Paediatric Blood-Injection-Injury Phobia
Abstract
Blood-Injection-Injury phobia is a major health issue throughout the life span. It usually starts in early childhood. Avoidance of health care is seen in such individuals. Children with blood injection injury phobia have uncontrollable fear of blood, injury, injections and needles. Because of the intense fear, these children will do everything possible to avoid it. Various physical symptoms including increased heart rate, chest discomfort, trembling movements,  feeling of choking and syncope may occur in these children on mentioning about blood, needles or any injury. Vasovagal fainting with diphasic response pattern occurs in about twenty percent of children on exposure to the phobic stimulus. Other anxiety disorders, depressive disorders and attention deficit hyperactivity disorder also occur co-morbidly in children with blood-injection-injury phobia which makes the prognosis poor. Avoidance of health care due to phobia causes significant negative impact on health outcomes. Hence early diagnosis and urgent management of blood-injection-injury phobia in children is essential.References
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3. Fond G, Franc N. Treating specific childhood phobia in a single session? A systematic review of the literature. Encephale. 2013;39 (2):109-14.
4. Bienvenu OJ, Eaton WW. The epidemiology of blood-injection-injury phobia. Psychol Med. 1998 Sep;28(5):1129-36.
5. Kim SJ, Kim BN, Cho SC, Kim JW, Shin MS, Yoo HJ, Kim HW. The prevalence of specific phobia and associated co-morbid features in children and adolescents. J Anxiety Disord. 2010 Aug;24(6):629-34.
6. Wani AL, Ara A, Bhat SA. Blood injury and injection phobia: the neglected one. Behav Neurol. 2014;2014:471340.
7. Ritz T, Meuret AE, Simon E.Cardiovascular activity in blood-injection-injury phobia during exposure: evidence for diphasic response patterns? Behav Res Ther. 2013 Aug;51(8):460-8.
8. Ritz T, Meuret AE, Ayala ES. The psychophysiology of blood-injection-injury phobia: looking beyond the diphasic response paradigm. Int J Psychophysiol. 2010;78(1):50-67.
9. Accurso V, Winnicki M, Shamsuzzaman AS, Wenzel A, Johnson AK, Somers VK.
Predisposition to vasovagal syncope in subjects with blood/injury phobia. Circulation. 2001 Aug 21;104(8):903-7.
10. Donadio V, Liguori R, Elam M, Karlsson T, Montagna P, Cortelli P, Baruzzi A, Wallin BG Arousal elicits exaggerated inhibition of sympathetic nerve activity in phobic syncope patients. Brain. 2007;130(Pt 6):1653-62.
11. Hermann A, Schafer A, Walter B, Stark R, Vaitl D, Schienle A. Diminished medial prefrontal cortex activity in blood-injection-injury phobia. Biol Psychol. 2007;75(2):124-30.
12. Olatunji BO, Williams NL, Sawchuk CN, Lohr JM. Disgust, anxiety and fainting symptoms associated with blood-injection-injury fears: a structural model. J Anxiety Disord. 2006;20(1):23-41.
13. Millon T, Blaney PH, Davis RD. Oxford Textbook of Psychopathology. Oxford University Press. 1999; p. 82.
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