Mass hysteria, most commonly known as mass psychogenic illness (MPI), is a sociological as well as psychological phenomenon. This article explores the history of MPI while posing the question whether MPI is specific to cultures and societies, or is a universal human trait. Most research shows that MPI is apparently a gender-specific phenomenon. A concise history of recent cases of MPI is presented, and a recent experiment into the causes of MPI is examined. The paper then looks at the role of the media in creating or sustaining mass hysteria, as well as its potential to help a public overcome its inclinations toward mass hysteria. The paper finishes with some journalistic considerations in media propagation.
Keywords Bioterrorism; Mass Sociogenic Illness (MSI); Mass Psychogenic Illness (MPI); Medically unexplained physical symptoms (MUPS); Modeling; Post Traumatic Stress Disorder (PTSD); Response Expectancy; Somatoform Disorder
Mass Hysteria: A Mysterious Medical Phenomenon
The general meaning for the term mass hysteria is that individuals in a group setting experience collective panic over some occurrence. Mass hysteria is considered a socially contagious frenzy of irrational behavior in a group of people in reaction to some event experienced in common. This definition emphasizes the psychological aspect of mass hysteria, so that the meaning can describe anything from screaming Beatles fans to a theater crowd rushing en masse, after smelling smoke, to the exit doors in a movie theater. Mass hysteria is a phenomenon that very few would deny exists, since many have witnessed it firsthand. However, once we attach a physical aspect to mass hysteria, wherein there is also an inexplicable appearance of physical symptoms of illness, the definition becomes less believed or accepted. Physicians, emergency personnel, psychologists, and sociologists find this physical aspect of mass hysteria to be intriguing and worthy of investigation, which is why much of the academic work that focuses on mass hysteria is actually focused on the curious physical effects. Thus, most researchers—and particularly researchers within the field of sociology— tend to define mass hysteria in the same way Mattoo, Gupta, Lobana, and Bedi (2002) define it, as "a constellation of symptoms suggestive of organic illness but without an identified cause in a group of people with shared beliefs about 'external' cause of the symptoms" (Mattoo et al., 2002, p. 645).
When examining the research and literature around this particular phenomenon, researchers posit very similar definitions as the one above. However, as noted by Weir (2005), the term "mass hysteria" is often synonymously termed, "mass psychogenic disorder" or "epidemic hysteria," and is "distinguished from collective delusions by the presence of illness symptoms" (Weir, 2005, ¶ 1). Thus, among researchers, the physical aspect of mass hysteria has been subdivided from the purely psychological aspect, and has been given its own specific term or terms. The individual experiences symptoms that have no external physical cause, which is quite similar to the concept of a psychosomatic disorder. Considering the group setting, this physical form of mass hysteria could be called a sociosomatic disorder rather than psychosomatic disorder. Other terms for this physical aspect of mass hysteria are "mass sociogenic illness" (MSI) and "mass psychogenic illness" (MPI). As Weir defines it, MPI is a
… rapid spread of illness signs and symptoms affecting members of a cohesive group, originating from a nervous system disturbance involving excitation, loss or alteration of function, whereby physical complaints that are exhibited unconsciously have no corresponding organic aetiology (Weir, 2005, ¶ 1).
Weir also observes that MPI usually occurs in the context of some believable physical source that causes a feeling of anxiety for a group. This physical source could be a strange odor or some unknown material that is perceived as a toxin.
As Lacy and Benedek (2003) note, such outbreaks of physical mass hysteria always have contagious physical symptoms within a group of people with the symptoms quickly affecting the entire group. The outbreak is usually spread "by sight and sound whether on-site or via media and are characterized by rapid onset and rapid remission" (p. 395). Lacy and Benedek also describe the symptoms as including "hyperventilation, dyspnea, dizziness, nausea, head ache, syncope, abdominal distress, and agitation," and the symptoms are often identical to whatever are the known symptoms of an infectious or chemical agent. The authors also observe that the most common settings for such outbreaks are "schools, factories, sporting events, and other social groupings" (Lacy & Benedek, 2003, p. 395).
A Response to Sociopolitical Threats
Mass Psychogenic Illness (MPI) is the most commonly used term for describing a mass hysteria or panic wherein individuals manifest physical symptoms that have no identifiable pathogen as the cause. According to Lorber, Mazzoni and Kirsch (2007), MPI has been chronicled for centuries, and they note that the effects of MPI can cost greatly in an economic as well as social sense. The authors propose that the current sociopolitical climate (i.e., the threat of terrorism) makes it very important that we as a society come to understand more fully this age-old phenomenon. As Lorber et al. note, the possible threat of biochemical weapons, as well as the fact that new infectious diseases can quickly spread from one continent to the next, has created an environment wherein cases of MPI are on the rise. The authors also warn that, "public health providers could be inundated by patients experiencing psychogenic symptoms following an actual biochemical attack or infectious outbreak" (Lorber, Mazzoni & Kirsch, 2007, ¶ 1).
Szegedy-Mazsak (2001) makes the astute comment that while anthrax isn't contagious, fear is. She notes, at the time of the 2001 anthrax scare in the United States, that as Americans learned of new cases of anthrax "an epidemic of vulnerability and panic spread" (1). She observes that this epidemic was an epidemic with real physical symptoms, and that some of those symptoms "even bear a striking resemblance to early anthrax." However, the author concludes that these reported symptoms may actually "portend an outbreak of mass psychogenic or sociogenic illness, more commonly known as mass hysteria" (Szegedy-Maszak 2001, ¶ 1). Spinney (2006) observes that, in industrialized nations, environmental contamination is more often the event that causes MPI in groups. Also, after the 9/11 terrorist attacks, some researchers predicted that there would be increased outbreaks of mass hysteria related particularly to bioterrorism. Spinney writes that, "despite the difficulties in spotting outbreaks [of MPI caused by bioterrorism], that now seems to be happening" (2006, ¶ 4).
As Weir (2005) observes, in recent history (twentieth century to the present), unknown odors have sparked cases of MPI because such odors can be misperceived as a toxic gas from industrial accidents, or perhaps as a consequence of bioterrorism or chemical warfare. Weir notes that such odors have caused episodes of mass hysteria wherein the patients feel breathlessness, nausea, headache, dizziness, and weakness. By way of example, the author cites the 1990 Gulf War, when Iraq sent a SCUD missile into Israel. The missile was widely feared to contain chemical weapons, and even though this proved not to be the case, "about 40% of Israeli civilians in the immediate vicinity of the attack reported breathing problems" (Weir, 2005, ¶ 4).
Specific Recent Cases
Mass hysteria is likely part of human nature and is not specific to historical periods or particular cultures. As Lorber, Mazzoni, and Kirsch (2007) have noted, the phenomenon of MPI has been recorded for centuries. Spinney (2006) notes that mass hysteria has been documented since the Middle Ages; the author observes that, in the past, witchcraft was often blamed for mass illness (these were most likely cases of MPI), and in some contemporary societies witchcraft is still blamed for mass illness. By considering the long history of MPI, as well as examining the location of cases, we can gain a clearer understanding on whether or not this physical form of mass hysteria is something universal or culturally specific. If cases occur globally and throughout history, it then becomes quite evident that MPI is some inextricable part of human nature, and that it is not a malady that only affects particular societies, nations, or cultures. For this reason, it is beneficial to summarize some of the recent locations and situations that have given rise to cases of MPI:
• In 1973, a ship that carried 50 barrels of a harmless organophosphate defoliant docked in Auckland, New Zealand. The workers detected a foul odor, saw the word "poison" written on the barrels of defoliant, and some unfortunate miscommunication about the ship's cargo ensued. The workers concern increased and a crisis developed. Although no one was actually physically affected by the barrels of defoliant, 643 people went for medical attention from typical MPI symptoms. The symptoms were "consistent with anxiety and somatoform reactions" (Lacy & Benedek, 2003, p. 395).
• In September 1998, 800 children in Jordan believed they were suffering the side effects of a tetanus-diphtheria toxoid vaccine that was administered in school. During this epidemic, over 100 children were admitted to hospital, but for the vast majority the symptoms resulted not from the vaccine but rather from psychogenic illness (Weir, 2005, ¶ 2).
• In November 1998, an American teacher noticed a smell similar to gasoline in her classroom, and soon thereafter felt a headache, nausea, shortness of breath, and dizziness. Officials evacuated the school and 80 students and 19 staff members went to the emergency room. Of these, 38 persons were hospitalized overnight. When the school reopened five days later, another 71 persons went to the emergency room. The individuals who reported symptoms during the first day were from 36 classrooms scattered throughout the building. The most frequent symptoms for this group—as well as for the group that reported symptoms five days later—were headache, dizziness, nausea, and drowsiness....
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