Psychodynamics and Psychopathology
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Blood-injury-illness phobia: A review
Bruce A. Thyer Ph.D.,
Joseph Himle, George C. Curtis,
Corresponding Author
Bruce A. Thyer Ph.D.
University of Michigan Hospitals
School of Social Work, Florida State University, Tallahassee, Florida 32306.Search for more papers by this authorBruce A. Thyer Ph.D.,
Joseph Himle, George C. Curtis,
Corresponding Author
Bruce A. Thyer Ph.D.
University of Michigan Hospitals
School of Social Work, Florida State University, Tallahassee, Florida 32306.Search for more papers by this authorFirst published: July 1985
Citations: 91
Abstract
The empirical literature that pertains to phobias of blood, injury, or illness (BII) is surveyed. BII phobia is selectively associated with a vasovagal fainting response upon exposure to phobic stimuli, and the clinical entity may represent an exaggeration of a response that is relatively prevalent in the general population. Clinical, demographic and etiological information obtained from a series of 15 BII phobics is presented, and the suggestion is made that this disorder warrants a diagnostic category separate from simple phobia.
References
- Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobias. Comprehensive Psychiatry. 10, 151–156.
- American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders ( 3rd ed.). Washington: Author.
- Arabian, J., Furedy, J., Morrison, J., & Szalai, J. (1983). Treatment of PAT: Bradycardic reflexes induced by dive vs. body tilt. Pavlovian Journal of Biological Science. 18, 88–93.
- Babcock, H., & Powell, D. (1982). Vasovagal fainting: Deconditioning an autonomic syndrome. Psychosomatics, 23, 969, 973.
- Borkovec, T., Stone, N., O'Brien, G., & Kaloupek, D. (1974). Evaluation of a clinically relevant target behavior for analog outcome research. Behavior Therapy, 5, 503–513.
- Chosy, J., & Graham, D. (1965). Catecholamines in vasovagal fainting. Journal of Psychosomatic Research. 9, 189–194.
-
Coggins, C.,
Lillington, G., &
Gray, C.
(1964).
Micturition syncope.
Archives of Internal Medicine,
113, 64–68.
10.1001/archinte.1964.00280070016004 Google Scholar
- Cohn, C., Kron, R., & Brady, J. (1976). A case of blood-illness-injury phobia treated behaviorally. Journal of Nervous and Mental Disease. 162. 62–68.
- Connolly, J., Hallam, R., & Marks, L. (1976). Selective association of vasovagal fainting with blood- injury-illness fear. Behavior Therapy, 1, 8–13.
- Costello, C. (1982). Fears and phobias in women: A community study. Journal of Abnormal Psychology, 91. 280–286.
- Curtis, G., Nesse, R., Buxton, M., & Lippman, D. (1919). Plasma growth hormone: Effect of anxiety during flooding in vivo. American Journal of Psychiatry, 135, 410–414.
- Curtis, G., Nesse, R., Buxton, J., Wright, J., & Lippman, D. (1976). Flooding in vivo as a research tool and treatment method of phobias: A preliminary report. Comprehensive Psychiatry. 11, 101–107.
- Curtis, G., & Thyer, B. (1983). Fainting on exposure to phobic stimuli. American Journal of Psychiatry. 140, 771–714.
- Deane, G. (1961). Human heart rate responses during experimentally induced anxiety. Journal of Experimental Psychology, 61, 489–493.
- Deane, G. (1964). Human heart rate responses during experimentally induced anxiety: A follow-up with controlled respiration. Journal of Experimental Psychology, 67, 193–195.
- Dimsdale, J., & Moss, J. (1980a). Short-term catecholamine response to psychological stress. Psychosomatic Medicine, 42, 493–497.
- Dimsdale, J., & Moss, J. (1980b). Plasma catecholamines in stress and exercise. Journal of the American Medical Association, 243, 340–342.
- Elmore, R., Wildman R., & Westefeld, J. (1980). The use of systematic desensitization in the treatment of blood phobia. Journal of Behavior Therapy and Experimental Psychiatry. 11, 277–219.
- Falloon, I., Lloyd, G., & Harpin, R. (1981). The treatment of social phobia: Real-life rehearsal with non- professional therapists. Journal of Nervous and Mental Disease, 169, 180–184.
- Graham, D. (1961). Prediction of fainting in blood donors. Circulation, 23, 901–906.
- Graham, D., Kabler, J., & Lunsford, L. (1961). Vasovagal fainting: A diphasic response. Psychosomatic Medicine, 23, 493–507.
- Harvey, F., & Hirschman, R. (1980). The influence of extraversion and neuroticism on heart rate responses to aversive visual stimuli. Personality and Individual Differences, 1, 97–100.
- Hebb, D. (1946). On the nature of fear. Psychological Review, 53, 259–276.
- Hsu, G. (1978). Novel symptom emergence after behavior therapy in a case of hypodermic injection phobia. American Journal of Psychiatry. 135, 238–239.
- Jansson, L., & St, L. (1982). Behavioral treatments for agoraphobia: An evaluative review. Clinical Psychology Review, 2, 311–336.
- Jenks, R., & Deane, G. (1963). Human heart rate responses during experimentally induced anxiety: A follow-up. Journal of Experimental Psychology, 65, 109–112.
- Jersild, A., & Holmes, F. (1935). Children's fears. Child Development Monographs, No. 20.
- Kirchner, J. (1983). Implosive therapy revisited. Psychology: A Quarterly Journal of Human Behavior, 20, 15–23.
- Klorman, R., Wiesenfeld, A., & Austin, M. (1975). Autonomic responses to affective visual stimuli. Psychophysiology, 12, 553–560.
- Lapouse, R., & Monk, M. (1959). Fears and worries in a representative sample of children. American Journal of Orthopsychiatry, 29, 803–818.
- Lloyd, G., & Deakin, H. (1975). Phobias complicating treatment of uterine carcinoma. British Medical Journal, 4, 440.
- Marks, I. (1981). Cure and care of neurosis. New York: John Wiley.
- Matthews, A. (1978). Fear reduction research and clinical phobias. Psychological Bulfefin, 85, 390–404.
- Mavissakalian, M., & Michelson, L. (1982). Patterns of psychophysiological change in the treatment of agoraphobia. Behaviour Research and Therapy, 20, 347–356.
- Nesse, R., Curtis, G., Thyer, B., McCann, D., Huber-Smith, M., & Knopf, R. (In press). Endocrine and cardiovascular responses during phobic anxiety. Psychosomatic Medicine.
- Ollendick, T., & Gruen, G. (1972). Treatment of a bodily injury phobia with implosive therapy. Journal of Consulting and Clinical Psychology, 38, 389–393.
- Öst, L., & Huggdahl, K. (1981). Acquisition of phobias and anxiety response patterns in clinical patients. Behavior Research and Therapy, 19. 439–447.
- Öst, L., Sterner, U., & Lindahl, I. (1984). Physiological responses in blood phobics. Behaviour Research and Therapy, 22, 109–117.
- Ruetz, P., Johnson, S., Callahan, R., Meade, R., & Smith, J. (1967). Fainting: A review of its mechanisms and a study in blood donors. Medicine. 46, 363–384.
- Seligman, M. (1971). Phobias and preparedness. Behavior Therapy, 2, 307–320.
- Sheehan, D. (1982). Panic attacks and phobias. New England Journal of Medicine. 307, 156–158.
- Sledge, W. (1978). Antecedent psychological factors in the onset of vasovagal syncope. Psychosomatic Medicine, 40, 568–579.
- Thyer, B. (1983). Treating anxiety disorders with exposure therapy. Social Casework, 64, 77–82.
- Thyer, B., & Curtis, G. (In press). On the diphasic nature of vasovagal fainting associated with blood- injury-illness phobia. Pavlovian Journal of Biological Science.
- Thyer, B., & Curtis, G. (1984). The effects of ethanol intoxication on phobic anxiety. Behavior Research and Therapy, 22, 599–610.
- Turnage, J., & Logan, D. (1974). Treatment of a hypodermic needle phobia by in vivo systematic desen-sitization. Journal of Behavior Therapy and Experimental Psychiatry, 5, 67–69.
- Vingerhoets, A. (1984). Biochemical changes in two subjects succumbing to syncope. Psychosomatic Medicine, 46, 95–103.
- Wade, T. (1978). Factor analytic approaches to the investigation of common fears: A critical appraisal and reanalysis. Behavior Therapy, 9, 923–935.
- Wallin, G., & Sundlof, G. (1982). Sympathetic outflow to muscles during vasovagal syncope. Journal of the Autonomic Nervous System, 6, 287–291.
- Wardle, J., & Jarvis, M. (1981). The paradoxical fear response to blood, injury and illness—a treatment report. Behavioral Psychotherapy, 9, 13–24.
- White, D. (1982, October). Good and bad blood. Psychology Today, 12, 14, 16.
- Wolf, S. (1967). The bradycardia of the drive reflex—A possible mechanism of sudden death. Conditional Reflex, 2, 88–95.
- Wolpe, J. (1954). Reciprocal inhibition as the main basis of psychotherapeutic effects. Archives of Neurology and Psychiatry, 72, 205–226.
- Wolpe, J. (1981). The dichotomy between classical conditioning and cognitively learned anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 12, 35–42.
- Yule, W., & Fernando, P. (1980). Blood phobia—beware. Behavior Research and Therapy, 18, 587–590.
