Blood phobia

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Blood phobia
Other namesHemophobia
Specialty Psychiatry, clinical psychology

Blood phobia (also known as hemophobia or hematophobia in American English and haemophobia or haematophobia in British English) is an extreme irrational fear of blood, a type of specific phobia. Severe cases of this fear can cause physical reactions that are uncommon in most other fears, specifically vasovagal syncope (fainting). [1] Similar reactions can also occur with trypanophobia and traumatophobia. For this reason, these phobias are categorized as blood-injection-injury phobia by the DSM-IV. [2] Some early texts refer to this category as "blood-injury-illness phobia." [3]

Contents

Causes

Blood phobia is often caused by direct or vicarious trauma in childhood. [3] Though some have suggested a possible genetic link, a study of twins suggests that social learning and traumatic events, rather than genetics, is of greater significance. [4] Blood-injection-injury phobia (BII) affects about 4% of the population in the United States. [5]

The inclusion of BII within the category of specific or simple phobias in classificatory systems reflects a perception that fear has a primary role in the disorder. Consistent with this assumption, blood-injury phobia appears to share a common etiology with other phobias. Kendler, Neale, Kessler, Heath, and Eaves (1992) have argued from data comparing monozygotic with dizygotic twins that the genetic factor common to all phobias (agoraphobia, social phobia, and specific phobias), strongly predisposes a person to specific phobias.

The recognition of an inherited vulnerability common to all phobias is consistent with the notion that elevated trait anxiety predisposes one to anxiety disorders. Trait anxiety provides a background of affective arousal that permits a more rapid activation of the fight or flight response. With respect to specific activating events, conditioning is one way that stimuli become able to elicit anxiety. It is believed that these changes are controlled by the vagus nerve, which affects activity in the chest and abdomen. [6]

Accordingly, painful experiences can condition fear to blood-injury stimuli. Investigators typically classify around 60% of self-reported onsets of blood-injury phobia as beginning with conditioning experiences. [7] However, examinations of available case-by-case verbal summaries call into question the conclusion that conditioning episodes are as prevalent as reported. For example, Thyer et al. (1985) identified a conditioning episode when a "patient received an injection at age 13 and fainted", [8] and in another person when "at age six she heard her elementary school teacher give a talk on the circulatory system. This frightened the patient to the point of syncope."

Symptoms

Physical

Emotional

Treatment

The standard approach to treatment is the same as with other phobias— cognitive-behavioral therapy, desensitization, and possibly medications to help with the anxiety and discomfort. In recent years, the technique known as applied tension, applying tension to the muscles in an effort to increase blood pressure, has increasingly gained favor as an often effective treatment for blood phobia associated with drops in blood pressure and fainting. [7] [9] [10] [11]

See also

Related Research Articles

<span class="mw-page-title-main">Phobia</span> Anxiety disorder classified by a persistent and excessive fear of an object or situation

A phobia is an anxiety disorder, defined by an irrational, unrealistic, persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, often found in agoraphobia and emetophobia. Around 75% of those with phobias have multiple phobias.

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

<span class="mw-page-title-main">Agoraphobia</span> Anxiety disorder

Agoraphobia is a mental and behavioral disorder, specifically an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no easy way to escape. These situations can include public transit, shopping centers, crowds and queues, or simply being outside their home on their own. Being in these situations may result in a panic attack. Those affected will go to great lengths to avoid these situations. In severe cases, people may become completely unable to leave their homes.

<span class="mw-page-title-main">Panic attack</span> Sudden periods of intense fear

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, otherwise defined as a rapid, irregular heartbeat, sweating, chest pain or discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a sense of impending doom or loss of control. Typically, these symptoms are the worst within ten minutes of onset and can last for roughly 30 minutes, though they can vary anywhere from seconds to hours. While they can be extremely distressing, panic attacks themselves are not physically dangerous.

Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the object or situation, persistence of the fear, and significant distress or problems functioning associated with the fear. A phobia can be the fear of anything.

<span class="mw-page-title-main">Hypotension</span> Abnormally low blood pressure

Hypotension, also known as low blood pressure, is a cardiovascular condition characterized by abnormally reduced blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood and is indicated by two numbers, the systolic blood pressure and the diastolic blood pressure, which are the maximum and minimum blood pressures within the cardiac cycle, respectively. A systolic blood pressure of less than 90 millimeters of mercury (mmHg) or diastolic of less than 60 mmHg is generally considered to be hypotension. Different numbers apply to children. However, in practice, blood pressure is considered too low only if noticeable symptoms are present.

Ergophobia is described as an extreme and debilitating fear associated with work, a fear of finding or losing employment, or fear of specific tasks in the workplace. The term ergophobia comes from the Greek "ergon" (work) and "phobos" (fear).

<span class="mw-page-title-main">Reflex syncope</span> Brief loss of consciousness due to a neurologically induced drop in blood pressure

Reflex syncope is a brief loss of consciousness due to a neurologically induced drop in blood pressure and/or a decrease in heart rate. Before an affected person passes out, there may be sweating, a decreased ability to see, or ringing in the ears. Occasionally, the person may twitch while unconscious. Complications of reflex syncope include injury due to a fall.

<span class="mw-page-title-main">Carotid sinus</span> Dilated area near internal carotid artery above bifurcation

In human anatomy, the carotid sinus is a dilated area at the base of the internal carotid artery just superior to the bifurcation of the internal carotid and external carotid at the level of the superior border of thyroid cartilage. The carotid sinus extends from the bifurcation to the "true" internal carotid artery. The carotid sinus is sensitive to pressure changes in the arterial blood at this level. It is the major baroreception site in humans and most mammals.

Selective mutism (SM) is an anxiety disorder in which a person who is otherwise capable of speech becomes unable to speak when exposed to specific situations, specific places, or to specific people, one or multiple of which serve as triggers. This is caused by the freeze response. Selective mutism usually co-exists with social anxiety disorder. People with selective mutism stay silent even when the consequences of their silence include shame, social ostracism, or punishment.

<span class="mw-page-title-main">Fear of needles</span> Phobia of injections or needles

Fear of needles, known in medical literature as needle phobia, is the extreme fear of medical procedures involving injections or hypodermic needles.

<span class="mw-page-title-main">Cynophobia</span> Fear of dogs and canines

Cynophobia is the fear of dogs and canines in general. Cynophobia is classified as a specific phobia, under the subtype "animal phobias". According to Timothy O. Rentz of the Laboratory for the Study of Anxiety Disorders at the University of Texas, animal phobias are among the most common of the specific phobias and 36% of patients who seek treatment report being afraid of dogs or afraid of cats. Although ophidiophobia or arachnophobia are more common animal phobias, cynophobia is especially debilitating because of the high prevalence of dogs and the general ignorance of dog owners to the phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) reports that only 12% to 30% of those with a specific phobia will seek treatment.

<span class="mw-page-title-main">Dental fear</span> Medical condition

Dental fear, or dentophobia, is a normal emotional reaction to one or more specific threatening stimuli in the dental situation. However, dental anxiety is indicative of a state of apprehension that something dreadful is going to happen in relation to dental treatment, and it is usually coupled with a sense of losing control. Similarly, dental phobia denotes a severe type of dental anxiety, and is characterised by marked and persistent anxiety in relation to either clearly discernible situations or objects or to the dental setting in general. The term ‘dental fear and anxiety’ (DFA) is often used to refer to strong negative feelings associated with dental treatment among children, adolescents and adults, whether or not the criteria for a diagnosis of dental phobia are met. Dental phobia can include fear of dental procedures, dental environment or setting, fear of dental instruments or fear of the dentist as a person. People with dental phobia often avoid the dentist and neglect oral health, which may lead to painful dental problems and ultimately force a visit to the dentist. The emergency nature of this appointment may serve to worsen the phobia. This phenomenon may also be called the cycle of dental fear. Dental anxiety typically starts in childhood. There is the potential for this to place strains on relationships and negatively impact on employment.

<span class="mw-page-title-main">Syncope (medicine)</span> Transient loss of consciousness and postural tone

Syncope, commonly known as fainting or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. Syncope may also be associated with a short episode of muscle twitching. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic; particularly before a stressful event, usually medical in nature. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated the same as syncope.

According to the DSM-IV classification of mental disorders, the injury phobia is a specific phobia of blood/injection/injury type. It is an abnormal, pathological fear of having an injury.

Blood-injection-injury (BII) type phobia is a type of specific phobia characterized by the display of excessive, irrational fear in response to the sight of blood, injury, or injection, or in anticipation of an injection, injury, or exposure to blood. Blood-like stimuli may also cause a reaction. This is a common phobia with an estimated 3-4% prevalence in the general population, though it has been found to occur more often in younger and less educated groups. Prevalence of fear of needles which does not meet the BII phobia criteria is higher. A proper name for BII has yet to be created.

Some people have a fear of medical procedures at some point in their lifetime, which can include the fear of surgery, dental work, doctors, or needles. These fears are seldom diagnosed or treated, as they are often extinguished into adulthood and do not often develop into phobias preventing individuals from seeking medical attention. Formally, medical fear is defined as "any experience that involves medical personnel or procedures involved in the process of evaluating or modifying health status in traditional health care settings."

<span class="mw-page-title-main">Fear of flying</span> Fear of being in a flying vehicle whilst in flight

Fear of flying is the fear of being on a flying vehicle, such as an airplane or helicopter, while it is in flight. It is also referred to as flying anxiety, flying phobia, flight phobia, aviophobia, aerophobia, or pteromerhanophobia.

Autophobia, also called monophobia, isolophobia, or eremophobia, is the specific phobia or a morbid fear or dread of oneself or of being alone, isolated, abandoned, and ignored. This specific phobia is associated with the idea of being alone, often causing severe anxiety.

Submechanophobia is a fear of submerged human-made objects, either partially or entirely underwater. These objects could be shipwrecks, statues, sea mines, animatronics as seen in theme parks, or old buildings, but also more mundane items such as buoys, chains, and miscellaneous debris.

References

  1. ↑ The Merck Manual, archived from the original on 2007-05-09, retrieved 2007-05-19
  2. ↑ Lipsitz, JD; Barlow, DH; Mannuzza, S; Hofmann, SG; Fyer, AJ (July 2002), "Clinical features of four DSM-IV-specific phobia subtypes", The Journal of Nervous and Mental Disease, 190 (7): 471–8, doi:10.1097/00005053-200207000-00009, PMID   12142850, S2CID   8580337
  3. 1 2 Thyer, Bruce A.; Himle, Joseph; Curtis, George C. (July 1985), "Blood-Injury-Illness Phobia: A Review", Journal of Clinical Psychology, 41 (4): 451–459, doi:10.1002/1097-4679(198507)41:4<451::AID-JCLP2270410402>3.0.CO;2-O, PMID   4031083
  4. ↑ Advice, Health Daily (2023-09-24). "Signs and Symptoms of Hemophobia". Health Daily Advice. Retrieved 2023-09-30.
  5. ↑ Stinson, FS (2007). The epidemiology of DSM-IV specific phobia in the USA. pp. 1047–1059.
  6. ↑ Öst, LG (1992). One versus five sessions of exposure in the treatment of injection phobia. pp. 263–282.
  7. 1 2 Ost, L.G.; et al. (1991), "Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia", Behaviour Research and Therapy, 29 (6): 561–574, doi:10.1016/0005-7967(91)90006-O, PMID   1684704.
  8. ↑ Thyer, Bruce A.; Himle, Joseph; Curtis, George C. (July 1985), "Blood-Injury-Illness Phobia: A Review", Journal of Clinical Psychology, 41 (4): 455, doi:10.1002/1097-4679(198507)41:4<451::AID-JCLP2270410402>3.0.CO;2-O, PMID   4031083
  9. ↑ Ditto, B.; et al. (2009), "Physiological correlates of applied tension may contribute to reduced fainting during medical procedures", Annals of Behavioral Medicine , 37 (3): 306–314, doi: 10.1007/s12160-009-9114-7 , PMID   19730965, S2CID   3429566.
  10. ↑ Ayala, E.S.; et al. (2009), "Treatments for blood-injury-injection phobia: a critical review of current evidence", Journal of Psychiatric Research, 43 (15): 1235–1242 REVIEW, doi:10.1016/j.jpsychires.2009.04.008, PMID   19464700.
  11. ↑ Peterson, Alan L. (Lt. Col.); Isler III, William C. (Capt.) (September 2004), "Applied tension treatment of vasovagal syncope during pregnancy", Military Medicine, 169 (9): 751–3, doi: 10.7205/milmed.169.9.751 , PMID   15495734
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