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A. De Jongh - One of the best experts on this subject based on the ideXlab platform.
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is dental Phobia a blood injection injury Phobia
Depression and Anxiety, 2014Co-Authors: C.m.h.h. Van Houtem, Dorret I. Boomsma, Lannie Ligthart, A. De Jongh, I H A Aartman, Corine M VisscherAbstract:Background Dental Phobia is part of the Blood-Injection-Injury (B-I-I) Phobia subtype of specific Phobia within DSM-IV-TR. To investigate the conceptual validity of this classification, the purpose of the present study was to determine the co-occurrence of dental Phobia, typical dental (and B-I-I related) fears, vasovagal fainting, and avoidance of dental care. Method Data were collected by an online survey in Dutch twin families (n = 11,213). Results Individuals with a positive screen of dental Phobia (0.4% of the sample) rated typical B-I-I-related stimuli as relatively little anxiety provoking (e.g. of all 28 fears the stimulus "the sight of blood" was ranked lowest). Presence of dental Phobia was significantly associated with a history of dizziness or fainting during dental treatment (OR = 3.4; 95% CI: 1.5-8.1), but of the dental phobic individuals only 13.0% reported a history of dizziness or fainting during dental treatment. Presence of dental Phobia (OR = 5.0; 95% CI: 2.8-8.8) was found to be associated with avoidance of dental care, but a history of dizziness or fainting during dental treatment was not (OR = 1.0; 95% CI: 0.8-1.2). Conclusions The present findings converge to the conclusion that dental Phobia should be considered a specific Phobia subtype independent of the B-I-I cluster within the DSM classification system.
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A review and meta-analysis of the heritability of specific Phobia subtypes and corresponding fears
Journal of Anxiety Disorders, 2013Co-Authors: C.m.h.h. Van Houtem, Marja L. Laine, Dorret I. Boomsma, Lannie Ligthart, A.j. Van Wijk, A. De JonghAbstract:Evidence from twin studies suggests that genetic factors contribute to the risk of developing a fear or a Phobia. The aim of the present study was to review the current literature regarding twin studies describing the genetic basis of specific Phobias and their corresponding fears. The analysis included five twin studies on fears and ten twin studies on specific Phobias. Heritability estimates of fear subtypes and specific Phobia subtypes both varied widely, even within the subtypes. A meta-analysis performed on the twin study results indicated that fears and specific Phobias are moderately heritable. The highest mean heritability (±SEM) among fear subtypes was found for animal fear (45%±0.004), and among specific Phobias for the blood-injury-injection Phobia (33%±0.06). For most phenotypes, variance could be explained solely by additive genetic and unique environmental effects. Given the dearth of independent data on the heritability of specific Phobias and fears, additional research is needed.
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blood injury injection Phobia and dental Phobia
Behaviour Research and Therapy, 1998Co-Authors: A. De Jongh, G Bongaarts, I Vermeule, Klaas Visser, P De Vos, P C MakkesAbstract:The present study was carried out to explore the relation between BII Phobia and dental Phobia. An additional aim was to determine the fainting tendency of dental phobics and BII phobics during an invasive treatment procedure. Participants were 63 patients undergoing treatment in a dental fear clinic, and 173 patients undergoing dental surgery in a university hospital. They completed measures on fears of particular medical and dental stimuli, fainting history, general trait anxiety, dental anxiety, BII anxiety, BII avoidance, and a questionnaire aimed to define a Phobia based on DSM-IV criteria. Immediately after treatment information was obtained on exposures to blood or injections, state anxiety, and feelings of faintness during treatment. The results did not indicate any significant relationship between measures of dental anxiety and BII anxiety or BII avoidance. However, 57% of the dental phobic patients could also be classified as BII phobic. The proportion of dental phobics who reported fainting episodes in their past was similar to that of the BII phobics (37%), but none of the participants fainted during treatment. It is concluded that, albeit the level of co-occurrence for both types of Phobias is high, dental Phobia should be considered as a specific Phobia, independent of the BII subtype within DSM-IV. Further, the findings are inconsistent with the notion that individuals with BII Phobia have a remarkably high tendency to faint in the presence of their phobic stimuli.
Anne Schienle - One of the best experts on this subject based on the ideXlab platform.
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sex specific associations between grey matter volume and phobic symptoms in dental Phobia
Neuroscience Letters, 2014Co-Authors: Albert Wabnegger, Wilfried Scharmüller, Anne SchienleAbstract:The knowledge about brain structure and function in men and women suffering from dental Phobia is still limited. We compared grey matter volume (GMV) data from 36 patients suffering from dental Phobia and 36 non-phobic controls via voxel-based morphometry. Half of the subjects were male, the other half female. Scores on different dental anxiety and pain questionnaires were correlated with GMV. Relative to controls, the patients had a smaller volume of the dorsomedial and dorsolateral prefrontal cortex (DMPFC/DLPFC). Within the phobic group, personal pain experience during dental treatment was negatively correlated with DLPFC volume. Sex-specific correlations were found for the amygdala and the hippocampus. Whereas in female patients GMV of both structures was positively correlated with self-reported dental anxiety, for male patients experienced dental pain was negatively associated with hippocampus volume. Our findings show that memory as well as anticipation of dental pain is associated with amygdala-hippocampal structure in men and women afflicted by dental Phobia.
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diminished medial prefrontal cortex activity in blood injection injury Phobia
Biological Psychology, 2007Co-Authors: Andrea Hermann, Axel Schafer, Bertram Walter, Rudolf Stark, Dieter Vaitl, Anne SchienleAbstract:We examined the effects of symptom induction on neural activation in blood-injection-injury (BII) Phobia. Nine phobic and 10 non-phobic subjects participated in an fMRI study in which they were presented with disorder-relevant, generally disgust-inducing, generally fear-evoking and neutral pictures. We observed diminished medial prefrontal cortex (MPFC) activity in patients compared to controls for Phobia-relevant and disgust-inducing pictures. The MPFC has been shown to be critically involved in the automatic and effortful cognitive regulation of emotions. Therefore, the results might reflect reduced cognitive control of emotions in BII phobics during the experience of phobic symptoms as well as during states of disgust. The latter response component might be a result of the elevated disgust sensitivity of BII phobics.
William W Eaton - One of the best experts on this subject based on the ideXlab platform.
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phobic panic and major depressive disorders and the five factor model of personality
Journal of Nervous and Mental Disease, 2001Co-Authors: O J Bienvenu, Gerald Nestadt, Jack Samuels, Paul T Costa, William R Howard, William W EatonAbstract:This study investigated five-factor model personality traits in anxiety (simple Phobia, social Phobia, agoraPhobia, and panic disorder) and major depressive disorders in a population-based sample. In the Baltimore Epidemiologic Catchment Area Follow-up Study, psychiatrists administered the Schedules for Clinical Assessment in Neuropsychiatry to 333 adult subjects who also completed the Revised NEO Personality Inventory. All of the disorders except simple Phobia were associated with high neuroticism. Social Phobia and agoraPhobia were associated with low extraversion. In addition, lower-order facets of extraversion, agreeableness, and conscientiousness were associated with certain disorders (i.e., low positive emotions in panic disorder; low trust and compliance in certain Phobias; and low competence, achievement striving, and self-discipline in several disorders). This study emphasizes the utility of lower-order personality assessments and underscores the need for further research on personality/psychopathology etiologic relationships.
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agoraPhobia simple Phobia and social Phobia in the national comorbidity survey
Archives of General Psychiatry, 1996Co-Authors: William J Magee, William W Eaton, Hans-ulrich Wittchen, Katherine A Mcgonagle, Ronald C KesslerAbstract:Background: Data are presented on the general population prevalences, correlates, comorbidities, and impairments associated with DSM-III-R Phobias. Methods: Analysis is based on the National Comorbidity Survey. Phobias were assessed with a revised version of the Composite International Diagnostic Interview. Results: Lifetime (and 30-day) prevalence estimates are 6.7% (and 2.3%) for agoraPhobia, 11.3% (and 5.5%) for simple Phobia, and 13.3% (and 4.5%) for social Phobia. Increasing lifetime prevalences are found in recent cohorts. Earlier median ages at illness onset are found for simple (15 years of age) and social (16 years of age) Phobias than for agoraPhobia (29 years of age). Phobias are highly comorbid. Most comorbid simple and social Phobias are temporally primary, while most comorbid agoraPhobia is temporally secondary. Comorbid Phobias are generally more severe than pure Phobias. Despite evidence of role impairment in Phobia, only a minority of individuals with Phobia ever seek professional treatment. Conclusions: Phobias are common, increasingly prevalent, often associated with serious role impairment, and usually go untreated. Focused research is needed to investigate barriers to help seeking.
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risk factors for the incidence of social Phobia as determined by the diagnostic interview schedule in a population based study
Acta Psychiatrica Scandinavica, 1994Co-Authors: J C Wells, Allen Y Tien, R Garrison, William W EatonAbstract:The Diagnostic Interview Schedule was used to identify 89 incident social Phobia cases in wave 2 household subjects from 9437 at risk persons age 18 or older as part of the Epidemiologic Catchment Area study. Crude annual incidence of Diagnostic Interview Schedule/DSM-III social Phobia was estimated at 9 per 1000 population per year. Onset of social Phobia was associated with low education, never having been married and female gender. First onsets occurred throughout the life course of this adult sample. Nervousness, headache, panic spells, palpitations, other Phobias, binge pattern of alcohol consumption, dysthymia and schizophrenic symptoms were also predictive of social Phobia onset. There was no difference in predictive factors when "primary" social Phobia (without premorbid panic) was analyzed separately.
C.m.h.h. Van Houtem - One of the best experts on this subject based on the ideXlab platform.
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is dental Phobia a blood injection injury Phobia
Depression and Anxiety, 2014Co-Authors: C.m.h.h. Van Houtem, Dorret I. Boomsma, Lannie Ligthart, A. De Jongh, I H A Aartman, Corine M VisscherAbstract:Background Dental Phobia is part of the Blood-Injection-Injury (B-I-I) Phobia subtype of specific Phobia within DSM-IV-TR. To investigate the conceptual validity of this classification, the purpose of the present study was to determine the co-occurrence of dental Phobia, typical dental (and B-I-I related) fears, vasovagal fainting, and avoidance of dental care. Method Data were collected by an online survey in Dutch twin families (n = 11,213). Results Individuals with a positive screen of dental Phobia (0.4% of the sample) rated typical B-I-I-related stimuli as relatively little anxiety provoking (e.g. of all 28 fears the stimulus "the sight of blood" was ranked lowest). Presence of dental Phobia was significantly associated with a history of dizziness or fainting during dental treatment (OR = 3.4; 95% CI: 1.5-8.1), but of the dental phobic individuals only 13.0% reported a history of dizziness or fainting during dental treatment. Presence of dental Phobia (OR = 5.0; 95% CI: 2.8-8.8) was found to be associated with avoidance of dental care, but a history of dizziness or fainting during dental treatment was not (OR = 1.0; 95% CI: 0.8-1.2). Conclusions The present findings converge to the conclusion that dental Phobia should be considered a specific Phobia subtype independent of the B-I-I cluster within the DSM classification system.
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A review and meta-analysis of the heritability of specific Phobia subtypes and corresponding fears
Journal of Anxiety Disorders, 2013Co-Authors: C.m.h.h. Van Houtem, Marja L. Laine, Dorret I. Boomsma, Lannie Ligthart, A.j. Van Wijk, A. De JonghAbstract:Evidence from twin studies suggests that genetic factors contribute to the risk of developing a fear or a Phobia. The aim of the present study was to review the current literature regarding twin studies describing the genetic basis of specific Phobias and their corresponding fears. The analysis included five twin studies on fears and ten twin studies on specific Phobias. Heritability estimates of fear subtypes and specific Phobia subtypes both varied widely, even within the subtypes. A meta-analysis performed on the twin study results indicated that fears and specific Phobias are moderately heritable. The highest mean heritability (±SEM) among fear subtypes was found for animal fear (45%±0.004), and among specific Phobias for the blood-injury-injection Phobia (33%±0.06). For most phenotypes, variance could be explained solely by additive genetic and unique environmental effects. Given the dearth of independent data on the heritability of specific Phobias and fears, additional research is needed.
Mats Fredrikson - One of the best experts on this subject based on the ideXlab platform.
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arousal modulation of memory and amygdala parahippocampal connectivity a pet psychophysiology study in specific Phobia
Psychophysiology, 2011Co-Authors: Fredrik Ahs, Asa Michelgard Palmquist, Anna Pissiota, Lieuwe Appel, Orjan Frans, Israel Liberzon, Tomas Furmark, Mats FredriksonAbstract:Phobic fear is accompanied by intense bodily responses modulated by the amygdala. An amygdala moderated psychophysiological measure related to arousal is electrodermal activity. We evaluated the contributions of electrodermal activity to amygdala-parahippocampal regional cerebral blood flow (rCBF) during phobic memory encoding in subjects with spider or snake Phobia. Recognition memory was increased for Phobia-related slides and covaried with rCBF in the amygdala and the parahippocampal gyrus. The covariation between parahippocampal rCBF and recognition was related to electrodermal activity suggesting that parahippocampal memory processes were associated with sympathetic activity. Electrodermal activity further mediated the amygdala effect on parahippocampal activity. Memory encoding during phobic fear therefore seems contingent on amygdala's influence on arousal and parahippocampal activity.
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disentangling the web of fear amygdala reactivity and functional connectivity in spider and snake Phobia
Psychiatry Research-neuroimaging, 2009Co-Authors: Fredrik Ahs, Anna Pissiota, Lieuwe Appel, Orjan Frans, Tomas Furmark, Asa Michelgard, Mats FredriksonAbstract:The objective was to study effects of fear on brain activity, functional connectivity and brain-behavior relationships during symptom provocation in subjects with specific Phobia. Positron emission tomography (PET) and (15)O water was used to measure regional cerebral blood flow (rCBF) in 16 women phobic of either snakes or spiders but not both. Subjects watched pictures of snakes and spiders serving either as phobic or fear-relevant, but non-phobic, control stimuli depending on Phobia type. Presentation of phobic as compared with non-phobic cues was associated with increased activation of the right amygdala and cerebellum as well as the left visual cortex and circumscribed frontal areas. Activity decreased in the prefrontal, orbitofrontal and ventromedial cortices as well as in the primary somatosensory cortex and auditory cortices. Furthermore, amygdala activation correlated positively with the subjective experience of distress. Connectivity analyses of activity in the phobic state revealed increased functional couplings between voxels in the right amygdala and the periamygdaloid area, fusiform gyrus and motor cortex. During non-phobic stimulation, prefrontal activity correlated negatively with amygdala rCBF, suggesting a Phobia-related functional decoupling. These results suggest that visually elicited phobic reactions activate object recognition areas and deactivate prefrontal areas involved in cognitive control over emotion-triggering areas like the amygdala, resulting in motor readiness to support fight or flight.
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social Phobia in the general population prevalence and sociodemographic profile
Social Psychiatry and Psychiatric Epidemiology, 1999Co-Authors: Tomas Furmark, Maria Tillfors, P O Everz, Ina Marteinsdottir, O Gefvert, Mats FredriksonAbstract:Background: The present study examined the prevalence of social Phobia in the Swedish general population and demographic characteristics associated with this anxiety disorder. Methods: Data were obtained by means of a postal survey administrated to 2000 randomly selected adults. A questionnaire, validated against clinical interviews and established social Phobia scales, was used to assess social distress in a broad range of phobic situations, as well as the diagnostic criteria for social Phobia corresponding to DSM-IV. Interpretable questionnaires were obtained from 1202 respondents (60.1%). Results: The point prevalence of social Phobia was estimated at 15.6%, but prevalence rates varied between 1.9 and 20.4% across the different levels of distress and impairment used to define cases. Public speaking was the most common social fear. Social Phobia was associated with female gender, low educational attainment, psychiatric medication use, and lack of social support. Conclusions: Although the exact diagnostic boundaries for social Phobia are difficult to determine, it can be concluded that social anxiety is a distressing problem for a considerable proportion of the general population.
