---
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.
altloc: []
chapter: ~
commentary: ~
commref: ~
confdates: ~
conference: ~
confloc: ~
contact_email: ~
creators_id: []
creators_name:
  - family: Bracha
    given: Stefan
    honourific: Dr.
    lineage: ''
  - family: Bienvenu
    given: O. Joseph
    honourific: Dr.
    lineage: ''
  - family: Eaton
    given: William W.
    honourific: Dr.
    lineage: ''
date: 2006
date_type: published
datestamp: 2006-08-01
department: ~
dir: disk0/00/00/50/36
edit_lock_since: ~
edit_lock_until: ~
edit_lock_user: ~
editors_id: []
editors_name: []
eprint_status: archive
eprintid: 5036
fileinfo: /style/images/fileicons/application_pdf.png;/5036/1/2006_J.A.D._ECA.pdf
full_text_status: public
importid: ~
institution: ~
isbn: ~
ispublished: inpress
issn: ~
item_issues_comment: []
item_issues_count: 0
item_issues_description: []
item_issues_id: []
item_issues_reported_by: []
item_issues_resolved_by: []
item_issues_status: []
item_issues_timestamp: []
item_issues_type: []
keywords: Brain evolution; Sexual selection; Mate choice; War; Anxiety disorders
lastmod: 2011-03-11 08:56:33
latitude: ~
longitude: ~
metadata_visibility: show
note: ~
number: ~
pagerange: ~
pubdom: TRUE
publication: Journal of Affective Disorders
publisher: ~
refereed: TRUE
referencetext: ~
relation_type: []
relation_uri: []
reportno: ~
rev_number: 12
series: ~
source: ~
status_changed: 2007-09-12 17:06:30
subjects:
  - bio-evo
  - evol-psy
succeeds: ~
suggestions: ~
sword_depositor: ~
sword_slug: ~
thesistype: ~
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
type: journalp
userid: 6567
volume: in pre
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