Emetophobia

The Emetophobia is a relatively unknown phobic disorder in which the patient has often inexplicable, completely irrational fear of any kind of vomiting. According to the classification, there is a specific phobia.

A typical symptom is the fear

• To surrender themselves, regardless of whether the other alone or in the presence
• Having to witness how other people or animals vomit
• Before any confrontation with the topic, such as through media or in discussions

Appearance

As was found in the first study on the Internet emetophobia, confirm other results, that the onset of anxiety is usually in childhood. An essential, also diagnostic feature is a pronounced avoidance of the feared situations and stimuli. The research group led by Lipsitz reported that 62 % of surveyed Emetophobiker social losses took into account, 34% had family avoidance behavior, about 20 % of patients had problems with the world of work, 9% had difficulty in school and 70 % reported a deterioration in the leisure activities. It is also quite common that those concerned contact with children or pregnant women to avoid, since they have a high tendency to vomiting in the eyes of Emetophobikers. Accordingly found Lipsitz and his research group, that 44 % of female sufferers avoided pregnancy for fear of the associated nausea and vomiting. Another quarter of respondents reported that they had a pregnancy for this reason, although feared, but her desire to have children still had yielded. Finally, even thought 12% of Emetophobikerinnen that they had the pregnancy because of the fear of vomiting experienced particularly unpleasant.

In particular, the eating pattern is disturbed in many sufferers, as some sufferers due to their phobia very little or eat irregularly or can avoid certain foods. Three quarters of respondents to a study reported that they just eat a certain way or just take certain foods and / or certain rituals surrounding the food wont, such as excessive washing or repeatedly checking the durability of the foods as they may fear a food to consume, which could already be spoiled. To avoid too many Emetophobiker restaurant visits because they can not verify where the hygienic preparation and preservation of food.

Boschen stresses that all these aspects of emetophobia have a strong somatic character. In addition to the fear described and the avoidance behavior are numerous physical accompanying symptoms, such as persistent nausea, added and possibly abdominal pain, diarrhea, irritable stomach / bowel, heartburn, vomiting, dizziness, schüttelfrostähnliches trembling, feeling faint (triggered by hours of nothing- food) ... why is a emetophobia by doctors often unrecognized and misdiagnosed. Boschen thinks cause these gastrointestinal symptoms, particularly of Emetophobikern are almost conjured up, as they are expected. This expectation leads to increased attention to signs of possible nausea. Such over-reactions are exactly what a failure of normality is different. The first Internet study with Emetophobikern found that half of the respondents from panic attacks with symptoms such as nausea (82%), breathlessness (62%) and gastrointestinal problems ( 57%) suffered. Other mental disorders that also indicated in this study by the victims themselves and were therefore diagnosed as in our study, not necessarily by a physician or psychologist, are, accordingly, specific phobias at 30 %, in particular associated with disgust reactions. 40 % reported that they had a panic disorder or agoraphobia. 46 % reported depression, 21% for social phobia, and 18% of OCD. In the latest internet study, the majority of surveyed Emetophobiker nausea and physical comorbidities described above suffers, as well as in numerous psychological comorbidities.

The Emetophobia is sometimes misdiagnosed due to the fact that Emetophobiker are partially underweight as anorexia. However, the underweight resulted mostly from the fear of eating something Corrupted or even to take too much, so that certain things, such as fat, calorie -containing, easily perishable, foods with raw eggs, be avoided. Nevertheless, it must be determined individually, whether it is a pure emetophobia or comorbidity, ie the association of phobia and eating disorders. This Kodiagnose is only permitted if the criteria are met for both disorders and not an error is better explained by the other. As a rule, but anorexia is not necessarily a concomitant. Is much more common such as the common occurrence of emetophobia and depression.

Diagnosis

In the diagnosis of emetophobia their lack of awareness and lack of diagnostic instruments plays an essential role. There is soon by Dutch researchers ( Bouman & Vanhout, in preparation ) a questionnaire for emetophobia, which is already used by insiders in research. The Emetophobia Questionnaire contains 115 questions that relate to the thoughts about vomiting, physical sensations, fear of vomiting (eg, "I am afraid that I will be sick. " ), Avoidance of situations in relation to the vomiting are (eg, " I avoid being close to people who look like them could be bad. " ) and the consequences of emetophobia for everyday life (eg, "Because of the fear of vomiting I have lost weight. "). The questions or statements must actually ( not at all) are rated to 5 (very much) on a scale of 1. The 16 statements with respect to the consequences of emetophobia also contain the rating 0 " not suitable " for for participants without emetophobische fears. Based on the clinical diagnostic guidelines of ICD -10 WHO are the symptoms studied, which 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 exaggerated so inappropriate.
• The Phobic situations are avoided or only from anxiety or severe discomfort endured (avoidance behavior).
• The fear leads to a significant restriction of professional, educational, or social activities or lifestyle.

This fear manifests itself in rapid heart beat, sweating, loss of reality, suffer feelings of anxiety, dizziness etc. when dealing with the attraction or is subliminally present continuously. This yields also the point to avoidance behavior, in particular so is that the person concerned to avoid public places and events, as well as movies, certain foods, etc. This avoidance behavior is also the breeding ground for the restrictions in the various spheres of life. In ICD -10 specific disorders such as emetophobia are distinguished from the Nosophobie and body dysmorphic disorder, two putative anxiety disorders, which are actually classified as hypochondriacal disorders. Here, the affected work intensively with the idea of suffering from one or more serious and progressive physical disorders. In fact, such patients develop physical symptoms, but also normal or commonplace sensations and symptoms are seen as pathological. The fear usually focuses on one or two organs. The distinction is a potentially tricky business for those who suffer from nausea. Is the fear of being sick, about the fear of vomiting, so really should be considered whether the Emetophobia is not the wrong diagnosis.

Frequency

The Emetophobia is not as rare as one might think because of their obscurity would ( Rink, 2006). There are prevalence estimates by various researchers. Prevalence is the occurrence of a failure in the population. The suspected figures range from 1.7 to 3.1 % for men and 6-7 % for women (Philips, 1985; Vanhout, Lansink, & Bouman, 2005). Obviously there are so more women than men among the Emetophobikern. The first Internet study found predominantly among the American participants 89 % female Emetophobiker, a British research team ( Veale & Lambrou, 2006) even came to 97% of women in the Netherlands, 88% were female participants in the study.

Social

The avoidance behavior of Emetophobiker often leads to social encapsulation. Dates with friends are often left without obligation ( " you do not know how you are " ) or canceled at short notice and on a regular basis, sometimes through lies out of shame before the actual cause, which is then in turn misinterpreted as apathy and lack of interest. Affected suffer - as with many other mental disorders - often at a very low self-esteem, feel useless and worthless. The " feeling of not- understood - feel " also plays a major role. For members of this disorder is difficult to understand. Even your self-confidence is affected because the feeling of helplessness and powerlessness is hard to bear. The consequences are often depression and Phobophobien. At worst, people go at the end barely out of her apartment to go shopping around the corner, even in the supermarket is designed as an almost insurmountable obstacle. There are also cases in which the Emetophobia occurs together with a social phobia.

Cause

The cause of emetophobia is not yet known. There are suspicions about traumatic experiences in connection with the Transfer. Also traumatic experiences in childhood (such examples a severe gastro-intestinal flu) can cause. About abuse in childhood is discussed, but this assertion can not empirically prove. A useful explanatory model provides the bio-psycho- social model that takes into account risk factors predisposing to triggers and maintaining factors, and such on biological, psychological and social level. So a predisposing psychological factor is a disputed Ekelneigung. As a maintaining factor can be seen a tendency to somatization: The nausea leads to increased avoidance behavior.