Effects of cluster size on trypophobic discomfort in children aged 4-9 years.

It has been reported that strong discomfort associated with clusters of circles and holes (trypophobia), including lotus pod seeds, manifests in individuals as young as 4 or 5 years old. This study investigated how the size and number of circles within clusters affected discomfort levels in adults and in children aged 4-9 years. In Experiment 1, we confirmed that the remote experimental procedure could evoke discomfort when participants were presented with cluster images. The findings reveal that children as young as 4 or 5 years old consistently experienced discomfort when rating trypophobic images, even printed images rated in real time during video calls. In Experiment 2, we explored the impact of cluster size, considering both the size and number of circles, in a remote experiment. The results indicate that discomfort tended to increase with cluster size in both children and adults, with the effect becoming more pronounced with age.

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%.

Is trypophobia real?

Approximately 10-18% of the adult population experience some form of anxiety when viewing clusters of small holes. 'Trypophobia' has been the subject of much discussion within the peer-reviewed literature, news outlets, health-related websites and social media. However, there is some scepticism surrounding the phenomenon. It is often stated that the condition is not recognised by the American Psychiatric Association, and not listed as a phobia in the DSM-5. It has also been claimed that trypophobia is no more than a particularly successful internet meme. In this editorial, I argue that such criticisms are misplaced. There is, for instance, no list of phobias in the DSM-5; only criteria that determine phobia classification. Using these criteria, as well as personal testimonials, trypophobia is clearly a phobia. Furthermore, the meme hypothesis cannot account for the fact that the phenomenon existed long before the internet.

Pupillary Responses to Dot Patterns on a Human Face Background.

Dots on natural backgrounds can elicit significant pupillary constrictions within the entire image phase associated with parasympathetic activation, suggesting disgust rather than fear. Although studies have reported that dots on faces elicit stronger disgust than dots on non-face backgrounds, it remains unclear whether dots on a face elicit stronger pupil constrictions than non-face backgrounds. Pupillometry was used while viewing dots on faces and compared with luminance- and spatial frequency-controlled images (dots on phase-scrambled faces) and luminance-controlled images (face only, phase-scrambled faces). Relative pupillary constrictions were elicited when dots were placed on faces and phase-scrambled faces; however, the response to dots on faces did not differ significantly from that to the control stimuli. Approximately 3-5 s after stimulus onset, pupillary responses to dots on faces recovered to baseline faster than those to dots on phase-scrambled faces with a larger pupil size. The initial pupillary constrictions observed are consistent with those in response to dots on natural backgrounds, suggesting that regardless of the background, dots may stimulate parasympathetic activation and elicit disgust rather than fear. The faster recovery from the pupil constriction and larger pupil size in the later phase may be caused by a dynamic balance between the sympathetic and parasympathetic neuronal activities.

Excessive fear of clusters of holes, its interaction with stressful life events and the association with anxiety and depressive symptoms: large epidemiological study of young people in Hong Kong.

BACKGROUND: Excessive and persistent fear of clusters of holes, also known as trypophobia, has been suggested to reflect cortical hyperexcitability and may be associated with mental health risks. No study, however, has yet examined these associations in representative epidemiological samples. AIMS: To examine the prevalence of trypophobia in a population-representative youth sample, its association with mental health and functioning, and its interaction with external stress. METHOD: A total of 2065 young people were consecutively recruited from a household-based epidemiological youth mental health study in Hong Kong. Trypophobia, symptoms of anxiety, depression and stress, and exposure to personal stressors were assessed. Logistic regression was used to assess the relationships between trypophobia and mental health. Potential additive and interaction effects of trypophobia and high stress exposure on mental health were also tested. RESULTS: The prevalence of trypophobia was 17.6%. Trypophobia was significantly associated with severe symptoms of anxiety (odds ratio (OR) = 1.83, 95% CI = 1.32-2.53), depression (OR = 1.78, 95% CI = 1.24-2.56) and stress (OR = 1.68, 95% CI = 1.11-2.53), even when accounting for sociodemographic factors, personal and family psychiatric history, resilience and stress exposure. Dose-response relationships were observed, and trypophobia significantly potentiated the effects of stress exposure on symptom outcomes, particularly for depressive symptoms. Those with trypophobia also showed significantly poorer functioning across domains and poorer health-related quality of life. CONCLUSIONS: Screening for trypophobia in young people may facilitate early risk detection and intervention, particularly among those with recent stress exposure. Nevertheless, the generally small effect sizes suggest that other factors have more prominent roles in determining recent mental health outcomes in population-based samples; these should be explored in future work.

Complex sublinear burrows in the deep sea may be constructed by amphipods.

Trails, burrows, and other "life traces" in sediment provide important evidence for understanding ecology-both of the maker and of other users-and behavioral information often lacking in inaccessible ecosystems, such as the deep sea or those that are already extinct. Here, we report novel sublinear rows of openings in the abyssal plains of the North Pacific, and the first plausible hypothesis for a maker of these constructions. Enigmatic serial burrows have now been recorded in the Pacific and Atlantic deep sea. Based on image and specimen evidence, we propose that these Bering Sea excavations represent amphipod burrows, while the maker of the previously known Mid-Atlantic Ridge constructions remains undetermined. We propose that maerid amphipods could create the Pacific burrows by eating-digging horizontally below the surface along a nutrient-rich layer in the sediment, making the serial openings above them as they go, for conveniently removing excavated sediment as the excavation progresses. These striking structures contribute to local biodiversity, and their maker could be considered a deep-sea ecosystem engineer.

Depth perception between dots and the background face reduces trypophobic discomfort.

BACKGROUND: Studies have shown that viewing a cluster of dots evokes feelings of discomfort in viewers and that the discomfort becomes especially strong when the dots are placed on background images of human skin. This phenomenon has been explained by the physical properties and spatial and semantic relationships between the dots and the background. However, it was not known whether the perceived, as well as the physical, spatial relationships contributes to the generation of discomfort. METHODS: We evoked illusory depth perception between black dots and the background face by drawing shadow-like gray dots around the black dots, while keeping the same black dots at the same positions, and examined whether illusory depth perception could increase or decrease discomfort. In each trial, participants viewed one of the following types of facial images: (a) face-only (face without dots), (b) a cluster of black dots on the face, (c) a cluster of gray dots on the face, and (d) a cluster of black dots and shadow-like gray dots on the face. After seeing each picture, they evaluated how much discomfort they felt from viewing the picture using a Likert scale and reported whether they perceived depth between the dots and the face. RESULTS: Participants felt discomfort toward all three types of faces with dots, that is, faces with black dots, gray dots, and both. However, interestingly, participants felt less discomfort when both black and gray dots were presented on the face than when only black dots were presented. The participants perceived depth between the black dots and the face in 85% of the trials with black dots and shadow-like gray dots, and there was a significant correlation between discomfort and frequency of depth perception. However, in the trials with black dots only and gray dots only, they perceived depth in only 18% and 27% of the trials, respectively, and the correlations between the frequencies of depth perception and discomfort were not significant. CONCLUSIONS: Our results suggest that the perceived spatial relationship, such as attached vs. separate, as well as the physical spatial relationship, contribute to the generation of discomfort.

Evaluating the 'skin disease-avoidance' and 'dangerous animal' frameworks for understanding trypophobia.

ABSTRACTTrypophobia refers to the extreme negative reaction when viewing clusters of circular objects. Two major evolutionary frameworks have been proposed to account for trypophobic visual discomfort. The skin disease-avoidance (SD) framework proposes that trypophobia is an over-generalised response to stimuli resembling pathogen-related skin diseases. The dangerous animal (DA) framework posits that some dangerous organisms and trypophobic stimuli share similar visual characteristics. Here, we performed the first experimental manipulations which directly compare these two frameworks by superimposing trypophobic imagery onto multiple image categories to evaluate changes in comfort. Participants from two countries (United States and Croatia) were evaluated on several measures, including general trypophobia levels, perceived vulnerability to disease, and generalised anxiety. Several analyses showed stronger changes in comfort in the human skin condition (hand, feet, and chest images) compared to the dangerous animal condition (snake and spider images). Furthermore, participants with higher levels of trypophobia showed significantly stronger changes in comfort in the skin condition than the dangerous animal condition, with comparable effects obtained across nationalities. Several variables entered as covariates failed to significantly account for this effect. The present work is the first to experimentally test both evolutionary frameworks of trypophobia, with results supporting the skin disease-avoidance framework.

Object Clusters or Spectral Energy? Assessing the Relative Contributions of Image Phase and Amplitude Spectra to Trypophobia.

Trypophobia refers to the visual discomfort experienced by some people when viewing clustered patterns (e.g., clusters of holes). Trypophobic images deviate from the 1/f amplitude spectra typically characterizing natural images by containing excess energy at mid-range spatial frequencies. While recent work provides partial support for the idea of excess mid-range spatial frequency energy causing visual discomfort when viewing trypophobic images, a full factorial manipulation of image phase and amplitude spectra has yet to be conducted in order to determine whether the phase spectrum (sinusoidal waveform patterns that comprise image details like edge and texture elements) also plays a role in trypophobic discomfort. Here, we independently manipulated the phase and amplitude spectra of 31 Trypophobic images using a standard Fast Fourier Transform (FFT). Participants rated the four different versions of each image for levels of visual comfort, and completed the Trypophobia Questionnaire (TQ). Images having the original phase spectra intact (with either original or 1/f amplitude) explained the most variance in comfort ratings and were rated lowest in comfort. However, images with the original amplitude spectra but scrambled phase spectra were rated higher in comfort, with a smaller amount of variance in comfort attributed to the amplitude spectrum. Participant TQ scores correlated with comfort ratings only for images having the original phase spectra intact. There was no correlation between TQ scores and comfort levels when participants viewed the original amplitude / phase-scrambled images. Taken together, the present findings show that the phase spectrum of trypophobic images, which determines the pattern of small clusters of objects, plays a much larger role than the amplitude spectrum in determining visual discomfort.

Trypophobic images induce oculomotor capture and inhibition.

It is known that unpleasant images capture our attention. However, the causes of the emotions evoked by these images can vary. Trypophobia is the fear of clustered objects. A recent study claimed that this phobia is elicited by the specific power spectrum of such images. In the present study, we measured saccade trajectories to examine how trypophobic images possessing a characteristic power spectrum affect visual attention. The participants' task was to make a saccade in the direction that was indicated by a cue. Four irrelevant images with different emotional content were presented as periphery distractors at 0 ms, 150 ms, and 450 ms in terms of cue-image onset asynchrony. The irrelevant images consisted of trypophobic, fearful, or neutral scenes. The presence of saccade trajectory deviations induced by trypophobic images suggest that intact trypophobic images oriented attention to their location. Moreover, when the images were phase scrambled, the saccade curved away from the trypophobic images, suggesting that trypophobic power spectra also triggered attentional capture, which was weak and then led to inhibition. These findings suggest that not only the power spectral characteristics but also the gist of a trypophobic image affect attentional deployment.

Trypophobic images gain preferential access to early visual processes.

Trypophobia is a common but unusual phobia that is induced by viewing many clustered objects. Previous studies suggested that this trypophobia is caused by the specific power spectrum of the images; this idea has not been fully investigated empirically. In the present study, we used breaking continuous flash suppression (b-CFS) to clarify whether the trypophobic images affect access to visual awareness, and what features of trypophobic images contribute to rapid access of awareness. In the b-CFS paradigms, a dynamic masking pattern presented to one eye suppresses the target images shown to the other eye. The participants' task was to indicate where the target image appeared in a dichoptic display through a mirror stereoscope. The target images consisted of trypophobic, fear-related, clusters or neutral images. The trypophobic images emerged into awareness faster than the other types of images. However, the phase-scrambled versions of the trypophobic images did not show any differences across the image types, suggesting that the trypophobic power spectra themselves did not affect access to awareness. Moreover, the phase-scrambled trypophobic images without CFS tended to be detected earlier than the phase-scrambled fearful and neutral images. These findings indicate that trypophobic power spectra might affect post-perceptual processing, such as response production.

Face-Inversion Effect on Disgust Evoked by a Cluster of Dots.

A cluster of dots such as lotus seed pods evokes extremely strong disgust when it is placed on human and animal skins. However, few empirical studies have examined the role of the background image, such as skin, in the generation of disgust. In this study, we investigated whether the orientation of background faces influences the disgust evoked by the dot pattern. The participants were asked to evaluate disgust to an upright, inverted, or phase-scrambled face image with or without a cluster of dots on it and then complete a questionnaire measuring trypophobia proneness (Trypophobia Questionnaire). The results suggested that disgust was intensified by the background faces, especially by the upright faces. The intensification of disgust in the upright face was correlated positively with the Trypophobia Questionnaire scores. The results indicated a face-inversion effect on the disgust to the dot pattern, suggesting a significant role of the background image.

Enhanced early visual processing in response to snake and trypophobic stimuli.

BACKGROUND: Trypophobia refers to aversion to clusters of holes. We investigated whether trypophobic stimuli evoke augmented early posterior negativity (EPN). METHODS: Twenty-four participants filled out a trypophobia questionnaire and watched the random rapid serial presentation of 450 trypophobic pictures, 450 pictures of poisonous animals, 450 pictures of snakes, and 450 pictures of small birds (1800 pictures in total, at a rate of 3 pictures/s). The EPN was scored as the mean activity at occipital electrodes (PO3, O1, Oz, PO4, O2) in the 225-300 ms time window after picture onset. RESULTS: The EPN was significantly larger for snake pictures than for the other categories, and significantly larger for trypophobic pictures and poisonous animal pictures than for bird pictures. Remarkably, the scores on the trypophobia questionnaire were correlated with the EPN amplitudes for trypophobic pictures at the occipital cluster (r = -.46, p = .025). CONCLUSIONS: The outcome for the EPN indicates that snakes, and to a somewhat lesser extent trypophobic stimuli and poisonous animals, trigger early automatic visual attention. This supports the notion that the aversion that is induced by trypophobic stimuli reflects ancestral threat and has survival value. The possible influence of the spectral composition of snake and trypophobic stimuli on the EPN is discussed.

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

In this article, we describe the case of a girl who suffers from a phobia to repetitive patterns, known as trypophobia. This condition has not yet been recognised by diagnostic taxonomies such as the Diagnostic and Statistical Manual of Mental Disorders. Trypophobia usually involves an intense and disproportionate fear towards holes, repetitive patterns, protrusions, etc., and, in general, images that present high-contrast energy at low and midrange spatial frequencies. It is commonly accompanied by neurovegetative symptoms. In the case we present here, the patient also suffered from generalised anxiety disorder and was treated with sertraline. After she was diagnosed, she showed symptoms of both fear and disgust towards trypophobic images. After some time following treatment, she only showed disgust towards said images. We finish this case report presenting a comprehensive literature review of the peer reviewed articles we retrieved after an exhaustive search about trypophobia, we discuss how this case report contributes to the understanding of this anxiety disorder, and what questions future studies should address in order to achieve a better understanding of trypophobia.

Pupillometry reveals the physiological underpinnings of the aversion to holes.

An unusual, but common, aversion to images with clusters of holes is known as trypophobia. Recent research suggests that trypophobic reactions are caused by visual spectral properties also present in aversive images of evolutionary threatening animals (e.g., snakes and spiders). However, despite similar spectral properties, it remains unknown whether there is a shared emotional response to holes and threatening animals. Whereas snakes and spiders are known to elicit a fear reaction, associated with the sympathetic nervous system, anecdotal reports from self-described trypophobes suggest reactions more consistent with disgust, which is associated with activation of the parasympathetic nervous system. Here we used pupillometry in a novel attempt to uncover the distinct emotional response associated with a trypophobic response to holes. Across two experiments, images of holes elicited greater constriction compared to images of threatening animals and neutral images. Moreover, this effect held when controlling for level of arousal and accounting for the pupil grating response. This pattern of pupillary response is consistent with involvement of the parasympathetic nervous system and suggests a disgust, not a fear, response to images of holes. Although general aversion may be rooted in shared visual-spectral properties, we propose that the specific emotion is determined by cognitive appraisal of the distinct image content.

Disgusting clusters: trypophobia as an overgeneralised disease avoidance response.

Individuals with trypophobia have an aversion towards clusters of roughly circular shapes, such as those on a sponge or the bubbles on a cup of coffee. It is unclear why the condition exists, given the harmless nature of typical eliciting stimuli. We suggest that aversion to clusters is an evolutionarily prepared response towards a class of stimuli that resemble cues to the presence of parasites and infectious disease. Trypophobia may be an exaggerated and overgeneralised version of this normally adaptive response. Consistent with this explanation, individuals with trypophobia, as well as comparison individuals, reported aversion towards disease-relevant cluster stimuli, but only the trypophobic group reported aversion towards objectively harmless cluster stimuli that had no relevance to disease. For both groups the level of aversion reported was predicted uniquely by a measure of disgust sensitivity. Scaled emotion ratings and open-ended responses revealed that the aversive response was predominantly based on the disease avoidance emotion, disgust. Many open-ended responses also described skin sensations (e.g. skin itching or skin crawling). These findings support the proposal that individuals with trypophobia primarily perceive cluster stimuli as cues to ectoparasites and skin-transmitted pathogens.

Trypophobia: an investigation of clinical features

Objective: Trypophobia refers to the fear of, or aversion to, clusters of holes. We assessed clinical features of trypophobia and investigated whether it most resembled a specific phobia or obsessive-compulsive disorder. Methods: An online survey was conducted to gather information on sociodemographic variables, course and duration, severity, associated features, comorbid psychiatric diagnoses, and levels of psychological distress and impairment in individuals with trypophobia. The survey also explored whether such individuals experienced more fear or disgust, and whether symptoms showed more resemblance to a specific phobia or to obsessive-compulsive disorder. Associations of symptom severity and duration with degree of impairment were investigated. Results: One hundred and ninety-five individuals completed the questionnaire. Symptoms were chronic and persistent. The most common associated comorbidities were major depressive disorder and generalized anxiety disorder. Trypophobia was associated with significant psychological distress and impairment. The majority of individuals experienced disgust rather than fear when confronted with clusters of holes, but were more likely to meet DSM-5 criteria for specific phobia than for obsessive-compulsive disorder. Symptom severity and duration were associated with functional impairment. Conclusions: Given that individuals with trypophobia suffer clinically significant morbidity and comorbidity, this condition deserves further attention from clinicians and researchers.

Trypophobic Discomfort is Spatial-Frequency Dependent.

Clusters of holes, such as those in a lotus seedpod, induce trypophobic discomfort. Previous research has demonstrated that high-contrast energy at midrange spatial frequencies in images causes trypophobic discomfort. The present study examined the effects on discomfort of eliminating various spatial frequency components from the images to reveal how each spatial frequency contributes to the discomfort. Experiment 1 showed that eliminating midrange spatial frequencies did not affect trypophobic discomfort, while Experiment 2 revealed that images of holes that consisted of only high-spatial frequencies evoked less discomfort than other images and that images containing only low or midrange spatial frequencies induced as much trypophobic discomfort as did the original images. Finally, Experiment 3 found that participants with a high level of the trypophobic trait experienced stronger discomfort from the original images and the images containing only low or midrange spatial frequencies than participants with a low level of the trypophobic trait. Our findings thus suggest that trypophobic discomfort can be induced by middle and low spatial frequencies.

Is Trypophobia a Phobia?

In the past 10 years, thousands of people have claimed to be affected by trypophobia, which is the fear of objects with small holes. Recent research suggests that people do not fear the holes; rather, images of clustered holes, which share basic visual characteristics with venomous organisms, lead to nonconscious fear. In the present study, both self-reported measures and the Preschool Single Category Implicit Association Test were adapted for use with preschoolers to investigate whether discomfort related to trypophobic stimuli was grounded in their visual features or based on a nonconsciously associated fear of venomous animals. The results indicated that trypophobic stimuli were associated with discomfort in children. This discomfort seemed to be related to the typical visual characteristics and pattern properties of trypophobic stimuli rather than to nonconscious associations with venomous animals. The association between trypophobic stimuli and venomous animals vanished when the typical visual characteristics of trypophobic features were removed from colored photos of venomous animals. Thus, the discomfort felt toward trypophobic images might be an instinctive response to their visual characteristics rather than the result of a learned but nonconscious association with venomous animals. Therefore, it is questionable whether it is justified to legitimize trypophobia.

Trypophobia is predicted by disgust sensitivity, empathic traits, and visual discomfort.

Trypophobia refers to disgust for a cluster of objects, and is considered an extension of disgust for dangerous objects. Furthermore, trypophobic images possess certain spatial properties that can induce perceptually unpleasant states (i.e., visual discomfort). We examined whether trypophobia is associated with disgust sensitivity, empathic traits, and visual discomfort. Japanese adults (n = 126) completed four scales: the Trypophobia Questionnaire, which measures trypophobia proneness; the Disgust Scale-Revised, which measures disgust sensitivity; the Interpersonal Reactivity Index, which measures empathic traits; and the Visual Discomfort Scale, which measures proneness to visual discomfort. Trypophobia proneness was found to be predicted by Core disgust sensitivity (i.e., threat of disease), Personal Distress (i.e., the empathic trait of self-oriented emotional distress), and proneness to visual discomfort. We suggest a number of potential factors relating to individual differences in trypophobia and the possible cognitive and perceptual mechanisms underlying trypophobia.