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Treatment Options for Fear of Blushing

  • Anxiety Disorders (A Pelissolo, Section Editor)
  • Published:
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Abstract

Purpose of Review

To review mechanisms of blushing and fear of blushing from physiological, neuropharmacological and psychological viewpoints, and to evaluate current forms of treatment for blushing-related fear.

Recent Findings

Blushing appears to be driven primarily by sympathetic adrenomedullary and neural vasodilator discharge, possibly in association with secondary neurovascular inflammation. Psychological risk factors for fear of blushing include social anxiety, coupled with heightened self-focused attention and inflated beliefs about the likelihood and social costs of blushing. In addition, schemas of emotional inhibition, social isolation and alienation may underlie blushing-related fears. Established psychological treatments for fear of blushing include task concentration training, exposure, cognitive therapy, social skills training, psychoeducation and applied relaxation. More novel approaches include mindfulness and mindful self-compassion, video feedback and imagery rescripting. There are no established pharmacological treatments specifically for fear of blushing. However, selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are effective treatments for social anxiety disorder and may thus help some patients manage their fear of blushing.

Summary

A reactive sympathetic nervous system may interact with psychological predispositions to intensify fear of blushing. These physiological and psychological risk factors could be promising targets for treatment.

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Authors and Affiliations

  1. Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia

    Peter D. Drummond & Graeme B. Shapiro

  2. Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands

    Milica Nikolić

  3. Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands

    Susan M. Bögels

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  1. Peter D. Drummond
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  3. Milica Nikolić
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  4. Susan M. Bögels
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Correspondence to Peter D. Drummond.

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Drummond, P.D., Shapiro, G.B., Nikolić, M. et al. Treatment Options for Fear of Blushing. Curr Psychiatry Rep 22, 28 (2020). https://doi.org/10.1007/s11920-020-01152-5

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