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Multiple Chemical Sensitivity: A Review of the Theoretical and Research Literature

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Abstract

Multiple chemical sensitivity (MCS) is a term used to describe a disorder characterized by a vast array of somatic, cognitive, and affective symptoms, the cause of which is attributed to exposure to extremely low levels of a variety of chemicals. Upon examination of the patient with a diagnosis of MCS, objective physical findings and consistent laboratory abnormalities are typically nonexistent. The concept of MCS has ignited considerable controversy in the fields of toxicology, immunology, allergy, psychology, and neuropsychology. Central to the controversy is the disagreement over the extent to which the manifestation of MCS is mediated by psychological factors. Because of the large number of neuropsychological symptoms associated with a diagnosis of MCS, neuropsychologists are increasingly receiving referrals for the assessment of these patients. It is important, therefore, that neuropsychologists become aware of the variety of clinical issues that must be taken into account when assessing an individual with a diagnosis of MCS. The theoretical and research literature on individuals with a diagnosis of MCS is reviewed here.

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REFERENCES

  • Adamec, R. (1994). Modelling anxiety disorders following chemical exposures. Toxicology and Industrial Health 10: 391-420.

    Google Scholar 

  • Albright, J. F., and Goldstein, R. A. (1992). Is there evidence of an immunological basis for multiple chemical sensitivity? Toxicology and Industrial Health 8: 215-219.

    Google Scholar 

  • American Academy of Allergy. (1981). Position statements: Controversial techniques. Journal of Allergy and Clinical Immunology 67: 333-338.

    Google Scholar 

  • American Academy of Allergy and Immunology. (1986). Position statement: Clinical ecology. Journal of Allergy and Clinical Immunology 78: 269-271.

    Google Scholar 

  • American Academy of Allergy and Immunology Training Program Directors' Committee on Controversial Practices. (1991, January). The role of training programs in dealing with controversial practices. Report prepared for American Academy of Allergy and Immunology Training Program Directors' Retreat.

  • American College of Physicians. (1989). Clinical ecology. Annals of Internal Medicine 111: 168-178.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd Ed.), Author, Washington, DC.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd Ed., revised), Author, Washington, DC.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.), Author, Washington, DC.

    Google Scholar 

  • Andiné, P., Rönnbäck, L., and Järvholm, B. (1997). Successful use of a selective serotonin reuptake inhibitor in a patient with multiple chemical sensitivities. Acta Psychiatrica Scandinavica 96: 82-83.

    Google Scholar 

  • Antelman, S. M. (1994).Time-dependent sensitization in animals:Apossible model of multiple chemical sensitivity in humans. Toxicology and Industrial Health 10: 335-342.

    Google Scholar 

  • Ashford, N. A., and Miller, C. S. (1991). Chemical Exposures: Low Levels and High Stakes, Van Nostrand Reinhold, New York.

    Google Scholar 

  • Ashford, N. A., and Miller, C. S. (1992). Case definitions for multiple chemical sensitivity. In National Academy of Science, Multiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 41-45.

    Google Scholar 

  • Association of Occupational and Environmental Clinics. (1992). Advancing the understanding of multiple chemical sensitivity. Toxicology and Industrial Health 8: 1-257.

    Google Scholar 

  • Baker, G. P. (1997). Intimidation of researchers by special-interest groups [Letter to the editor]. New England Journal of Medicine 337: 1314-1315.

    Google Scholar 

  • Bardana, E. J., and Montanaro, A. (1989). “Chemically sensitive” patients: Avoiding the pitfalls. The Journal of Respiratory Diseases 10: 32-45.

    Google Scholar 

  • Barlow, D. H. (ed.). (1993). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual (2nd Ed.), Guilford, New York.

    Google Scholar 

  • Bascom, R. (1992). Multiple chemical sensitivity: A respiratory disorder? Toxicology and Industrial Health 8: 221-228.

    Google Scholar 

  • Bascom, R., Meggs, W. J., Frampton, M., Hudnell, K., Killburn, K., Kobal, G., Medinsky, M., and Rea, W. (1997). Neurogenic inflammation: With additional discussion of central and perceptual integration of nonneurogenic inflammation. Environmental Health Perspectives 105(suppl. 2): 531-537.

    Google Scholar 

  • Bass, C. (1992). Patients with chronic somatization: What can the psychiatrist offer? In Hawton, K., and Cowen, P. (eds.), Practical Problems in Clinical Psychiatry, Oxford University Press, Oxford, pp. 105-117.

    Google Scholar 

  • Bass, C., and Gardner, W. N. (1985). Respiratory and psychiatric abnormalities in chronic symptomatic hyperventilation. British Medical Journal 290: 1387-1390.

    Google Scholar 

  • Bauer, R. M., Greve, K. W., Besch, E. L., Schramke, C. J., Crouch, J., Hicks, A., Ware, M. R., and Lyles, W. B. (1992). The role of the psychological factors in the report of the building-related symptoms in sick building syndrome. Journal of Consulting and Clinical Psychology 60: 213-219.

    Google Scholar 

  • Beck, A. T. (1967). Depression: Clinical, Experimental and Theoretical Aspects, Staples Press, London.

    Google Scholar 

  • Beck, A. T., Emery, G., and Greenberg, R. L. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective, Basic Books, New York.

    Google Scholar 

  • Bell, I. R. (1982). Clinical Ecology: A New Medical Approach to Environmental Illness, Common Knowledge, Bolinas, CA.

    Google Scholar 

  • Bell, I. R. (1992). Neuropsychiatric and biosocial mechanisms in multiple chemical sensitivity: An olfactory-limbic model. In National Academy of Science, Multiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 89-108.

    Google Scholar 

  • Bell, I. R. (1994). White paper: Neuropsychiatric aspects of sensitivity to low-level chemicals: A neural sensitization model. Toxicology and Industrial Health 10: 277-312.

    Google Scholar 

  • Bell, I. R., Miller, C. S., and Schwartz, G. E. (1992). An olfactorylimbic model of multiple chemical sensitivity syndrome: Possible relationships to kindling and affective spectrum disorders. Biological Psychiatry 32: 218-242.

    Google Scholar 

  • Bell, I. R., Patarca, R., Baldwin, C. M., Klimas, N. G., Schwartz, G. E. R., and Hardin, E. E. (1998a). Serum neopterin and somatization inwomen with chemical intolerance, depressives, and normals. Neuropsychobiology 38: 13-18.

    Google Scholar 

  • Bell, I. R., Rossi, J., III, Gilbert, M. E., Kobal, G., Morrow, L. A., Newlin, D. B., Sorg, B. A., and Wood, R. W. (1997a). Testing the neural sensitization and kindling hypothesis for illness from low levels of environmental chemicals. Environmental Health Perspectives 105(suppl. 2): 539-547.

    Google Scholar 

  • Bell, I. R., Schwartz, G. E., Baldwin, C. M., Hardin, E. E., Klimas, N. G., Kline, J. P., Patarca, R., and Song, Z. (1997b). Individual differences in neural sensitization and the role of context in illness from low-level environmental chemical exposures. Environmental Health Perspectives 105(suppl. 2): 457-466.

    Google Scholar 

  • Bell, I. R., Schwartz, G. E., Baldwin, C. M., Hardin, E. E., and Kline, J. P. (1998b). Differential resting qEEG alpha patterns in women with environmental chemical intolerance, depressives, and normals. Biological Psychiatry 43: 376-388.

    Google Scholar 

  • Bell, I. R., Schwartz, G. E., Bootzin, R. R., and Wyatt, J. K. (1997c). Time-dependent sensitization of heart rate and blood pressure over multiple laboratory sessions in elderly individuals with chemical odor intolerance. Archives of Environmental Health 52: 6-17.

    Google Scholar 

  • Benignus, V. A. (1997). Systematic considerations in the area of multiple chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 485.

    Google Scholar 

  • Binkley, K. E., and Kutcher, S. (1997). Panic response to sodium lactate infusion in patients with multiple chemical sensitivity syndrome. Journal of Allergy and Clinical Immunology 99: 570-574.

    Google Scholar 

  • Black, D. W. (1993). Environmental illness and misdiagnosis:Agrowing problem. Regulatory Toxicology and Pharmacology 18: 23-31.

    Google Scholar 

  • Black, D. W. (1996). Iatrogenic (physician-induced) hypochondriasis: Four patient examples of “chemical sensitivity.” Psychosomatics 37: 390-393.

    Google Scholar 

  • Black, D. W., and Rathe, A. (1990). Total environmental allergy: 20th century disease or deception? Resident and Staff Physician 36: 47-54.

    Google Scholar 

  • Black, D. W., Rathe, A., and Goldstein, R. B. (1990). Environmental illness: A controlled study of 26 subjects with “20th century disease.” Journal of the American Medical Association 264: 3166-3170.

    Google Scholar 

  • Black, D.W., Rathe, A., and Goldstein, R. B. (1993). Measures of distress in 26 “environmentally ill” subjects. Psychosomatics 34: 131-138.

    Google Scholar 

  • Bock, K. W., and Birbaumer, N. (1997). MCS: Cooperation between toxicology and psychology may facilitate solutions of the problems: Commentary. Human and Experimental Toxicology 16: 481-484.

    Google Scholar 

  • Bolla-Wilson, K., Wilson, R. J., and Bleecker, M. L. (1988). Conditioning of physical symptoms after neurotoxic exposure. Journal of Occupational Medicine 30: 684-686.

    Google Scholar 

  • Brodsky, C. M. (1983a). “Allergic to everything”: A medical subculture. Psychosomatics 24: 731-742.

    Google Scholar 

  • Brodsky, C. M. (1983b). Psychological factors contributing to somatoform diseases attributed to the workplace: The case of intoxication. Journal of Occupational Medicine 25: 459-464.

    Google Scholar 

  • Brodsky, C. M. (1987). Multiple chemical sensitivities and other “environmental illness”: A psychiatrist's view. Occupational Medicine: State of the Art Reviews 2: 695-704.

    Google Scholar 

  • Buchwald, D., and Garrity, D. (1994). Comparison of patients with chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities. Archives of Internal Medicine 154: 2049-2053.

    Google Scholar 

  • Burge, S., Hedge, A., Wilson, S., Bass, J. H., and Robertson, A. (1987). Sick building syndrome: A study of 4,373 office workers. Annals of Occupational Hygiene 31: 493-504.

    Google Scholar 

  • Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A. M., and Kaemmer, B. (1989). MMPI-2: Manual for Administration and Scoring, University of Minnesota Press, Minneapolis.

    Google Scholar 

  • Butler, S., Chalder, T., Ron, M., and Wessely, S. (1991). Cognitive behaviour therapy in chronic fatigue syndromes. Journal of Neurology, Neurosurgery, and Psychiatry 54: 153-158.

    Google Scholar 

  • California Medical Association Scientific Board Task Force on Clinical Ecology. (1986). Clinical ecology-A critical appraisal. Western Journal of Medicine 144: 239-245.

    Google Scholar 

  • Cohen, N., Kehrl, H., Berglund, B., O'Leary, A., Ross, G., Seltzer, J., and Wiesel, C. (1997). Psychoneuroimmunology. Environmental Health Perspectives 105(suppl. 2): 527-529.

    Google Scholar 

  • Colligan, M. J., and Murphy, L. R. (1982).Are viewof mass psychogenic illness in work settings. In Colligen, M. J., Pennebaker, J. W., and Murphy, L. R. (eds.), Mass Psychogenic Illness: A Social Psychological Analysis, Erlbaum, Hillsdale, NJ, pp. 33-52.

    Google Scholar 

  • Committee on Environmental Hypersensitivities. (1985). Report of the ad hoc committee on environmental hypersensitivity disorders, Government of Ontario Printing Office, Toronto.

    Google Scholar 

  • Cone, J. E., Harrison, R., and Reiter, R. (1987). Patients with multiple chemical sensitivities: Clinical diagnostic subsets among an occupational health clinic population. Occupational Medicine: State of the Art Reviews 2: 721-738.

    Google Scholar 

  • Council of Scientific Affairs, American Medical Association. (1992). Clinical ecology. Journal of the American Medical Association 268: 3465-3467.

    Google Scholar 

  • Cowley, D. S., and Arana, G. W. (1990). The diagnostic utility of lactate sensitivity in panic disorder. Archives of General Psychiatry 47: 277-284.

    Google Scholar 

  • Cullen, M. R. (1987). The worker with chemical sensitivities: An overview. Occupational Medicine: State of the Art Reviews 2: 655-661.

    Google Scholar 

  • Cullen, M. R. (1991). Multiple chemical sensitivities: Development of public policy in the face of scientific uncertainty. New Solutions 1: 16-24.

    Google Scholar 

  • Cullen, M. R., Pace, P. E., and Redlich, C. A. (1992). The experience of the Yale occupational and environmental medicine clinics with multiple chemical sensitivities. Toxicology and Industrial Health 8: 15-19.

    Google Scholar 

  • Custer, W. V. (1996). Multiple chemical sensitivity syndrome: The wavering influence of the courts on public policy. Regulatory Toxicology and Pharmacology 24: S182-S187.

    Google Scholar 

  • Dager, S. R., Holland, J. P., Cowley, D. S., and Dunner, D. L. (1987). Panic disorder precipitated by exposure to organic solvents in the workplace. American Journal of Psychiatry 144: 1056-1058.

    Google Scholar 

  • Dalton, P., Wysocki, C. J., Brody, M. J., and Lawley, H. J. (1997). The influence of cognitive bias on the perceived odor, irritation and health symptoms from chemical exposure. International Archives of Occupational and Environmental Health 69: 407-417.

    Google Scholar 

  • Daniell, W. E., Stockbridge, H. L., Labbe, R. F., Woods, J. S., Anderson, K. E., Bissell, D. M., Bloomer, J. R., Ellefson, R. D., Moore, M. R., Pierach, C. A., Schreiber, W. E., Tefferi, A., and Franklin, G. M. (1997). Environmental chemical exposures and disturbances of heme synthesis. Environmental Health Perspectives 105(suppl. 1): 37-53.

    Google Scholar 

  • Davidoff, A. L., and Fogarty, L. (1994). Psychogenic origins of multiple chemical sensitivities syndrome: A critical review of the research literature. Archives of Environmental Health 49: 316-325.

    Google Scholar 

  • DeHart, R. L. (1998). Multiple chemical sensitivity. American Family Physician 58: 652-654.

    Google Scholar 

  • Delis, D. C., Kramer, J. H., Kaplan, E., and Ober, B. A. (1987). California Verbal Learning Test Manual, The Psychological Corporation, San Antonio, TX.

    Google Scholar 

  • Derogatis, L. R. (1983). SCL-90-R: Administration, Scoring and Procedures Manual-II, Clinical Psychometrics Research, Baltimore, MD.

    Google Scholar 

  • Derogatis, L. R., and Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine 13: 595-605.

    Google Scholar 

  • Deyo, R. A., Psaty, B. M., Simon, G., Wagner, E. H., and Omenn, G. S. (1997). The messenger under attack-intimidation of researchers by special-interest groups. New England Journal of Medicine 336: 1176-1180.

    Google Scholar 

  • DiPino, R. K., and Kane, R. L. (1996). Neurocognitive functioning in chronic fatigue syndrome. Neuropsychology Review 6: 47-60.

    Google Scholar 

  • Donnay, A. (1997). Intimidation of researchers by special-interest groups [Letter to the editor]. New England Journal of Medicine 337: 1314.

    Google Scholar 

  • Donnay, A., and Ziem, G. (1995, March). Protocol for Evaluating Disorders of Porphyrin Metabolism in Chemically Sensitive Patients, MCS Referral and Resources, Baltimore.

    Google Scholar 

  • Doty, R. L. (1994). Olfaction and multiple chemical sensitivity. Toxicology and Industrial Health 10: 359-368.

    Google Scholar 

  • Doty, R. L., Deems, D. A., Frye, R. E., Pelberg, R., and Shapiro, A. (1988). Olfactory sensitivity, nasal resistance, and autonomic function in patients with multiple chemical sensitivities. Archives of Otolaryngology and Head and Neck Surgery 114: 1422-1427.

    Google Scholar 

  • Doty, R. L., Shaman, P., and Dann, M. (1984). Development of the University of Pennsylvania Smell Identification Test: A standardized microencapsulated test of olfactory function. Physiology and Behavior 32: 489-502.

    Google Scholar 

  • Downey, D. C. (1994). Fatigue syndromes revisited: The possible role of porphyrins. Medical Hypotheses 42: 285-290.

    Google Scholar 

  • Dryden, W., and Rentoul, R. (eds.). (1991). Adult Clinical Problems: A Cognitive-Behavioural Approach, Routledge, New York.

    Google Scholar 

  • Dunn, J. T., Lees-Haley, P. R., Brown, R. S., and Williams, C. W. (1995). Neurotoxic complaint base rates of personal injury claimants: Implications for neuropsychological assessment. Journal of Clinical Psychology 51: 577-584.

    Google Scholar 

  • Escobar, J. I., Burnam, M. A., Karno, M., Forsythe, A., and Golding, J. M. (1987). Somatization in the community. Archives of General Psychiatry 44: 713-718.

    Google Scholar 

  • Fiedler, N., and Kipen, H. (1997). Chemical sensitivity: The scientific literature. Environmental Health Perspectives 105(suppl. 2): 409-415.

    Google Scholar 

  • Fiedler, N., Kipen, H., DeLuca, J., Kelly-McNeil, K., and Natelson, B. (1994). Neuropsychology and psychology of MCS. Toxicology and Industrial Health 10: 545-554.

    Google Scholar 

  • Fiedler, N., Kipen, H. M., DeLuca, J., Kelly-McNeil, K., and Natelson, B. (1996). A controlled comparison of multiple chemical sensitivity and chronic fatigue syndrome. Psychosomatic Medicine 58: 38-49.

    Google Scholar 

  • Fiedler, N., Maccia, C., and Kipen, H. (1992). Evaluation of chemically sensitive patients. Journal of Occupational Medicine 34: 529-538.

    Google Scholar 

  • Fischer, J. S. (1999). Assessment of neuropsychological function. In Rudick, R. A., and Goodkin, D. E. (eds.), Multiple sclerosis therapeutics, Martin Dunitz, London, pp. 31-47.

    Google Scholar 

  • Ford, C. V. (1986). The somatizing disorders. Psychosomatics 27: 327-337.

    Google Scholar 

  • Ford, C. V. (1997). Somatization and fashionable diagnoses: Illness as a way of life. Scandinavian Journal of Work and Environmental Health 23(suppl. 3): 7-16.

    Google Scholar 

  • Fung, F. Y. (1991). Multiple chemical sensitivity and environmental toxicology. Allergy Proceedings 12: 81-84.

    Google Scholar 

  • Galland, L. (1987). Biochemical abnormalities in patients with multiple chemical sensitivities. Occupational Medicine: State of the Art Reviews 2: 713-720.

    Google Scholar 

  • Goldenberg, D. L. (1988). Psychiatric and psychological aspects of fibromyalgia syndrome. Rheumatic Diseases Clinics of North America 15: 105-114.

    Google Scholar 

  • Goldstein, G., Beers, S. R., Morrow, L. A., Shemansky, W. J., and Steinhauer, S. R. (1996). A preliminary neuropsychological study of Persian Gulf veterans. Journal of the International Neuropsychological Society 2: 368-371.

    Google Scholar 

  • Gothe, C., Odont, C. M., and Nilsson, C. G. (1995). The environmental somatization syndrome. Psychosomatics 36: 1-11.

    Google Scholar 

  • Gots, R. E., Hamosh, T. D., Flamm, W. G., and Carr, C. J. (1993). Multiple chemical sensitivities: A symposium on the state of the science. Regulatory Toxicology and Pharmacology 18: 61-78.

    Google Scholar 

  • Graham, J. R. (1987). The MMPI: A Practical Guide (2nd Ed.). Oxford University Press, New York.

    Google Scholar 

  • Guglielmi, R. S., Cox, D. J., and Spyker, D. A. (1994). Behavioral treatment of phobic avoidance in multiple chemical sensitivity. Journal of Behavior Therapy and Experimental Psychiatry 25: 197-209.

    Google Scholar 

  • Hahn, M., and Bonkovsky, H. L. (1997). Multiple chemical sensitivity syndrome and porphyria: A note of caution and concern. Archives of Internal Medicine 157: 281-285.

    Google Scholar 

  • Haller, E. (1993). Successful management of patients with “multiple chemical sensitivities” on an inpatient psychiatric unit. Journal of Clinical Psychiatry 54: 196-199.

    Google Scholar 

  • Hartman, D. E. (1995). Neuropsychological Toxicology: Identification and Assessment of Human Neurotoxic Syndromes (2nd Ed.), Plenum, New York.

    Google Scholar 

  • Hathaway, S. R., and McKinley, J. C. (1967). Minnesota Multiphasic Personality Inventory Manual-Revised, The Psychological Corporation, New York.

    Google Scholar 

  • Heuser, G., Wojdani, A., and Heuser, S. (1992). Diagnostic markers of multiple chemical sensitivity. In National Academy of Science, Multiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 117-138.

    Google Scholar 

  • Hileman, B. (1991). Multiple chemical sensitivity. Chemical and Engineering News 22 July: 26-42.

    Google Scholar 

  • Howard, L. M., and Wessely, S. (1993). The psychology of multiple allergy. British Medical Journal 307: 747-748.

    Google Scholar 

  • Hummel, T., Roscher, S., Jaumann, M. P., and Kobal, G. (1996). Intranasal chemoreception in patients with multiple chemical sensitivities: A double-blind investigation. Regulatory Toxicology and Pharmacology 24: S79-S86.

    Google Scholar 

  • International Programme on Chemical Safety. (1996). Conclusions and recommendations of a workshop on multiple chemical sensitivities (MCS). Regulatory Toxicology and Pharmacology 24: S188-S189.

    Google Scholar 

  • IUES/WHOWorking Group. (1981). Use and abuse of laboratory tests in clinical immunology: Critical considerations of eight widely used diagnostic procedures. Clinical and Experimental Immunology 46: 662-674.

    Google Scholar 

  • Jewett, D. L. (1992a). Diagnosis and treatment of hypersensitivity syndrome. Toxicology and Industrial Health 8: 111-123.

    Google Scholar 

  • Jewett, D. L. (1992b). Research strategies for investigating multiple chemical sensitivity. Toxicology and Industrial Health 8: 175-179.

    Google Scholar 

  • Kahn, E., and Letz, G. (1989). Clinical ecology: Environmental medicine or unsubstantiated theory? Annals of Internal Medicine 111: 104-106.

    Google Scholar 

  • Kehrl, H. R. (1997). Laboratory testing of the patient with multiple chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 443-444.

    Google Scholar 

  • Kellner, R. (1990). Somatization: Theories and research. Journal of Nervous and Mental Disease 178: 150-160.

    Google Scholar 

  • Kilburn, K. H. (1993). Symptoms, syndrome, and semantics: Multiple chemical sensitivity and chronic fatigue syndrome. Archives of Environmental Health 48: 368-369.

    Google Scholar 

  • Kipen, H., Fiedler, N., Maccia, C., Yurkow, E., Todaro, J., and Laskin, D. (1992). Immunological evaluation of chemically sensitive patients. Toxicology and Industrial Health 8: 125-135.

    Google Scholar 

  • Klimes, I., Mayou, R. A., Pearce, M. J., Coles, L., and Fagg, J. (1990). Psychological treatment for atypical non-cardiac chest pain: A controlled evaluation. Psychological Medicine 20: 605-611.

    Google Scholar 

  • Knasko, S. C. (1993). Performance, mood, and health during exposure to intermittent odors. Archives of Environmental Health 48: 305-308.

    Google Scholar 

  • Kroll-Smith, S., and Floyd, H. H. (1997). Bodies in Protest: Environmental Illness and the Struggle over Medical Knowledge, NewYork University Press, New York.

    Google Scholar 

  • Kurtz, D., White,T., and Belknap, E. (1993). Perceived odor intensity and hedonics in subjects with multiple chemical sensitivity. Chemical Senses 18: 584.

    Google Scholar 

  • Labarge, A. S., and McCaffrey, R. J. (1997, June). Base Rates of Symptoms in Patients with Multiple Chemical Sensitivity Versus Non-Medical Controls. Poster session presented at the annual meeting of the NewYork State Psychological Association, Saratoga Springs, NY.

    Google Scholar 

  • Lees-Haley, P. R. (1997a). Manipulation of perception in mass tort litigation. Natural Resources and Environment 12: 64-68.

    Google Scholar 

  • Lees-Haley, P. R. (1997b). Neurobehavioral assessment in toxic injury evaluations. Applied Neuropsychology 4: 180-190.

    Google Scholar 

  • Lees-Haley, P. R., and Brown, R. S. (1992). Biases in perception and reporting following a perceived toxic exposure. Perceptual and Motor Skills 75: 531-544.

    Google Scholar 

  • Lees-Haley, P. R., and Williams, C. W. (1997). Neurotoxicity of chronic low-dose exposure to organic solvents: A skeptical review. Journal of Clinical Psychology 53: 699-712.

    Google Scholar 

  • Lees-Haley, P. R., Williams, C. W., and English, L. T. (1996). Response bias in self-reported history of plaintiffs compared with nonlitigating patients. Psychological Reports 79: 811-818.

    Google Scholar 

  • Lees-Haley, P. R., Williams, C. W., Zasler, N. D., Margulies, S., English, L. T., and Stevens, K. B. (1997). Response bias in plaintiff's histories. Brain Injury 11: 791-799.

    Google Scholar 

  • Lehrer, P. M. (1997). Psychophysiological hypotheses regarding multiple chemical sensitivity syndrome. Environmental Health Perspectives 105(suppl. 2): 479-483.

    Google Scholar 

  • Lessof, M. (1997). Report of multiple chemical sensitivities workshop, Berlin, Germany, 21-23 February 1996. PCS/96.29 IPCS, Geneva, Switzerland. Human and Experimental Toxicology 16: 233-234.

    Google Scholar 

  • Letz, R., and Baker, E. (1985). Neurobehavioral Evaluation System (NES). Neurobehavioral Systems, Winchester, MA.

    Google Scholar 

  • Levin, A. S., and Byers, V. S. (1987). Environmental illness: A disorder of immune regulation. Occupational Medicine: State of the Art Reviews 2: 669-681.

    Google Scholar 

  • Levin, A. S., and Byers, V. S. (1992). Multiple chemical sensitivities: A practicing clinician's point of view. Clinical and immunologic research findings. Toxicology and Industrial Health 8: 95-110.

    Google Scholar 

  • Levine, S. (1983a). Oxidants/anti-oxidants and chemical hypersensitivities (Part one). International Journal of Biosocial Research 4: 51-54.

    Google Scholar 

  • Levine, S. (1983b). Oxidants/anti-oxidants and chemical hypersensitivities (Part two). International Journal of Biosocial Research 4: 102-105.

    Google Scholar 

  • Levine, S., and Reinhardt, J. H. (1983). Biochemical-pathology initiated by free radicals, oxidant chemicals, and therapeutic drugs in the etiology of chemical hypersensitivity disease. Orthomolecular Psychiatry 12: 166-183.

    Google Scholar 

  • Levy, F. (1997). Clinical features of multiple chemical sensitivity. Scandinavian Journal of Work and Environmental Health 23(suppl. 3): 69-73.

    Google Scholar 

  • Leznoff, A. (1997a). Provocative challenges in patients with multiple chemical sensitivity. Journal of Allergy and Clinical Immunology 99: 439-442.

    Google Scholar 

  • Leznoff, A. (1997b). Reply [Letter]. Journal of Allergy and Clinical Immunology 100: 856.

    Google Scholar 

  • Lieberman, M. S., DiMuro, B. J., and Boyd, J. B. (1995). Multiple chemical sensitivity: An emerging area of trial law. Trial 31: 22-23.

    Google Scholar 

  • Lyles, W. B., Greve, K. W., Bauer, R. M., Ware, M. R., Schramke, C. J., Crouch, J., and Hicks, A. (1991). Sick building syndrome. Southern Medical Journal 84: 65-72.

    Google Scholar 

  • MacPhail, R. C. (1997). Evolving concepts of chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 455-456.

    Google Scholar 

  • Magill, M. K., and Suruda, A. (1998). Multiple chemical sensitivity syndrome. American Family Physician 58: 721-728.

    Google Scholar 

  • Margarian, G. S. (1982). Hyperventilation syndromes: Infrequently recognized common expressions of anxiety and stress. Medicine (Baltimore) 61: 219-236.

    Google Scholar 

  • Martin, R. L., and Yutzy, S. H. (1994). Somatoform disorders. In Hales, R. E., Yudofsky, S. C., and Talbott, J. A. (eds.). The American Psychiatric Press Textbook of Psychiatry, American Psychiatric Press, Washington, DC, pp. 591-622.

    Google Scholar 

  • Matarazzo, J. D., and Herman, D. O. (1985). Clinical uses of theWAIS-R: Base rate differences between VIQ and PIQ in the WAIS-R standardization sample. In Wolman, B. B. (ed.), Handbook of Intelligence, Wiley, New York, pp. 899-932.

    Google Scholar 

  • McGovern, J. J., Lazaroni, J. A., Hicks, M. F., Adler, J. C., and Cleary, P. (1983). Food and chemical sensitivities. Clinical and immunologic correlates. Archives of Otolaryngology 109: 292-297.

    Google Scholar 

  • McLellan, R. K. (1987). Biological interventions in the treatment of patients with multiple chemical sensitivities. Occupational Medicine: State of the Art Reviews 2: 755-777.

    Google Scholar 

  • Meggs, W. J. (1992). Immunological mechanisms of disease and the multiple chemical sensitivity syndrome. In National Academy of Science, Multiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 155-168.

    Google Scholar 

  • Meggs, W. J. (1993). Neurogenic inflammation and sensitivity to environmental chemicals. Environmental Health Perspectives 101: 234-238.

    Google Scholar 

  • Meggs, W. J. (1995). Neurogenic switching: A hypothesis for a mechanism for shifting the site of inflammation in allergy and chemical sensitivity. Environmental Health Perspectives 103: 54-56.

    Google Scholar 

  • Meggs, W. J. (1997a). Hypothesis for induction and propagation of chemical sensitivity based on biopsy studies. Environmental Health Perspectives 105(suppl. 2): 473-478.

    Google Scholar 

  • Meggs, W. J. (1997b). Psychogenic versus biologic basis for chemical sensitivity [Letter]. Journal of Allergy and Clinical Immunology 100: 855-856.

    Google Scholar 

  • Meggs, W. J., and Cleveland, C. H., Jr. (1993). Rhinolaryngoscopic examination of patients with the multiple chemical sensitivity syndrome. Archives of Environmental Health 48: 14-18.

    Google Scholar 

  • Miller, C. S. (1992). Possible models for multiple chemical sensitivity: Conceptual issues and role of the limbic system. Toxicology and Industrial Health 8: 181-202.

    Google Scholar 

  • Miller, C. S. (1994). White paper: Chemical sensitivity: History and phenomenology. Toxicology and Industrial Health 10: 253-276.

    Google Scholar 

  • Miller, C. S. (1997). Toxicant-induced loss of tolerance: An emerging theory of disease? Environmental Health Perspectives 105(suppl. 2): 445-453.

    Google Scholar 

  • Miller, C. S., and Ashford, N. A. (1992). Allergy and multiple chemical sensitivities distinguished. In National Academy of Science, Multiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 47-63.

    Google Scholar 

  • Miller, C., Ashford, N., Doty, R., Lamielle, M., Otto, D., Rahill, A., and Wallace, L. (1997). Empirical approaches for the investigation of toxicant-induced loss of tolerance. Environmental Health Perspectives 105(suppl. 2): 515-519.

    Google Scholar 

  • Miller, C. S., and Mitzel, H. C. (1995). Chemical sensitivity attributed to pesticide exposure versus remodeling. Archives of Environmental Health 50: 119-129.

    Google Scholar 

  • Mooser, S. B. (1987). The epidemiology of multiple chemical sensitivities. Occupational Medicine: State of the Art Reviews 2: 663-668.

    Google Scholar 

  • Morton, W. E. (1996). Redefinition of abnormal susceptibility to environmental chemicals. In Johnson, B. L., Xintaras, C., and Andrews, J. S., Jr. (eds.), Hazardous Waste: Impacts on Human and Ecological Health, Princeton Scientific Publishing, Princeton, NJ, pp. 320-327.

    Google Scholar 

  • Mowrer, O. H. (1947). On the dual nature of learning: A reinterpretation of “conditioning” and “problem-solving.” Harvard Educational Review 17: 102-150.

    Google Scholar 

  • Munford, P. R., and Liberman, R. P. (1982). Behaviour therapy of hysterical disorders. In Roy, A. (ed.), Hysteria, John Wiley & Sons, Chichister, pp. 287-303.

    Google Scholar 

  • National Research Council. (1992a). Multiple Chemical Sensitivities: Addendum to Biologic Markers in Immunotoxicology, National Academy Press, Washington, DC.

    Google Scholar 

  • National Research Council. (1992b). Use of biologic markers in controversial areas of environmental health. In National Research Council, Biologic Markers in Immunotoxicology, National Academy Press, Washington, DC, pp. 127-139.

    Google Scholar 

  • Nethercott, J. R., Davidoff, L. E., Curbow, B., and Abbey, H. (1993). Multiple chemical sensitivities syndrome: Toward a working case definition. Archives of Environmental Health 48: 19-26.

    Google Scholar 

  • NIEHS seeks data on multiple chemical sensitivity. (1998). Environmental Health Perspectives 106: A226.

  • Norback, D., Michel, I., and Widstrom, J. (1990). Indoor air quality and personal factors related to the sick building syndrome. Scandinavian Journal of Work and Environmental Health 16: 121-128.

    Google Scholar 

  • Pennebaker, J. W. (1994). Psychological bases of symptom reporting: Perceptual and emotional aspects of chemical sensitivity. Toxicology and Industrial Health 10: 497-511.

    Google Scholar 

  • Peyser, J. M., Rao, S. M., LaRocca, N. G., and Kaplan, E. (1990). Guidelines for neuropsychological research in multiple sclerosis. Archives of Neurology 47: 94-97.

    Google Scholar 

  • Philips, C. (1987). The effects of behavioural treatment on chronic pain. Behaviour Research and Therapy 25: 365-378.

    Google Scholar 

  • Post, R. M., and Contel, N. R. (1983). Human and animal studies of cocaine: Implications for the development of behavioral pathology. In Creese, I. (ed.), Stimulants: Neurochemical, Behavioral, and Clinical Perspectives, Raven Press, New York, pp. 169-203.

    Google Scholar 

  • Post, R. M., Rubinow, D. R., and Ballenger, J. C. (1984). Conditioning, sensitization, and kindling: Implications for the course of affective illness. In Post, R. M., and Ballenger, J. C. (eds.), Neurobiology of Mood Disorders, Williams and Wilkins, Baltimore, pp. 432-466.

    Google Scholar 

  • Post, R. M., Weiss, S. R. B., and Smith, M. (1994). Sensitization and kindling: Implications for the evolving neural substrates of posttraumatic stress disorder. In Friedman, M. J., Charney, D. S., and Deutch, A. Y. (eds.), Neurobiological and Clinical Consequences of Stress: From Normal Adaptation to Post-Traumatic Stress Disorder, Lippincott-Raven, Philadelphia, pp. 203-224.

    Google Scholar 

  • Randolph, T. G. (1954). Allergic-type reactions to industrial solvents and liquid fuels; mosquito abatement fogs and mists; motor exhausts; indoor utility gas and oil fumes; chemical additives of foods and drugs; and synthetic drugs and cosmetics. Journal of Laboratory and Clinical Medicine 44: 910-914.

    Google Scholar 

  • Randolph, T. G. (1955). Depressions caused by home exposure to gas and combustion products of gas, oil, and coal. Journal of Laboratory and Clinical Medicine 46: 942.

    Google Scholar 

  • Randolph, T. G. (1956). The specific adaptation syndrome. Journal of Laboratory and Clinical Medicine 48: 934.

    Google Scholar 

  • Randolph, T. G. (1962). Human Ecology and Susceptibility to the Chemical Environment. Charles C. Thomas, Springfield, IL.

    Google Scholar 

  • Rao, S. M., Leo, G. J., Bernardin, L., and Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis: I. Frequency, patterns, and prediction. Neurology 41: 685-691.

    Google Scholar 

  • Rea, W. J., Bell, I. R., Suits, C. W., and Smiley, R. E. (1978). Food and chemical susceptibility after environmental chemical overexposure: Case histories. Annals of Allergy 41: 101-110.

    Google Scholar 

  • Rea, W. J., Johnson, A. R., Ross, G. H., Butler, J. R., Fenyves, E. J., Griffiths, B., and Laseter, J. (1992). Considerations for the diagnosis of chemical sensitivity. In National Academy of Science, iMultiple Chemical Sensitivities, National Academy Press, Washington, DC, pp. 169-192.

    Google Scholar 

  • Rea, W. J., Johnson, A. R., Youdim, S., Fenyves, E. J., and Samadi, N. (1986). T & B lymphocyte parameters measures in chemically sensitive patients and controls. Clinical Ecology 4: 11-14.

    Google Scholar 

  • Rea, W. J., Ross, G. H., Johnson, A. R., Smiley, R. E., Sprague, D. E., Fenyves, E. J., and Samadi, N. (1990). Confirmation of chemical sensitivity by means of double-blind inhalant challenge of toxic volatile chemicals. Clinical Ecology 6: 113-118.

    Google Scholar 

  • Reitan, R. M., and Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Neuropsychology Press, Tucson.

    Google Scholar 

  • Rest, K. M. (1992). A survey of AOEC physician practices and attitudes regarding multiple chemical sensitivity. Toxicology and Industrial Health 8: 51-65.

    Google Scholar 

  • Rey, A. (1964). L'examen clinique en psychologie, Presses Universitaires de France, Paris.

    Google Scholar 

  • Richter, E. (1993). Multiple chemical sensitivity: Respect the observations... suspect the interpretations? Archives of Environmental Health 48: 366-367.

    Google Scholar 

  • Rinkle, H. J., Randolph, T. G., and Zeller, M. (1950). Food Allergy. Charles C. Thomas, Springfield, IL.

    Google Scholar 

  • Ritts, R. (1982). Clinical utility of immunologic tests. Annals of Internal Medicine 96: 779-781.

    Google Scholar 

  • Robins, L. N., and Helzer, J. E. (1985). Diagnostic Interview Schedule (DIS) Version III-A, Washington University School of Medicine, St. Louis, MO.

    Google Scholar 

  • Robins, L. N., Helzer, J. E., Croughan, J., and Ratcliff, K. S. (1981). The NIMH Diagnostic Interview Schedule: Its history, characteristics, and validity. Archives of General Psychiatry 38: 381-389.

    Google Scholar 

  • Rogers, R. (1988). Clinical Assessment of Malingering and Deception. Guilford, New York.

    Google Scholar 

  • Ross, G. H. (1992a). History and clinical presentation of the chemically sensitive patient. Toxicology and Industrial Health 8: 21-28.

    Google Scholar 

  • Ross, G. H. (1992b). Treatment options in multiple chemical sensitivity. Toxicology and Industrial Health 8: 87-94.

    Google Scholar 

  • Ross, G. H. (1997). Clinical characteristics of chemical sensitivity: An illustrative case history of asthma and MCS. Environmental Health Perspectives 105(suppl. 2): 437-441.

    Google Scholar 

  • Rowat, S. C. (1998). Integrated defense system overlap as a disease model: With examples for multiple chemical sensitivity. Environmental Health Perspectives 106(suppl. 1): 85-109.

    Google Scholar 

  • Rowe, A. H. (1931). Food Allergy. Its Manifestations, Diagnosis, and Treatment, Lea and Febiger, Philadelphia.

    Google Scholar 

  • Ryan, C. M., and Morrow, L. A. (1992). Dysfunctional buildings or dysfunctional people: An examination of the sick building syndrome and allied disorders. Journal of Consulting and Clinical Psychology 60: 220-224.

    Google Scholar 

  • Salvaggio, J. E. (1990). The impact of allergy and immunology on our expanding industrial environment. Journal of Allergy and Clinical Immunology 85: 689-699.

    Google Scholar 

  • Salvaggio, J. E. (1991). Clinical and immunological approach to patients with alleged environmental injury. Annals of Allergy 66: 493-503.

    Google Scholar 

  • Salvaggio, J. E. (1996). Understanding clinical immunological testing in alleged chemically induced environmental illness. Regulatory Toxicology and Pharmacology 24: S16-S27.

    Google Scholar 

  • Salvaggio, J. E., and Terr, A. I. (1996). Multiple chemical sensitivity, multiorgan dysthesia, multiple symptom complex, and multiple confusion: Problems in diagnosing the patient presenting with unexplained multisystemic symptoms. Critical Reviews in Toxicology 26: 617-631.

    Google Scholar 

  • Sandman, C. A., Barron, J. L., Nackoul, K., Goldstein, J., and Fidler, F. (1993). Memory deficits associated with chronic fatigue immune dysfunction syndrome. Biological Psychiatry 33: 618-623.

    Google Scholar 

  • Schottenfeld, R. S. (1987). Workers with multiple chemical sensitivities: A psychiatric approach to diagnosis and treatment. Occupational Medicine: State of the Art Reviews 2: 739-752.

    Google Scholar 

  • Schottenfeld, R. S., and Cullen, M. R. (1985). Occupation-induced posttraumatic stress disorders. American Journal of Psychiatry 142: 198-202.

    Google Scholar 

  • Schottenfeld, R. S., and Cullen, M. R. (1986). Recognition of occupationinduced posttraumatic stress disorders. Journal of Occupational Medicine 28: 365-369.

    Google Scholar 

  • Selner, J. C., and Staudenmayer, H. (1992a). Psychological factors complicating the diagnosis of work-related chemical illness. Immunology and Allergy Clinics of North America 12: 909-919.

    Google Scholar 

  • Selner, J. C., and Staudenmayer, H. (1992b). Neuropsychophysiologic observations in patients presenting with environmental illness. Toxicology and Industrial Health 8: 145-155.

    Google Scholar 

  • Sharpe, M., Peveler, R., and Mayou, R. (1992). Invited review: The psychological treatment of patients with functional somatic syndromes: A practical guide. Journal of Psychosomatic Research 36: 515-529.

    Google Scholar 

  • Shorter, E. (1997). Multiple chemical sensitivity: Pseudodisease in historical perspective. Scandinavian Journal of Work and Environmental Health 23(suppl. 3): 35-42.

    Google Scholar 

  • Shusterman, D., Balmes, J., and Cone, J. (1988). Behavioral sensitization to irritants/odorants after acute overexposures. Journal of Occupational Medicine 30: 565-567.

    Google Scholar 

  • Siegel, S., and Kreutzer, R. (1997). Pavlovian conditioning and multiple chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 521-526.

    Google Scholar 

  • Sikorski, E. E., Kipen, H. M., Selner, J. C., Miller, C. M., and Rodgers, K. E. (1995). The question of multiple chemical sensitivity. Fundamental and Applied Toxicology 24: 22-28.

    Google Scholar 

  • Simon, G. E. (1992). Psychiatric treatments in multiple chemical sensitivity. Toxicology and Industrial Health 8: 67-72.

    Google Scholar 

  • Simon, G. E. (1994a). Psychiatric symptoms in multiple chemical sensitivity. Toxicology and Industrial Health 10: 487-496.

    Google Scholar 

  • Simon, G. E. (1994b). Questions and answers #3. Toxicology and Industrial Health 10: 523-535.

    Google Scholar 

  • Simon, G. E., Daniell, W., Stockbridge, H., Claypoole, K., and Rosenstock, L. (1993). Immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity. Annals of Internal Medicine 119: 97-103.

    Google Scholar 

  • Simon, G., and Deyo, R. A. (1997). Intimidation of researchers by special-interest groups [Letter to the editor]. New England Journal of Medicine 337: 1315-1316.

    Google Scholar 

  • Simon, G. E., Katon, W. J., and Sparks, P. J. (1990). Allergic to life: Psychological factors in environmental illness. American Journal of Psychiatry 147: 901-906.

    Google Scholar 

  • Singer, R. (1990). Neurotoxicity Guidebook, Van Nostrand Reinhold, New York.

    Google Scholar 

  • Skov, P. (1992). The sick building syndrome. In Tucker, W. G., Leaderer, B. P., Molhave, L., and Cain, W. S. (eds.), Sources of Indoor Air Contaminants: Characterizing Emissions and Health Impacts, New York Academy of Sciences, New York, pp. 17-20.

    Google Scholar 

  • Skov, P., Valbjorn, O., Pedersen, B. V., and Danish Indoor Climate Study Group. (1989). Influence of personal characteristics, job-related factors and psychosocial factors on the sick building syndrome. Scandinavian Journal of Work, Environment and Health 15: 286-295.

    Google Scholar 

  • Slotkoff, A. T., Radulovic, D. A., and Clauw, D. J. (1997). The relationship between fibromyalgia and the multiple chemical sensitivity syndrome. Scandinavian Journal of Rheumatology 26: 364-367.

    Google Scholar 

  • Smith, G. R. (1990). Somatization Disorder in the Medical Setting, U.S. Department of Health and Human Services, Rockville, MD.

    Google Scholar 

  • Sorg, B. A., Hooks, M. S., and Kalivas, P. W. (1994). Neuroanatomy and neurochemical mechanisms of time-dependent sensitization. Toxicology and Industrial Health 10: 369-386.

    Google Scholar 

  • Sorg, B. A., and Prasad, B. M. (1997). Potential role of stress and sensitization in the development and expression of multiple chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 467-471.

    Google Scholar 

  • Sorg, B. A., Willis, J. R., See, R. E., Hopkins, B., and Westberg, H. H. (1998). Repeated low-level formaldehyde exposure produces crosssensitization to cocaine: Possible relevance to chemical sensitivity in humans. Neuropsychopharmacology 18: 385-394.

    Google Scholar 

  • Sparks, P. J., Daniell, W., Black, D. W., Kipen, H. M., Altman, L. C., Simon, G. E., and Terr, A. I. (1994a). Multiple chemical sensitivity syndrome: A clinical perspective. I. Case definition, theories of pathogenesis, and research needs. Journal of Occupational Medicine 36: 718-730.

    Google Scholar 

  • Sparks, P. J., Daniell, W., Black, D. W., Kipen, H. M., Altman, L. C., Simon, G. E., and Terr, A. I. (1994b). Multiple chemical sensitivity syndrome: A clinical perspective. II. Evaluation, diagnostic testing, treatment, and social considerations. Journal of Occupational Medicine 36: 731-737.

    Google Scholar 

  • Spitzer, R. L., Williams, J. B., and Gibbon, M. (1986). Structured clinical interview for DSM-III-R, Biometrics Research Department, New York State Psychiatric Institute, New York.

    Google Scholar 

  • Sprague, D. (1987). The concept of an environmental unit. In Brostoff, J., and Challacombe, R. (eds.), Food Allergy and Intolerance, Bailliere Tindall/W. B. Saunders, Philadelphia, pp. 947-960.

    Google Scholar 

  • Stangl, D., Pfohl, B., Zimmerman, M., and Bowers,W. (1987). A structured interview for DSM-III personality disorder. Archives of General Psychiatry 42: 591-596.

    Google Scholar 

  • Staudenmayer, H. (1997). Multiple chemical sensitivities or idiopathic environmental intolerances: Psychophysiologic foundation of knowledge for a psychogenic explanation. Journal of Allergy and Clinical Immunology 99: 434-437.

    Google Scholar 

  • Staudenmayer, H., and Selner, J. C. (1990). Neuropsychophysiology during relaxation in generalized, universal “allergic” reactivity to the environment: A comparison study. Journal of Psychosomatic Research 34: 259-270.

    Google Scholar 

  • Staudenmayer, H., and Selner, J. C. (1995). Failure to assess psychopathology in patients presenting with chemical sensitivities. Journal of Occupational and Environmental Medicine 37: 704-709.

    Google Scholar 

  • Staudenmayer, H., Selner, J. C., and Buhr, M. P. (1993). Double-blind provocation chamber challenges in 20 patients presenting with “multiple chemical sensitivity.” Regulatory Toxicology and Pharmacology 18: 44-53.

    Google Scholar 

  • Stenn, P. G., and Binkley, K. (1998). Multiple chemical sensitivity. Psychosomatics 39: 393-394.

    Google Scholar 

  • Stewart, D. E. (1987). Environmental hypersensitivity disorder, total allergy and 20th century disease: A critical review. Canadian Family Physician 33: 405-410.

    Google Scholar 

  • Stewart, D. E. (1990a). Emotional disorders misdiagnosed as physical illness: Environmental hypersensitivity, candidiasis hypersensitivity, and chronic fatigue syndrome. International Journal of Mental Health 19: 56-68.

    Google Scholar 

  • Stewart, D. E. (1990b). The changing faces of somatization. Psychosomatics 31: 153-158.

    Google Scholar 

  • Stewart, D. E., and Raskin, J. (1985). Psychiatric assessment of patients with “20th-century disease” (“total allergy syndrome”). Canadian Medical Association Journal 133: 1001-1006.

    Google Scholar 

  • Terr, A. I. (1986). Environmental illness: A clinical review of 50 cases. Archives of Internal Medicine 146: 145-149.

    Google Scholar 

  • Terr, A. I. (1987). “Multiple chemical sensitivities”: Immunologic critique of clinical ecology theories and practice. Occupational Medicine: State of the Art Reviews 2: 683-694.

    Google Scholar 

  • Terr, A. I. (1989). Clinical ecology in the workplace. Journal of Occupational Medicine 31: 257-261.

    Google Scholar 

  • Terr, A. I. (1993). Immunological issues in “multiple chemical sensitivities.” Regulatory Toxicology and Pharmacology 18: 54-60.

    Google Scholar 

  • Thomas, J. G. (1998). A critical analysis of multiple chemical sensitivities. Medical Hypotheses 50: 303-311.

    Google Scholar 

  • Tollefson, L. (1993). Multiple chemical sensitivity: Controlled scientific studies as proof of causation. Regulatory Toxicology and Pharmacology 18: 32-43.

    Google Scholar 

  • Trahan, D. E., and Larrabee, G. J. (1988). Continuous Visual Memory Test, Psychological Assessment Resources, Odessa, FL.

    Google Scholar 

  • Trenerry, M. R., Crosson, B., DeBoe, J., and Leber, W. R. (1989). Stroop Neuropsychological Screening Test Manual, Psychological Assessment Resources, Odessa, FL.

    Google Scholar 

  • Trites, R. L. (1981). Neuropsychological Test Manual, Technolab, Montreal.

  • Van den Bergh, O., Stegen, K., and Van deWoestijne, K. P. (1997). Learning to have psychosomatic complaints: Conditioning of respiratory behavior and somatic complaints in psychosomatic patients. Psychosomatic Medicine 59: 13-23.

    Google Scholar 

  • Waddell, W. J. (1993). The science of toxicology and its relevance to MCS. Regulatory Toxicology and Pharmacology 18: 13-22.

    Google Scholar 

  • Wallace, D. J. (1997). The fibromyalgia syndrome. Annals of Medicine 29: 9-21.

    Google Scholar 

  • Wechsler, D. (1981). WAIS-R Manual, The Psychological Corporation, New York.

    Google Scholar 

  • Wechsler, D. (1987). Wechsler Memory Scale-Revised Manual, The Psychological Corporation, San Antonio, TX.

    Google Scholar 

  • Weiss, B. (1997). Experimental strategies for research on multiple chemical sensitivity. Environmental Health Perspectives 105(suppl. 2): 487-494.

    Google Scholar 

  • Weiss, B. (1998). Neurobehavioral properties of chemical sensitivity syndromes. NeuroToxicology 19: 259-268.

    Google Scholar 

  • Weiss, S. R. B., and Post, R. M. (1994). Caveats in the use of the kindling model of affective disorders. Toxicology and Industrial Health 10: 421-447.

    Google Scholar 

  • Williams, C. W., and Lees-Haley, P. R. (1993). Perceived toxic exposure: A review of four cognitive influences on perception of illness. Journal of Social Behavior and Personality 8: 489-506.

    Google Scholar 

  • Williams, C.W., Lees-Haley, P. R., and Brown, R. S. (1993). Human response to traumatic events: An integration of counterfactual thinking, hindsight bias, and attributional theory. Psychological Reports 72: 483-494.

    Google Scholar 

  • Young, E., Patel, S., Stoneham, M., Rona, R., and Wilkinson, J. (1987). The prevalence of reactions to food additives in a survey population. Journal of the Royal College of Physicians 721: 241-247.

    Google Scholar 

  • Ziem, G., and McTamney, J. (1997). Profile of patients with chemical injury and sensitivity. Environmental Health Perspectives 105(suppl. 2): 417-436.

    Google Scholar 

  • Ziem, G. E. (1992). Multiple chemical sensitivity: Treatment and followup with avoidance and control of chemical exposures. Toxicology and Industrial Health 8: 73-86

    Google Scholar 

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Labarge, A.S., McCaffrey, R.J. Multiple Chemical Sensitivity: A Review of the Theoretical and Research Literature. Neuropsychol Rev 10, 183–211 (2000). https://doi.org/10.1023/A:1026460726965

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