Trypophobia: What Do We Know So Far? A Case Report and Comprehensive Review of the Literature

The social learning account of trypophobia

Trypophobia is the condition in which individuals report a range of negative emotions when viewing clusters of small holes. Since the phenomenon was first described in the peer-reviewed literature a decade ago, 49 papers have appeared together with hundreds of news articles. There has also been much discussion on various Internet forums, including medical and health-related websites. In the present article, we examine the degree to which the phenomenon is caused by a form of social learning, specifically, its ubiquitous social media presence. We also examined its prevalence among the broad population. In Experiment 1 (n = 2,558), we assessed whether younger people and females (i.e., greater social media users) are more sensitive to trypophobic stimuli, as predicted by the social media hypothesis. In Experiment 2 (n = 283), we examined whether sensitivity to trypophobic stimuli and rates of trypophobia is greater in people who are aware of the condition's existence, as opposed to those who have never heard of the phenomenon. In line with the social media theory, results showed that younger people and females are indeed more susceptible to trypophobia. However, 24% of trypophobic individuals have never heard of the condition. Overall, these data suggest that both social learning and non-social learning contribute to trypophobia. We also find that the prevalence of trypophobia is approximately 10%.

Contamination in Trypophobia: investigating the role of disgust

Trypophobia is a relatively common aversion to clusters of holes. There is no consensus yet on which emotions are involved in Trypophobia nor in its functional utility. This report investigates the role of disgust using contamination tasks in two studies, which contrast people with an aversion to trypophobic stimuli to those without. In Study 1, participants reported their emotional reactions to imagined contamination of trypophobic images. In Study 2, participants evaluated physically present trypophobic, disgust, fear, and control stimuli. The capacity of these stimuli to contaminate other objects was established using a chain of contagion task. Across both studies, contamination was present, however, only those with an aversion to trypophobic stimuli evidenced contamination on the chain of contagion task, a hallmark of disgust responding. Elevated levels were not only reported for disgust, but also alongside fear/anxiety. Participant reports suggest an underlying disease avoidance mechanism in Trypophobia, with trypophobic participants demonstrating an exaggerated response to such stimuli involving disgust and fear/anxiety, which is also seen in small animal phobia, BII, and C-OCD. Implications, particularly for treatment are discussed.

A social media network analysis of trypophobia communication

Trypophobia has attracted scientific attention in recent years. Few related studies have recruited participants using online methods, and even less is known about health communication in an environment where trypophobia was first widely discussed (i.e., the Internet). This study describes communication patterns in a Facebook group for trypophobia by detecting frequent topics, top contributors, and their discourses. We identified key commenters and performed word frequency analysis, word co-occurrence analysis, topic modeling, and content analysis. Impactful users posted and replied more often when discussing peer-reviewed science. Triggering content was actively removed by the group administrators. A wide variety of triggers not discussed in trypophobia-related literature were frequently mentioned. However, there was a lack of discussion on peer-reviewed treatments. The combination of a few expert and many supportive amateur gatekeepers willing to understand trypophobia, along with active monitoring by administrators, might contribute to in-group trust and the sharing of peer-reviewed science by top users of the trypophobia Facebook group.

Priming with skin-problems increases fear of clusters

Trypophobia is induced by viewing multiple clustered objects. To date, several studies have investigated why certain people experience discomfort when looking at clustered patterns. Recently, “involuntary protection against dermatosis” (IPAD) hypothesis was proposed to explain the causes of trypophobia. The IPAD hypothesis suggests that involuntary aversive responses to skin diseases cause discomfort in response to image clusters. However, this idea has not been fully investigated empirically. Therefore, the present study used a modified version of the priming procedure and tested whether the activation of the concept of skin-related diseases affected the evaluation of trypophobic images. In Experiment 1, participants engaged in a lexical decision task in which words related to skin problems, negative events, or neutral events were presented. Then, they evaluated the discomfort of trypophobic, negative, and neutral images. The results indicated that participants evaluated trypophobic images as more discomforting after they were exposed to skin-problem-related words, whereas the exposure to words related to skin-problems did not enhance the discomfort of negative images. These findings demonstrate that the association with skin-related problems increases the discomfort of trypophobic images. In Experiment 2, we further tested the reproducibility of the priming effect observed in Experiment 1 and investigated the effect of priming with words related to COVID-19 in the context of a spreading infection. Contrary to predictions, no priming effect was produced by either skin-related words or COVID-19-related words. Future studies should further explore the causal relationship of the association between skin disease and trypophobia.

Sertraline for Trypophobia: Report of an Adolescent Case

Trypophobia is a clinical entity that is characterized by unpleasant feelings related to or an aversion to irregular patterns of small holes or bumps. There are insufficient data about the etiological factors underlying trypophobia. It has been associated with anxiety disorders because it shows comorbidity and symptom similarity with anxiety disorders. Literature on the treatment strategies of trypophobia is somewhat limited. In this case report, we present an adolescent girl with trypophobia that is successfully treated with sertraline.