@misc{cogprints5036,
          volume = {in pre},
           title = {Testing the Paleolithic-human-warfare hypothesis of blood-injectiion phobia in the Balitmore ECA Follow-up Study-Towards a more etiologically-based conceptualization for DSM-V},
          author = {Dr. Stefan Bracha and Dr. O. Joseph Bienvenu and Dr. William W. Eaton},
            year = {2006},
         journal = {Journal of Affective Disorders},
        keywords = {Brain evolution; Sexual selection; Mate choice; War; Anxiety disorders},
             url = {http://cogprints.org/5036/},
        abstract = {Objective: 
The 
research 
agenda 
for 
the 
fifth 
edition 
of 
the 
Diagnostic 
and 
Statistical 
Manual 
of 
Mental 
Disorders 
(DSM-V) 
has
emphasized 
the 
need 
for a 
more 
etiologically-based 
classification 
system, 
especially 
for 
stress-induced 
and 
fear-circuitry 
disorders.
Testable 
hypotheses 
based 
on 
threats 
to 
survival 
during 
particular 
segments 
of 
the 
human 
era 
of 
evolutionary 
adaptedness 
(EEA)
may 
be 
useful 
in 
developing a 
brain-evolution-based 
classification 
for 
the 
wide 
spectrum 
of 
disorders 
ranging 
from 
disorders 
which
are 
mostly 
overconsolidationally 
such 
as 
PTSD, 
to 
fear-circuitry 
disorders 
which 
are 
mostly 
innate 
such 
as 
specific 
phobias. 
The
recently 
presented 
Paleolithic-human-warfare 
hypothesis 
posits 
that 
blood?injection 
phobia 
can 
be 
traced 
to a 
?survival 
(fitness)
enhancing? 
trait, 
which 
evolved 
in 
some 
females 
of 
reproductive-age 
during 
the 
millennia 
of 
intergroup 
warfare 
in 
the 
Paleolithic
EEA. 
The 
study 
presented 
here 
tests 
the 
key a 
priori 
prediction 
of 
this 
hypothesis{--}that 
current 
blood?injection 
phobia 
will 
have
higher 
prevalence 
in 
reproductive-age 
women 
than 
in 
post-menopausal 
women.
Method: 
The 
Diagnostic 
Interview 
Schedule 
(version 
III-R)
, 
which 
included a 
section 
on 
blood 
and 
injection 
phobia, 
was
administered 
to 
1920 
subjects 
in 
the 
Baltimore 
ECA 
Follow-up 
Study.
Results: 
Data 
on 
BII 
phobia 
was 
available 
on 
1724 
subjects 
(1078 
women 
and 
646 
males)
. 
The 
prevalence 
of 
current 
blood?
injection 
phobia 
was 
3.3\% 
in 
women 
aged 
27?49 
and 
1.1\% 
in 
women 
over 
age 
50 
(OR 
3.05, 
95\% 
CI 
1.20?7.73)
. 
[The
corresponding 
figures 
for 
males 
were 
0.8\% 
and 
0.7\% 
(OR 
1.19, 
95\% 
CI 
0.20?7.14)]
.
Conclusions: 
This 
epidemiological 
study 
provides 
one 
source 
of 
support 
for 
the 
Paleolithic-human-warfare 
(Paleolithic-threat)
hypothesis 
regarding 
the 
evolutionary 
(distal) 
etiology 
of 
bloodletting-related 
phobia, 
and 
may 
contribute 
to a 
more 
brain-
evolution-based 
re-conceptualization 
and 
classification 
of 
this 
fear 
circuitry-related 
trait 
for 
the 
DSM-V. 
In 
addition, 
the 
finding
reported 
here 
may 
also 
stimulate 
new 
research 
directions 
on 
more 
proximal 
mechanisms 
which 
can 
lead 
to 
the 
development 
of
evidence-based 
psychopharmacological 
preventive 
interventions 
for 
this 
common 
and 
sometimes 
disabling 
fear-circuitry 
disorder.}
}

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