Basic principles of stimulus processing and perception in Olfactory Reference Syndrome

患有嗅觉参照综合征（ORS）的人确信他们散发出令人不快的体臭（尽管这种气味不会被其他人察觉），这导致了社会排斥。他们将无害的手势和面部表情误解为拒绝和气味存在的证据。随后，他们试图摆脱气味，这往往会导致重复的行为或精神行为。由于大多数ORS文献是指单一病例报告，因此很难对流行病学、现象学或导致ORS脆弱性和维持的关键因素做出结论。此外，似乎还不清楚，如果ORS是一个实体，或另一种精神疾病的表型。为了跟进这个问题，一组40人的嗅觉问题（包括15人患有ORS）将运行几个实验，与精神健康的控制。这些问题是：1. 哪项相关特征可区分有嗅觉问题但无心理紧张和重复行为或精神行为的个体与患有ORS（嗅觉问题、心理紧张和重复行为或精神行为）的个体？社交焦虑的水平，自己的体味的评级，和程度的信念，气味被闻到，并判断为负面的其他人，应进行比较。2. 对自己身体气味的感知是ORS（内部触发）的基础，还是ORS（外部触发）的症状？行为分析应探索外部触发因素是否激活感知。此外，还应检查是否可能被他人拒绝（因为气味、外观或习性）。3. 嗅觉障碍者的嗅觉辨别能力是否不足？这应通过嗅觉测试（自己的气味和陌生人的气味）进行测试。4. 在ORS中，嗅觉测试产生的情绪反应是否更强（与有嗅觉问题但没有ORS的个体和心理健康的对照组相比）？这应通过模拟分析进行评估。5. 有嗅觉问题的人的体味是否与精神健康的人的体味有系统的不同（指的是化合物）？这应通过化学分析进行分析。上述研究有助于加深对ORS病因学的认识。

Individuals suffering from Olfactory Reference Syndrome (ORS) are convinced that they emit an unpleasing body odor (although this odor is not perceived by others), which leads to social rejection. They misinterpret harmless gestures and facial expressions as rejection and evidence of the existence of the odor. Subsequently, they try to get rid of the odor, which often leads to repetitive behaviors or mental acts. Because most ORS-literature refers to single case reports, it is difficult to make conclusions about epidemiology, phenomenology, or key factors that underlie vulnerability to, and maintenance of, ORS. Further, it seems unclear, if ORS is an entity, or a phenotype of another mental disorder.To follow up this question, a group of 40 individuals with olfactory concerns (including 15 individuals suffering from ORS) shall run several experiments, in comparison to mentally healthy controls. The questions are:1. Which relevant feature separates individuals with olfactory concerns, but without psychological strain and repetitive behaviors or mental acts from individuals suffering from ORS (olfactory concerns, psychological strain and repetitive behaviors or mental acts)? The level of social anxiety, the rating of the own body odor, and the degree of the belief, the odor is smelled and judged as negative by others, shall be compared.2. Is perception of the own body odor the basis for ORS (internal trigger), or a symptom of ORS (external trigger)? Behavior analyses shall explore, whether external triggers activate perceptions. Moreover, a potentially rejection by others (because of odor, appearance, or habitus) shall be checked.3. Is the olfactory discrimination ability in individuals with olfactory concerns not sufficient? This shall be tested by presentation of olfactory tests (own odor, and odor of an unfamiliar individual). 4. Is the emotional response resulting from the olfactory tests stronger in ORS (compared to individuals with olfactory concerns, but without ORS, and mentally healthy controls)? This shall be evaluated by mimic analyses.5. Is the body odor of individuals with olfactory concerns systematically different from the body odor of mentally healthy individuals (referring to the chemical compounds)? This shall be analyzed by chemical analyses. The above-mentioned investigations may enhance our etiological understanding of ORS.