Abstract
Recent research has linked the ability to identify odours to parts of the brain that, when impaired, are associated with mental illness or disease. The link between impaired odour perception and some psychological disorders has led to the suggestion that standardised assessments probing smell be routinely adopted in the clinical environment. Odour tests currently on the market utilise the orthonasal route, though the retronasal route is a viable, but overlooked, alternative. In this study, a flavour delivery system has been developed which quickly dissolves in the buccal cavity, rapidly releasing flavours that reach the olfactory system by the retronasal route. We tested seven different types of retronasal flavour stimuli (peppermint, aniseed, liquorice, coffee, orange, lemon, and valeric acid) on 171 undergraduate and postgraduate university students and related perceptual measures with psychological wellbeing scores. Olfactory measures included odour identification, pleasantness, intensity, and familiarity. Psychological measures of schizotypy (SPQ-B), depression, stress and anxiety (DASS-21), and autism spectrum disorder (RAADS-R) were obtained to represent psychological wellbeing. A battery of hierarchical multiple linear regressions were run to determine the relationships between odour perception and the psychometric measures. After controlling for age and gender, significant negative associations were found between odour identification and the stress (β = −.347, p < .001), anxiety (β = −.376, p < .001), depression (β = −.318, p < .001), schizotypy (β = −.473, p < .001), and RAADS-R (β = −.285, p < .001) scales. Additionally, both overall pleasantness (β = −.203, p < .01) and intensity (β = .194, p < .05) ratings were negatively correlated to the RAADS-R. Our findings indicate that retronasal stimuli present a feasible alternative to olfactory assessment of psychological states and further reinforces evidence indicating a correlation between olfactory and psychological measures.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing https://www.psychiatry.org/psychiatrists/practice/dsm.
Barnett, R., Maruff, P., Purcell, R., Wainwright, K., Kyrios, M., Brewer, W., & Pantelis, C. (1999). Impairment of olfactory identification in obsessive-compulsive disorder. Psychological Medicine, 29(5), 1227–1233.
Boudjarane, M. A., Grandgeorge, M., Marianowski, R., Misery, L., & Lemonnier, É. (2017). Perception of odours and tastes in autism spectrum disorders: A systematic review of assessments. Autism Research, 10, 1045–1057. https://doi.org/10.1002/aur.1760.
Brewer, W. J., Pantelis, C., Anderson, V., Velakoulis, D., Singh, B., Copolov, D. L., & McGorry, P. D. (2001). Stability of olfactory identification deficits in neuroleptic-naive patients with first-episode psychosis. American Journal of Psychiatry, 158(1), 107–115.
Burón, E., & Bulbena, A. (2013). Olfaction in affective and anxiety disorders: A review of the literature. Psychopathology, 46(2), 63–74.
Callahan, C. D., & Hinkebein, J. H. (2002). Assessment of anosmia after traumatic brain injury: Performance characteristics of the University of Pennsylvania Smell Identification Test. The Journal of Head Trauma Rehabilitation, 17(3), 251–256.
Compton, M. T., & Chien, V. H. (2008). No association between psychometrically-determined schizotypy and olfactory identification ability in first-degree relatives of patients with schizophrenia and non-psychiatric controls. Schizophrenia Research, 100(1), 216–223.
Deems, D. A., Doty, R. L., Settle, R. G., Moore-Gillon, V., Shaman, P., Mester, A. F., Kimmelman, C. P., Brightman, V. J., & Snow, J. B. (1991). Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and taste center. Archives of Otolaryngology-Head & Neck Surgery, 117(5), 519–528.
Dileo, J., Brewer, W., Hopwood, M., Anderson, V., & Creamer, M. (2008). Olfactory identification dysfunction, aggression and impulsivity in war veterans with post-traumatic stress disorder. Psychological Medicine, 38(4), 523–531.
Distel, H., Ayabe-Kanamura, S., Martínez-Gómez, M., Schicker, I., Kobayakawa, T., Saito, S., & Hudson, R. (1999). Perception of everyday odours—Correlation between intensity, familiarity and strength of hedonic judgement. Chemical Senses, 24(2), 191–199.
Doty, R. L. (2001). Olfaction. Annual Review of Psychology, 52(1), 423–452.
Doty, R. L., Shaman, P., & Dann, M. (1984). Development of the University of Pennsylvania Smell Identification Test: A standardized microencapsulated test of olfactory function. Physiology & Behaviour, 32(3), 489–502.
Doty, R. L., McKeown, D. A., Lee, W. W., & Shaman, P. (1995). A study of the test-retest reliability of ten olfactory tests. Chemical Senses, 20(6), 645–656.
Drevets, W. C., Price, J. L., & Furey, M. L. (2008). Brain structural and functional abnormalities in mood disorders: Implications for neurocircuitry models of depression. Brain Structure and Function, 213(1–2), 93–118.
Dudova, I., & Hrdlicka, M. (2013). Olfactory functions are not associated with autism severity in autism spectrum disorders. Neuropsychiatric Disease and Treatment, 9, 1847.
Endevelt-Shapira, Y., Perl, O., Ravia, A., Amir, D., Eisen, A., Bezalel, V., Rozenkrantz, L., Mishor, E., Pinchover, L., & Soroka, T. (2018). Altered responses to social chemosignals in autism spectrum disorder. Nature Neuroscience, 21(1), 111–119.
Evans, W. J., Kobal, G., Lorig, T. S., & Prah, J. D. (1993). Suggestions for collection and reporting of chemosensory (olfactory) event-related potentials. Chemical Senses, 18(6), 751–756.
Goldberg, E. D., Goldberg, R. J., & Vannoppen, B. (1991). Sense of smell and obsessional behavior. The American Journal of Psychiatry, 148(12), 1757.
Gooding, D. C., Matts, C. W., & Rollmann, E. A. (2006). Sustained attention deficits in relation to psychometrically identified schizotypy: Evaluating a potential endophenotypic marker. Schizophrenia Research, 82(1), 27–37.
Havlíček, J., Nováková, L., Vondrová, M., Kuběna, A. A., Valentová, J., & Roberts, S. C. (2012). Olfactory perception is positively linked to anxiety in young adults. Perception, 41(10), 1246–1261.
Hedner, M., Larsson, M., Arnold, N., Zucco, G. M., & Hummel, T. (2010). Cognitive factors in odour detection, odour discrimination, and odour identification tasks. Journal of Clinical and Experimental Neuropsychology, 32(10), 1062–1067.
Heilmann, S., Strehle, G., Rosenheim, K., Damm, M., & Hummel, T. (2002). Clinical assessment of retronasal olfactory function. Archives of Otolaryngology-Head & Neck Surgery, 128(4), 414–418.
Hoenen M, Wolf OT, Pause BM. 2017. The impact of stress on odour perception. Perception 46(3–4):366–376.
Hummel, T., Sekinger, B., Wolf, S. R., Pauli, E., & Kobal, G. (1997). ‘Sniffin’sticks': Olfactory performance assessed by the combined testing of odour identification, odour discrimination and olfactory threshold. Chemical Senses, 22(1), 39–52.
Hummel, T., Seo, H.-S., Pellegrino, R., & Heilmann, S. (2017). Electro-Olfactograms in humans in response to Ortho-and Retronasal chemosensory stimulation. Chemosensory Perception, 10(4), 114–118.
Kamath, V., & Bedwel, J. S. (2008). Olfactory identification performance in individuals with psychometrically-defined schizotypy. Schizophrenia Research, 100(1–3), 212–215.
Killgore, W. D., Gruber, S. A., & Yurgelun-Todd, D. A. (2007). Depressed mood and lateralized prefrontal activity during a Stroop task in adolescent children. Neuroscience Letters, 416(1), 43–48.
Kobal G, Hummel T, Sekinger B, Barz S, Roscher S, Wolf S. 1996. " Sniffin'sticks": Screening of olfactory performance. Rhinology 34(4):222–226.
Kohli, P., Soler, Z. M., Nguyen, S. A., Muus, J. S., & Schlosser, R. J. (2016). The association between olfaction and depression: A systematic review. Chemical Senses, 41(6), 479–486.
Kopala, L. C., & Good, K. P. (1996). Olfactory identification ability in patients with panic disorder. Journal of Psychiatry and Neuroscience, 21(5), 340–342.
Kopala, L. C., Good, K. P., Morrison, K., Bassett, A. S., Alda, M., & Honer, W. G. (2001). Impaired olfactory identification in relatives of patients with familial schizophrenia. American Journal of Psychiatry, 158(8), 1286–1290.
Landis, B. N., Cao Van, H., Guinand, N., Horvath, J., Haehner, A., Savva, E., Hugentobler, M., Lacroix, J. S., & Burkhard, P. R. (2009). Retronasal olfactory function in Parkinson's disease. The Laryngoscope, 119(11), 2280–2283.
Lane, A. E., Molloy, C. A., & Bishop, S. L. (2014). Classification of children with autism spectrum disorder by sensory subtype: A case for sensory-based phenotypes. Autism Research, 7(3), 322–333.
Larsson, M., Tirado, C., & Wiens, S. (2017). A meta-analysis of odour thresholds and odour identification in autism Spectrum disorders. Frontiers in Psychology, 8, 679.
Lochner, C., & Stein, D. J. (2014). Prevalence of olfactory reference syndrome in obsessive-compulsive disorder and social anxiety disorder. Journal of Clinical Psychiatry, 75(11), 1266.
Lombion-Pouthier, S., Vandel, P., Nezelof, S., Haffen, E., & Millot, J.-L. (2006). Odour perception in patients with mood disorders. Journal of Affective Disorders, 90(2), 187–191.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.
Moberg, P. J., Agrin, R., Gur, R. E., Gur, R. C., Turetsky, B. I., & Doty, R. L. (1999). Olfactory dysfunction in schizophrenia: A qualitative and quantitative review. Neuropsychopharmacology, 21(3), 325–340.
Moberg, P. J., Kamath, V., Marchetto, D. M., Calkins, M. E., Doty, R. L., Hahn, C.-G., Borgmann-Winter, K. E., Kohler, C. G., Gur, R. E., & Turetsky, B. I. (2013). Meta-analysis of olfactory function in schizophrenia, first-degree family members, and youths at-risk for psychosis. Schizophrenia Bulletin, 40(1), 50–59.
Mueller CA, Grassinger E, Naka A, Temmel AF, Hummel T, Kobal G. 2006. A self-administered odour identification test procedure using the “sniffin'sticks”. Chemical Senses 31(6):595–598.
Muratori, F., Tonacci, A., Billeci, L., Catalucci, T., Igliozzi, R., Calderoni, S., & Narzisi, A. (2017). Olfactory processing in male children with autism: Atypical odour threshold and identification. Journal of Autism and Developmental Disorders, 47(10), 3243–3251.
Naudin, M., El-Hage, W., Gomes, M., Gaillard, P., Belzung, C., & Atanasova, B. (2012). State and trait olfactory markers of major depression. PLoS One, 7(10), e46938.
Osborne-Crowley, K., & McDonald, S. (2016). A review of social disinhibition after traumatic brain injury. Journal of Neuropsychology, 12, 176–199. https://doi.org/10.1111/jnp.12113.
Park, S., & Schoppe, S. (1997). Olfactory identification deficit in relation to schizotypy. Schizophrenia Research, 26, 191–197.
Pierce, J., & Halpern, B. P. (1996). Orthonasal and retronasal odourant identification based upon vapor phase input from common substances. Chemical Senses, 21(5), 529–543.
Quarmley, M., Moberg, P. J., Mechanic-Hamilton, D., Kabadi, S., Arnold, S. E., Wolk, D. A., & Roalf, D. R. (2017). Odour identification screening improves diagnostic classification in incipient Alzheimer’s disease. Journal of Alzheimer's Disease, 55(4), 1497–1507.
Raine, A., & Benishay, D. (1995). The SPQ-B: A brief screening instrument for schizotypal personality disorder. Journal of Personality Disorders, 9(4), 346–355.
Renner, B., Mueller, C. A., Dreier, J., Faulhaber, S., Rascher, W., & Kobal, G. (2009). The candy smell test: A new test for retronasal olfactory performance. The Laryngoscope, 119(3), 487–495.
Ritvo, R. A., Ritvo, E. R., Guthrie, D., Ritvo, M. J., Hufnagel, D. H., McMahon, W., Tonge, B., Mataix-Cols, D., Jassi, A., & Attwood, T. (2011). The Ritvo autism Asperger diagnostic scale-revised (RAADS-R): A scale to assist the diagnosis of autism spectrum disorder in adults: An international validation study. Journal of Autism and Developmental Disorders, 41(8), 1076–1089.
Rolls, E. T., Critchley, H. D., Verhagen, J. V., & Kadohisa, M. (2010). The representation of information about taste and odour in the orbitofrontal cortex. Chemosensory Perception, 3(1), 16–33.
Roxo MR, Franceschini PR, Zubaran C, Kleber FD, Sander JW. 2011. The limbic system conception and its historical evolution. The scientific world journal, vol. 11, Article ID 157150, 14, 2011. https://doi.org/10.1100/2011/157150, 2440.
Rozenkrantz, L., Zachor, D., Heller, I., Plotkin, A., Weissbrod, A., Snitz, K., Secundo, L., & Sobel, N. (2015). A mechanistic link between olfaction and autism spectrum disorder. Current Biology, 25(14), 1904–1910.
Rumeau, C., Nguyen, D. T., & Jankowski, R. (2016). How to assess olfactory performance with the Sniffin’Sticks test®. European Annals of Otorhinolaryngology, Head and Neck Diseases, 133, 203–206.
Savage, S. A., Butler, C. R., Milton, F., Han, Y., & Zeman, A. Z. (2017). On the nose: Olfactory disturbances in patients with transient epileptic amnesia. Epilepsy & Behavior, 66, 113–119.
Shepherd, D., & Hautus, M. J. (2015). The feasibility of gelatin-based retronasal stimuli to assess olfactory perception. SAGE Open, 5(4), 2158244015610173.
Shepherd, D., Hautus, M. J., & Urale, P. W. (2017). Personality and perceptions of common Odours. Chemosensory Perception, 10(1–2), 23–30.
Sigurdardottir, S., Andelic, N., Skandsen, T., Anke, A., Roe, C., Holthe, O. O., & Wehling, E. (2016). Olfactory identification and its relationship to executive functions, memory, and disability one year after severe traumatic brain injury. Neuropsychology, 30(1), 98–108.
Small, D. M., Gerber, J. C., Mak, Y. E., & Hummel, T. (2005). Differential neural responses evoked by Orthonasal versus Retronasal odorant perception in humans. Neuron, 47, 593–605.
Stewart, M. G., Witsell, D. L., Smith, T. L., Weaver, E. M., Yueh, B., & Hannley, M. T. (2004). Development and validation of the nasal obstruction symptom evaluation (NOSE) scale. Otolaryngology–Head and Neck Surgery, 130(2), 157–163.
Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. American Journal of Occupational Therapy, 61(2), 190–200.
Tonacci, A., Billeci, L., Tartarisco, G., Ruta, L., Muratori, F., Pioggia, G., & Gangemi, S. (2015). Olfaction in autism spectrum disorders: A systematic review. Child Neuropsychology, 23(1), 1–25.
Vasterling, J. J., Brailey, K., & Sutker, P. B. (2000). Olfactory identification in combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 13(2), 241–253.
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Pal, P.R., Shepherd, D., Hamid, N. et al. The potential for retronasally delivered olfactory stimuli to assess psychiatric conditions. Curr Psychol 40, 2970–2979 (2021). https://doi.org/10.1007/s12144-019-00238-5
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DOI: https://doi.org/10.1007/s12144-019-00238-5