Emetophobia – A Metacognitive Therapeutic Approach for an Overlooked Disorder
Abstract
Abstract.Objective: Emetophobia is the specific fear of vomiting that usually commences during childhood and adolescence. Cognitive behavioral therapy aims to expose patients to vomiting. In this paper, a newly developed metacognitive concept and treatment approach to this disorder is illustrated within a small case series. Method: Three adolescent girls with emetophobia were treated with metacognitive therapy (MCT). Measures of anxiety, worry, depression, and metacognitions before and after the treatment were documented. Results: All patients recovered during the course of 8 to 11 sessions, and measurements of anxiety, worry, depression, and metacognitions dropped markedly. Conclusions: MCT presents a valuable treatment option for emetophobia in adolescents.
Zusammenfassung.Fragestellung: Emetophobie zählt zu den spezifischen Phobien und ist die Angst vor dem Erbrechen. Die Kognitive Verhaltenstherapie zielt darauf ab, Patienten mit Erbrechen zu konfrontieren. Die vorliegende Arbeit präsentiert ein neu entwickeltes metakognitives Störungs- und Behandlungskonzept und eine kleine Fallserie. Methode: Drei weibliche Jugendliche mit Emetophobie wurden mit Metakognitiver Therapie (MCT) behandelt. Maße für Angst, Sorgen, Depressivität und Metakognitionen vor und nach der Behandlung werden berichtet. Ergebnisse: Alle Patienten gesundeten im Verlauf der 8- bis 11-stündigen Behandlung. Die Werte für Angst, Sorgen, Depressivität und Metakognitionen gingen deutlich zurück. Schlussfolgerungen: MCT könnte eine wertvolle Behandlungsoption für Jugendliche mit Emetophobie sein.
Literature
(1994). Diagnostic and statistical manual of mental disorders. 4th ed.
Washington, DC: APA. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: Author.
(2007). Generalisierte Angststörung: Ein Therapieprogramm. Weinheim: Beltz.
, (2007). Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study. European Psychiatry, 22,
69e74 .(2007). Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda. Journal of Anxiety Disorders, 21, 407–419.
(2006). CS-exposure works for emetophobia. Dutch Journal of Behaviour Therapy, 39, 127–138.
(2004). Development and preliminary validation of the Meta-cognitions Questionnaire – Adolescent Version. Journal of Anxiety Disorders, 18, 411–422.
(2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.
(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.
(2003). Emetic exposure and desensitization procedures in the reduction of nausea and a fear of emesis. Clinical Case Studies, 2,199–210.
(2013). Nausea in specific phobia of vomiting. Behavioral Sciences, 3,
445-458 .(2009). Cognitive-behavioral treatment of emetophobia: The role of interoceptive exposure. Cognitive and Behavioral Practice, 16, 84–91.
(1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.
(1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Initial reliability and validity data. Western Psychiatric Institute and Clinic, Pittsburgh, USA.
(2012). Feelings into words: Contributions of language to exposure therapy. Psychological Science, 23, 1086–1091.
(2001). Emetophobia: Preliminary results of an internet survey. Depression and Anxiety, 14, 149–152.
(1986). Can panic disorder present as irritable bowel syndrome? Journal of Clinical Psychiatry, 47, 470–473.
(2013). Exposure therapy for emetophobia: A case study with three-year follow-up. Journal of Anxiety Disorders, 27, 527–534.
(1987). Fears, phobias and rituals. New York: Oxford University Press.
(1983). You don’t have to be sick to be a behaviour therapist but it can help! Treatment of a “vomit” phobic. Behavioural Psychotherapy, 11, 173–176.
(1994). Hypnotherapy for vomiting phobia in a 40-year-old woman. Contemporary Hypnosis, 11, 37–40.
(2005). Competence imagery: A case study treating emetophobia. Psychological Reports, 96, 635–636.
(1985). Return of fear in the treatment of a fear of vomiting. Behaviour Research and Therapy, 23, 45–52.
(1996). Agoraphobia without panic: Case illustrations of an overlooked syndrome. The Journal of Nervous and Mental Disorders, 184, 61–62.
(2012). Intrusive imagery in people with a specific phobia of vomiting. Journal of Behavior Therapy and Experimental Psychiatry, 43, 672–678.
(2006). Normwerte für das Vereinfachte Beck-Depressions-Inventar (BDI-V) in der Allgemeinbevölkerung. Diagnostica, 52, 51–59.
(1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545–566.
(2000). Depressions-Inventar für Kinder und Jugendliche (DIKJ). Handanweisung (2., überarb. und neunormierte Auflage). Göttingen: Hogrefe.
(2015). Comorbidity in emetophobia (specific phobia of vomiting). Clinical Psychology and Psychotherapy, DOI: 10.1002/cpp.1964.
(2012). Clinical features, prevalence and psychiatric complaints in subjects with fear of vomiting. Clinical Psychology and Psychotherapy, 19, 531–539.
(2011). Media hype, diagnostic fad or genuine disorder? Professionals’ opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eating Disorders, 19, 145–155.
(2012). Abnormal eating behaviour in people with a specific phobia of vomiting (emetophobia). European Eating Disorders Review, 20, 414–418.
(2015). Is a specific phobia of vomiting part of the obsessive compulsive and related disorders? Journal of Obsessive-Compulsive and Related Disorders, 7, 1–6.
(2006). The psychopathology of vomit phobia. Behavioural and Cognitive Psychotherapies, 34, 139–150.
(1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5–13.
(1990). Panic disorder in association with relaxation induced anxiety: An attention training approach to treatment. Behaviour Therapy, 21, 273–280.
(1997). Cognitive therapy of anxiety disorders. A practice manual and conceptual guide. Chichester: Wiley.
(2009). Metacognitive therapy for anxiety and depression. New York: Guilford.
(1992). The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva: Author.
(2015). Phenomenology, clinical correlates, and impairment in emetophobia. Journal of Cognitive Psychotherapy, 29, 356–368.
(2015). Emotional disorders and metacognition: Examining the metacognitive model in a clinical sample of children and adolescents. Master thesis, University of Bonn.
