Attentional Bias, Memory Bias, and Symptom Attribution in Idiopathic Environmental Intolerance and Classical Somatoform Disorders

Idiopathic Environmental Intolerance (IEI) refers to a polysymptomatic condition of unknown etiology, poorly understood pathogeneses, and somatoform-like phenomenology. Two studies were designed to assess cognitive biases in people with IEI (

The underestimated significance of conditioning in placebo hypoalgesia and nocebo hyperalgesia

Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit conditioning (i.e., without contingency awareness) that bypass the development of explicit expectation suggest that conditioning without explicit expectation can lead to placebo and nocebo effects in pain perception. Because only few studies have investigated clinical samples, the picture seems less clear when it comes to patient populations with chronic pain. However, conditioning appears to be a promising means to optimize treatment. In order to get a better insight into the mechanisms of placebo and nocebo effects in pain and the possible benefits of conditioning compared to explicit expectation, future studies should carefully distinguish both methods of induction

Idiopathic Environmental Intolerance: A comprehensive model

Idiopathic environmental intolerance refers to a group of poorly understood health conditions characterized by heterogeneous somatic symptoms that occur in response to environmental triggers, but for which no physiological causes can be found. We focus on three varieties, namely symptoms attributed to (a) chemical substances, (b) electromagnetic fields, and (c) infrasound and vibroacoustic sources. As no clear link with organ pathology or dysfunction has been established so far, we review critical evidence about alternative causal mechanisms as a platform for a novel unifying model of these conditions. There is consistent evidence that expectancy and nocebo mechanisms are critically involved. Using recent predictive coding models of brain functioning, we describe a comprehensive new model to explain how symptoms come about and become linked to specific environmental cues. This new model integrates phenomenally different pathologies, suggests testable new hypotheses, and specifies implications for treatment.</jats:p

Behavioral and electrodermal data on implicit nocebo conditioning using supraliminally presented visual stimuli

This article contains intensity and aversiveness ratings of electrical stimuli and data on electrodermal activity (skin conductance level and skin conductance response) during an implicit conditioning procedure. Further, answers from a questionnaire on contingency awareness are provided. The experiment consisted of three phases. In the acquisition, two types of visual stimuli (CS+ and CS-) were coupled to weakly and moderately painful electrical stimuli presented to the participants’ (N = 48) dominant hand. In the test phase, after both CS+ and CS- only the weakly painful electrical stimuli were presented. In the contingency test phase, no more electrical stimuli were presented and participants had the task to rate intensity and aversiveness as if an electrical stimulus had been presented. This phase served as a test for first-order contingency awareness. Afterwards participants filled in a questionnaire with five questions to assess their level of second-order contingency awareness. For more insight, please see Nocebo hyperalgesia induced by implicit conditioning (Bräscher and Witthöft, 2019)

An idiographic approach to Idiopathic Environmental Intolerance attributed to Electromagnetic Fields (IEI-EMF) Part I. Environmental, psychosocial and clinical assessment of three individuals with severe IEI-EMF

IEI-EMF refers to an environmental illness whose primary feature is the occurrence of symptoms that are attributed to exposure to weak electromagnetic fields (EMFs). There is a growing evidence that this condition is characterized by marked individual differences thus a within-subject approach might add important information beyond the widely used nomothetic method. A mixed qualitative/quantitative idiographic protocol with a threefold diagnostic approach was tested with the participation of three individuals with severe IEI-EMF. In this qualitative paper, the environmental, psychosocial, and clinical aspects are presented and discussed (results of ecological momentary assessment are discussed in Part II of this study). For two participants, psychopathological factors appeared to be strongly related to the condition. Psychological assessment indicated a severe pre-psychotic state with paranoid tendencies, supplemented with a strong attentional focus on bodily sensations and health status. The psychological profile of the third individual showed no obvious pathology. Overall, the findings suggest that the condition might have uniformly been triggered by serious psychosocial stress for all participants. Substantial aetiological differences among participants with severe IEI-EMF were revealed. The substantial het-erogeneity in the psychological and psychopathological profiles associated with IEI-EMF warrants the use of idiographic multimodal assessments in order to better understand the different ways of aetiology and to facilitate person-taylored treatments

Rejection sensitivity as a vulnerability marker for depressive symptom deterioration in men

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