Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 11
Chemical Agents of Opportunity for Terrorism:
TICs & TIMs
Definitions
• Diagnostic and Statistical Manual of Mental
Disorders -IV-TR
– Epidemic Hysteria
• Shared symptoms develop in a circumscribed group of people
following "exposure" to a common precipitant.
• Medical literature
– Multiple Unexplained Symptoms
• Typically chronic and not triggered by a specific event
Module One – Observed Behaviors during Mass Chemical Exposures
11
A specific term is now used in the Diagnostic and Statistical Manual of Mental Disorders-
IV-TR (DSM-IV) that describes the observed behaviors of groups exposed to an event.
It is termed ‘epidemic hysteria.’ Although somewhat medicalized, this term carries a
nonmedical meaning that may not be ideal (i.e., hysteria).
A common term in the medical literature, but not in DSM, is Multiple Unexplained
Symptoms (sometimes called Multiple Medical Unexplained Symptoms, MMUS; and
other variants). This syndrome is very common, and while clinically similar in nature to
epidemic hysteria, it is not generally triggered by a single event, is long standing, and is
often pervasive in a patient’s life. Patients with this syndrome often come to attention in
outpatient toxicology clinics with multiple previous physicians and diagnoses, and many
tests showing normal or inconclusive results.
The DSM is the standard manual for psychiatric diagnoses. It generally lists a number of
criteria (symptoms, exclusion criteria, and timeframes) required for a consensus
diagnosis of psychiatric conditions. The DSM-IV-TR is the fourth update (text revision) of
this manual, published in 2000.
December 2008 Version 2.0 Page 437