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Blood-Injury Phobia With and Without a History of Fainting: Disgust Sensitivity Does Not Explain the Fainting Response
Abstract
Objective Individuals diagnosed with blood-injury phobia respond to venipuncture with strong psychophysiological responses. We investigated whether disgust sensitivity contributes to the fainting response and is associated with parasympathetic activation, as suggested by previous research. Methods Twenty individuals diagnosed with blood-injury phobia (9 with a history of fainting to the sight of blood, 11 without such a fainting history) and 20 healthy controls were compared. Psychophysiological responses and self-report measures of anxiety, disgust, and embarrassment were monitored during rest, a paced breathing task, and venipuncture. In addition, trait disgust sensitivity and blood-injury fears were assessed. Results Blood-injury phobics reported enhanced anxiety, disgust, and embarrassment during venipuncture. They also experienced heightened arousal, as indicated by heart rate, respiration rate, and minute ventilation. Blood-injury phobics without a fainting history tended toward higher anxiety and disgust scores. There was no evidence for increased parasympathetic activation in either blood-injury phobic subgroup or of an association of disgust and parasympathetic activation. Conclusion The tendency to faint when exposed to blood-injury stimuli may suffice as a conditioning event leading into phobia, without specific involvement of disgust sensitivity and parasympathetic activation.
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Gerlach et al. (2006) observed no falls below initial levels of HR and BP in a group of BII phobia patients undergoing venipuncture, but two participants that fainted showed such falls.
“Gerlach et al. (2006) observed no falls below initial levels of HR and BP in a group of BII phobia patients undergoing venipuncture, but two participants that fainted showed such falls.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Gerlach et al., 2006
In some studies, fainters were characterized by their reported history of fainting in response to BII stimuli, but it is not always explicit whether researchers' and patients' definitions of fainting adhered to the criterion of rapid-onset, transient loss of consciousness.
“In some studies, fainters were characterized by their reported history of fainting in response to the sight of blood, injuries, or injections (e.g. Gerlach et al., 2006; Vögele et al., 2003), but it is not always explicit whether researchers’ and patients’ definitions of fainting actually adhered to the criterion of rapid-onset, transient loss of conscience.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Gerlach et al., 2006
Two more studies that had implemented at least one form of respiratory control with RSA produced similarly negative findings.
“Two more studies that had implemented at least one form of respiratory control with RSA produced similarly negative findings (Gerlach et al., 2006; Steptoe & Wardle, 1988).”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Gerlach et al., 2006
Findings coincide with Gerlach et al. that showed increases in minute ventilation in BII-phobia patients during venipuncture and massive increases during recovery in two patients that fainted.
“The findings coincide with those of Gerlach et al. (2006) that showed increases in minute ventilation in BII-phobia patients during venipucture and massive increases in this parameter during the recovery period in two patients that fainted.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Gerlach et al. (2006)
Gerlach et al. observed little change in respiratory sinus arrhythmia throughout a protocol of venipuncture and no association with reported disgust, which was significantly lower than anxiety in this situation.
“Gerlach et al. (2006) observed little change in RSA throughout a protocol of venipuncture and no association with reported disgust, which was significantly lower than anxiety in this situation.”
From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Gerlach et al. (2006)
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Disgust, fear, and the anxiety disorders: a critical review
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“Similarly, Gerlach et al. (2006) observed a rapid heart rate increase among BII phobics during an actual venopuncture but did not observe a subsequent heart rate deceleration.”
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Cognitive biases in blood-injection-injury phobia: a review
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Metadata
- Authors
- Gerlach, A. L., Spellmeyer, G., Vögele, C., Huster, R., Stevens, S., Hetzel, G., & Deckert, J.
- Affiliations
- University of Münster (DE)
- Corresponding author
- Gerlach, Alexander L.
- Venue
- Psychosomatic Medicine
- Published
- 2006-03
- Volume
- 68
- Issue
- 2
- Pages
- 331-339
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2050417182
- Cited by
- 53
- References
- 6
- Citations by year
- 2026: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 7
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Open Repository and Bibliography (University of Luxembourg) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- syncope, disgust sensitivity, parasympathetic activation, venipuncture, psychophysiological responses, heart rate variability, respiratory sinus arrhythmia, anxiety, embarrassment, fear conditioning
- MeSH terms
- Adult, Anxiety, Blood, Emotions, Female, Humans, Male, Parasympathetic Nervous System, Phobic Disorders, Syncope, Wounds and Injuries, Phlebotomy
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