Discipline of Psychology, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia.
Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.
Curr Psychiatry Rep. 2020 May 7;22(6):28. doi: 10.1007/s11920-020-01152-5.
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.
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. 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.
从生理、神经药理学和心理学的角度来回顾脸红和怕脸红的机制，并评估目前针对脸红相关恐惧的治疗方法。
脸红似乎主要是由交感肾上腺髓质和神经血管舒张引起的，可能与继发性神经血管炎症有关。脸红恐惧的心理风险因素包括社交焦虑，加上高度的自我关注和对脸红的可能性和社会成本的夸大信念。此外，情绪抑制、社会孤立和疏远的图式可能是脸红相关恐惧的基础。针对脸红恐惧的既定心理治疗方法包括任务集中训练、暴露、认知疗法、社交技能训练、心理教育和应用放松。更新颖的方法包括正念和正念自我同情、视频反馈和意象重写。目前尚无专门针对脸红恐惧的既定药物治疗方法。然而，选择性 5-羟色胺再摄取抑制剂和 5-羟色胺去甲肾上腺素再摄取抑制剂是治疗社交焦虑障碍的有效方法，因此可能有助于一些患者控制他们对脸红的恐惧。反应性交感神经系统可能与心理倾向相互作用，加剧对脸红的恐惧。这些生理和心理风险因素可能是治疗的有希望的靶点。
