Psychogenic illness in response to pandemic or mass biological exposure: Developm

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DESCRIPTION (provided by applicant): Psychogenic illness is recognized as a potentially major factor in bioterrorism and pandemic. It is defined as the onset of physical and mental symptoms due to perceived exposure to a biological/toxic agent in the context of social contagion including when there is no bone fide exposure. The psychogenic response has been described as "a monsoon of the worried well" in some situations, such as the sarin release in the Tokyo subway system in 1995 in which Tokyo hospitals were overwhelmed. Apart from "post mortem" observational analyses of such spontaneous events in the community, there is no research on the phenomenon to inform public health efforts for improving preparedness and management in the event of a large scale biological event. Public health messages and media coverage are believed to be powerful determinants of individuals' assessment of risk and perception of symptoms. In the context of an influenza pandemic or other biological event, especially with significant mortality, the manner in which information is communicated to public health officials, health care providers, media organizations and the public could have enormous implications for social control, hospital surge, and utilization of limited medical resources. Consequently, investigation of communication factors that increase and decrease the public's response could yield important guidelines for public health agencies. It is very difficult to conduct rigorous research during an actual biological disaster, and experimental designs are almost impossible to implement. The proposed research is innovative as it is designed to be a proof of concept project to demonstrate that psychogenic illness can be induced experimentally. Specifically, this application will develop an experimental paradigm for inducing psychogenic illness in a community sample in a controlled, non-disaster setting. This will set the stage for experimental work to evaluate interventions for use during preparedness efforts and during biological disasters.