Cognitive biases in blood-injection-injury phobia: a review
Open accessAbstract
Blood-injection-injury (BII) phobia can lead to avoidance of crucial medical procedures and to detrimental health consequences, even among health workers. Yet unlike other specific phobias, BII phobia has been understudied. Specifically, while cognitive biases have been extensively investigated in other anxiety disorders, little is known about the same biases in BII phobia. The current article reviews cognitive biases in BII phobia and suggest future directions for further study and treatment. The reviewed biases include attention, expectancy, memory, perception, and interpretation biases. The investigation of these biases is highly relevant, as cognitive biases have been found to interact with anxiety symptoms. Results showed that attention, expectancy, and memory biases are involved in BII phobia, while no studies were found on interpretation nor perception biases. Mixed results were found for attention bias, as different studies found different components of attention bias, while others found no attention bias at all. Similarly, some studies found a-priori/a-posteriori expectancy biases, while other studies found only one type of bias. A better understanding of the cognitive particularities of BII phobia may lead to better treatments and ultimately reduce avoidance of needles and blood-related situations, thereby enabling individuals with BII phobia to undergo potentially life-saving medical procedures.
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In the case of BII, studies identified a distinct pathophysiological mechanism.
“However, in the case of phobia relating to blood, injury, and injection (BII), studies identified a distinct pathophysiological mechanism (9, 21–28)”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [22]
The Introduction (page unavailable) reports distinct neurobiological responses in BII phobia compared with spider phobia and says some studies suggest a cardiac response found only in BII. But it also says BII physiology is debated and the empirical basis for the proposed biphasic response has been criticized. The claim presents a distinct pathophysiological mechanism as more firmly established than the review does. (LLM, conf=0.81)
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Factors associated with documented distress during venipuncture in routine health checkups
Yuan, Y., YEN, Y.-C., Chu, W., Lin, S.-Y., Hsu, C.-Y., Yang, S.-H., & Lin, C.-F. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1866329
- Authors
- Abado, E., Aue, T., & Okon-Singer, H.
- Affiliations
- University of Haifa (IL)
- University of Bern (CH)
- Corresponding author
- Abado, Elinor
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2021-07-13
- Volume
- 12
- Pages
- 678891-678891
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC8313757
- OpenAlex
- W3182153185
- Cited by
- 19
- References
- 87
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 3
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- MPG.PuRe (Max Planck Society) (submittedVersion, cc-by)
- Open Access CRIS of the University of Bern
- Funders
- Israel Science Foundation
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- blood-injection-injury phobia, cognitive biases, attentional bias, expectancy bias, memory bias, perceptual bias, interpretation bias, needle phobia, healthcare workers, anxiety disorders
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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