Mass phenomena at a black South African primary school.
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It has been my aim in this paper to revise the existing psychoanalytic theory of group psychology in accordance with current structural concepts. The need for fundamental revision in the existing theory of group organization is demonstrated by its restriction to an oedipal paradigm, which cannot account for the regression to an oral paradigm of group organization during group formation. Freud's explanation of regression in crowds is reviewed. The limitations inherent in Freud's topographic and narcisistic models are demonstrated; irreconcilable contradictions are shown to exist between the two theories. A structural model of group psychology that is free from internal contradictions and provides a unifying explanation for both regression and merging in the crowd is developed. As a consequence of these revisions it is possible to conceptualize preoedipal organizations of group structure in addition to the oedipal paradigm proposed by Freud.
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The few isolated reports of individual koro exhibit a symptomatology indicative of major psychiatric conditions (ie. psychosis or affective disorder), and appear unrelated to collective episodes which involve social, cultural, cognitive and physiological factors in the diffusion of koro-related beliefs. Yet, koro 'epidemics' continue to be viewed as exemplifying mass psychopathology or irrationality. An examination of the similarities between koro 'outbreaks' and a sub-category of behaviour which has been loosely labeled as 'mass hysteria', suggests an alternative, non-psychopathological explanation. In reclassifying 'epidemic' koro as a collective misperception rather than a culture-bound syndrome, it is argued that koro is a rational attempt at problem-solving which involves conformity dynamics, perceptual fallibility and the local acceptance of koro-associated folk realities, which are capable of explaining such episodes as normal within any given population.
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An investigation was undertaken of an apparent outbreak of contagious psychogenic illness at an electronics plant in which approximately 50 females reported a variety of subjective nonspecific symptoms. The workers believed that the physical symptomatology was triggered by an unidentified odor in the plant which was not verified by environmental sampling for chemicals or by medical evaluations of affected workers. A random sample of non-affected and affected workers was surveyed by means of psychological health status inventories and epidemiological indices to determine the role that life-history, personality characteristics and job dissatisfaction had on susceptibility to illness. Results indicated that those workers reporting the highest level of perceived stress due to job dissatisfaction, family problems, and personal conflict were most likely to experience somatic symptoms. In the present study sources of dissatisfaction identified as potential precipitating factors of the illness outbreak were: 1) working conditions, 2) supervisory style, and 3) personal lifestyle.
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"In a cluster of illness reported among students at an elementary school parents mentioned many signs and symptoms including headache, pallor, dark circles under the eyes, nausea, and vomiting--which they attributed to exposure to recurrent leaks of natural gas at the school. It is likely that the parents spread among themselves the notion of toxic exposure at the school. A questionnaire revealed no spatial clustering, but increased reports of symptoms were related to intense media coverage. A thorough environmental and epidemiological investigation was negative, there being no evidence of a continuing gas leak or other potential causes. At a strictly biological level, the complaints in this reported 'cluster' apparently represented the sporadic occurrence of common childhood illnesses. The possibility of an epidemic from toxic exposure at the school caused intense parental concern and led to a major public health problem. The established term 'mass sociogenic illness' seems inapplicable here because complaints did not come principally from the students and the apparent epidemic illness was not transmitted among them. The term 'mass sociogenic illness by proxy' is proposed to describe this incident, in which transmission in one group (the parents) resulted in reports of an epidemic in another group (students)."
BACKGROUND: It has been suggested that mass hysteria can be divided into two syndromes; one with predominant features of anxiety and the other with predominant abnormalities of motor behaviour. In the former condition, prior tension is absent and spread is by visual contact. In the latter, prior tension is present, initial cases can be identified and spread is gradual. METHOD: The development and resolution of neurological symptoms in 156 Nigerian school girls were studied and a diagnosis of 'mass hysteria' made. RESULTS: The signs and symptoms manifested by the school girls during the outbreak of illness had features of both 'anxiety' and 'motor' predominant forms of mass hysteria. CONCLUSIONS: Although there may be two patterns of symptom presentation in mass hysteria, other supposedly discrete features overlap. This weakens the argument that there are two separate syndromes.
BACKGROUND: Episodes of mass sociogenic illness are becoming increasingly recognised as a significant health and social problem that is more common than is presently reported. AIMS: To provide historical continuity with contemporary episodes of mass sociogenic illness in order to gain a broader transcultural and transhistorical understanding of this complex, protean phenomenon. METHOD: Literature survey to identify historical trends. RESULTS: Mass sociogenic illness mirrors prominent social concerns, changing in relation to context and circumstance. Prior to 1900, reports are dominated by episodes of motor symptoms typified by dissociation, histrionics and psychomotor agitation incubated in an environment of preexisting tension. Twentieth-century reports feature anxiety symptoms that are triggered by sudden exposure to an anxiety-generating agent, most commonly an innocuous odour or food poisoning rumours. From the early 1980s to the present there has been an increasing presence of chemical and biological terrorism themes, climaxing in a sudden shift since the 11 September 2001 terrorist attacks in the USA. CONCLUSIONS: A broad understanding of the history of mass sociogenic illness and a knowledge of episode characteristics are useful in the more rapid recognition and treatment of outbreaks.
The possibility of terrorists employing chemical, biological, or nuclear/ radiological (CBN) materials has been a concern since 1995 when sarin gas was dispersed in a Tokyo subway. Contingency planning almost exclusively involved detection. containment, and emergency health care for mass casualties. However, it is clear that even small-scale CBN incidents--like the recent spread of anthrax spores through the mail--can cause widespread confusion, fear, and psychological stress that have lasting effects on the health of affected communities and on a nation's sense of well-being. More emphasis therefore needs to be placed on indirect effects and on the medical, social, economic, and legal consequences that follow months to years afterward. To respond effectively to CBN attacks, a comprehensive strategy needs to be developed that includes not only emergency response, but also long-term health care, risk communication, research, and economic assistance. Organizing an effective response challenges government institutions because the issues involved--eligibility for health care, the effects of low-level exposure to toxic agents. stress-related illnesses, unlicensed therapeutics. financial compensation--are complex and controversial.
Physicians are increasingly called upon to provide medical support for mass gatherings such as concerts, sporting events, political conventions, and other special events. Until recently, individuals planning such support have had little reliable information to assist them in determining what specific personnel and equipment are necessary to optimally support a mass gathering. Recently, the National Association of Emergency Medical Services Physicians established and published the most definitive and up-to-date document to assist a physician with planning medical care for a mass gathering: Mass Gathering Medical Care: The Medical Director's Checklist. As one of the most important developments in mass gathering medicine, this article highlights and discusses key areas of the document.
Since January 2005, the list of prohibited substances established by the World Anti-Doping Agency prohibits the opioid agent fentanyl as well as its related drugs in professional and amateur sports. Fast, reliable and robust analytical assays are required that allow the sensitive determination of these compounds or respective metabolites in human urine, and liquid chromatography interfaced to mass spectrometry has proven to be a suitable and powerful tool for drug testing for several years. A screening and confirmation method was developed that enables the identification of fentanyl, alfentanil, remifentanil and sufentanil as well as their N-dealkylated or de-esterified metabolites utilizing solid-phase extraction of a 2 mL urine aliquot followed by LC-electrospray-MS/MS analysis. The procedure was validated in terms of recovery (95.8-104.9%), lower limit of detection (0.5 ng mL-1), specificity and interday precision (3.9-19.8%) for the four opioid drugs and the metabolic product norfentanyl. In addition, the mass spectrometric behavior of fentanyl after electrospray ionization and collision-induced dissociation was studied by synthesis and analysis of structurally related compounds, and dissociation pathways were proposed allowing the characterization of target analytes and corresponding metabolites.