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Cognitive-behavioural Treatment of Blood-Injury-Injection Phobia: A Case Study

Published online by Cambridge University Press:  22 February 2012

Alanda Thompson*
Affiliation:
University of Queensland
*
*Address for correspondence: Alanda Thompson, School of Psychology, University of Queensland, St Lucia QLD 4072, Australia. Email: alanda@psy.uq.edu.au
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Abstract

This single case study examined the treatment of blood-injury-injection (BII) phobia in a 14-year-old female. Thirteen 1-hour sessions of cognitive behavioural therapy were conducted. The intervention included a combination of exposure, applied tension, and cognitive restructuring in an effort to produce clinically significant reductions in anxiety and fainting in response to BII stimuli. Results did indeed show dramatic reductions in subjective distress in BII situations from baseline to post-treatment. This was supported by small reductions in phobic anxiety and general anxiety on self-report measures. In contrast to baseline, fainting did not occur during treatment. The subject rated cognitive restructuring as the most effective treatment component for the latter half of therapy. It is suggested that, to date, the importance of cognitive therapy for the treatment of BII phobia has been overlooked.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1999

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References

Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobias. Comprehensive Psychiatry, 10, 151156.CrossRefGoogle Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).Washington, DC: Author.Google Scholar
Butler, G. (1989). Phobic disorders. In K. Hawton, P.M. Salkovskis, J. Kirk, & D.M. Clark (Eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp. 97128). Oxford: Oxford University Press.CrossRefGoogle Scholar
Connolly, J., Hallam, R.S., & Marks, I.M. (1976). Selective association of fainting with blood-injuryillness fear. Behavior Therapy, 7, 813.CrossRefGoogle Scholar
Costello, C.G. (1982). Fears and phobias in women: A community study. Journal of Abnormal Psychology, 91, 280286.CrossRefGoogle ScholarPubMed
Curtis, G.C., & Thyer, B.A. (1983). Fainting on exposure to phobic stimuli. American Journal of Psychiatry, 140, 771774.Google ScholarPubMed
Foulds, J. (1993). Cerebral circulation during treatment of blood-injury phobia: A case study. Behavioural Psychotherapy, 21, 137146.CrossRefGoogle Scholar
Foulds, J., Wiedmann, K., Patterson, J., & Brooks, N. (1990). The effects of muscle tension on cerebral circulation in blood phobic and non-phobic subjects. Behaviour Research and Therapy, 28, 481486.CrossRefGoogle ScholarPubMed
King, N.J., Ollier, K., Iacuone, R., Schuster, S., Bays, K., Gullone, E., & Ollendick, T.H. (1989). Fears of children and adolescents: A cross-sectional Australian study using the Revised Fear Survey Schedule for Children. Journal of Child Psychology and Psychiatry, 30, 775784.CrossRefGoogle ScholarPubMed
Kleinknecht, R.A., & Lenz, J. (1989). Blood/injury fear, fainting and avoidance of medically-related situations: A family correspondence study. Behaviour Research and Therapy, 27, 537547.CrossRefGoogle ScholarPubMed
Marks, I. (1986). Genetics of fear and anxiety disorders. British Journal of Psychiatry, 149, 406418.CrossRefGoogle ScholarPubMed
Marks, I. (1988). Blood-injury phobia: A review. American Journal of Psychiatry, 145, 12071213.Google ScholarPubMed
Ollendick, T.H. (1983). Reliability and validity of the Revised Fear Survey Schedule for Children (FSSCR). Behaviour Research and Therapy, 21, 685692.CrossRefGoogle Scholar
Ost, L. (1992). Blood and injection phobia: Background and cognitive, physiological, and behavioural variables. Journal of Abnormal Psychology, 101, 6874.CrossRefGoogle Scholar
Ost, L., Fellenius, J., & Sterner, U. (1991). Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behaviour Research and Therapy, 29, 561574.CrossRefGoogle ScholarPubMed
Ost, L., Lindahl, I., Sterner, U., & Jerremalm, A. (1984). Exposure in vivo vs applied relaxation in the treatment of blood phobia. Behaviour Research and Therapy, 22, 205216.CrossRefGoogle ScholarPubMed
Ost, L., & Sterner, U. (1987). Applied tension: A specific behavioural method for treatment of blood phobia. Behaviour Research and Therapy, 25, 2529.CrossRefGoogle ScholarPubMed
Ost, L., Sterner, U., & Fellenius, J. (1989). Applied tension, applied relaxation, and the combination in the treatment of blood phobia. Behaviour Research and Therapy, 27, 109121.CrossRefGoogle ScholarPubMed
Ost, L., Sterner, U., & Lindahl, I. (1984). Physiological responses in blood phobics. Behaviour Research and Therapy, 22, 109117.CrossRefGoogle ScholarPubMed
Ost, L., Westling, B.E., & Hellstrom, K. (1993). Applied relaxation, exposure in vivo and cognitive methods in the treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 31, 383394.CrossRefGoogle ScholarPubMed
Page, A.C. (1994). Blood-injury phobia. Clinical Psychology Review, 14, 443461.CrossRefGoogle Scholar
Reynolds, C.R., & Paget, K.D. (1981). Factor analysis of the Revised Children's Manifest Anxiety Scale for blacks, whites, males and females with a national normative sample. Journal of Consulting and Clinical Psychology, 49, 352359.CrossRefGoogle ScholarPubMed
Reynolds, C.R., & Richmond, B.O. (1978). What I Think and Feel: A revised measure of children's manifest anxiety. Journal of Abnormal Child Psychology, 6, 271280.CrossRefGoogle Scholar
Sledge, W.H. (1978). Antecedent psychological factors in the onset of vasovagal syncope. Psychosomatic Medicine, 40, 568579.CrossRefGoogle ScholarPubMed
Steptoe, A., & Wardle, J. (1988). Emotional fainting and the psychophysiologic response to blood and injury: Autonomic mechanisms and coping strategies. Psychosomatic Medicine, 50, 402417.CrossRefGoogle ScholarPubMed
Thyer, B.A., & Curtis, G.C. (1985). On the diphasic nature of vasovagal fainting associated with bloodinjury- illness phobia. Pavlovian Journal of Biological Science, 20, 8487.CrossRefGoogle Scholar
Thyer, B.A., Himle, J., & Curtis, G.C. (1985). Bloodinjury- illness phobia: A review. Journal of Clinical Psychology, 41, 451459.3.0.CO;2-O>CrossRefGoogle Scholar
Wardle, J., & Jarvis, M. (1981). The paradoxical fear response to blood, injury and illness: A treatment report. Behavioural Psychotherapy, 9, 1324.CrossRefGoogle Scholar