Cognitive behaviour therapy for a specific phobia of vomiting. The Cognitive Behaviour Therapist

Abstract. This article summarizes the current knowledge and treatment for a specific phobia of vomiting (SPOV). It is relatively uncommon compared to other specific phobias but may have been misdiagnosed in catchment-area surveys. The differential diagnosis of SPOV includes obsessive–compulsive disorder, hypochondriacal disorder and anorexia nervosa. I discuss the following: a model that is linked to past aversive experiences of vomiting; conducting a clinical assessment; making a formulation; psycho-education, engagement and therapy. The strategies employed depend on the formulation but are likely to include: exposure in vivo to cues of vomiting, exposure in imagination and role-plays of vomiting, imagery re-scripting, behavioural experiments; and dropping of safety-seeking behaviours. Key words: Cognitive behaviour therapy, exposure, specific phobia, vomiting. Epidemiology A specific phobia of vomiting (SPOV) has been a neglected area of research. Epidemiological studies suggest that the prevalence of specific phobias in general is extremely common with a 12-month prevalence of about 7–13 % (Boyd et al. 1990; Kessler et al. 2005; Becker et al