Abstract
Specific phobia of vomiting (SPOV) is a clinical condition with early onset, chronic course and substantial psychosocial impairment due to a rigorous avoidance behavior. A primary symptom which drives patients to consult a medical practitioner is nausea. In this study our aim was to further analyze this symptom of SPOV and examined its role in the development and manifestation of the phobia. We conducted an internet survey in the german SPOV-internet-forum. We calculated a nausea score and grouped participants in a high-and low-nausea group to examine the relationship between nausea and characteristics of the fear of vomiting. In this sample (N = 131), nausea was fairly common in most participants with fear of vomiting. Participants in the high-nausea group had significantly higher ratings of subjective fear and significantly longer duration of fear of vomiting. Additionally, the high-nausea group contained more participants with a body mass index below 19 than the low-nausea group. The present findings suggest that nausea is a core symptom in SPOV which is closely related to intensity of the fear, duration of the fear, and body weight. Future research should investigate if nausea-specific design of treatment could improve therapy outcome.
Highlights
Specific phobia of vomiting (SPOV, known as emetophobia) is still unknown among 29.7% of eating disorder specialists [1]
In this study we explored nausea in a relatively understudied disorder (SPOV) because we believe that nausea could be the reason why patients with SPOV often happen to be misdiagnosed
The findings indicate that nausea is associated with food-avoidance, which could pose making a differential diagnosis between anorexia nervosa and SPOV a challenging task, and even more so without proper knowledge of SPOV-symptomatology
Summary
Specific phobia of vomiting (SPOV, known as emetophobia) is still unknown among 29.7% of eating disorder specialists [1]. Patients with SPOV avoid situations which may increase their risk of vomiting themselves (e.g., eating certain food, traveling, going to an amusement park, meeting ill people, pregnancy...), seeing someone vomiting (e.g., events where guests drink alcohol, meeting pregnant women, places where children play...) [2,3] or vomiting in the presence of others [4]. Vomiting cues lead to imagination of worst-case scenarios and activation of autobiographical memories, which in turn maintain the fear of vomiting [5,6]. By consistently avoiding these situations, such biased and catastrophical scenarios about the threat-value of a situation remain uncorrected
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