Patterns of Response and Remission Following a One-Session Treatment for Blood-Injection-Injury Phobia in Youth

ABSTRACT

Blood-Injection-Injury (BII) Phobia is a severe and impairing disorder that has been understudied in youth. The present study aimed to define patterns of response and remission following a modified One-Session Treatment (OST) including an e-therapy maintenance program for children and adolescents with BII Phobia. Moreover, characteristics of different responder groups were examined in order to determine correlates of a poorer response. Youth (n = 20; 8–18 years) were categorized into four responder groups (e.g., immediate remitter, delayed remitter, partial responder, and nonresponder) based upon defined criteria for remission. Immediate remitters to treatment were more likely to have a primary diagnosis of injection phobia, rather than a combined blood and injection phobia. Nonresponders reported significantly greater disgust sensitivity at pretreatment and were more likely to have a comorbid diagnosis of Social Phobia. In regards to within session change, youth who achieved the exposure goal of having a blood test during treatment had a significantly stronger treatment response. These preliminary findings may assist clinicians in the planning and delivering of intensive Cognitive Behavioral Treatment (CBT) approaches for BII Phobia in youth.

KEYWORDS:

• Blood-Injection-Injury (BII)
• children
• intensive treatment
• One-Session Treatment (OST)
• remission

Acknowledgments

The authors acknowledge the contributions of physiotherapist Andrea Miller and pathology nurses Jacqueline Molloy and Ruth Macalpine for their involvement in delivering the treatment. In addition, we acknowledge the contributions of Michelle Tomlin, Ivan Pickert, and Dipti McGowan who were involved as therapists and/or independent assessors on the trial. The authors wish to thank the Griffith University Physiotherapy and Active Health Centre and the Griffith University Medical Centre.

Notes

Rates of remission in the present study varied from the original multiple baseline controlled trial (Oar, Farrell, Waters, et al., 2015) due to differences in the criteria used to define response and remission and a small number of youth being excluded due to missing data (n = 4).