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had strong social supports reported fewer symptoms of any kind, but these individuals nevertheless exhibited differences in biochemical and physiological measurements. Finally, there were no differences reported in any of the groups between those individuals who were actually exposed and those who believed they were exposed.

Indeed, the entire issue of exposure to toxic chemicals or radiation is complex in terms of psychological, physiological, and social responses. Uncertainty is probably the most important characteristic in increased perception of risk and level of stress, yet uncertainty on the part of the involved health professionals can also decrease the effectiveness of health care for those exposed. The interplay of such variables has been the subject of Henry Vyner's 1988 analysis of the psychosocial correlates of exposure to toxic chemicals and radiation, so-called invisible environmental contaminants. In his book, Vyner analyzed numerous studies done with various "exposed" populations, including people living at Love Canal, veterans exposed to radiation during the A-bomb tests, people in Michigan who were affected when a toxic chemical known as PBB was mistakenly put into cattle feed, and the TMI community.

According to Vyner, the psychological effects of such exposures proceed in sequential fashion, from uncertainty arising from the individual's attempt to adapt to the possible health threats of the exposure, to hypervigilance about one's health and the development of nonempirical belief systems, to "traumatic neuroses."

Vyner argues that this sequence can become a vicious circle in which these individuals get caught. The more hypervigilant they are, the more they believe their health is threatened, the less seriously their complaints are taken by the medical establishment or other groups charged with the medical care or compensation of these individuals. Institutional responses to persons exposed to toxic chemicals or radiation often show a tendency to blame the victims and view them as hypochondriacs or malingerers. When this happens, the individual becomes more threatened and more vigilant. Vyner writes that the challenge to physicians and health care providers is to recognize such an individual's uncertainty and vigilance, and to provide the patient with as much information and control as possible, in order to increase the effectiveness of health care for that person and, likely, the eventual outcome.


The experiences of the human subjects represent a combination of variables seen in combat stress and environmental contaminations. Such a combination fits quite well into several of the broad categories of reactions to stressful life events outlined above and would be expected to increase the likelihood of adverse psychological effects for a certain

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