A Preliminary Investigation of the Efficacy of Disgust Exposure Techniques in a Subclinical Population With Blood and Injection Fears

2008 ◽  
Vol 25 (3) ◽  
pp. 129-148 ◽  
Author(s):  
Michiyo Hirai ◽  
Heather M. Cochran ◽  
Jennifer S. Meyer ◽  
Jennifer L. Butcher ◽  
Laura L. Vernon ◽  
...  
Keyword(s):  
Preliminary Investigation ◽  
Effect Sizes ◽  
Single Session ◽  
Treatment Groups ◽  
Domain Specific ◽  
Injection Injury ◽  
Blood Injection ◽  
Bii Phobia ◽  
Over Time

AbstractThe current study examined whether a traditional exposure-based treatment for blood-injection-injury (BII) phobia would be effective at reducing disgust responses to BII stimuli and whether the addition of modules targeting disgust would provide incremental efficacy. Participants, many of whom reported subclinical BII phobia symptoms, underwent one of two single-session exposure protocols, one targeting fear alone, and the other targeting both fear and disgust. Both treatments consisted of education components (fear-only or fear-disgust) and in vivo exposure (fear-only or fear-disgust). Both the fear-only and the fear-disgust treatment groups significantly decreased fear and avoidance behaviour toward BII stimuli over time. The two groups also experienced similar reductions in disgust responses to BII-related stimuli and global as well as domain-specific disgust sensitivity. The effect sizes indicated that the fear-disgust group evidenced greater reduction in symptoms than did the fear-only group. The implications of the results for models of phobia maintenance and treatment are discussed.

scholarly journals Señales de amenaza y sesgo atencional en lafobia a la sangre, inyecciones y heridasy en la fobia a las serpientes

2021 ◽  
Vol 37 (3) ◽  
pp. 459-467
Author(s):  
Juan Pedro Sánchez-Navarro ◽  
José M. Martínez-Selva ◽  
Vladimir Kosonogov ◽  
Eduvigis Carrillo-Verdejo ◽  
Sara Pineda ◽  
...  
Keyword(s):  
Attentional Bias ◽  
Exogenous Attention ◽  
Relevant Stimulus ◽  
Electrocortical Activity ◽  
Injection Injury ◽  
Blood Injection ◽  
Snake Phobia ◽  
Threat Cues ◽  
Bii Phobia ◽  
Los Grupos

El objetivo de esta investigación fue estudiar el efecto de una señal que indica la aparición de una imagen fóbica sobre la actividad electrocortical provocada por el estímulo relevante para el trastorno en la fobia a la sangre por lesión en inyección (BII) y la fobia a las serpientes. Una muestra de 13 participantes con fobia BII, 12 individuos con fobia a las serpientes y 14 controles no fóbicos se sometieron a una tarea S1-S2, donde S1 era una palabra que describía el contenido de una imagen posterior (relacionada con la sangre, serpiente y neutral) que apareció 2 segundos después (S2). Obtuvimos las amplitudes ERP P200 y P300 provocadas por las imágenes. Nuestros resultados revelan que P200 no diferenciaba entre el contenido de las imágenes en la fobia BII mientras que, por el contrario, las imágenes relacionadas con la serpiente y la sangre provocaron las respuestas más grandes en los participantes con fobia a las serpientes. Tanto las imágenes relacionadas con la sangre como las de serpientes provocaron amplitudes de P300 mayores que las imágenes neutrales en todos los grupos. Las señales de amenaza redujeron la reacción electrocortical del BII, posiblemente por la provocación de respuestas anticipatorias o reguladoras. Estos resultados son indicativos de una baja atención automática exógena hacia los estímulos temidos en la fobia BII, como lo revela P200, probablemente relacionado con una falta de sesgo de atención al objeto fóbico. The aim of this research was to study the effect of a cue signalling the upcoming of a phobic picture on the electrocortical activity provoked by the disorder-relevant stimulus in in blood-injection-injury (BII) phobia and snake phobia. A sample of 13 BII phobia participants, 12 snake phobia individuals and 14 non-phobic controls underwent an S1-S2 task, where S1 was a word that described the content of a subsequent picture (blood-related, snake and neutral) that appeared 2 seconds later (S2). We obtained the P200 and P300 ERP amplitudes provoked by the pictures. Our results reveal that P200 did not differentiate between picture contents in BII phobia while, in contrast, snake and blood-related pictures provoked the largest responses in snake phobia participants. Both blood-related and snake pictures provoked greater P300 amplitudes than neutral pictures in all the groups. Threat cues reduced the electrocortical reaction of the BII, possibly by the elicitation of anticipatory or regulatory responses. These results are indicative of a low automatic, exogenous attention towards the feared stimuli in BII phobia, as revealed by P200, probably related to a lack of attentional bias to the phobic object.

Domain-specific and generalized disgust sensitivity in blood-injection-injury phobia:

2002 ◽  
Vol 16 (5) ◽  
pp. 511-527 ◽  
Author(s):  
Michelle D. Koch ◽  
H.Katherine O’Neill ◽  
Craig N. Sawchuk ◽  
Kevin Connolly
Keyword(s):  
Disgust Sensitivity ◽  
Domain Specific ◽  
Injection Injury ◽  
Blood Injection ◽  
Blood Injection Injury Phobia

scholarly journals The functional neuroanatomy of blood-injection-injury phobia: a comparison with spider phobics and healthy controls

2009 ◽  
Vol 40 (1) ◽  
pp. 125-134 ◽  
Author(s):  
X. Caseras ◽  
V. Giampietro ◽  
A. Lamas ◽  
M. Brammer ◽  
O. Vilarroya ◽  
...  
Keyword(s):  
Anterior Insula ◽  
Anterior Cingulate ◽  
Healthy Controls ◽  
Functional Neuroanatomy ◽  
Psychophysiological Response ◽  
Injection Injury ◽  
Specific Effects ◽  
Neurobiological Substrates ◽  
Blood Injection ◽  
Bii Phobia

BackgroundMost neuroimaging studies of specific phobia have investigated the animal subtype. The blood-injection-injury (BII) subtype is characterized by a unique biphasic psychophysiological response, which could suggest a distinct neural substrate, but direct comparisons between phobia types are lacking.MethodThis study compared the neural responses during the presentation of phobia-specific stimuli in 12 BII phobics, 14 spider (SP) phobics and 14 healthy controls using functional magnetic resonance imaging (fMRI).ResultsSubjective ratings showed that the experimental paradigm produced the desired symptom-specific effects. As in many previous studies, when viewing spider-related stimuli, SP phobics showed increased activation in dorsal anterior cingulate and anterior insula, compared to BII phobics and healthy controls. However, when viewing images of blood-injection-injuries, participants with BII phobia mainly showed increased activation in the thalamus and visual/attention areas (occipito-temporo-parietal cortex), compared with the other two groups. The degree of provoked anxiety and disgust by phobia-relevant images was strongly associated with activation in several common regions across the two phobia groups (thalamus, cerebellum, occipito-temporal regions) but only correlated with activation in the dorsal anterior cingulate gyrus and the anterior insula in the SP phobics.ConclusionsThese results suggest partially distinct neurobiological substrates of animal and BII phobias and support their current classification as two distinct subtypes in the DSM-IV-TR. Further research is needed to better understand the precise neurobiological mechanisms in BII phobia and particularly the fainting response.

Disgust Processing in Phobia of Blood-Injection-Injury

2003 ◽  
Vol 17 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Anne Schienle ◽  
Axel Schäfer ◽  
Rudolf Stark ◽  
Bertram Walter ◽  
Peter Kirsch ◽  
...  
Keyword(s):  
Inferior Frontal Gyrus ◽  
Self Report ◽  
Dynamic Responses ◽  
Left Inferior Frontal Gyrus ◽  
Injection Injury ◽  
Lingual Gyrus ◽  
Fmri Study ◽  
Blood Injection ◽  
The Right ◽  
Bii Phobia

Abstract An elevated disgust sensitivity (DS) is considered to be a vulnerability factor for the development of a blood-injection-injury (BII) phobia. Within the present functional Magnetic Resonance Imaging (fMRI) study, 12 female BII phobics were scanned while viewing alternating blocks of 40 disgust-inducing, 40 fear-inducing, and 40 affectively neutral pictures. Each block lasted 60s and was repeated six times during the experiment. All scenes were phobia-irrelevant. Afterwards, the subjects gave affective ratings for the pictures and described their DS on a self-report measure for different areas (e.g., poor hygiene, unusual food, death/deformation). The responses were compared with those of 12 nonphobic females. The BII phobics showed a stronger occipital activation within the right cuneus and lingual gyrus during the first viewing of the disgusting pictures. Aside from this finding, which could be interpreted as reflecting increased attention, there was little evidence for a generally elevated DS in BII phobia. On the DS questionnaire, the patients had indicated a greater reactivity only for disorder-relevant contents (death/deformation). Further, both groups gave similar disgust ratings for the pictures and showed comparable brain-dynamic responses over all blocks of the disgust condition, which included the activation of both amygdalae and the left inferior frontal gyrus.

scholarly journals Cognitive Biases in Blood-Injection-Injury Phobia: A Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Elinor Abado ◽  
Tatjana Aue ◽  
Hadas Okon-Singer
Keyword(s):  
Cognitive Biases ◽  
Health Workers ◽  
A Priori ◽  
Attention Bias ◽  
Medical Procedures ◽  
Memory Biases ◽  
Injection Injury ◽  
Interpretation Biases ◽  
Blood Injection ◽  
Bii Phobia

Blood-injection-injury (BII) phobia can lead to avoidance of crucial medical procedures and to detrimental health consequences, even among health workers. Yet unlike other specific phobias, BII phobia has been understudied. Specifically, while cognitive biases have been extensively investigated in other anxiety disorders, little is known about the same biases in BII phobia. The current article reviews cognitive biases in BII phobia and suggest future directions for further study and treatment. The reviewed biases include attention, expectancy, memory, perception, and interpretation biases. The investigation of these biases is highly relevant, as cognitive biases have been found to interact with anxiety symptoms. Results showed that attention, expectancy, and memory biases are involved in BII phobia, while no studies were found on interpretation nor perception biases. Mixed results were found for attention bias, as different studies found different components of attention bias, while others found no attention bias at all. Similarly, some studies found a-priori/a-posteriori expectancy biases, while other studies found only one type of bias. A better understanding of the cognitive particularities of BII phobia may lead to better treatments and ultimately reduce avoidance of needles and blood-related situations, thereby enabling individuals with BII phobia to undergo potentially life-saving medical procedures.

Medical Avoidance and Anxiety in Subtypes of Blood-Injection-Injury Phobia

2000 ◽  
Author(s):  
Craig N. Sawchuk ◽  
Suzanne A. Meunier ◽  
Jeffrey M. Lohr ◽  
David F. Tolin
Keyword(s):  
Injection Injury ◽  
Blood Injection ◽  
Blood Injection Injury Phobia

The Development of Homologous (Canine/Anti-Canine) Antibodies in Dogs with Haemophilia A (Factor VIII Deficiency): A Ten-Year Longitudinal Study

1993 ◽  
Vol 69 (01) ◽  
pp. 021-024 ◽  
Author(s):  
Shawn Tinlin ◽  
Sandra Webster ◽  
Alan R Giles
Keyword(s):  
Factor Viii ◽  
Canine Model ◽  
Significant Inhibition ◽  
Human Condition ◽  
Haemophilia A ◽  
Variable Expression ◽  
The Family ◽  
Over Time

SummaryThe development of inhibitors to factor VIII in patients with haemophilia A remains as a serious complication of replacement therapy. An apparently analogous condition has been described in a canine model of haemophilia A (Giles et al., Blood 1984; 63:451). These animals and their relatives have now been followed for 10 years. The observation that the propensity for inhibitor development was not related to the ancestral factor VIII gene has been confirmed by the demonstration of vertical transmission through three generations of the segment of the family related to a normal (non-carrier) female that was introduced for breeding purposes. Haemophilic animals unrelated to this animal have not developed functionally significant factor VIII inhibitors despite intensive factor VIII replacement. Two animals have shown occasional laboratory evidence of factor VIII inhibition but this has not been translated into clinical significant inhibition in vivo as assessed by clinical response and F.VIII recovery and survival characteristics. Substantial heterogeneity of inhibitor expression both in vitro and in vivo has been observed between animals and in individual animals over time. Spontaneous loss of inhibitors has been observed without any therapies designed to induce tolerance, etc., being instituted. There is also phenotypic evidence of polyclonality of the immune response with variable expression over time in a given animal. These observations may have relevance to the human condition both in determining the pathogenetic factors involved in this condition and in highlighting the heterogeneity of its expression which suggests the need for caution in the interpretation of the outcome of interventions designed to modulate inhibitor activity.

scholarly journals Prevalence and Photobiology of Photosynthetic Dinoflagellate Endosymbionts in the Nudibranch Berghia stephanieae

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2200
Author(s):  
Ruben X. G. Silva ◽  
Paulo Cartaxana ◽  
Ricardo Calado
Keyword(s):  
Food Deprivation ◽  
Photosynthetic Efficiency ◽  
Rapid Decrease ◽  
Complete Loss ◽  
Symbiotic Association ◽  
Non Invasive ◽  
Sea Slugs ◽  
Non Destructive ◽  
Over Time

Berghia stephanieae is a stenophagous sea slug that preys upon glass anemones, such as Exaiptasia diaphana. Glass anemones host photosynthetic dinoflagellate endosymbionts that sea slugs ingest when consuming E. diaphana. However, the prevalence of these photosynthetic dinoflagellate endosymbionts in sea slugs appears to be short-lived, particularly if B.stephanieae is deprived of prey that host these microalgae (e.g., during bleaching events impacting glass anemones). In the present study, we investigated this scenario, along with food deprivation, and validated the use of a non-invasive and non-destructive approach employing chlorophyll fluorescence as a proxy to monitor the persistence of the association between sea slugs and endosymbiotic photosynthetic dinoflagellates acquired through the consumption of glass anemones. Berghia stephanieae deprived of a trophic source hosting photosynthetic dinoflagellate endosymbionts (e.g., through food deprivation or by feeding on bleached E. diaphana) showed a rapid decrease in minimum fluorescence (Fo) and photosynthetic efficiency (Fv/Fm) when compared to sea slugs fed with symbiotic anemones. A complete loss of endosymbionts was observed within 8 days, confirming that no true symbiotic association was established. The present work opens a new window of opportunity to rapidly monitor in vivo and over time the prevalence of associations between sea slugs and photosynthetic dinoflagellate endosymbionts, particularly during bleaching events that prevent sea slugs from incorporating new microalgae through trophic interactions.

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