The inclusion of „blood-injury phobia“ within the category of specific or simple phobias in classificatory systems reflects a perception that fear has a primary role in the disorder. Consistent with this assumption, blood-injury phobia appears to share a common etiology with other phobias. Kendler, Neale, Kessler, Heath, and Eaves (1992) have argued from data comparing monozygotic with dizygotic twins that the genetic factor common to all phobias (agoraphobia, social phobia, and specific phobias), strongly predisposes a person to specific phobias. The recognition of an inherited vulnerability common to all phobias is consistent with the notion that elevated trait anxiety predisposes one to anxiety disorders Trait anxiety provides a background
of affective arousal that permits a more rapid activation of the fight or flightresponse.
With respect to specific activating events, conditioning is one way that stimuli become
able to elicit anxiety (Rachman, 1991). Accordingly, painful experiences can condition
fear to blood-injury stimuli. Investigators typically classify around 60% of self-reported
onsets of blood-injury phobia as beginning with conditioning experiences (Ost, 1991; Ost,
1992; Ost & Hugdahl, 1985; Thyer et al., 1985). However, examinations of available
case-by-case verbal summaries call into question the conclusion that conditioning episodes
are as prevalent as reported (see Mattick, Page, & Lampe, in press). For example, Thyer
et al. (1985) identified a conditioning episode when a „patient received an injection at age
13 and fainted“ (p. 455), and in another person when ‘at age six she heard her elementary
school teacher give a talk on the circulatory system. This frightened the patient to the
point of syncope“ (Thyer et al., 1985
Neale, MC, Walters, EE, Eaves, LJ. Genetics of blood-injury fears and phobias: a population-based twin study. American Journal of Medical Genetics. Т. 54. 15 декември 1994. DOI:10.1002/ajmg.1320540411. с. 326 – 34.
Ost, L.G. и др. Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behaviour Research and Therapy. Т. 29. 1991. DOI:10.1016/0005-7967(91)90006-O. с. 561 – 574.
Ayala, E.S. и др. Treatments for blood-injury-injection phobia: a critical review of current evidence. Journal of Psychiatric Research. Т. 43. 2009. DOI:10.1016/j.jpsychires.2009.04.008. с. 1235 – 1242 REVIEW.
