Fear Of Blood Research Articles

ASSESSING NURSING STUDENTS’ BLOOD AND INJURY PHOBIA

In this study, nursing students' blood and injury phobia and the conditions affecting it were evaluated. This descriptive study was conducted with 289 nursing students between September and December 2020. Data were collected using a prepared questionnaire and the Multidimensional Blood/Injury Phobia Inventory. Number, percentage, mean, standard deviation, quartiles, Mann–Whitney U and Kruskal–Wallis tests were used to evaluate the data. The mean score of students in the Multidimensional Blood/Injury Phobia Inventory was 56 ± 19.03, having a low level of blood injury phobia. In the total Multidimensional Blood/Injury Phobia Inventory, a significant difference (p

Four-session treatment for specific phobias: Memory regression as a therapeutic tool for blood phobia

This study addresses the effectiveness of memory regression as a therapeutic method for individuals with blood-injection-injury (BII) phobia, a condition that manifests itself through extreme fear and avoidance of seeing blood, receiving injections, or being present in invasive medical situations. Differentiated from other phobias by its unique physiological response, including fainting, and the feeling of disgust, BII significantly impacts patients' lives, limiting access to essential medical care and influencing professional and lifestyle choices. The prevalence of this phobia ranges from 0.8 to 1.5% among children and adolescents, reaching 3 to 4.5% in adults, but its therapeutic approach is often neglected in the specialized literature. This article explores memory regression as a promising intervention, suggesting that by revisiting and reinterpreting the past traumatic experiences that underlie the phobia, patients can achieve a deeper understanding and resolution of their fears. Preliminary results indicate a significant reduction in anxiety and phobic avoidance, demonstrating the potential of memory regression as a valuable tool in the therapeutic arsenal for the treatment of IBD. This study contributes to the field of psychotherapy by providing insights into the applicability and efficacy of memory regression, emphasizing the importance of innovative approaches in the treatment of specific phobias.

Usability Analysis of a Virtual Reality Exposure Therapy Serious Game for Blood Phobia Treatment: Phobos

Phobias are characterized as the excessive or irrational fear of an object or situation, and specific phobias affect about 10% of the world population. Blood-injection-injury phobia is a specific phobia that has a unique physical response to phobic stimuli, that is, a vasovagal syncope that causes the person to faint. Phobos is a serious game intended for blood phobia treatment that was created to be played in virtual reality with an HTC Vive that has photorealistic graphics to provide a greater immersion. We also developed a console application in C# for electrocardiography sensor connectivity and data acquisition, which gathers a 1 min baseline reading and then has continuous data acquisition during gameplay. Usability tests were conducted with self-reported questionnaires and with a case study population of 10 testers, which gave insight into the previous game experience of the tester for both digital games and virtual reality games, evaluating the discomfort for hardware on both the sensor and the virtual reality headset, as well as the game regarding usability, user experience, level of immersion, and the existence of motion sickness and its source. The results corroborate that the immersion of the game is good, which suggests that it will help with triggering the phobia.

Virtual Reality as Exposure Therapy in the Treatment of Blood-Injection-Injury Phobias

Introduction Virtual Reality (VR) is a transformative technology that facilitates the development of immersive virtual environments. Its application is steadily growing within Cognitive Behavioral Therapy (CBT) techniques, notably in virtuo exposure therapy. This is particularly evident in the treatment of specific phobias, with a specific focus on addressing blood-injection-injury phobias.ObjectivesThe objective of our study is to design a treatment protocol for patients suffering from blood phobia based on VR.MethodsWe used the following scales: -Fear Survey Schedule-III (FSS-III) and the Injection Phobia Scale (IPS) for psychometric evaluation of the intensity of avoidance fear.-Questionnaire on cybersickness: to identify potential adverse effects of exposure to virtual reality.To conduct a functional analysis of phobias, we used the SECCA grid and the SORC grid.ResultsThe therapeutic protocol stages of VR for a patient suffering from Blood-Injection-Injury Phobia (BIIP) are as follows:1.Collection of sociodemographic and clinical data.2.Functional analysis to identify triggering factors, contributing factors, and consequences of behavior. The SECCA or SORC grid can help in conducting this functional analysis.3.Psychometric evaluation of the intensity of avoidance fear using the three scales: FSS-III, IPS, and the cybersickness scale.4.Patient education on the mechanisms of the phobia.5.Setting of objectives.6.Therapeutic contract.7.The Protocol :8.Cognitive approach: identification of automatic thoughts and replacement with more rational thoughts.9.Behavioral approach: Progressive exposure, controlled immersion of the patient in virtual environments corresponding to situations that trigger their phobia. This exposure is coupled with relaxation.The treatment continues with regular follow-up to ensure the consolidation of progress and to adjust strategies.For relapse prevention, simple measures ,like personalized exercises to be done by the patient, can favor the long-term maintenance of the acquired skills.Conclusions Virtual reality exposure therapies (in virtuo) are as effective as in-vivo therapies. Besides, they offer a significant advantage over the latter as they facilitate access to stimuli or anxiety-provoking situations that are difficult to access or control in the real world.Disclosure of InterestNone Declared

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A randomised wait-list controlled pilot trial of one-session virtual reality exposure therapy for blood-injection-injury phobias

Virtual reality exposure therapy (VRET) has been recognized as an effective treatment for specific phobias and has the potential to overcome the limitations of traditional in vivo exposure therapy (e.g., acceptability). No past research has evaluated the efficacy of VRET for the treatment of blood-injection-injury (BII) phobia. Therefore, we conducted a randomized controlled trial to examine the acceptability and efficacy of a single-session VRET intervention for BII phobias. Participants who met DSM-5 criteria for BII phobia (N = 43) were randomized to VRET or a waiting list control group, and completed self-report measures of BII severity (Medical Fear Survey [MFS] and Multidimensional Blood Phobia Inventory [MBPI]) and dental anxiety (Modified Dental Anxiety Scale), as well as clinician ratings of BII phobia severity and catastrophic cognitions at baseline, one-week post-treatment, and 3-month follow-up. We found medium to large differences in catastrophic cognitions (probability [g = 0.88] and cost [g = 0.66] ratings), favouring VRET. We found moderate to large differences favouring VRET on the MBPI Injection and Injury fears subscales (g's=0.64–1.14) at one-week post-treatment and 3-month follow-up, and on the MBPI Fainting subscale (g = 0.84) and Injections subscale of the Medical Fear Survey (g = 0.63) at follow-up. There were no other significant group differences. These findings provided some initial evidence to suggest that a single-session VRET may provide some improvements in fears of injections, injury, and fainting. While it may be a useful adjunct or interim step before in vivo exposure therapy, it is not sufficient as a standalone treatment for BII phobia.

Is this blood? An ERP study on the visual identification of red fluids in patients with blood phobia

Blood can be easily recognized in situations involving injury. However, very little is known about the ability of humans to identify blood without such context information. We investigated the blood detection capacity and associated electrocortical correlates (event-related potentials) in 20 women with blood phobia and 20 non-phobic females. The participants viewed images depicting droplets of pig blood, and water with pink or red food coloring. They were asked to decide, whether the pictures showed real blood or not. Blood provoked enhanced P100 amplitudes (90–140 ms) in blood phobics. Late positivity (P300: 340–500 ms) as well as classification accuracy did not differ between the groups. However, blood elicited a general P300 enhancement (relative to red and pink fluids) possibly reflecting elevated visual attention to blood as a general characteristic in humans. The P100 augmentation in blood phobics very likely reflects enhanced early selective attention. Patients with BII phobia showed prioritized visual processing of blood without having to rely on contextual information.

The two faces of avoidance: Time-frequency correlates of motivational disposition in blood phobia.

Contrary to other phobias, individuals with blood phobia do not show a clear-cut withdrawal disposition from the feared stimulus. The study of response inhibition provides insights into reduced action disposition in blood phobia. Twenty individuals with and 20 without blood phobia completed an emotional go/no-go task including phobia-related pictures, as well as phobia-unrelated unpleasant, neutral, and pleasant stimuli. Behavioral results did not indicate a phobia-specific reduced action disposition in the phobic group. Time-frequency decomposition of event-related EEG data showed a reduction of right prefrontal activity, as indexed by an increase in alpha power (200 ms), for no-go mutilation trials in the phobic group but not in controls. Moreover, theta power (300 ms) increased specifically for phobia-related pictures in individuals with, but not without, blood phobia, irrespective of go or no-go trial types. Passive avoidance of phobia-related stimuli subtended by the increased alpha in the right prefrontal cortex, associated with increased emotional salience indexed by theta synchronization, represents a possible neurophysiological correlate of the conflicting motivational response in blood phobia. Through the novel use of time-frequency decomposition in an emotional go/no-go task, the present study contributed to clarifying the neurophysiological correlates of the overlapping motivational tendencies in blood phobia.

Patterns of Response and Remission Following a One-Session Treatment for Blood-Injection-Injury Phobia in Youth

ABSTRACTBlood-Injection-Injury (BII) Phobia is a severe and impairing disorder that has been understudied in youth. The present study aimed to define patterns of response and remission following a modified One-Session Treatment (OST) including an e-therapy maintenance program for children and adolescents with BII Phobia. Moreover, characteristics of different responder groups were examined in order to determine correlates of a poorer response. Youth (n = 20; 8–18 years) were categorized into four responder groups (e.g., immediate remitter, delayed remitter, partial responder, and nonresponder) based upon defined criteria for remission. Immediate remitters to treatment were more likely to have a primary diagnosis of injection phobia, rather than a combined blood and injection phobia. Nonresponders reported significantly greater disgust sensitivity at pretreatment and were more likely to have a comorbid diagnosis of Social Phobia. In regards to within session change, youth who achieved the exposure goal of having a blood test during treatment had a significantly stronger treatment response. These preliminary findings may assist clinicians in the planning and delivering of intensive Cognitive Behavioral Treatment (CBT) approaches for BII Phobia in youth.

Vasovagal Response After Pain Procedures

Vasovagal syncope (VVS) is a specific type of syncope associated with hypotension, bradycardia, and peripheral vasodilation usually lasting 20 seconds and rarely longer than several minutes. It is caused by emotional stress, fear, pain, instrumentation, blood phobia, heat, and orthostatic stress. When a triggering event is present, VVS is usually preceded by autonomic symptoms of pallor, sweating, nausea, and abdominal discomfort. It is a frequently cited immediate adverse event during pain procedures, with rates ranging between 0 and 8.7%. The use of moderate sedation has been shown to reduce the risk of first-time and repeat episodes of vasovagal reactions. However, early detection, simple conservative management, and a willingness to terminate the procedure have resulted in no serious adverse outcomes.

The Efficacy of Psychological Therapies for Specific Phobias in Adults and Some Unanswered Questions

Background: Specific phobias are common across the lifespan. Although exposure-based therapies have the most evidence of efficacy, reviews have cautioned that evaluations of some interventions are limited in number and have pointed to the need for more research. Furthermore, several permitted the inclusion of non-randomized clinical trials or samples exhibiting elevated fear but not necessarily a full diagnosis. We sought to update the literature on the empirical support of psychological treatments for specific phobias in adults through the selection of studies that met stringent criteria along with application of the system developed by Chambless and Hollon [1998: J Consult Clin Psychol 66: 7-18], which had not in isolation been done so previously. Methods: Electronic searches of the PubMed and PsycINFO databases were conducted in February 2014 to identify suitable randomized clinical trials. Thirty-eight met our inclusion criteria. Results: In vivo exposure was the most researched psychological therapy and found to be efficacious and specific. The evidence for virtual reality exposure was less strong though it had a similar level of empirical support. Several other therapies, including applied tension for blood phobia, were found to be possibly efficacious pending replication by other groups. Conclusions: Exposure-based therapy is the optimal treatment for specific phobias, but several gaps remain in the literature. Most studies investigated interventions for spider phobia. More clinical trials conducted by independent research teams are needed on therapies for other subtypes. There is a dearth of literature on the treatment of phobic disorders in older adults and medically unwell patients. This needs to be a priority on research agendas since we have an aging population. Moreover, failure to address blood-injection-injury phobia in a timely manner in patients who are under the care of medical services may affect adherence to recommendations and lead to a deterioration in health. Keywords: Empirically supported treatments, qualitative review, randomized clinical trials.

Brain's oscillatory responses in perception of emotional pictures

try to identify central and peripheral markers related to emotional processes. Furthermore, the increased abilities of functional neural techniques have consistently favored the exploration of emotional components in health and in pathology. In this frame, the aim of this symposium is to bring together innovative researches integrating neurobehavioral data related to normal and dysregulated emotional reactivity. Consequently, the first (H. Sequeira, University of Lille, France) and second (B. Guntekin, Istanbul Kultur University, Turkey) speakers will illustrate the brain dynamic of affective pictures processing in healthy individuals by using magnetoencephalographic and oscillatory cerebral analyses. C. Baeken (Ghent University and University Hospital of Brussels, Belgium), through the application of repetitive Transcranial Magnetic Stimulation (rTMS), will show the potential importance of cingulate functional connectivity in treatment-resistant depression. J.M. Martinez-Selva (University of Murcia, Spain) will focus on the relevance of autonomic (the heart, electrodermal and respiratory activities) and somatic (corrugator supercilii activity) responses to understand mechanisms of neural and behavioral reactivity of persons with blood and snake phobia. J. Martineau (INSERM and University of Tours, France), thanks to behavioral (gaze patterns) and eye physiological indices (pupil diameter and blink rates), will show the interest of emotional static and dynamic faces analyses to explain the impaired social interaction in autistic pathology. In brief, by the original combination of psychophysiological tools in healthy and in behavioral disturbed individuals, this symposium will give an updated and prospective panorama of neurobehavioral exploration of emotion.

Abordaje de la hematofobia y sus distintas líneas de investigación

Blood phobia could be defined by the presence of fear and a number of avoiding or escaping behaviors regarding places, objects and situations related to the sight of blood, needles or injuries, with nearly an 80% of cases having a history of fainting. This phobia has a prevalence of 31‰ and usually implies a great impact on the subject's life. The present study is a review of the most outstanding literature in the field, addressing the explanatory variables along with the most effective treatments. Then, literature has been searched along three research lines: sensitivity to disgust, the role of hyperventilation, and the attentional bias. Also, the most effective procedures in the field have being reviewed. The results show that there is not a significant difference between the Applied Tension (AT) and the Exposure (E) alone – the most efficient techniques to treat this phobia. Regarding the three research lines mentioned above, the more significant procedures used over the last few years have been the role of hyperventilation and the attentional bias. Finally, a set of guidelines to work with these patients are put forward regarding these findings.

Abordaje de la hematofobia y sus distintas líneas de investigación

Blood phobia could be defined by the presence of fear and a number of avoiding or escaping behaviors regarding places, objects and situations related to the sight of blood, needles or injuries, with nearly an 80% of cases having a history of fainting. This phobia has a prevalence of 31‰ and usually implies a great impact on the subject’s life. The present study is a review of the most outstanding literature in the field, addressing the explanatory variables along with the most effective treatments. Then, literature has been searched along three research lines: sensitivity to disgust, the role of hyperventilation, and the attentional bias. Also, the most effective procedures in the field have being reviewed. The results show that there is not a significant difference between the Applied Tension (AT) and the Exposure (E) alone – the most efficient techniques to treat this phobia. Regarding the three research lines mentioned above, the more significant procedures used over the last few years have been the role of hyperventilation and the attentional bias. Finally, a set of guidelines to work with these patients are put forward regarding these findings.

Why humans do not make good vampires. Testing the ability of humans to detect true blood

Background: Research indicating the effects of real blood or of its iconic representation on human behaviour has thus far concentrated on phobia and aggressiveness. Little is known about other responses or, more fundamentally, about the biological basis of all such responses.Aim: In this study it is examined whether or not humans are able to detect real blood.Methods: Human subjects (n = 89) were asked to distinguish different kinds of blood from red control fluids under varying visual and choice conditions. Relevant differences between subjects were tested for through written questionnaires, including standardized scales for disgust sensitivity (DS-R) and blood phobia (MBPI) and performance on two clinical olfactory tests.Results: Analysis of variance shows that humans are excellent detectors of animal blood (in casu pig blood), whereas the ability of detecting human blood is much less developed. Surprisingly, differences in olfactory capacities and personal experience with blood have no effect on blood detection, while blood fear lowers and disgust sensitivity ameliorates this performance.Conclusion: This study allows further mapping of the exact role of disgust sensitivity in human behaviour, as well as a deliberate choice of materials in blood-related experiments. It is imperative for further research on the behavioural and psychological impact ‘blood’ resorts on humans.

The structure of genetic and environmental risk factors for phobias in women

To explore the genetic and environmental factors underlying the co-occurrence of lifetime diagnoses of DSM-IV phobia. Female twins (n=1430) from the population-based Norwegian Institute of Public Health Twin Panel were assessed at personal interview for DSM-IV lifetime specific phobia, social phobia and agoraphobia. Comorbidity between the phobias were assessed by odds ratios (ORs) and polychoric correlations and multivariate twin models were fitted in Mx. Phenotypic correlations of lifetime phobia diagnoses ranged from 0.55 (agoraphobia and social phobia, OR 10.95) to 0.06 (animal phobia and social phobia, OR 1.21). In the best fitting twin model, which did not include shared environmental factors, heritability estimates for the phobias ranged from 0.43 to 0.63. Comorbidity between the phobias was accounted for by two common liability factors. The first loaded principally on animal phobia and did not influence the complex phobias (agoraphobia and social phobia). The second liability factor strongly influenced the complex phobias, but also loaded weak to moderate on all the other phobias. Blood phobia was mainly influenced by a specific genetic factor, which accounted for 51% of the total and 81% of the genetic variance. Phobias are highly co-morbid and heritable. Our results suggest that the co-morbidity between phobias is best explained by two distinct liability factors rather than a single factor, as has been assumed in most previous multivariate twin analyses. One of these factors was specific to the simple phobias, while the other was more general. Blood phobia was mainly influenced by disorder specific genetic factors.

Airway response to emotion‐ and disease‐specific films in asthma, blood phobia, and health

Earlier research found autonomic and airway reactivity in asthma patients when they were exposed to blood-injection-injury (BII) stimuli. We studied oscillatory resistance (R(os)) in asthma and BII phobia during emotional and disease-relevant films and examined whether muscle tension counteracts emotion-induced airway constriction. Fifteen asthma patients, 12 BII phobia patients, and 14 healthy controls viewed one set of negative, positive, neutral, BII-related, and asthma-related films with leg muscle tension and a second set without. R(os), ventilation, cardiovascular activity, and skin conductance were measured continuously. R(os) was higher during emotional compared to neutral films, particularly during BII material, and responses increased from healthy over asthmatic to BII phobia participants. Leg muscle tension did not abolish R(os) increases. Thus, the airways are particularly responsive to BII-relevant stimuli, which could become risk factors for asthma patients.

The Multi-Dimensional Blood/Injury Phobia Inventory: Its psychometric properties and relationship with disgust propensity and disgust sensitivity

The Multi-Dimensional Blood Phobia Inventory (MBPI; Wenzel & Holt, 2003) is the only instrument available that assesses both disgust and anxiety for blood-phobic stimuli. As inflated levels of disgust propensity (i.e., tendency to experience disgust more readily) are often observed in blood phobia, the MBPI appears a promising instrument for disgust research. First, we examined its psychometric properties. Next, it was examined whether disgust sensitivity (i.e., considering experiencing disgust as something horrid) had added predictive value compared to disgust propensity in blood phobia. Therefore, students and university employees (N=616) completed the MBPI, indices on blood phobia, disgust propensity and sensitivity.The MBPI proved to be reliable and valid. Further, it correlated moderately to high with disgust propensity and sensitivity. Additionally, disgust propensity and sensitivity were both significant predictors for blood phobia. In conclusion, the MBPI appears a valuable addition to the currently available arsenal of indices to investigate blood phobia.

Lack of startle blink potentiation to mutilation pictures irrespective of fearfulness

Previous research has shown that in healthy individuals blood-related stimuli elicit a distinctive autonomic response pattern and heightened processing as compared with other unpleasant and arousing visual stimuli. In addition, growing evidence suggests that information processing of disorder-related stimuli is also different in blood phobia as compared with other specific phobias. In the present study, the magnitude of the startle eyeblink reflex elicited during the viewing of mutilation, human attack, erotica and neutral pictures was recorded in 22 blood phobics and 25 healthy controls. Startle eyeblink responses were measured at 300, 1500, 3500 and 4500-ms time intervals after picture onset in order to assess the attentional/affective modulation and its temporal course. Reliable startle inhibition to erotic pictures and startle potentiation to human attack scenes were found relative to neutral pictures. However, while both groups rated mutilations as the most unpleasant and arousing content, no blink facilitation relative to neutral contents was found at either early or late probe times. Crucially, such effect occurred independently of fear levels, as no difference between phobics and controls was found in the size of the startle blinks elicited throughout the viewing of blood pictures.

The neural correlates of attentional bias in blood phobia as revealed by the N2pc.

In the literature, a lack of attentional bias in blood phobia has been reported, using both behavioral and ERP measures. However, in the tasks employed so far, attentional resources to single stimuli, rather than attentional selection, were evaluated. The present study investigated whether in blood phobics disorder-relevant pictures can capture visuo-spatial attention when paired with neutral or non-specific unpleasant pictures (attack), and participants have to focus on a visual detection task. The N2pc component of the ERPs was measured as an index of spatial attentional selection. Results showed that in blood phobics, but not in controls, injuries elicited a larger early N2pc than attack pictures when paired with neutral material. Moreover, only in blood phobics a reliable N2pc to injury-attack pairs was found. The late N2pc reversal to injury pictures suggests that early orienting to phobic cues was followed by cognitive avoidance.