A Case Report on Cognitive Behavioral Therapy for Vomiting Fear (Emetophobia) with Comorbid Panic Disorder and Agoraphobia: A Treatment Model Incorporating an Opinion Survey

Abstract

This paper reports on a case of individual cognitive behavioral therapy for a woman experiencing agoraphobia (anxiety of entering open places) with comorbid panic disorder and restrictions on meal contents consumed due to emetophobia (fear of vomiting). Two associated beliefs were identified: 1) a physical internal sensation, such as a discomfort in the throat, is a precursor to vomiting; and 2) other people will evaluate vomiting as negative. Prior to implementing treatment, we adopted a cognitive behavioral therapy approach to panic disorders (Seki & Shimizu, 2016) associated with emetophobia. Before and after treatment, the average points on the emetophobia rating scale decreased from 78.0 to 37.3, and the SUDs of vomiting decreased from 70 to 20. A remarkable response was observed in the panic and agoraphobia related symptoms after treatment via remote cognitive behavioral therapy, primarily using video-conferencing. The findings suggested that these techniques can improve symptoms of severe emetophobia, and may lead to generalizations of uses of these psychological interventions.