Prevalence of self-reported specific phobia symptoms in an Israeli sample of young conscripts

The spider and the snake - A psychometric study of two phobias and insights from the Hungarian validation

Specific phobias-particularly zoophobias-are prevalent worldwide and can have fairly dramatic health consequences. Self-report measurements play a crucial role in phobia research studies; thus, it is important to have a reliable tool in different languages. The present investigation examined the psychometric properties of the Hungarian version of two commonly used measures of fear: the Spider Phobia Questionnaire (i.e. SPQ) and the Snake Questionnaire (i.e. SNAQ). The SPQ and SNAQ scores both demonstrated excellent reliability, including a test-retest over a 4-week period. Supportive evidence for the validity of the SPQ and SNAQ scores was found using questions assessing fainting and avoidance history, regarding snakes and spiders, based on DSM-V criteria. Both questionnaires could discriminate between participants who reported such an event and those who did not. Further analyses also revealed a sex difference, with women scoring higher than men on both scales. Moreover, 9.5% and 4.24% of the respondents reached the cut-off point, set by previous studies, for spider and snake phobias, respectively. These findings suggest that the SPQ and SNAQ have excellent psychometric properties, making them suitable for use in further cross-cultural research and epidemiological studies.

Single-session gamified virtual reality exposure therapy for spider phobia vs. traditional exposure therapy: study protocol for a randomized controlled non-inferiority trial

BACKGROUND

Traditional one-session exposure therapy (OST) in which a patient is gradually exposed to feared stimuli for up to 3 h in a one-session format has been found effective for the treatment of specific phobias. However, many individuals with specific phobia are reluctant to seek help, and access to care is lacking due to logistic challenges of accessing, collecting, storing, and/or maintaining stimuli. Virtual reality (VR) exposure therapy may improve upon existing techniques by facilitating access, decreasing cost, and increasing acceptability and effectiveness. The aim of this study is to compare traditional OST with in vivo spiders and a human therapist with a newly developed single-session gamified VR exposure therapy application with modern VR hardware, virtual spiders, and a virtual therapist.

METHODS/DESIGN

Participants with specific phobia to spiders (N = 100) will be recruited from the general public, screened, and randomized to either VR exposure therapy (n = 50) or traditional OST (n = 50). A behavioral approach test using in vivo spiders will serve as the primary outcome measure. Secondary outcome measures will include spider phobia questionnaires and self-reported anxiety, depression, and quality of life. Outcomes will be assessed using a non-inferiority design at baseline and at 1, 12, and 52 weeks after treatment.

DISCUSSION

VR exposure therapy has previously been evaluated as a treatment for specific phobias, but there has been a lack of high-quality randomized controlled trials. A new generation of modern, consumer-ready VR devices is being released that are advancing existing technology and have the potential to improve clinical availability and treatment effectiveness. The VR medium is also particularly suitable for taking advantage of recent phobia treatment research emphasizing engagement and new learning, as opposed to physiological habituation. This study compares a market-ready, gamified VR spider phobia exposure application, delivered using consumer VR hardware, with the current gold standard treatment. Implications are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT02533310. Registered on 25 August 2015.

Mental disorders in primary care in Israel: prevalence and risk factors

OBJECTIVE

Psychiatric morbidity is common among patients in primary care services and leads to disability and increased use of medical services. Comparison of primary care and community prevalence data is of interest in relation to the health services planning for mental disorders. The aim of the present study was to measure prevalence of mental disorders in six primary care clinics in Israel and to assess risk factors for these disorders.

METHOD

Prevalence of mental disorders was measured in a sample of 2,948 primary care consecutive attendees, using two-stage stratified sampling with the General Health Questionnaire 12 (GHQ-12) and the Composite International Diagnostic Interview (CIDI).

RESULTS

A high rate (46.3%) of current mental disorders was found, with rates of current depressive episode, generalized anxiety disorder, somatization disorder, and neurasthenia being relatively high in comparison with rates in other countries. Low education was a risk factor for all categories of disorders, unemployment a risk factor for depressive disorders, and parenthood was protective for most categories of disorders.

CONCLUSIONS

High rates of mental disorders were found in this Israeli primary care sample as compared to other countries, while in the community the rates were midrange as compared to other countries, pointing to a relatively higher use of primary care services by patients with mental disorders in Israel than in other countries.

A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds

This population-based study reports on the prevalence and characteristics of specific phobia (SP) and phobic fears in an elderly population. A representative population sample of Swedish 70-year-olds without dementia (N = 558) was examined using semi-structured interviews. Phobic fears included fear of animals, natural environment, specific situations, blood-injection-injury and 'other'. Mental disorders, including SP, were diagnosed according to DSM-IV. Phobic fears (71.0% vs. 37.9%) and SP (13.8% vs. 4.5%) were more common in women than in men. Among those with phobic fears, more than 80% reported onset before age 21. Of those with SP, 35.7% had another DSM-IV diagnosis compared to 8.5% of those reporting no fear. Fear of specific situations and 'other' fears were related to SP and other anxiety disorders. SP was related to lower global functioning. We conclude that specific phobia in the elderly should receive attention from health professionals as it is common and associated with a decrease in global functioning.

Recent trends in the study of specific phobias

PURPOSE OF REVIEW

Specific phobias are prevalent and often disabling anxiety disorders. The present review examines relevant investigations that have been published during the last 2 years on major aspects of this group of disorders.

RECENT FINDINGS

Recent studies have come mainly from epidemiology, brain imagery and cognitive-behavioral therapy, including virtual reality exposure therapy.

SUMMARY

Studies published in the last 2 years confirm the high prevalence of specific phobias in the general population and provide new insights into the mechanisms underlying the fear reaction after exposure to a phobic stimulus.

Understanding animal fears: a comparison of the cognitive vulnerability and harm-looming models

BACKGROUND

The Cognitive Vulnerability Model holds that both clinical and sub-clinical manifestations of animal fears are a result of how an animal is perceived, and can be used to explain both individual differences in fear acquisition and the uneven distribution of fears in the population. This study looked at the association between fear of a number of animals and perceptions of the animals as uncontrollable, unpredictable, dangerous and disgusting. Also assessed were the perceived loomingness, prior familiarity, and negative evaluation of the animals as well as possible conditioning experiences.

METHODS

162 first-year University students rated their fear and perceptions of four high-fear and four low-fear animals.

RESULTS

Perceptions of the animals as dangerous, disgusting and uncontrollable were significantly associated with fear of both high- and low-fear animals while perceptions of unpredictability were significantly associated with fear of high-fear animals. Conditioning experiences were unrelated to fear of any animals. In multiple regression analyses, loomingness did not account for a significant amount of the variance in fear beyond that accounted for by the cognitive vulnerability variables. However, the vulnerability variables accounted for between 20% and 51% of the variance in all animals fears beyond that accounted for by perceptions of the animals as looming. Perceptions of dangerousness, uncontrollability and unpredictability were highly predictive of the uneven distribution of animal fears.

CONCLUSION

This study provides support for the Cognitive Vulnerability Model of the etiology of specific fears and phobias and brings into question the utility of the harm-looming model in explaining animal fear.