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

描述（由申请人提供）： 精神疾病被认为是生物恐怖主义和大流行病的一个潜在的主要因素。它被定义为在社会传染的背景下，包括在没有真正接触的情况下，由于感知到接触生物/有毒制剂而出现的身体和精神症状。在某些情况下，心因性反应被描述为“忧虑之井的季风”，例如1995年东京地铁系统释放沙林毒气，东京医院不堪重负。除了对社区中的此类自发事件进行“事后”观察分析外，没有对这一现象进行研究，以便为公共卫生工作提供信息，在发生大规模生物事件时改进防备和管理。公共卫生信息和媒体报道被认为是个人风险评估和症状感知的强有力决定因素。在流感大流行或其他生物事件的背景下，特别是在死亡率很高的情况下，向公共卫生官员、卫生保健提供者、媒体组织和公众传达信息的方式可能对社会控制、医院激增和有限医疗资源的利用产生巨大影响。因此，增加和减少公众反应的传播因素的调查可以为公共卫生机构提供重要的指导方针。在实际的生物灾难中进行严格的研究是非常困难的，实验设计几乎不可能实施。拟议的研究是创新的，因为它被设计成一个概念项目的证明，以证明心因性疾病可以通过实验诱导。具体而言，本申请将开发一个实验范例，用于在受控的非灾难环境中诱导社区样本中的心因性疾病。这将为评价备灾工作和生物灾害期间所用干预措施的实验性工作奠定基础。

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.