Blood-injury-illness phobia: A review

Thyer, Bruce A.; Himle, Joseph A.; Curtis, George C.

doi:10.1002/1097-4679(198507)41:4<451::aid-jclp2270410402>3.0.co;2-o

Cited by 109 publications

(49 citation statements)

References 52 publications

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“…Soon after, there is bradycardia and hypotension, with consequent reduced blood supply to the brain, which leads to syncope. 4,5,11,12 Thus, there is a precedent to suggest that fainting during blood exposure is vasovagally mediated.…”

Section: Discussionmentioning

confidence: 99%

“…6 Typical examples encoun- tered in the clinical setting include the fainting of medical students at the sight of blood or autopsies. Vasovagal syncope is also widely described among blood donors (an incidence of 1% to 15%), 4,13,14 especially during their first experience, and also among dental patients. Bradycardia has also been reported in normal subjects and in medical audiences on viewing violent films.…”

Section: Discussionmentioning

confidence: 99%

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Predisposition to Vasovagal Syncope in Subjects With Blood/Injury Phobia

et al. 2001

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Background-Most subjects with blood/injury phobia experience syncope or presyncope as part of the phobic response.We tested the hypothesis that these subjects have a constitutional autonomic dysregulation that predisposes them to vasovagal syncope during head-up tilt. Methods and Results-We studied 11 subjects (9 females, 2 males) who had a history of syncope or presyncope only in response to a blood or injury stimulus and 11 healthy matched controls (10 females, 1 male) without a history of syncope. Blood pressure (BP) and heart rate (HR) were measured during a 15-minute baseline period with subjects in the supine position and then during 45 minutes of head-up tilt to 70°. Measurements at rest did not differ between the blood phobic and control subjects. During tilt, 9 (82%) of the 11 blood phobic subjects experienced presyncope or syncope, leading to termination of the study after 22Ϯ17 minutes of tilt. Only 1 (9%) of the 11 control subjects experienced presyncope ( 2 ϭ11.7, Pϭ0.001). Hemodynamic responses to tilt were consistent with a vasovagal mechanism in the blood phobic subjects, with simultaneous decreases in BP and HR during tilt. During tilt, systolic BP fell by 21Ϯ15 mm Hg (Pϭ0.001), and HR fell by 22Ϯ25 bpm (Pϭ0.01). By contrast, BP and HR were very stable in the control group. Conclusions-Subjects with syncope related to blood/injury phobia have an underlying autonomic dysregulation predisposing them to neurally mediated syncope, even in the absence of any blood or injury stimulus. Fainting related to these stimuli may in large part be due to dysfunction in neural circulatory control, which may secondarily lead to the phobia because of repeated syncopal events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predisposition to Vasovagal Syncope in Subjects With Blood/Injury Phobia

et al. 2001

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“…Also, confrontation with the phobic stimulus elicits sympathetic activation (e.g., tachycardia) in animal phobia, but a biphasic response pattern (i.e., initial tachycardia followed by bradycardia; Page, 1994) in blood-injection-injury phobia. That is, while exposure to the phobic stimulus produces heightened arousal in animal phobics, lowered arousal that may result in fainting is seen in blood-injection-injury phobia (Thyer, Himle, & Curtis, 1985;Marks, 1988). Referring to these peculiar characteristics of blood-injection-injury phobia, Rachman (1990b) has argued that the term bloo&njectti-injury phobia is a misnomer.…”

Section: Etiology Ofs+ijic Phobia 339mentioning

confidence: 99%

The etiology of specific phobias: A review

Jong

Muris

Hout

1996

Clinical Psychology Review

129

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ABSTRACT. The present article summarizes themy and data about symptomutology, epid.emio&y, and etiology of specijii phobias. Additionally, the cognitive mechanisms involved in specific phobias are briefly discussed. By and Icrrg, the general pattern behind tk development of specific phobias can be summarized as follows. Specijk fears are highly preualent among young children. In most children, these fears r@esent transitory phenomma. Howevq in a small sub grvup of children, speczfu: fears become chronic due to classical conditioning, modelling, and/or negative infMmation transmission. Once a specjk phobia bus okveluped, it may be maintained by cognitive biases (i.e., attentional bias, covariation bias, and reasoning bias). Though specif ic phobias form a heterogeneous class of disomks, this pattern appears to be a good approximation. Neverth.ebzss, several questions remain. For example, there is no ready explanation for the fact that specijc phobias are mo7e often diagnosed in women than in mm. Similarly, it is not clear to what extent the nonrandom distribution of phobias can be interp-ted in terms of cultural factors. Resolving these issues is not only important in its own right, but may have considerable kristic value fm our unokrstanding of other anxiety disorti.SPECIFIC (formerly "simple," "monosymptomatic," or "focal") phobias are irrational and persistent fears of certain objects or animals. Whereas the concept of "specific phobia" is relatively recent, the condition to which it refers is not (Errera, 1962). For example, Hippocrates described a man displaying an irrational fear of bridges. Likewise, detailed discussions of phobic symptoms can be found in the work of 17th and 18th century authors such as Descartes, Le Camus, and Sauvages. Although descriptions of phobic behavior have remained remarkably consistent throughout history, theories purporting to explain this behavior have changed dramatically. In early medical texts, speculations about eye muscle dysfunction, vascular abnormalities, or mysterious underground water streams were not uncommon (Errera, 1962). During the past decades, our understanding of the origins of specific phobias Correspondence should be addressed to Harald Merckelbach,

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“…The pre/syncopal response is not universal but affects approximately 80% of individuals endorsing such phobia [28,35]. While the experience of syncopal symptoms is itself considered medically benign, two risks are of note.…”

Section: Introductionmentioning

confidence: 99%

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

Trost

Jones

Guck

et al. 2017

Journal of Anxiety Disorders

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Fear of blood, injections, and needles commonly prevents or delays individuals' receipt of health care, such as vaccines or blood draws. Innovative methods are needed to overcome these fears and reduce anxiety related to activities of this nature. The present study describes initial testing of an arm illusion paradigm that may prove useful during early phases of graded exposure for people with blood and needle fear. Seventy-four undergraduate students aged 18-29 years were tested. In line with study aims, results indicated that the virtual blood draw paradigm promoted strong perceptions of arm ownership and elicited significant changes in physiological indices (blood pressure, heart rate, electrodermal activity, respiratory rate) in response to key procedure elements (e.g., needle insertion). Further, bivariate correlations indicated that individual differences in self-reported blood and needle fear collected prior to the illusion paradigm were significantly associated with presyncopal symptoms reported following the procedure. In regression analyses, self-reported measures of blood and needle fear explained unique variance in presyncopal symptoms even after controlling for general state anxiety. These findings provide initial support for the virtual blood draw paradigm as a promising tool to help provide graded exposure to medical procedures involving needles and blood draw.

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Blood-injury-illness phobia: A review

Cited by 109 publications

References 52 publications

Predisposition to Vasovagal Syncope in Subjects With Blood/Injury Phobia

Predisposition to Vasovagal Syncope in Subjects With Blood/Injury Phobia

The etiology of specific phobias: A review

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

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