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Trypophobia is an aversion to the sight of irregular patterns or clusters of small
hole A hole is an opening in or through a particular medium, usually a solid body. Holes occur through natural and artificial processes, and may be useful for various purposes, or may represent a problem needing to be addressed in many fields of en ...
s or bumps. It is not officially recognized as a
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
, but may be diagnosed as a
specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
if excessive fear and distress occur. Most affected people experience mainly
disgust Disgust (Middle French: ''desgouster'', from Latin ''gustus'', "taste") is an emotional response of rejection or revulsion to something potentially contagious or something considered offensive, distasteful, or unpleasant. In ''The Expression o ...
when they see trypophobic imagery. A minority of people experience the same level of fear and disgust, and a few express only disgust or fear. The scientific understanding of trypophobia is limited. Although few studies have been done on trypophobia, researchers hypothesize that it is the result of a biological revulsion that associates trypophobic shapes with danger or
disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
, and may therefore have an
evolutionary Evolution is change in the heredity, heritable Phenotypic trait, characteristics of biological populations over successive generations. These characteristics are the Gene expression, expressions of genes, which are passed on from parent to ...
basis.
Exposure therapy Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thou ...
is a possible treatment. The term ''trypophobia'' was coined by a participant in an online forum in 2005. It has since become a popular topic on
social media Social media are interactive media technologies that facilitate the creation and sharing of information, ideas, interests, and other forms of expression through virtual communities and networks. While challenges to the definition of ''social medi ...
.


Classification

Trypophobia is not recognized by name as a mental disorder, and so is not a specific diagnosis in the
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are involve ...
's ''Diagnostic and Statistical Manual'', Fifth Edition (DSM-5). However, it may fall under the broad category of
specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
if it involves fear that is excessive, persistent, and associated with significant distress or impairment. Whether trypophobia can be accurately described as a specific phobia might depend on whether the person mainly responds with fear or with disgust. Because
phobia A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avo ...
s involve fear, a response to trypophobic imagery that is based mostly or solely on disgust renders its status as a specific phobia questionable. In one study, most of the participants with trypophobia met the DSM-5 criteria for a specific phobia, even though they experienced disgust instead of fear when shown imagery of clusters of holes; however, they did not meet the distress or impairment criterion.


Signs and symptoms

Trypophobia often presents with an
autonomic nervous system The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control ...
response. Shapes that elicit a trypophobic reaction include clustered holes in innocuous contexts, such as fruit and bubbles, and in contexts associated with danger, such as holes made by insects and holes in wounds and diseased tissue such as those caused by mango flies in animals, especially dogs. Upon seeing these shapes, some people said they shuddered, felt their skin crawl, experienced
panic attack Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...
s, sweated, palpitated, or felt nauseated or itchy. Other reported symptoms include
goose bumps Goose bumps, goosebumps or goose-pimples are the bumps on a person's skin at the base of body hairs which may involuntarily develop when a person is tickled, cold or experiencing strong emotions such as fear, euphoria or sexual arousal. The fo ...
, body shakes, feeling uncomfortable, and visual discomfort such as eyestrain, distortions, or illusions. Trypophobia may manifest as a reaction of fear, disgust, or both. Disgust is usually the stronger emotion in those with trypophobia.


Causes

The understanding of trypophobia is limited. Several possible causes have been proposed. Geoff Cole and Arnold Wilkins believe the reaction is an "unconscious
reflex reaction In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus. Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs ...
" based on a biological revulsion, rather than a learned cultural fear. Imagery of various venomous animals (for example, certain types of snakes, insects, and spiders) have visual characteristics similar to trypophobic imagery. Furthermore, other animals such as the frog
Pipa pipa The pipa, pípá, or p'i-p'a () is a traditional China, Chinese List of traditional Chinese musical instruments, musical instrument, belonging to the Plucked string instrument, plucked category of instruments. Sometimes called the "Chinese lute" ...
have been known to be a trypophobia trigger. Because of this, it is hypothesized that trypophobia has an
evolutionary Evolution is change in the heredity, heritable Phenotypic trait, characteristics of biological populations over successive generations. These characteristics are the Gene expression, expressions of genes, which are passed on from parent to ...
basis meant to alert humans of dangerous organisms. Can ''et al.'', however, believe the connection between trypophobia and evolution as a result of a threat from deadly creatures to be weak and that, if a connection does exist, it manifests later in life rather than in childhood. Martínez-Aguayo ''et al.'' described trypophobia as usually involving "an intense and disproportionate fear towards holes, repetitive patterns, protrusions, etc., and, in general, images that present high-contrast energy at low and midrange
spatial frequencies In mathematics, physics, and engineering, spatial frequency is a characteristic of any structure that is periodic across position in space. The spatial frequency is a measure of how often sinusoidal components (as determined by the Fourier tra ...
." Cole and Wilkins also stated the imagery has high spatial frequency with greater energy at midrange. Whether together or separate, it appears that low and midrange spatial frequencies are necessary for inducing trypophobic reactions. Based on the imagery's visual cues, An Trong Dinh Le, Cole, and Wilkins developed a symptom questionnaire that they believe can be used to identify trypophobia. Researchers have also speculated that trypophobic reactions could be perceived as cues to infectious disease, which could be alerts that give one a survival advantage. In a study by Kupfer and Le, trypophobic and non-trypophobic participants showed significant aversion to disease-relevant cluster images, but only trypophobic participants displayed a significant aversion to disease-irrelevant cluster images. Martínez-Aguayo ''et al.'' stated that, because the reactions could not be attributed to different sensitivity levels or
neuroticism In the study of psychology, neuroticism has been considered a fundamental personality trait. For example, in the Big Five approach to personality trait theory, individuals with high scores for neuroticism are more likely than average to be moody ...
differences, Kupfer and Le believe it supports their hypothesis that trypophobia is "an overgeneralized aversion towards cluster stimuli that indicates a parasitic and infectious disease threat". Yamada and Sasaki also propose that trypophobic reactions are due to the imagery's visual similarities to skin diseases. Whether trypophobia is associated with
obsessive–compulsive disorder Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and/or feels the need to perform certain routines repeatedly to the extent where it induces distress or impairs general ...
(OCD) has also been studied. A significant minority of those with trypophobia meet the DSM-5 criteria for an obsessive-compulsive disorder. Martínez-Aguayo ''et al.'' stated that other findings refer to trypophobia having common
comorbid In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary c ...
psychiatric diagnosis, such as
major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...
or
generalized anxiety disorder Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily function ...
, although Le ''et al.'' felt that general anxiety does not cause trypophobia.


Treatment

There are no known treatments for trypophobia, but
exposure therapy Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger (desensitization). Doing so is thou ...
, which has been used to treat phobias, is likely to be an effective treatment.


Epidemiology

The extent to which trypophobia exists is unknown, but the available data suggests that having an aversion to trypophobic imagery is relatively common. 16% of a sample of 286 participants in a 2013 study reported discomfort or repulsion when presented with an image of a lotus seed pod and its authors found that non-trypophobic individuals also experienced more discomfort when viewing trypophobic imagery than when viewing neutral images. Trypophobia appears to be more prevalent in women.


Society and culture

The term ''trypophobia'' is believed to have been coined by a participant in an online forum in 2005. The word is from the grc-gre, τρῦπα, ', meaning "hole" and , ', meaning "fear". Groups on social media sites such as
Facebook Facebook is an online social media and social networking service owned by American company Meta Platforms. Founded in 2004 by Mark Zuckerberg with fellow Harvard College students and roommates Eduardo Saverin, Andrew McCollum, Dustin M ...
and
Instagram Instagram is a photo and video sharing social networking service owned by American company Meta Platforms. The app allows users to upload media that can be edited with filters and organized by hashtags and geographical tagging. Posts can ...
exist for self-identified trypophobics to share and discuss images that they say induce the reaction. Because trypophobia is not well known to the general public, many people with the condition do not know the name for it and believe that they are alone in their trypophobic reactions and thoughts until they find an online community to share them with. This has led to an increase in trypophobic images on social media; in some cases, people seek to intentionally induce trypophobia in those who have it by showing them trypophobic images, with the most trypophobic-inducing images being holes and clusters (especially the lotus seedhead) photoshopped onto human skin. Cole and Wilkins also stated that the level of disgust with trypophobia increases if the holes are on human skin. Writing in ''
Popular Science ''Popular Science'' (also known as ''PopSci'') is an American digital magazine carrying popular science content, which refers to articles for the general reader on science and technology subjects. ''Popular Science'' has won over 58 awards, incl ...
'', Jennifer Abbasi argues that
emotional contagion Emotional contagion is a form of social contagion that involves the spontaneous spread of emotions and related behaviors. Such emotional convergence can happen from one person to another, or in a larger group. Emotions can be shared across individ ...
within such social media groups may be responsible for some of the aversive reactions to such images. In 2017, trypophobia received media attention when ''
American Horror Story ''American Horror Story'' is an American anthology horror television series created by Ryan Murphy and Brad Falchuk for the cable network FX. The first installment in the '' American Story'' media franchise, each season is conceived as a ...
'' featured a trypophobic character and trypophobia-inducing advertisements promoting the storyline; some people were disturbed by the imagery, and criticized the show for "insensitivity towards sufferers of trypophobia". Although there was sentiment that the increased media attention could lead to people trying to induce trypophobia, there were also opinions that it might help people understand trypophobia and encourage more research on the matter. Some users responded to the September 2019 release of Apple's
iPhone 11 Pro The iPhone 11 Pro and iPhone 11 Pro Max are smartphones designed, developed and marketed by Apple Inc. Serving as the Apple's flagship models of the 13th-generation of iPhones, they succeeded the iPhone XS and iPhone XS Max, respectively, ...
, which features three closely spaced camera lenses, with comments that it triggered their trypophobia. Writer and editor Kathleen McAuliffe suggested that trypophobia is yet to be extensively studied because researchers have not given as much attention to topics of disgust as they have to other areas of research, and because of the revulsion viewing the images could incite in researchers.


See also

*
List of phobias The English suffixes -phobia, -phobic, -phobe (from Greek φόβος ''phobos'', "fear") occur in technical usage in psychiatry to construct words that describe irrational, abnormal, unwarranted, persistent, or disabling fear as a mental diso ...
* Ommetaphobia


References


External links

* {{Wiktionary inline 2000s neologisms Holes Phobias