Exposure and Participant Modelling in a Case of Injection Phobia

Abstract

From the literature it appears that there may be two types of injection phobia, (1) the 'vasovagal' type, and (2) the 'resistant' type. The first type is characterized by a diphasic cardiovascular response during or after injection and by a tendency to react in a passive, nonresisting way when injected. The second type is characterized by strong, sometimes violent resistance and no vasovagal reaction to an injection. Characteristics of blood injury phobia apply to the first type, but not to the second. The possibility is considered that exposure may be an effective treatment in the first type, and participant modelling in the second type. A single case study was carried out with a case of injection phobia of the second type in which exposure with modelling, followed by participant modelling of the injection, was applied. Measures of state anxiety (STAI) and heart rate were obtained. According to expectation, participant modelling of injections was effective in eliminating the fear of injections in a patient of the second type of injection phobia. The results of this study warrant further investigation of the model in a group design in which the differential treatment effects of exposure and participant modelling are tested.