Cognitive behavioral therapy for emetophobia in 16-year-old adolescent: a case study

Abstract Background A specific phobia of vomiting, often known as emetophobia, is a particularly common psychiatric disorder among adolescents. It is accompanied by a significant level of distress given the severity of its symptoms and the frequency of comorbidities, especially anxiety. Although no treatment protocols have been established for adolescents, cognitive behavioral therapy (CBT) is the most frequently recommended treatment in the few published reports on adolescents with emetophobia. This case study aims to add to existing data indicating that CBT could be an effective treatment for emetophobia in adolescents. Case presentation We illustrate the case of a 16-year-old adolescent girl who presented with a specific phobia of vomiting that had lasted 6 years and was comorbid with social anxiety. These diagnoses were made by the child psychiatrist according to the Diagnosis and Statistical Manual of Mental Disorder in its 5th version (DSM-5). CBT for his specific phobia of vomiting was recommended. The Emetophobia Questionnaire (EmetQ-13) and the Screen for Child Anxiety Related Emotional Disorders (SCARED-41) were used to assess disease evolution. CBT for emetophobia lasted 22 weekly sessions of 1 h each and included: psychoeducation, relaxation, positive self-talk techniques, cognitive restructuring, imagery rescripting of flashback memories, and graduated exposure in vivo. At the end of CBT, the specific phobia of vomiting was no longer retained as a diagnosis according to the DSM-5. The psychometric evaluation revealed that the EmetQ-13 scores considerably decreased. A decrease in both the total score and the social anxiety subscale score of the SCARED-41 was also obtained. The clinical and psychometric improvements were maintained 3 months after the end of therapy. Conclusions This case report suggests that CBT could be an effective treatment for emetophobia in adolescents. It also helps reduce the level of associated anxiety. This article may encourage future research into randomized and controlled trials to protocolize and adapt the psychotherapeutic management of emetophobia in adolescents.