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On the diphasic nature of vasovagal fainting associated with blood-injury-illness phobia
Abstract
A detailed psychophysiologic analysis of a vasovagal faint occurring in a "blood-injury-illness" phobic demonstrated that the syncopal episode consisted of a diphasic response. This lends support to the hypothesis that vasovagal fainting in these patients is caused by an overcompensating rebound parasympathetic activation following sympathetic arousal. Treatment and research implications of this finding are discussed.
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The underlying pattern of autonomic regulation in BII phobia has been characterized as a diphasic response, with initial increases in heart rate and blood pressure typical of fight-flight and subsequent drops in blood pressure and/or heart rate that may precipitate vasovagal fainting.
“The underlying pattern of autonomic regulation has been characterized as a diphasic response, with initial increases in heart rate and blood pressure that are typical of a fight-flight response, and subsequent drops in blood pressure and/or heart rate that may precipitate vasovagal fainting.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Thyer and Curtis, 1985
The typical BII response pattern described in the literature comprises two phases: an initial increase in heart rate and blood pressure, and a subsequent sharp fall in heart rate and blood pressure leading to reduced cerebral blood flow and fainting.
“The typical response pattern has been described in the literature as an event comprising two phases, the diphasic (alternatively, using the Latin prefix: biphasic) response (e.g., Engel, 1978; Kozak and Montgomery, 1981; Thyer and Curtis, 1985).”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Thyer and Curtis, 1985
Thyer and Curtis estimated on the basis of behavioral observation that approximately half of their patients hyperventilated during exposure sessions.
“Thyer and Curtis (1985) estimated on the basis of behavioral observation that approximately half of their patients hyperventilated during exposure sessions.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Thyer and Curtis (1985)
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Research works printed but not linked: 15
- Babcock, H. H., and Powell, D. H. Vasovagal fainting: Deconditioning an autonomic syndrome.Psychosomatics, 1982,23, 969–973. · DOI
- Cohn, C. K., Kron, R. E., and Brady, J. F. A case of blood/injury/illness phobia treated behaviorally.Journal of Nervous and Mental Disease, 1976,162, 65–68. · DOI
- Connolly, J., Hallam, R., and Marks, I. Selective association of fainting with blood-injury-illness fear.Behavior Therapy, 1976,7, 8–13. · DOI
- Curtis, G. C., Nesse, R. M., Buxton, J., Wright, J., and Lippman, D. Flooding in vivo as a research tool and treatment method for phobias: A preliminary report.Comprehensive Psychiatry, 1976,11, 101–107.
- Curtis, G. C., and Thyer, B. A. Fainting on exposure to phobic stimuli.American Journal of Psychiatry, 1983,140, 771–774. · DOI
- Davis, R. C., Buchwald, A. M., and Frankman, R. W. Autonomic and muscular responses and their relation to simple stimuli.Psychological Monographs, 1955,69, (20, Whole No. 405). · DOI
- Elmore, R. T., Wildman, R. W. II, and Westefeld, J. S. The use of systematic desensitization in the treatment of blood phobia.Journal of Behavior Therapy and Experimental Psychiatry, 1980,11, 277–279. · DOI · Paper page
- Engle, G. L.Fainting: Physiological and Psychological Considerations. Springfield, Ill: Charles C Thomas, 1950.
- Graham, D. T., Kabler, J. D., and Lunsford, L. Jr. Vasovagal fainting: A diphasic response.Psychosomatic Medicine, 1961,23, 493–507. · DOI · Paper page
- Harvey, F., and Hirschman, R. The influence of extraversion and neuroticism, on heart rate responses to aversive visual stimuli.Personality and Individual Differences, 1980,1, 97–100. · DOI
- Lang, P. J., and Hnatiow, M. Stimulus repetition and the heart rate response.Journal of Comparative and Physiological Psychology, 1962,55, 781–785. · DOI
- Marks, I. M.Cure and Care of Neurosis. New York: John Wiley & Sons, 1981.
- Sledge, W. H. Antecedent psychological factors in the onset of vasovagal syncope.Psychosomatic Medicine, 1978,40, 568–579. · DOI · Paper page
- Thyer, B. A. Treating anxiety disorders with exposure therapy,Social Casework, 1983,64, 77–82. · DOI
- Wilson, R. S. Autonomic changes produced by noxious and innocuous stimulation.Journal of Comparative and Physiological Psychology, 1964,58, 290–295. · DOI
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Öst, L.-G., Fellenius, J., & Sterner, U. (1991) · Behaviour Research and Therapy · doi:10.1016/0005-7967(91)90006-o · Cited by 138
Applied tension, applied relaxation, and the combination in the treatment of blood phobia
Öst, L.-G., Sterner, U., & Fellenius, J. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90069-7 · Cited by 87
The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm
Ritz, T., Meuret, A. E., & Ayala, E. S. (2010) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2010.05.007 · Cited by 74
“The typical response pattern has been described in the literature as an event comprising two phases, the diphasic (alternatively, using the Latin prefix: biphasic) response (e.g., Engel, 1978; Kozak and Montgomery, 1981; Thyer and Curtis, 1985).”
BackgroundMethod
Metadata
- Authors
- Thyer, B. A., & Curtis, G. C.
- Affiliations
- University of Michigan (US)
- ORCID
- Thyer, Bruce A.
- Venue
- The Pavlovian Journal of Biological Science
- Published
- 1985-04
- Volume
- 20
- Issue
- 2
- Pages
- 84-87
- ISSN
- 0010-5392 (ISSN-L)
- 0093-2213
- OpenAlex
- W56548049
- Cited by
- 35
- References
- 0
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 2 · 2020: 1 · 2017: 1 · 2016: 1 · 2014: 1 · 2013: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pavlovian Journal of Biological Science (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- vasovagal syncope, sympathetic activation, autonomic nervous system
- MeSH terms
- Adult, Blood, Blood Pressure, Disease, Female, Heart Rate, Humans, Phobic Disorders, Sympathetic Nervous System, Syncope, Vagus Nerve, Wounds and Injuries
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