Purging Anxiety: A Case Study of Transdignostic CBT for a Complex Fear of Vomiting (Emetophobia)
Abstract Emetophobia is defined as a specific phobia of vomiting, currently diagnosed as specific phobia "other" type in DSM 5 (American Psychiatric Association, 2013) Though there is a dearth of research conducted on emetophobia and its treatment, there is limited data from case studies (Hunter Antony, 2009; Maack, Deacon, Zhao, 2013) and one open trial of group therapy (Ahlen, Edberg, Di Schiena, Bergstrom, 2014) providing initial evidence regarding the efficacy of targeted cognitive behavioral treatment (CBT) in treating emetophobia. To date, no study has evaluated transdiagnostic CBT for emetophobia. Given suggestions that emetophobia frequently has a complex presentation, which shares elements with multiple anxiety disorder diagnoses, including specific phobia, panic disorder, obsessive compulsive disorder, and generalized anxiety disorder, (e.g. Boschen, 2007; Veale, 2009; Veale Lambrou, 2006) a transdiagnostic approach could prove promising. Transdiagnostic CBT has exhibited success in treating a range of anxiety disorders (Reinholt Krogh, 2014) and in reducing comorbid symptoms more effectively than diagnosis specific CBT (Norton et al. 2013) It was expected that a transdiagnostic treatment approach would be beneficial in treating emetophobia due to the treatment's flexibility in targeting multiple features of anxiety disorders concurrently.