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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 -
BMJ (Clinical Research Ed.) Sep 2003
Topics: Anti-Anxiety Agents; Cognitive Behavioral Therapy; Fear; Humans; Phobic Disorders
PubMed: 12958087
DOI: 10.1136/bmj.327.7414.515 -
PloS One 2021Trypophobia is characterised by an aversion to or even revulsion for patterns of holes or visual stimuli featuring such patterns. Past research has shown that...
BACKGROUND
Trypophobia is characterised by an aversion to or even revulsion for patterns of holes or visual stimuli featuring such patterns. Past research has shown that trypophobic stimuli trigger emotional and physiological reactions, but relatively little is known about the antecedents, prodromes, or simply covariates of trypophobia.
AIM
The goals of this study were (a) to draw the contours of the nomological network of trypophobia by assessing the associations of symptoms of trypophobia with several constructs that were deemed relevant from past research on anxiety disorders and specific phobias, (b) to compare such associations with those found for symptoms of spider phobia and blood and injection phobia (alternative dependent variables), and (c) to investigate the main effect of gender on symptoms of trypophobia and replicate the association of gender with symptoms of spider phobia and blood and injection phobia (higher scores for women).
METHODS
Participants (N = 1,134, 53% men) in this cross-sectional study completed an online questionnaire assessing the constructs of interest.
RESULTS
Most assessed constructs typically associated with anxiety disorders (neuroticism, conscientiousness, anxiety sensitivity, trait anxiety, disgust sensitivity, and disgust propensity) were also associated with trypophobia in the predicted direction. All of these constructs were also associated with spider phobia and blood and injection phobia. Behavioral inhibition was negatively associated with trypophobia and spider phobia-contrary to what was expected, but positively with blood and injection phobia. We found no gender difference in trypophobia, whereas women scored higher on spider phobia and blood and injection phobia.
DISCUSSION
Although some differences were observed, the nomological network of trypophobia was largely similar to that of spider phobia and blood and injection phobia. Further studies are needed to clarify similarities and dissimilarities between trypophobia and specific phobia.
Topics: Adult; Affect; Animals; Anxiety; Behavior; Cross-Sectional Studies; Disgust; Emotions; Fear; Female; Form Perception; Humans; Male; Phobic Disorders; Sex Factors; Spiders; Surveys and Questionnaires
PubMed: 34520484
DOI: 10.1371/journal.pone.0257409