJ. Psychiatric aspects of ‘chemical sensitivity’ syndromes. In: Stoudemire A, Vogel B, editors. Medical psychiatric practice. Vol. 3. Washington, DC: American Psychiatric Press, 1995: 347–80

    Google Scholar 

  221. Brodsky CM. ‘Allergic to everything’: a medical subculture. Psychosomatics 1983; 24: 731–42

    Article  PubMed  CAS  Google Scholar 

  222. Gupta K, Perharic L, Volans GN, et al. Apparent poisoning by wood preservatives: an attributional syndrome. J Psychosom Res 1997; 43: 391–8

    Article  PubMed  CAS  Google Scholar 

  223. Black DW. Iatrogenic (physician-induced) hypochondriasis: four patient examples of ‘chemical sensitivity’. Psychosomatics 1996; 37: 390–3

    Article  PubMed  CAS  Google Scholar 

  224. Black DW, Okiishi C, Schlosser S. A nine-year follow-up of people diagnosed with multiple chemical sensitivities. Psychosomatics 2000; 41: 253–61

    Article  PubMed  CAS  Google Scholar 

  225. Gibson PR, Elms AN, Ruding LA. Perceived treatment efficacy for conventional and alternative therapies reported by persons with multiple chemical sensitivity. Environ Health Perspect 2003; 111: 1498–504

    Article  PubMed  Google Scholar 

  226. Staudenmayer H. Clinical consequences of the EI/MCS ‘diagnosis’: two paths. Reg Toxicol Pharmacol 1996; 24: S96–S110

    Article  CAS  Google Scholar 

  227. Bentall RP, Powell P, Nye FJ, et al. Predictors of response to treatment for chronic fatigue syndrome. Br J Psychiatry 2002; 181: 248–52

    Article  PubMed  Google Scholar 

  228. Busch FN, Cooper AM, Klerman GL, et al. Neurophysiological, cognitive-behavioral, and psychoanalytic approaches to panic disorder: toward an integration. Psychoanalytic Inquiry 1991; 11: 316–32

    Article  Google Scholar 

  229. Shear MK, Cooper AM, Klerman GL, et al. A psychodynamic model of panic disorder. Am J Psychiatry 1993; 150: 859–66

    PubMed  CAS  Google Scholar 

  230. Shear MK. Factors in the etiology and pathogenesis of panic disorder: revisiting the attachment-separation paradigm. Am J Psychiatry 1996; 153: 125–36

    PubMed  CAS  Google Scholar 

  231. Shorter E. Multiple chemical sensitivity: pseudodisease in historical perspective. Scand J Work Environ Health 1997; 23Suppl. 3: 35–42

    PubMed  CAS  Google Scholar 

  232. Ford CV. Somatization and fashionable diagnoses: illness as a way of life. Scand J Work Environ Health 1997; 23Suppl. 3: 7–16

    PubMed  Google Scholar 

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Acknowledgements

No funding was received to assist the preparation of this manuscript. The authors have no conflict of interest. We thank Su Dierbeck for secretarial assistance. We dedicate this work to the memory of our colleague, Neil L. Rosenberg, M.D.

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Authors and Affiliations

  1. Behavioral Medicine, Multi-Disciplinary Toxicology, Treatment and Research Center, 5800 E. Evans Ave, Suite 20B, Denver, Colorado, 80222, USA

    Herman Staudenmayer

  2. Division of Clinical Immunology and Allergy, University of Toronto, Toronto, Canada

    Karen E. Binkley & Arthur Leznoff

  3. Toxicology Associates, Multi-Disciplinary Toxicology, Treatment and Research Center, Denver, Colorado, USA

    Scott Phillips

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  1. Herman Staudenmayer
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  2. Karen E. Binkley
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Correspondence to Herman Staudenmayer.

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Staudenmayer, H., Binkley, K.E., Leznoff, A. et al. Idiopathic Environmental Intolerance. Toxicol Rev 22, 247–261 (2003). https://doi.org/10.2165/00139709-200322040-00006

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