Abstract

This paper presents the first systematic case-control study of correlates of mass psychogenic illness (MPI) in an adolescent school population. MPI is generally construed as a dissociative phenomenon spread by social contagion to individuals who are prone to dissociation. We sought to test if the correlates of dissociative experiences most commonly proposed in the literature could predict caseness among students affected by episodes of mass psychogenic illness occurring in schools in Nepal. We assessed 194 cases and 190 controls (N = 384) of ages 11–18 years from 12 public schools. Cases and controls were comparable on all demographic variables, except for family configuration, with nuclear families more common among those affected. In bivariate comparisons, caseness was associated with childhood physical neglect and abuse, as well as living in nuclear families, peritraumatic dissociation, dissociative tendencies, and depressive and post-traumatic stress symptoms. Hypnotizability emerged as the strongest correlate of psychogenic illness among the cognitive and personality trait variables. However, in multivariable logistic regression, the correlates of dissociation did not predict caseness, suggesting that they do not adequately account for the phenomenon of mass psychogenic illness. An ad-hoc Classification and Regression Trees analysis showed that if an adolescent was highly hypnotizable and reported high rates of peritraumatic dissociative experiences, then there was a 73% probability of being a case in a mass psychogenic illness episode. Future studies involving other psychological, social and cultural factors, as well as school- and family-related factors are needed to understand the correlates of mass psychogenic illness and guide prevention and intervention.

Highlights

  • In this paper, we present the first systematic case-control study of correlates of mass psychogenic illness (MPI) in an adolescent school population

  • A majority (55.5 %) of the affected were living in nuclear families, while a majority (54.8%) of the controls were living in united/extended families

  • In the present study, these variables had either small or no effect on MPI case status. This challenges the assumption that the trance and possession episodes in MPI can be adequately explained by the same variables associated with dissociative symptoms and behaviors in the general adolescent population, that is cognitive failures, fantasy proneness, and post-traumatic stress [30]

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Summary

Introduction

We present the first systematic case-control study of correlates of mass psychogenic illness (MPI) in an adolescent school population. Mass Psychogenic Illness in Schools in Nepal identifiable pathogen or medical cause, and which are assumed to be of psychogenic origin [1, 2]. Over time, the contagion spreads to affect a large number of people [10]. This contagion effect is influenced by witnessing the behavior of afflicted individuals or by the communication of rumors and stories of the outbreak through word of mouth or popular media [1, 4, 6, 7, 11, 12]

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