Symptoms associated with environmental factors (SAEF; also known as idiopathic environmental intolerance) include the presentation of various common symptoms that are causally attributed to normally benign environmental triggers, such as electromagnetic fields, odors, and chemicals. SAEF are typically conceptualized as psychogenic in origin, and multiple models have proposed that dissociation and responsiveness to suggestions may contribute to the manifestation or expression of these symptoms. This preregistered study sought to characterize these variables’ independent and interactive predictive utility. Participants (N = 294) completed psychometric measures of dissociative tendencies, trauma, SAEF, and a behavioral scale indexing responsiveness to direct verbal suggestions. Moderation analyses were used to evaluate predictions derived from different models regarding whether these variables would uniquely and interactively predict individual differences in the reporting of SAEF. Responsiveness to verbal suggestions individually predicted SAEF, but no clear evidence was observed for an interaction with dissociation or trauma. Dissociation similarly individually predicted SAEF with additional evidence that this association was moderated by trauma such that the positive association between dissociation and SAEF was only significant in those with moderate-to-high trauma exposure. These results align with the proposal that environmental factors may function as suggestions that trigger involuntary symptoms in some individuals. Our findings further suggest that among individuals with a history of trauma exposure, those with dissociative tendencies may be at an increased risk of experiencing SAEF.

1.
Stein
MV
,
Holt
L
,
Wieder
L
,
Terhune
DB
.
Responsiveness to direct verbal suggestions and dissociation predict symptoms attributed to environmental factors
.
PsyArXiv [Preprint]
.
2022
. Available from: https://psyarxiv.com/nhb9q/.
2.
Van den Bergh
O
,
Brown
RJ
,
Petersen
S
,
Witthöft
M
.
Idiopathic environmental intolerance: a comprehensive model
.
Clin Psychol Sci
.
2017
;
5
(
3
):
551
67
.
3.
Dieudonné
M
.
Electromagnetic hypersensitivity: a critical review of explanatory hypotheses
.
Environ Health
.
2020
;
19
(
1
):
48
.
4.
Haanes
JV
,
Nordin
S
,
Hillert
L
,
Witthöft
M
,
van Kamp
I
,
van Thriel
C
,
.
“Symptoms associated with environmental factors” (SAEF) – towards a paradigm shift regarding “idiopathic environmental intolerance” and related phenomena
.
J Psychosom Res
.
2020
;
131
:
109955
.
5.
Bailer
J
,
Witthöft
M
,
Paul
C
,
Bayerl
C
,
Rist
F
.
Evidence for overlap between idiopathic environmental intolerance and somatoform disorders
.
Psychosom Med
.
2005
;
67
(
6
):
921
9
.
6.
Witthöft
M
,
Rist
F
,
Bailer
J
.
Evidence for a specific link between the personality trait of absorption and idiopathic environmental intolerance
.
J Toxicol Environ Health A
.
2008
;
71
(
11–12
):
795
802
.
7.
Van den Bergh
O
,
Witthöft
M
,
Petersen
S
,
Brown
RJ
.
Symptoms and the body: taking the inferential leap
.
Neurosci Biobehav Rev
.
2017 Mar
;
74
(
Pt A
):
185
203
.
8.
Eltiti
S
,
Wallace
D
,
Russo
R
,
Fox
E
.
Symptom presentation in idiopathic environmental intolerance with attribution to electromagnetic fields: evidence for a nocebo effect based on data Re-analyzed from two previous provocation studies
.
Front Psychol
.
2018 Aug
;
9
:
1563
.
9.
Bräscher
A-K
,
Sütterlin
S
,
Scheuren
R
,
Van den Bergh
O
,
Witthöft
M
.
Somatic symptom perception from a predictive processing perspective: an empirical test using the thermal grill illusion
.
Psychosom Med
.
2020
;
82
(
7
):
708
14
.
10.
Popkirov
S
,
Grönheit
W
,
Wellmer
J
.
A systematic review of suggestive seizure induction for the diagnosis of psychogenic nonepileptic seizures
.
Seizure
.
2015 Sep
;
31
:
124
32
.
11.
Wieder
L
,
Brown
R
,
Thompson
T
,
Terhune
DB
.
Suggestibility in functional neurological disorder: a meta-analysis
.
J Neurol Neurosurg Psychiatry
.
2021
;
92
(
2
):
150
7
.
12.
Staudenmayer
H
,
Binkley
KE
,
Leznoff
A
,
Phillips
S
.
Idiopathic environmental intolerance: part 2 – a causation analysis applying Bradford Hill’s criteria to the psychogenic theory
.
Toxicol Rev
.
2003
;
22
(
4
):
247
61
.
13.
Nordin
S
,
Palmquist
E
,
Claeson
AS
.
The environmental symptom-attribution scale: metric properties and normative data
.
J Environ Psychol
.
2013
;
36
:
9
17
.
14.
Nijenhuis
ERs
,
Hart
O
,
Kruger
K
.
The psychometric characteristics of the Traumatic Experience Checklist (TEC): first findings among psychiatric outpatients
.
Clin Psychol Psychother
.
2002
;
9
(
3
):
200
10
.
15.
Schimmenti
A
.
The trauma factor: examining the relationships among different types of trauma, dissociation, and psychopathology
.
J Trauma Dissociation
.
2018 Oct–Dec
;
19
(
5
):
552
71
.
16.
Carlson
EB
,
Putnam
FW
.
An update on the dissociative experiences scale
.
Dissociation Prog Dissociative Disord
.
1993
;
6
(
1
):
16
27
.
17.
Wieder
L
,
Terhune
DB
.
Trauma and anxious attachment influence the relationship between suggestibility and dissociation: a moderated-moderation analysis
.
Cogn Neuropsychiatry
.
2019 May
;
24
(
3
):
191
207
.
18.
Weitzenhoffer
AM
,
Hilgard
ER
.
Standford hypnotic susceptibility scale: form C
.
Palo Alto, CA
:
Consulting Psychologists Press
;
1962
.
19.
Shor
RE
,
Orne
EC
.
Norms on the Harvard group scale of hypnotic susceptibility, form A
.
Int J Clin Exp Hypn
.
1963
;
11
(
1
):
39
47
.
20.
Bowers
KS
.
Waterloo-stanford group scale of hypnotic susceptibility, form c: manual and response booklet
.
Int J Clin Exp Hypn
.
1998
;
46
(
3
):
250
68
.
21.
Bowers
KS
.
Do the Stanford scales tap the “classic suggestion effect”
.
Int J Clin Exp Hypn
.
1981
;
29
(
1
):
42
53
.
22.
Bowers
P
,
Laurence
J-R
,
Hart
D
.
The experience of hypnotic suggestions
.
Int J Clin Exp Hypn
.
1988
;
36
(
4
):
336
49
.
23.
IBM Corp
.
IBM SPSS statistics for Macintosh Version 26.0
.
Armonk, NY
:
IBM Corp
;
2019
.
24.
Hayes
AF
.
Introduction to mediation, moderation, and conditional process analysis: a regression-based approach
. 2nd ed.
New York, NY
:
Guilford Press
;
2017
.
25.
Davidson
R
,
MacKinnon
JG
.
Estimation and inference in econometrics
.
Oxford
:
Oxford University Press
;
1993
.
26.
Johnson
PO
,
Neyman
J
.
Tests of certain linear hypotheses and their applications to some educational problems
.
Stat Res Mem
.
1936
;
1
:
57
63
.
27.
Holmes
EA
,
Brown
RJ
,
Mansell
W
,
Fearon
RP
,
Hunter
ECM
,
Frasquilho
F
,
.
Are there two qualitatively distinct forms of dissociation? A review and some clinical implications
.
Clin Psychol Rev
.
2005 Jan
;
25
(
1
):
1
23
.
28.
Brown
RJ
.
Different types of “dissociation” have different psychological mechanisms
.
J Trauma Dissociation
.
2006
;
7
(
4
):
7
28
.
29.
Bell
V
,
Oakley
DA
,
Halligan
PW
,
Deeley
Q
.
Dissociation in hysteria and hypnosis: evidence from cognitive neuroscience
.
J Neurol Neurosurg Psychiatry
.
2011 Mar
;
82
(
3
):
332
9
.
30.
Terhune
DB
,
Cardeña
E
.
Dissociative subtypes in posttraumatic stress disorders and hypnosis: neurocognitive parallels and clinical implications
.
Curr Dir Psychol Sci
.
2015
;
24
(
6
):
452
7
.
31.
Deeley
Q
.
Hypnosis as therapy for functional neurologic disorders
.
Handb Clin Neurol
.
2016
;
139
:
585
95
.
32.
Wieder
L
,
Brown
RJ
,
Thompson
T
,
Terhune
DB
.
Hypnotic suggestibility in dissociative and related disorders: a meta-analysis
.
Neurosci Biobehav Rev
.
2022 Jun
;
139
:
104751
.
33.
Butler
LD
,
Duran
RE
,
Jasiukaitis
P
,
Koopman
C
,
Spiegel
D
.
Hypnotizability and traumatic experience: a diathesis-stress model of dissociative symptomatology
.
Am J Psychiatry
.
1996 Jul
;
153
(
7 Suppl
):
42
63
.
34.
Boehmert
C
,
Witthöft
M
,
Van den Bergh
O
.
Causal perception is central in electromagnetic hypersensitivity: a commentary on “Electromagnetic hypersensitivity – a critical review of explanatory hypotheses
.
Environ Health
.
2020 Nov
;
19
(
1
):
122
.
35.
Jamieson
GA
.
Expectancies of the future in hypnotic suggestions
.
Psychol Conscious Theor Res Pract
.
2018
;
5
(
3
):
258
77
.
36.
Martin
J-R
,
Pacherie
E
.
Alterations of agency in hypnosis: a new predictive coding model
.
Psychol Rev
.
2019
;
126
(
1
):
133
52
.
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