Putting the mass in mass hysteria

If you've been following medical news over the past few months, you may have heard about some goings on in a little town called Le Roy. Over 20 high school girls from Le Roy High School have developed Tourette-like tics. The symptoms are severe enough that afflicted students have dropped out of school.

After the New York State Health Department failed to identify any known toxins or infections, a neurologist from the area gave his verdict. From the New York Times:

...it was conversion disorder, he said, which meant the girls were subconsciously converting stress into physical symptoms. And because so many students were afflicted with similar symptoms, it was also considered to be mass psychogenic illness, which is another way of saying mass hysteria.

More recently, neurologist Rosario Trifiletti saw some of the patients and put forth a different theory:

... the girls were suffering from an illness similar to Pandas (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus), a disease in which the immune system alters the neurochemistry of young people suffering from strep infection ... [A] week later, after examining the girls, Trifiletti revealed on “Dr. Drew” that all nine of the girls he tested showed evidence of either strep exposure or exposure to the organism associated with pneumonia.

Dr. Trifiletti's patients have shown dramatic signs of improvement on antibiotics. That proves their illness is physical instead of psychological, right? Not according to skeptics of the PANDAS diagnosis; they say the antibiotics are only working as a placebo.

So who's right?

A few TV clips provide clues. Back in January, before Dr. Trifiletti arrived on the scene, the Today Show ran a couple of segments about Le Roy, interviewing some of the afflicted girls and their parents. There was a lot of footage showing the tics themselves, giving viewers a better idea of what it would be like to live with them.

Segments are here. The first tics begin at 0:22.

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Did you watch?

So did a whole lot of other people. If what's happened to these girls is purely psychological, having nothing to do with area-specific toxins or infections, why hasn't the "mass hysteria" spread across the whole country?

Are there no stressed-out, impressionable teenage girls outside of Le Roy?

Mass hysteria?

Over a thousand people have become sick while working in Cambodian shoe and garment factories. Stricken employees report dizziness, nausea, exhaustion, and shortness of breath; hundreds have required brief hospitalization.

With no concrete explanation for the symptoms, a few people with an interest in such things have leapt to the obvious conclusion:

It's been almost 50 years since girls at a boarding school in Tanganyika (now Tanzania) were struck by an illness whose symptoms — fainting, nausea and helpless laughter — soon spread to other communities. Or consider the Pokémon contagion in 1997, when 12,000 Japanese children experienced fits, nausea and shortness of breath after watching a television cartoon. Sufferers of World Trade Center syndrome, meanwhile, blamed proximity to Ground Zero for coughs and other respiratory problems long after airborne contaminants posed any health threat.

All these are examples of mass hysteria, a bizarre yet surprisingly common phenomenon that is increasingly recognized as a significant health and social problem. For centuries it has crossed cultures and religions, taking on different forms to keep pace with popular obsessions and fears. In our post-9/11 world, it thrives on the anxiety caused by terrorist attacks, nuclear radiation and environmental gloom.

More ...

It's an interesting theory. Far more interesting than the symptoms turning out to be real. Time won't sell any magazines with headlines like "Toxins are Toxic" or "Flu Virus Gives People Flu."

The problem is, hysteria doesn't have any real evidence behind it. Failing to discover a virus or toxin that's making people sick doesn't mean the virus or toxin doesn't exist. It may simply mean we haven't found it yet. Think how many people died of AIDS before anybody knew what HIV was.

Is hysteria a real thing? Do we have any way of finding out?


Here's my challenge to any researcher who backs the mass hysteria hypothesis:

Test it.

This should be relatively easy if you have access to facilities, grant money, and cheap graduate student labor. Bring subjects into an experiment that's ostensibly about something else. While everyone is answering survey questions on an unrelated topic, have numerous confederates (people pretending to be subjects, but who are in on the experiment) fake some kind of medical issue. Seizures, maybe, or fainting.

Then see if the one real subject in the room starts feeling and mimicking the "symptoms."

It took me five seconds to think up this experiment, and I'm not even a psychologist.

I hope some enterprising mental health professional takes up the challenge, because this isn't just a matter of scientific curiosity. Ask people with myalgic encephalomyelitis. When there was an outbreak of the disease in Incline Village, Nevada, back in 1984, the CDC declared it to be mass hysteria despite evidence of neurological problems. 27 years later, the victims haven't recovered ... and most of the scant funding that exists for their disease goes to psychological research.

If patients have to prove that their illnesses are real, then the scientific community should have to prove that mass hysteria is real. It's only fair.