Wednesday, February 8, 2012

Psychological contagion? The mysterious case of LeRoy, NY

LeRoy, NY
In a small country town, population 7,500, a cheerleader and honor roll student woke up from an afternoon nap to discover she had developed a stutter. Soon, the stutter gave way to uncontrollable twitching. When her mother took her to the doctor, they discovered that she wasn’t the only one with these symptoms - in all, 14 teenage girls, one teenage boy, and one 36 year-old woman had recently developed Tourettes-like symptoms. The local doctors diagnosed the mysterious illness as “conversion disorder,” a disorder in which mental and emotional stress literally plays out in physical symptoms. Sound like the plot of a bad TV movie? Perhaps. But it’s also the latest happenings in LeRoy, New York, where sixteen people suddenly developed twitching, facial tics and vocal outbursts last October, 15 of whom attended the same high school. 

Reporting of the Tennessee "poisoning"
This isn’t the first time there’s been a case of mass “conversion disorder,” also known as mass psychogenic illness. For example, in 1998, a teacher at a Tennessee High School thought she smelled gas in her classroom. Soon after, she began experiencing headaches, nausea, shortness of breath and dizziness. Her class was evacuated and soon other students in the school began experiencing similar symptoms. The school was evacuated and the afflicted teacher and students were sent to the hospital. After classes resumed, people again reported feeling sick, and the school was again evacuated. Soon after, everyone recovered and classes resumed. By the end of the event, over 170 teachers, students and staff had been sent to the hospital, but no organic cause for their symptoms was ever found. This is just one of many examples of this type of contagion (see further reading below for the 1965 case of the “overbreathing girls”). 

Conversion disorder sheds just one more light on the power of the mind and the intricate link between the mind and the body. These cases of mass psychogenic illness also have relevance for social psychology. The 1998 case in Tennessee is described in detail in the “conformity” chapter of the social psychology textbook I have. The idea being that one or two people may feel sick, perhaps the result of a physical manifestation of stress, or possibly from a physical condition, but if they, or those around them, interpret their sickness to be the result of some larger problem (gas leak, food poisoning, biological warfare), other people who are also exposed to the supposed source of the problem may find themselves having similar symptoms. In the Tennessee case, people who knew someone who was sick were much more likely to report getting sick themselves relative to people who were not exposed to a sick person (although the supposed cause was “poison” and not something that would be passed from one person to another). One striking difference between these cases and the LeRoy case, however, is that with mass psychogenic illness, the symptoms are often vague, such as a headache, stomachache or nausea.  I know I’ve convinced myself a time or two that I had a severe stomachache after learning that someone I’d eaten dinner with had gotten sick from the food. But facial tics and vocal outbursts? Those seem like very specific symptoms. 

Perhaps a mimicry or copycat effect, another aspect of social psychology, is also at work in LeRoy. The Werther Effect is an extreme example of this. The term refers to the rash of copycat suicides that follow a publicized suicide. David Phillips, who coined the term, found that within two months of every suicide story that ended up on the front-page, 58 more people than usual would commit suicide. Strikingly, the suicides were likely to be similar to the publicized suicide. If a young man had killed himself, more young men would follow suit. Again, I reiterate that this is an extreme example, but I think it highlights the power of social influence, even at an unconscious level. 

Throughout this post I have kept quotation marks around “conversion disorder” because not all the experts are in agreement that “conversion disorder” is the appropriate diagnosis for what’s going on in LeRoy. Dr. Rosario Trifiletti thinks that the affected patients may actually be experiencing another disorder known as PANS (Pediatric Autoimmune Illness Associated with Streptococci). This disorder sounds like an even weirder TV movie – people (most often young children) suddenly develop Obsessive Compulsive Disorder (OCD) or another similar neurological disorder as a result of an infection, like strep throat. That’s right, in some rare cases, strep throat can turn into OCD. How’s that for evidence of a strong mind-body connection? Still, this is a very rare disease that most often occurs in children, what’s the likelihood it’s going to be the cause of a small, adult, epidemic in a remote town?

And for a less psychology-relevant explanation: Le Roy is near the site of a 1970’s toxic chemical spill. The school and state have tested the site and provided clean environment reports, but Erin Brokovich isn’t satisfied and she has sent her team out to the town to further test for environmental problems. But why a chemical spill from the 1970’s would lead to sudden developments of facial tics and vocal outbursts several decades later, and in only a handful of people, mainly teenage girls, is something I continue to ponder.

Are you as fascinated by these neurological disorders and physical mysteries as I am?!? What do you think is the explanation behind this mysterious? Is it psychological, biological, or environmental? I’m not convinced conversion disorder is the way to go. To be honest, I think to some extent it’s a bit of a cop-out diagnosis since it can only be diagnosed by its symptoms. However, I don’t currently have a better explanation. 

Further Reading 

5 comments:

  1. Yeah, definitely we should ask Dr. House :)

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    1. Agreed! Thanks for reading :)

      Amie

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  2. Plenty of science on brainstem toxicity with TCE, in fact characteristic of jerking motor activation. In fact the environment is NOT proven clean because 5PPB TCE was found in a nearby quarry. 50 wells in the area (3 miles from the original spill)were shut down in 1994 because of contamination, then they stopped testing. Theory is the heavy TCE molecule travels through ground water and because of high water table in 2011 (see google earth historic)this groundwater oozed into ditches by the school and vicinities. No testing of surface water or swamp soils, has been done near school. Authorities are refusing. School was built on a swamp that was filled. It's the TCE causing oxidative stress with ATP depletion and neuro excitotoxicity. Nobody can do anything because someone high up (the chemical company?) won't allow testing. The volatility of the compound means it will dissipate over time in air, and the delays are to make the results look better. SAMPLE NOW!!!

    J Neurochem. 2010 Feb;112(3):773-83. Epub 2009 Nov 17.
    Trichloroethylene induces dopaminergic neurodegeneration in Fisher 344 rats.
    Liu M, Choi DY, Hunter RL, Pandya JD, Cass WA, Sullivan PG, Kim HC, Gash DM, Bing G.Department of Anatomy and Neurobiology, College of Medicine, University of Kentucky, Lexington, KY 40536, USA.
    Abstract
    Trichloroethylene, a chlorinated solvent widely used as a degreasing agent, is a common environmental contaminant. Emerging evidence suggests that chronic exposure to trichloroethylene may contribute to the development of Parkinson's disease. The purpose of this study was to determine if selective loss of nigrostriatal dopaminergic neurons could be reproduced by systemic exposure of adult Fisher 344 rats to trichloroethylene. In our experiments, oral administration of trichloroethylene induced a significant loss of dopaminergic neurons in the substantia nigra pars compacta in a dose-dependent manner, whereas the number of both cholinergic and GABAergic neurons were not decreased in the striatum. There was a robust decline in striatal levels of 3, 4-dihydroxyphenylacetic acid without a significant depletion of striatal dopamine. Rats treated with trichloroethylene showed defects in rotarod behavior test. We also found a significantly reduced mitochondrial complex I activity with elevated oxidative stress markers and activated microglia in the nigral area. In addition, we observed intracellular alpha-synuclein accumulation in the dorsal motor nucleus of the vagus nerve, with some in nigral neurons, but little in neurons of cerebral cortex. Overall, our animal model exhibits some important features of Parkinsonism, and further supports that trichloroethylene may be an environmental risk factors for Parkinson's disease.

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  3. Tried posting this before but apparently I did something wrong:
    http://www.sciencebasedmedicine.org/index.php/mass-media-attention-psychogenic-syndrome-mmaps/

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    1. Great link. The article does a good job of explaining mass psychogenic illness and ruling out other potential causes.

      Thanks for reading!
      Amie

      Delete