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The Lancet. Psychiatry Aug 2018Anxiety disorders are among the most prevalent mental disorders, but the subcategory of specific phobias has not been well studied. Phobias involve both fear and... (Review)
Review
Anxiety disorders are among the most prevalent mental disorders, but the subcategory of specific phobias has not been well studied. Phobias involve both fear and avoidance. For people who have specific phobias, avoidance can reduce the constancy and severity of distress and impairment. However, these phobias are important because of their early onset and strong persistence over time. Studies indicate that the lifetime prevalence of specific phobias around the world ranges from 3% to 15%, with fears and phobias concerning heights and animals being the most common. The developmental course of phobias, which progress from fear to avoidance and then to diagnosis, suggests the possibility that interrupting the course of phobias could reduce their prevalence. Although specific phobias often begin in childhood, their incidence peaks during midlife and old age. Phobias persist for several years or even decades in 10-30% of cases, and are strongly predictive of onset of other anxiety, mood, and substance-use disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders. Exposure therapy remains the treatment of choice, although this approach might be less effective in the long term than previously believed. This Review discusses the literature regarding the prevalence, incidence, course, risk factors, and treatment of specific phobias, and presents epidemiological data from several population-based surveys.
Topics: Age Factors; Age of Onset; Avoidance Learning; Comorbidity; Global Health; Humans; Phobic Disorders; Prevalence; Sex Factors; Substance-Related Disorders
PubMed: 30060873
DOI: 10.1016/S2215-0366(18)30169-X -
Journal of Advanced Nursing Jan 2019The aim of this study was to evaluate the prevalence of needle fear and summarize the characteristics of individuals who exhibit this fear. (Comparative Study)
Comparative Study Meta-Analysis
AIMS
The aim of this study was to evaluate the prevalence of needle fear and summarize the characteristics of individuals who exhibit this fear.
BACKGROUND
Injections are among the most common medical procedures, yet fear of needles can result in avoidance of preventive measures and treatment.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
MEDLINE (1966-2017), Embase (1947-2017), PsycINFO (1967-2017), and CINAHL (1961-2017) were searched, with no restrictions by age, gender, race, language, or country.
REVIEW METHODS
The prevalence of needle fear was calculated and restricted maximum likelihood random effects models were used for meta-analysis and meta-regression.
RESULTS
The search yielded 119 original research articles which are included in this review, of which 35 contained sufficient information for meta-analysis. The majority of children exhibited needle fear, while prevalence estimates for needle fear ranged from 20-50% in adolescents and 20-30% in young adults. In general, needle fear decreased with increasing age. Both needle fear and needle phobia were more prevalent in females than males. Avoidance of influenza vaccination because of needle fear occurred in 16% of adult patients, 27% of hospital employees, 18% of workers at long-term care facilities, and 8% of healthcare workers at hospitals. Needle fear was common when undergoing venipuncture, blood donation, and in those with chronic conditions requiring injection.
CONCLUSIONS
Fear of needles is common in patients requiring preventive care and in those undergoing treatment. Greater attention should be directed to interventions which alleviate fear in high-risk groups.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Fear; Female; Humans; Incidence; Injections; Male; Middle Aged; Needles; Phobic Disorders; Sex Factors; Young Adult
PubMed: 30109720
DOI: 10.1111/jan.13818 -
Learning & Memory (Cold Spring Harbor,... Sep 2017Fear, which can be expressed innately or after conditioning, is triggered when a danger or a stimulus predicting immediate danger is perceived. Its role is to prepare... (Review)
Review
Fear, which can be expressed innately or after conditioning, is triggered when a danger or a stimulus predicting immediate danger is perceived. Its role is to prepare the body to face this danger. However, dysfunction in fear processing can lead to psychiatric disorders in which fear outweighs the danger or possibility of harm. Although recognized as highly debilitating, pathological fear remains insufficiently treated, indicating the importance of research on fear processing. The neurobiological basis of normal and pathological fear reactions is reviewed in this article. Innate and learned fear mechanisms, particularly those involving the amygdala, are considered. These fear mechanisms are also distinguished in specific phobias, which can indeed be nonexperiential (implicating innate, learning-independent mechanisms) or experiential (implicating learning-dependent mechanisms). Poor habituation and poor extinction are presented as dysfunctional mechanisms contributing to persistence of nonexperiential and experiential phobias, respectively.
Topics: Animals; Brain; Fear; Humans; Instinct; Neurobiology; Phobic Disorders
PubMed: 28814472
DOI: 10.1101/lm.044115.116 -
Journal of Perinatal Medicine Feb 2018To identify the prevalence of and to determine the risk factors for developing a fear of childbirth (tokophobia).
OBJECTIVE
To identify the prevalence of and to determine the risk factors for developing a fear of childbirth (tokophobia).
METHODS
We evaluated 191 pregnant women during Parenting and Childbirth Classes. Participants were approached when attending Parenting and Childbirth Classes between June 2014 and September 2014 and were asked to complete several questionnaires related to depression (CES-D), anxiety (STAI X1 and X2), satisfaction with life (SWLS), delivery expectation/experience (W-DEQ), and specific fears.
RESULTS
Most (90%) of the responders were nulliparous. As many as 75% of the participants reported low to moderate tokophobia, whereas 25% exhibited high or very high fear of childbirth. Pathological fear occurred in 1.6% of the participants. The most significant was the fear of having an episiotomy followed by fear of having no control on the situation and fear of pain. An association exists between a preferred elective cesarean birth and tokophobia.
CONCLUSIONS
The results draw attention to the need for early detection and treatment of fear of childbirth. The data may help identifying women at risk that require prenatal psychological intervention.
Topics: Adult; Cesarean Section; Delivery, Obstetric; Fear; Female; Humans; Parturition; Phobic Disorders; Pregnancy; Pregnant Women; Prevalence; Risk Factors; Slovenia; Surveys and Questionnaires
PubMed: 28379837
DOI: 10.1515/jpm-2016-0282 -
Journal of Affective Disorders Dec 2016There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD).
BACKGROUND
There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD).
GOAL
This study investigated whether GAD and PD could be discriminated through differences in developmental etiological factors including childhood parental loss/separation, psychological disorders, and maternal and paternal attachment.
METHOD
Twenty people with adult generalized anxiety disorder (GAD), 20 with adult panic disorder (PD), 11 with adult comorbid GAD and PD, and 21 adult non-anxious controls completed diagnostic interviews to assess symptoms of mental disorders in adulthood and childhood. Participants also reported on parental attachment, loss and separation.
RESULTS
Childhood diagnoses of GAD and PD differentiated clinical groups from controls as well as from each other, suggesting greater likelihood for homotypic over heterotypic continuity. Compared to controls, specific phobia was associated with all three clinical groups, and childhood depression, social phobia, and PTSD were uniquely associated with adult GAD. Both maternal and paternal attachment also differentiated clinical groups from controls. However, higher levels of subscales reflecting maternal insecure avoidant attachment (e.g., no memory of early childhood experiences and balancing/forgiving current state of mind) emerged as more predictive of GAD relative to PD. There were no group differences in parental loss or separation.
CONCLUSIONS
These results support differentiation of GAD and PD based on developmental risk factors. Recommendations for future research and implications of the findings for understanding the etiology and symptomatology of GAD and PD are discussed.
Topics: Adolescent; Adult; Anxiety Disorders; Comorbidity; Female; Humans; Male; Panic Disorder; Parenting; Phobia, Social; Phobic Disorders; Risk Factors; Young Adult
PubMed: 27466747
DOI: 10.1016/j.jad.2016.07.008 -
Journal of Anxiety Disorders 2007[Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia:...
[Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment, and treatment (pp. 69-93). New York: Guildford Press] cognitive model of social phobia suggests that both public and private sources of information contribute to the construction of the self as a social object, which is thought to maintain the disorder. This study used two concepts developed in social psychology that might help to explain the processes that contribute to the development of this constructed self. These two concepts are the spotlight effect [Gilovich, T., Medvec, V. H., & Savitsky, K. (2000). The spotlight effect in social judgment: an egocentric bias in estimates of the salience of one's own actions and appearance. Journal of Personality and Social Psychology, 78(2), 211-222] and the illusion of transparency [Gilovich, T., Medvec, V. H., & Savitsky, K. (1998). The Illusion of transparency: biased assessments of others' ability to read one's own emotional states. Journal of personality and social psychology, 75(2), 332-346]. Participants performed a memory task under either a low or a high social-evaluative condition. In the high social-evaluative condition, participants reported higher levels of the spotlight effect and more negative evaluation of task performance, compared to participants in the low social-evaluative condition. There were no differences between the two conditions in levels of the illusion of transparency. Surprisingly, however, in the low social-evaluative condition, participants reported higher levels of the illusion of transparency than the spotlight effect, whereas, in the high social-evaluative condition, they reported the opposite. Results suggest that the spotlight effect may be specific to social-evaluative concerns, whereas, the illusion of transparency may represent more general features of social anxiety concerns. Implications of the results for Clark and Wells' cognitive model of social phobia model are discussed.
Topics: Anxiety; Attention; Awareness; Delusions; Humans; Judgment; Memory; Mental Recall; Models, Psychological; Personality Inventory; Phobic Disorders; Psychiatric Status Rating Scales; Self Concept; Self Psychology; Surveys and Questionnaires; Tape Recording; Task Performance and Analysis
PubMed: 17166695
DOI: 10.1016/j.janxdis.2006.11.006 -
Journal of Clinical Oncology : Official... Nov 2019Fear of cancer recurrence (FCR) is a significantly distressing problem that affects a substantial number of patients with and survivors of cancer; however, the overall... (Meta-Analysis)
Meta-Analysis
PURPOSE
Fear of cancer recurrence (FCR) is a significantly distressing problem that affects a substantial number of patients with and survivors of cancer; however, the overall efficacy of available psychological interventions on FCR remains unknown. We therefore evaluated this in the present systematic review and meta-analysis.
METHODS
We searched key electronic databases to identify trials that evaluated the effect of psychological interventions on FCR among patients with and survivors of cancer. Controlled trials were subjected to meta-analysis, and the moderating influence of study characteristics on the effect were examined. Overall quality of evidence was evaluated using the GRADE system. Open trials were narratively reviewed to explore ongoing developments in the field (PROSPERO registration no.: CRD42017076514).
RESULTS
A total of 23 controlled trials (21 randomized controlled trials) and nine open trials were included. Small effects (Hedges's ) were found both at postintervention ( = 0.33; 95% CI, 0.20 to 0.46; < .001) and at follow-up ( = 0.28; 95% CI, 0.17 to 0.40; .001). Effects at postintervention of contemporary cognitive behavioral therapies (CBTs; = 0.42) were larger than those of traditional CBTs ( = 0.24; β = .22; 95% CI, .04 to .41; = .018). At follow-up, larger effects were associated with shorter time to follow-up (β = -.01; 95% CI, -.01 to -.00; = .027) and group-based formats (β = .18; 95% CI, .01 to .36; = .041). A GRADE evaluation indicated evidence of moderate strength for effects of psychological intervention for FCR.
CONCLUSION
Psychological interventions for FCR revealed a small but robust effect at postintervention, which was largely maintained at follow-up. Larger postintervention effects were found for contemporary CBTs that were focused on processes of cognition-for example, worry, rumination, and attentional bias-rather than the content, and aimed to change the way in which the individual relates to his or her inner experiences. Future trials could investigate how to further optimize and tailor interventions to individual patients' FCR presentation.
Topics: Adaptation, Psychological; Adult; Aged; Cancer Survivors; Cognitive Behavioral Therapy; Fear; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms; Phobic Disorders; Randomized Controlled Trials as Topic; Risk Factors; Treatment Outcome
PubMed: 31532725
DOI: 10.1200/JCO.19.00572 -
Annali Di Igiene : Medicina Preventiva... 2021The outbreak of Coronavirus Disease 2019 (COVID-19) have changed into a global crisis. Psychologically, this process of alteration can lead to feelings of fear,...
INTRODUCTION
The outbreak of Coronavirus Disease 2019 (COVID-19) have changed into a global crisis. Psychologically, this process of alteration can lead to feelings of fear, insecurity, and anxiety. This fear and anxiety can be caused by a variety of factors. However, due to the lack of extensive studies at this time, there are little data on these conditions related to COVID-19. Therefore, in this narrative review, we have tried to identify the most important possible causes of anxiety and fear due to this disease, based on logical shreds of evidence. Then we tried to discuss the consequences and ways to manage and prevent them.
METHODS
The current focus was on three major axes of corona-phobia, fear and anxiety. PubMed, Science Direct, Scopus, Google Scholar and authoritative news and information sources were considered as the data sources.
RESULTS
Findings from the analysis of the results revealed that, in addition to the real and the logical reasons which belong to the intrinsic properties of SARS-CoV-2, some misleadings and misconceptions induced by media, governmental policies, public awareness level, and non-scientific speculations and contradictory data expressed by experts, researchers and scientific societies, could provide the way for the development of corona-phobia, and fear.
CONCLUSIONS
Each of these causal components, in its place, leads to some degrees of psychological disorders and subsequent consequences and complications. Finally, here we reviewed, summarized the previous research findings on how to prevent and manage this type of psychological disorder, and made comparisons.
Topics: Anxiety; COVID-19; Communication; Consumer Health Information; Culture; Dissent and Disputes; Expert Testimony; Fear; Health Policy; Humans; Information Dissemination; Mass Media; Pandemics; Phobic Disorders; Quarantine; SARS-CoV-2; Trust
PubMed: 33908601
DOI: 10.7416/ai.2021.2446 -
La Medicina Del Lavoro Jun 2022This study aims at investigating level and contributor factors of Cyberchondria, Covid-19-related Phobia, and Well-Being in a sample of teachers in Turkey.
BACKGROUND
This study aims at investigating level and contributor factors of Cyberchondria, Covid-19-related Phobia, and Well-Being in a sample of teachers in Turkey.
METHODS
The study was conducted on teachers (n=1000) working in a province in eastern Turkey. Data for the study were collected using a form that included participants' descriptive characteristics, the Covid-19 Phobia Scale (C19P-SE), the Cyberchondria Severity Scale, and the World Health Organization-5 Well-Being Index (WHO-5). Spearman correlation analysis, Mann-Whitney U test, and Kruskal Wallis analysis of variance were used to analyze the data.
RESULTS
As participant's cyberchondria levels rose, C19P-SE scores increased (r=0.271, p<0.001), and WHO-5 scores decreased (r=-0.224, p<0.05). Corona-phobia was higher in those who used social media than in those who did not (p<0.05). Cyberchondria scale scores were higher among those who had taken medications without a physician's recommendation during the pandemic. Participants who had a disabled person or a person in need of care in their household had higher scores for distrust of the physician and C19P-SE than for the cyberchondria severity scale sub-dimension, and the WHO-5 mean scores were lower (p<0.001, P=0.016, and P=0.020, respectively).
CONCLUSIONS
The study results show that increasing levels of cyberchondria trigger Covid-19 phobias in teachers during the Covid-19 pandemic and negatively affect their well-being. This descriptive study can help understand the risk group for cyberchondria, the influencing factors, and the health and economic consequences, and identify strategies for effective combating with cyberchondria.
Topics: Anxiety; COVID-19; Cross-Sectional Studies; Humans; Pandemics; Phobic Disorders; Surveys and Questionnaires
PubMed: 35766648
DOI: 10.23749/mdl.v113i3.12661 -
PloS One 2023Needle phobia remains a major drawback of conventional injectable medications, leading to avoidance and low adherence among a reasonable portion of patients. Despite...
Needle phobia remains a major drawback of conventional injectable medications, leading to avoidance and low adherence among a reasonable portion of patients. Despite this, there is a limited number of studies investigating needle phobia prevalence and symptoms. In this survey, we studied the knowledge and prevalence of needle phobia and its manifestations among 1182 adult Jordanians. Moreover, we assessed the feasibility of microneedles delivery systems as an alternative approach to conventional injectable methods. The results revealed that 28.5% of the participants identified themselves with needle phobia, with a notably higher prevalence among females compared to males (p-value < 0.001). The overall prevalence of needle phobia based on its measured manifestations was found to be 27.4%. The survey also found that 68% of the population were unfamiliar with the concept of microneedles despite the reasonable proportion of the population who were aware of the disadvantages of conventional injectable medications. Furthermore, the survey identified four significant predictors of needle phobia through hierarchical linear regression analysis. Gender, occupation, and negative past experiences with needle injections accounted for 3%, 1%, and 1% of the variance in needle phobia, respectively. In addition, the participants' preference for microneedles over conventional injectables medications appeared as another significant predictor, contributing 5% of the variance. Overall, the model explained 10% of the variance in needle phobia. Collectively, this study provides an insight into needle phobia prevalence and manifestations in Jordan, while also exploring microneedles as an alternative drug delivery system for patients with needle phobia.
Topics: Female; Male; Humans; Adult; Jordan; Prevalence; Drug Delivery Systems; Phobic Disorders
PubMed: 37729191
DOI: 10.1371/journal.pone.0291807