Afraid to vomit? The relationship between temperamental fear, emetophobia symptoms, and the impact of sex.

Emetophobia, the specific phobia of vomiting (SPOV), is an anxiety disorder associated with persistent fear of emesis. The temperament of fear is evident in phobic and anxiety disorders, which behaviorally manifests through sensitivity in the fight, flight, freeze system (FFFS). The present study aimed to test specific associations between these constructs. Undergraduate students (N= 186) completed self-report measures assessing symptoms of emetophobia, the FFFS, and general anxiety. Correlational analyses were used to test initial relations, followed by regression analyses to assess unique contribution of temperamental fear to the emetophobia symptom experience. Significant positive correlations were found between emetophobia symptoms with anxiety symptoms and the overall temperament of fear. However, only the fight response of the FFFS was significantly associated with symptoms of emetophobia. Further regression analyses demonstrated that the fight response did not uniquely predicted emetophobia symptoms above and beyond anxiety. However, post-hoc analyses illustrated sex moderated the relationship between temperamental fear and emetophobia symptoms, such that the relationship was significantly stronger for male participants than female participants. Results of this study expand upon the current conceptualization of emetophobia to incorporate underlying temperamental vulnerabilities and sex differences, which may function to exacerbate and/or maintain symptoms. Keywords: emetophobia; specific phobia of vomiting (SPOV); fight, flight, freeze system (FFFS); fight, flight, freeze questionnaire (FFFQ); sex differences