Resistance to extinction in an odor–20% CO2 inhalation paradigm: Further evidence for a symptom learning account of multiple chemical sensitivity

ObjectiveMultiple chemical sensitivity (MCS) is characterized by a variety of symptoms in response to nontoxic concentrations of chemicals. To further test a laboratory model of MCS based on symptom learning, we used a stronger respiratory challenge in this study than in previous studies to induce symptoms (20% CO2-enriched air, unconditioned stimulus). Additionally, extinction of learned symptoms was investigated.MethodsDiluted ammonia (AM) and butyric acid (BA) served as conditioned (odor) stimuli (CSs). In a learning phase, healthy participants received three breathing trials of BA mixed with CO2 and three trials of AM mixed with regular air, or the reversed combination. In a test phase, the same trials were administered without CO2. Immediately after odor onset, participants rated their anxiety and expectancy to experience symptoms during that trial. Self-reported symptoms were assessed after each trial; respiratory behavior was measured throughout the experiment.ResultsOnly participants who learned to correctly anticipate symptoms (learning phase) reported elevated symptoms in response to the CS+ odor (test phase). Anticipation was more likely correct and learned symptoms were more elevated when BA had been previously associated with CO2. Across test trials, anticipatory anxiety diminished, but learned symptoms did not. Participants failing to learn the prearranged contingencies reported overall more symptoms and anxiety.ConclusionsStrong respiratory challenges impede extinction of learned symptoms. Conscious expectancy, which may be modulated by odor quality, determines whether learned symptoms develop in response to a specific odor or to the general context. The results further support a symptom learning account of MCS.