Emetophobia

Emetophobics may also suffer from other complicating disorders and phobias, such as social anxiety, fear of flying and agoraphobia. These three are very common, because people who fear vomiting are often terrified of doing so, or encountering it, in a public place. Therefore, they may restrict their social activities so they avoid any situations with alcohol or dining out in restaurants. Emetophobics may also limit exposure to children for fear of germs. Females who suffer from this disorder delayed pregnancy or avoided it altogether because of the fear of morning sickness. People who have a fear of vomiting may avoid travel because of the worry about motion sickness or others experiencing it around them. They may also fear roller coasters for the same reason.

Dr. Lipsitz et al.'s findings also showed that those afflicted with emetophobia often have difficulties comfortably leading a normal life.[1] Many find that they have problems being alone with young children, and they may also avoid social gatherings where alcohol is present.[1] Retaining an occupation becomes difficult for emetophobics. Professions and personal goals can be put on hold due to the high anxiety associated with the phobia,[4] and travelling becomes almost impossible for some.[1]

In Lipsitz et al.'s survey, women afflicted with emetophobia said that they either delayed pregnancy or avoided pregnancy altogether because of the morning sickness associated with the first trimester,[1][5] and if they did become pregnant, it made pregnancy difficult.[1]

Other inhibitions on daily life can be seen in meal preparation.[1] Many emetophobic people also have specific "rituals" for the food they eat and how they prepare it.[1] They frequently check the freshness of the food along with washing it several times in order to prevent any potential sicknesses that they could contract from foods not handled properly.[1] Eating out is also avoided, if possible, and when asked Lipsitz et al.'s survey, many felt they were underweight because of the strict diets that they put upon themselves.[1]

There are some cases where anorexia is the result of a fear of vomiting instead of the typical psychological problems that trigger it.[4] In Frank M. Datillio's clinical case study, a situation where anorexia results from emetophobia is mentioned. Datillio says, "...in one particular case report, atypical anorexia in several adolescent females occurred as a result of a fear of vomiting that followed a viral illness as opposed to the specific desire to lose weight or because of an anxiety reaction.".[4] It is not clear that this should be termed "anorexia", however. In cases such as this, many emetophobes may also have avoidant/restrictive food intake disorder (ARFID), which is characterized by a general disinterest in food, sensory issues with food (taste, texture, look, smell) or a fear of adverse consequences from eating (vomiting or choking).

Oftentimes, this phobia is comorbid with several others, making it necessary to deal with each phobia individually in order for the patient to recover fully. For example, it is common for emetophobics to also suffer from a fear of food, known as cibophobia, where the sufferer worries that the food they are eating is carrying pathogens that can cause vomiting. As such, people will develop specific behaviors that will, in their minds, make the food safe to eat, such as a ritualistic type of washing or the intentional overcooking of meat to avoid the intake of harmful pathogens. In time, these fears can become so ingrained that the person who has them can begin to suffer from anorexia nervosa. Again, it is not clear that this should be deemed "anorexia" rather than, for instance OCD, given this different presentation.

There are two assessment tools used to diagnose emetophobia: the Specific Phobia of Vomiting inventory[7] and the Emetophobia Questionnaire.[8] They are self-report questionnaires that focus on a different range of symptoms.

There have been a limited number of studies in regard to emetophobia.[2] Victims of the phobia usually experience fear before vomiting but feel less afterwards. The fear comes back, however, if the victim fears they will throw up again.

Also noted in the emetophobia internet survey was information about medications. People were asked whether they would consider taking anxiety medication to potentially help their fear, and many in the study answered they wouldn't for fear that the drugs would make them nauseated.[1] Others, however, stated that some psychotropic medications (such as benzodiazepines and antidepressants) did help with their phobia, and some said gastrointestinal medications were also beneficial.[1]

Exposure methods, using video-taped exposure to others vomiting,[9] hypnosis,[10] exposure to nausea[11] and exposure to cues of vomiting,[12] systemic behavior therapy,[13] psychodynamic[14] and psychotherapy[15] have also shown positive effects for the treatment of emetophobia. However, in some cases it may cause re-traumatization, and the phobia may become more intense as a result.