Ultra-brief behavioral skills trainings for blood injection injury phobia

Meuret, Alicia E.; Simon, Erica; Bhaskara, Lavanya; Ritz, Thomas

doi:10.1002/da.22616

Cited by 13 publications

(14 citation statements)

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“…Treatments proved effective, also when administered in a one-session format ( Öst et al, 1992 ). A recent study ( Meuret et al, 2017 ) demonstrated that even very brief (12 min) video-based instructions of applied tension or a hypoventilation breathing techniques led to substantial reductions of subjective and bodily-symptoms during exposure to BII-relevant stimuli.…”

Section: Introductionmentioning

confidence: 99%

Large-Group One-Session Treatment: A Feasibility Study of Exposure Combined With Applied Tension or Diaphragmatic Breathing in Highly Blood-Injury-Injection Fearful Individuals

et al. 2018

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Objective: Large-group one-session treatments (LG-OSTs) might represent a promising treatment tool as increasing evidence suggests their effectiveness in individuals with different situational fears. In the present study, we explored feasibility and effectiveness of an exposure-based LG-OST protocol applying applied tension and diaphragmatic breathing as coping strategies in a sample of 40 individuals, highly fearful of blood-injury-injection (BII).Method: We assessed participants’ BII-fear using questionnaires and a behavioral approach test (BAT) before and after treatment, consisting of a blood-drawing procedure. Stability of treatment effects was assessed via online-survey at 7-month follow-up.Results: The LG-OST procedure evidenced feasible and effective. Pre-post treatment comparisons showed medium to large treatment effects (d = 0.40–0.93) regarding the questionnaire measures. After being treated, 70% of the individuals successfully underwent a blood drawing. Moreover, participants continued to improve in the post follow-up interval leading to large treatment effects (d = 1.19–1.62).Conclusion: In treating BII-fear, LG-OSTs might not only serve within a framework of a stepped care approach but also could represent a useful single-treatment option. Additionally, due to their high efficiency and standardization of treatment delivery, LG-OST protocols might foster research at the interface of basic and clinical research.

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Section: Introductionmentioning

confidence: 99%

Large-Group One-Session Treatment: A Feasibility Study of Exposure Combined With Applied Tension or Diaphragmatic Breathing in Highly Blood-Injury-Injection Fearful Individuals

et al. 2018

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“…The most notable feature of the results was the usefulness of RESP in reducing vasovagal symptoms in blood donors. Previous research has noted the potential value of “anti‐hyperventilation” techniques for blood‐injury‐injection (BII) phobics, people with especially strong fears of blood and needles . However, this is the first use of this approach in a more general, non‐BII population.…”

Section: Discussionmentioning

confidence: 92%

“…Nevetheless, it might not require much more training to observe positive effects in higher‐fear individuals. Meuret et al recently found that it was possible to impact the reactions of individuals with BII phobia to strong stimuli (e.g., a video depicting portions of open heart surgery) with 12 minutes of Hypoventilation Respiratory Training. Although longer than the videos used in the present study, this is quite brief in comparison to typical behavior therapy and had effects on people with much stronger fears.…”

Section: Discussionmentioning

confidence: 99%

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Respiration and applied tension strategies to reduce vasovagal reactions to blood donation: A randomized controlled trial

et al. 2018

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BACKGROUND: Whether produced by breathing too fast or too deeply, hyperventilation is common in stressful situations and may contribute to blood donation-related vasovagal symptoms. The effects of some previously tested interventions for vasovagal symptoms, for example, applied tension (AT), may be related to reduction of hyperventilation. More targeted breathing techniques might be useful. STUDY DESIGN AND METHODS:This was a randomized controlled trial comparing the effects of AT, a slow, shallow "anti-hyperventilation" breathing technique previously tested in phobic individuals (respiration control [RESP]), the combination of AT and RESP, and no intervention on blood donors participating in university clinics. A total of 547 eligible donors were assigned randomly to one of these four groups. Observational, self-report, and physiologic measures (primarily via respiratory capnometry) were obtained. RESULTS:Although both RESP and AT had some positive impact on blood donation outcome, the effects of RESP were more numerous, albeit limited primarily to donors who had less general fear of medical procedures. For example, lower-fear donors assigned to practice RESP had significantly lower Blood Donation Reaction Inventory scores and were significantly less likely to require treatment for symptoms than no-treatment individuals. In general, RESP led to a significant decrease in respiration rate, though it did not influence end-tidal CO 2 , a more precise measure of hyperventilation.CONCLUSION: While the mechanisms remain somewhat unclear and the interventions did not benefit more fearful, higher-risk donors, respiration control is a promising additional approach to reducing vasovagal symptoms. ABBREVIATIONS: AT = applied tension; BDRI = Blood DonationReactions Inventory; BII = blood-injury-injection; CI = confidence interval; GLMs = general linear models; OR = odds ratio; PetCO2 = end-tidal CO2; RESP = respiration control; RR = respiration rate. From

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“…The review also yielded a study that investigated relaxation in the treatment of blood-injection-injury phobias. Meuret et al 41 compared the efficacies of Symptom Associated Tension (SAT) Training and Hypoventilation Respiratory Training (HRT) with that of Relaxation Skills Training (RST) in treating blood-injection-injury phobias. These were delivered via 12-minute video-guided trainings.…”

Section: Others (N = 9)mentioning

confidence: 99%

Recent developments in the intervention of specific phobia among adults: A rapid review.

et al. 2020

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F1000 Faculty Reviews are written by members of the prestigious . They are F1000 Faculty commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. The reviewers who approved the final version are listed with their names and affiliations. AbstractSpecific phobia is highly prevalent worldwide. Although the body of intervention studies is expanding, there is a lack of reviews that summarise recent progress and discuss the challenges and direction of research in this area. Hence, this rapid review seeks to systematically evaluate the available evidence in the last five years in the treatment of specific phobias in adults. Studies published between January 2014 to December 2019 were identified through searches on the electronic databases of Medline and PsychINFO. In total, 33 studies were included. Evidence indicates that psychotherapy, and in particular cognitive behaviour therapy, when implemented independently or as an adjunctive, is a superior intervention with large effect sizes. Technology-assisted therapies seem to have a beneficial effect on alleviating fears and are described to be more tolerable than exposure therapy. Pharmacological agents are investigated in vivo solely as adjuncts to exposure therapy, but the effects are inconsistent; propranolol and glucocorticoid may be promising. A handful of cognitive-based therapies designed to alter fear arousal and activation pathways of phobias have presented preliminary, positive outcomes. Challenges remain with the inherent heterogeneity of specific phobia as a disorder and the accompanying variability in outcome measures and intervention approaches to warrant a clear conclusion on efficacy. A Randomized, Controlled Trial With a 6-Month Follow-Up. J Arthroplasty. 2018; 33(3): 704-10. PubMed Abstract | Publisher Full Text | F1000 Recommendation 12. Soravia LM, Heinrichs M, Winzeler L, et al.: Glucocorticoids enhance in vivo exposure-based therapy of spider phobia. Depress Anxiety. 2014; 31(5): 429-35. PubMed Abstract | Publisher Full Text | F1000 Recommendation 13. Rouhe H, Salmela-Aro K, Toivanen R, et al.: Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial. J Psychosom Obstet Gynaecol. 2015; 36(1): 1-9. PubMed Abstract | Publisher Full Text 14. Dumville JC, Torgerson DJ, Hewitt CE: Reporting attrition in randomised controlled trials. BMJ. 2006; 332(7547): 969-71. PubMed Abstract | Publisher Full Text | Free Full Text 15. Klabbers GA, Wijma K, Paarlberg KM, et al.: Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial. J Psychosom Obstet Gynaecol. 2019; 40(1): 38-47. PubMed Abstract | Publisher Full Text | F1000 Recommendation 16. Rondung E, Ekdahl J, Hildingsson I, et al.: Heterogeneity in childbirth related fear or anxiety. Scand J Psychol. 2018; 59(6): 634-43. PubMed Abstract | Publisher Full Text | F1000 Recommendation 17. Tellez M, Potter CM...

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Ultra-brief behavioral skills trainings for blood injection injury phobia

Abstract: Brief, video-based instructions in muscle tension and normocapnic breathing are effective in reducing BII symptom severity and require minimal time and expertise. HRT may be particularly helpful in reducing fainting caused by cerebral vasoconstriction.

Cited by 13 publications

References 37 publications

Large-Group One-Session Treatment: A Feasibility Study of Exposure Combined With Applied Tension or Diaphragmatic Breathing in Highly Blood-Injury-Injection Fearful Individuals

Large-Group One-Session Treatment: A Feasibility Study of Exposure Combined With Applied Tension or Diaphragmatic Breathing in Highly Blood-Injury-Injection Fearful Individuals

Respiration and applied tension strategies to reduce vasovagal reactions to blood donation: A randomized controlled trial

Recent developments in the intervention of specific phobia among adults: A rapid review.

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