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Cognitive behaviour therapy for a specific phobia of vomiting

Published online by Cambridge University Press:  22 October 2009

David Veale
David Veale*
Affiliation:
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King's College London, UK
*
*Author for correspondence: Dr D. Veale, Centre for Anxiety Disorders and Trauma, 99 Denmark Hill, London SE5 8AZ, UK (email: [email protected])
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Abstract

This article summarizes the current knowledge and treatment for a specific phobia of vomiting (SPOV). It is relatively uncommon compared to other specific phobias but may have been misdiagnosed in catchment-area surveys. The differential diagnosis of SPOV includes obsessive–compulsive disorder, hypochondriacal disorder and anorexia nervosa. I discuss the following: a model that is linked to past aversive experiences of vomiting; conducting a clinical assessment; making a formulation; psycho-education, engagement and therapy. The strategies employed depend on the formulation but are likely to include: exposure in vivo to cues of vomiting, exposure in imagination and role-plays of vomiting, imagery re-scripting, behavioural experiments; and dropping of safety-seeking behaviours.

Keywords

Cognitive behaviour therapyexposurespecific phobiavomiting
Type
Education and supervision
Information
the Cognitive Behaviour Therapist , Volume 2 , Issue 4 , December 2009 , pp. 272 - 288
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Arntz, A, Weertman, A (1999). Treatment of childhood memories: theory and practice. Behaviour Research and Therapy 37, 715–740.Google Scholar
Becker, ES, Rinck, M, Türke, V, Kause, P, Goodwin, R, Neumer, S, Margraf, J (2007). Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study. European Psychiatry 22, 69–74.Google Scholar
Boschen, MJ (2007). Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda. Journal of Anxiety Disorders 21, 407–419.Google Scholar
Boyd, JH, Rae, DS, Thompson, JW, Burns, BJ, Bourdon, K, Locke, BZ, Regier, DA (1990). Phobia: prevalence and risk factors. Social Psychiatry and Psychiatric Epidemiology 25, 314–323.Google Scholar
Clark, DM (1988). A cognitive model of panic. In: Panic: Psychological Perspectives (ed. Rachman, S. J. and Maser, J.), pp. 71–91. Hillsdale, NJ: Erlbaum.Google Scholar
Clark, DM, Salkovskis, PM, Hackmann, A, Wells, A, Fennel, M, Ludgate, J, Ahmad, S, Richards, HC, Gelder, M (1998). Two psychological treatments for hypochondriasis. A randomised controlled trial. British Journal of Psychiatry 173, 218–225.Google Scholar
Davidson, A, Boyle, C, Lauchlan, F (2008). Scared to lose control? General and health locus of control in females with a phobia of vomiting. Journal of Clinical Psychology 64, 30–39.Google Scholar
Garcia, JR, Rusiniak, KW, Brett, LP (1977). Conditioning food-illness aversions in wild animals. In: Operant Pavlovian Interactions (ed. David, H. and Hurwitz, H.), pp. 273–316. New York, Wiley.Google Scholar
Hayes, SC, Strosahl, KD, Wilson, K (1999). Acceptance and Commitment Therapy. New York: Guilford Press.Google Scholar
Herman, DS, Rozensky, RH, Mineka, S (1993). Cognitive behavioural therapy for panic disorder with a primary fear of vomiting: conceptual and treatment issues. Proceedings for Association for Advancement of Behaviour Therapy. Atlanta, GA, USA.Google Scholar
Hunter, PV, Antony, MM (2009). Cognitive-behavioral treatment of emetophobia: the role of interoceptive exposure. Cognitive and Behavioral Practice 16, 84–91.Google Scholar
Kessler, RC, Chiu, WT, Demler, O, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617–627.Google Scholar
Kirkpatrick, DR, Berg, AJ (1981). Fears of a heterogeneous non-psychiatric sample. Paper presented at the Annual Conference of the American Psychological Association, Los Angeles, California.Google Scholar
Lesage, A, Lamontagne, Y (1985). Paradoxical intention and exposure in vivo in the treatment of psychogenic nausea: report of two cases. Behavioural Psychotherapy 13, 69–75.CrossRefGoogle Scholar
Lipsitz, JD, Fyer, AJ, Paterniti, A, Klein, DF (2001). Emetophobia: preliminary results of an internet survey. Depression & Anxiety 14, 149–52.Google Scholar
Lydiard, RB, Laraia, MT, Howell, EF, Ballenger, JC (1986). Can panic disorder present as irritable bowel syndrome? Journal of Clinical Psychiatry 47, 470–473.Google Scholar
Manassis, K, Kalman, E (1990). Anorexia resulting from fear of vomiting in four adolescent girls. Canadian Journal of Psychiatry 35, 548–550.Google Scholar
McFadyen, M, Wyness, J (1983). You don't have to be sick to be a behaviour therapist but it can help! Treatment of a vomit phobia. Behavioural Psychotherapy 11, 173–176.Google Scholar
McKenzie, S (1994). Hypnotherapy for vomiting phobia in a 40-year-old woman. Contemporary Hypnosis 11, 37–40.Google Scholar
McNally, RJ (1997). Vomiting phobia. In: Phobias: a Handbook of Theory, Research and Treatment (ed. Davey, G. C.), pp. 186–187. Chichester: Wiley.Google Scholar
Moran, DJ, O'Brien, RM (2005). Competence imagery: a case study treating emetophobia. Psychological Reports 96, 635–636.Google Scholar
O'Connor, JJ (1983). Why can't I get hives: brief strategic therapy with an obsessional child. Family Process 22, 201–209.Google Scholar
Ohman, A, Mineka, S (2001). Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. Psychological Review 108, 483–522.Google Scholar
Philips, HC (1985). Return of fear in the treatment of a fear of vomiting. Behaviour Research Therapy 23, 45–52.Google Scholar
Porges, SW (2007). The polyvagal perspective. Biological Psychology 74, 116–143.Google Scholar
Ritow, JK (1979). Brief treatment of a vomiting phobia. American Journal of Clinical Hypnosis 21, 293–296.Google Scholar
Salkovskis, PM, Wroe, AL, Gledhill, A, Morrison, N, Forrester, E, Richards, C, Reynolds, M, Thorpe, S (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy 38, 347–372.CrossRefGoogle ScholarPubMed
Smucker, MR, Dancu, CV (1999). Cognitive Behavioral Treatment for Adult Survivors of Childhood Trauma: Rescripting and Reprocessing. Northvale, NJ: Jason Aronson.Google Scholar
Stinson, FS, Dawson, DA, Chou, PS, Smith, S, Goldstein, R, Ruan, J, Grant, B (2007). The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine 37, 1047–1059.CrossRefGoogle ScholarPubMed
van Overveld, M, De Jong, PJ, Peters, ML, Van Hout, WJPJ, Bouman, TK (2008). An internet-based study on the relation between disgust sensitivity and emetophobia. Journal of Anxiety Disorders 22, 524–531.Google Scholar
Veale, D, Lambrou, C (2006). The psychopathology of vomit phobia. Behavioural and Cognitive Psychotherapy 34, 139–150.Google Scholar
Wijesinghe, B (1974). A vomiting phobia overcome by one session of flooding with hypnosis. Journal of Behavioural Therapy and Experimental Psychiatry 5, 169–170.Google Scholar
Wild, J, Hackmann, A, Clark, DM (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behavior Therapy 39, 47–56.CrossRefGoogle ScholarPubMed
Wolitzky-Taylor, KB, Horowitz, JD, Powers, MB, Telch, MJ (2008). Psychological approaches in the treatment of specific phobias: a meta-analysis. Clinical Psychology Review 28, 1021–1037.Google Scholar
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