Emetophobia

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Classification according to ICD-10
F40.2 Specific (isolated) phobias
ICD-10 online (WHO version 2019)

The Emetophobia is a phobic disorder in which the patient is an often inexplicable, irrational fear of any kind of vomiting has. According to the ICD-10 classification, it is a specific phobia .

A typical symptom is fear

  • to vomit, whether alone or in the presence of others
  • To see other people or animals throw up
  • before any confrontation with the topic, e.g. B. through the media or in conversations

Appearance

The onset of the disorder often occurs in childhood. An essential characteristic is a pronounced avoidance behavior towards dreaded situations and stimuli. The research group around Lipsitz reported that 62% of the emetophobes surveyed accepted social losses, around 20% of those affected had problems with the world of work, 9% had difficulties at school and 70% reported impaired leisure activities. Often those affected avoid contact z. B. with children or pregnant women, as they have a high tendency to vomit in the eyes of an emetophobic. For this reason, three quarters of women affected avoid pregnancy .

The avoidance behavior of those affected often leads to social isolation. Appointments are often left without obligation or canceled at short notice, sometimes through excuses out of shame in front of the actual cause. Affected people often suffer from low self-esteem and do not feel understood. In severe cases, people rarely leave their own apartment, and even going to the supermarket around the corner to go shopping turns out to be an almost insurmountable obstacle. This disease is difficult to understand for relatives.

The eating behavior is disturbed in many of those affected. Three quarters of the respondents in a study stated that they eat in a cautious way or only eat certain foods and / or practice certain rituals around eating. The fear of spoiled food can lead to excessive washing or repeated checking of the shelf life of the food. Going to restaurants is therefore often avoided.

In addition to the fear and avoidance behavior described, there are often numerous accompanying physical symptoms such as persistent nausea, as well as possibly abdominal pain, diarrhea , irritable stomach , irritable bowel , heartburn , vomiting, dizziness , chills-like tremors, fainting (often triggered by long periods of not eating), which is why an emetophobia is often not recognized and misdiagnosed even by doctors. The anxious anticipation of gastrointestinal symptoms leads to increased awareness of signs of possible nausea. The nausea - mostly without a physical cause - occurs in over 80% of those affected.

diagnosis

The diagnosis of emetophobia is made difficult by its lack of awareness. The "Emetophobia Questionnaire (EmetQ-13)" is an English-language diagnostic questionnaire. Based on the clinical-diagnostic guidelines of the ICD-10 of the WHO, the following symptoms are necessary to diagnose a specific phobia:

  • The fear is strong and has existed for a long time.
  • The person is aware that this fear is excessive, i.e. inappropriate.
  • The phobic situations are avoided or only endured with fear or severe discomfort (avoidance behavior).
  • The fear leads to a significant restriction in professional, school or social activities or lifestyle.

The latent or acute anxiety can manifest itself in rapid heartbeat , sweating , loss of reality express, anxiety feelings, dizziness. Avoidance behavior relates to vomiting and thus typically to public places and events or certain foods. This often results in serious social restrictions.

In the ICD-10, emetophobia is to be differentiated from nosophobia or hypochondria . The avoidant nutritional behavior of those affected can lead to being underweight and misdiagnose anorexia . In addition to emetophobia, depression is often diagnosed.

frequency

Prevalence estimates are between 1.7 and 3.1% for men and between 6 and 7% for women. Several studies show a significantly higher proportion of women among those affected.

root cause

There are different theories about the development of emetophobia. However, none of them have been scientifically proven. However, a distinction can be made between predisposing and triggering factors. The Dutch research group found an increased tendency to disgust in patients with emetophobia. A strong tendency to somatize and an increased fear of loss of control were also examined - however, this does not adequately explain the emergence of emetophobia.

Most people affected can report on an event that they perceive as a trigger. In most cases this will be an intense experience of vomiting. Traumatizing experiences related to nausea and vomiting are therefore discussed, such as severe gastrointestinal flu in childhood. A broader explanatory model is offered by the bio-psycho-social model, which, in addition to predisposing risk factors, postulates triggers and sustaining factors and takes the biological, psychological and social level into account. The interaction of these factors in certain phases of development in childhood represents a possible explanation.

therapy

As with all disease-related phobias, psychotherapeutic treatment is recommended for emetophobia. The current S3 treatment guideline of the AWMF (Association of Scientific Medical Societies) recommends behavioral psychotherapy methods for specific phobias .

literature

  • Yvonne Höller: Emetophobia - The fear of vomiting. 3rd edition . Rhombos Verlag, 2018, ISBN 978-3-941216-88-4 .
  • Michael Stefan Metzner: My head says: "I have to vomit!" With mindfulness out of emetophobia. A guide for those affected and for therapists. Rhombos Verlag 2020, ISBN 978-3-944101-87-3 .
  • AWMF Treatment Guideline Anxiety Disorders, Classification S3, 2014

Web links

Wiktionary: Emetophobia  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ a b c d e J. D. Lipsitz, AJ Fyer, A. Paterniti, D. Klein: Emetophobia: Preliminary Results of an Internet Survey. In: Depression and Anxiety. 2001, Issue 14, pp. 149–152.
  2. ↑ a b c d Y. Höller: Emetophobia - The fear of vomiting. 3rd edition Rhombos-Verlag, Berlin 2018, ISBN 978-3-941216-88-4 .
  3. ↑ a b M. J. Boschen: Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda. In: Journal of Anxiety Disorders . tape 21 , no. 3 , 2007, p. 407-419 .
  4. ^ Y. Höller, M. van Overveld, H. Jutglar, E. Trinka: Nausea in specific phobia of vomiting. In: Behavioral Sciences (Basel). 2013, 3 (3), pp. 445–458.
  5. ↑ K. Nigbur, A. Bohne, AL Gerlach: Emetophobia - pathological fear of vomiting: An Internet study. Psychological Institute I, Westphalian Wilhelms University, Münster 2007.
  6. ↑ Mark J. Boschen, David Vealec, Nell Ellisonc, Tamara Reddella: The emetophobia questionnaire (EmetQ-13): Psychometric validation of a measure of specific phobia of vomiting (emetophobia). In: The Journal Of Anxiety Disorders (27). Elsevier, 2013, accessed July 26, 2017 .
  7. ^ WHO, (1991/1993). International classification of mental disorders. ICD-10 Chapter V (F). Clinical diagnostic guidelines. 1./2. Edition. Huber, Bern.
  8. ↑ a b WHO: International Statistical Classification of Diseases and Related Health Problems 10th Revision. 2000.
  9. ^ HC Philips: Return of fear in the treatment of a fear of vomiting. In: Behavior Research and Therapy. 1985, 23 (1), pp. 45-52.
  10. ↑ WJPJ van Hout, PO Lansink, TK Bouman: De fenomenologie en comorbiditeit van emetofobie (fear voor overgeven). In: Gedragstherapie. 2005, 38, pp. 49-64.
  11. ↑ D. Veale, C. Lanbrou: The Psychopathology of Vomit Phobia. In: Behavioral and Cognitive Psychotherapy. 2006, 34 (2), pp. 139-150.
  12. ^ A b W. JM van Overveld, PJ De Jong, ML Peters, WJPJ van Hout, TK Bouman: An internet-based study on the relation between disgust sensitivity and emetophobia. In: Journal of Anxiety Disorders. 2008, 22 (3), pp. 524-531.
  13. ↑ AL Davidson, C. Boyle, F. Lauchlan: Scared to Lose Control? General and Health Locus of Control in Females With a Phobia of Vomiting. In: Journal of Clinical Psychology. 2008, 64 (1), pp. 30-39.
  14. ↑ EA Klonoff, SM Knell, JW Janata: Fear of Nausea and Vomiting: The Interaction Among Psychosocial stressors, Development and Transitions Adventitious reinforcement. In: Journal of Clinical Child Psychology. 1984, 13 (3), pp. 263-267.
  15. ↑ Treatment guideline for anxiety disorders. AWMF, April 15, 2014, accessed May 26, 2017 .
  16. ↑ K. Rink: Cognitive behavioral therapy for phobic fear of vomiting. In: Psychotherapist. 2006, 51, pp. 223-228.