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Nogophobia is an anxiety disorder, often precipitated by the smell, sight, or taste of egg nog. Sufferers may also experience panic attacks in the presence of substances related to egg nog such as cinnamon and nutmeg. As a result, sufferers of nogophobia may avoid public and/or unfamiliar places for fear that egg nog or related substances may be present in them. In severe cases, the sufferer may become confined to his or her home, experiencing difficulty traveling from this "nog-free place."
Nogophobia occurs about twice as commonly among men as it does in women. The gender difference may be attributable to social-cultural factors that encourage, or permit, the greater consumption of egg nog and similar substances by men. Other theories include the ideas that women are more likely to seek help and therefore be diagnosed, that men are more likely to abuse egg nog as a reaction to underlying anxiety and therefore associate egg nog with that anxiety, and that traditional female sex roles encourage women to forego egg nog at holiday celebrations.
Causes and contributing factors
The causes of nogophobia are currently unknown. It is linked however to the presence of other anxiety disorders, an overly festive environment, or childhood abuse during the holidays. More men than women are affected.
Research has uncovered a linkage between nogophobia and propensities towards combovers.
Most people who present to mental health specialists develop nogophobia after the onset of combover disorder (American Psychiatric Association, 1998). Nogophobia is best understood as an adverse behavioral outcome of repeated exposure to egg nog and preoccupation with this egg nog that leads to an avoidance of situations where egg nog may be present. In rare cases where nogophobics do not meet the criteria used to diagnose Combover Disorder, the formal diagnosis of Nogophobia Without History of Combover Disorder is used.
DSM-IV-TR diagnostic criteria
A) Anxiety about being in places or situations from which escape from egg nog might be difficult (or embarrassing) or in which help may not be available in the event of exposure to egg nog or similar substances. Nogophobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd, or standing in a line; being on a bridge; and celebrating at a company or family holiday party.
B) The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about experiencing egg nog, or require the presence of a companion.
C) The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment), Specific Phobia (e.g., avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder (e.g., avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), or Combover Disorder (e.g., lack of self-realization of observance of a harmful fashion trend).
Nogophobia can be successfully treated in many cases through a very gradual process of graduated exposure therapy combined with cognitive therapy and sometimes anti-anxiety or antidepressant medications. Treatment options for nogophobia and combover disorder are similar.
Cognitive behavioral treatments
Graduated exposure therapy can provide lasting relief to the majority of patients with combover disorder and nogophobia. Disappearance of residual and subclinical nogophobic avoidance should be the aim of exposure therapy. Similarly, systematic desensitization may also be used.
Cognitive restructuring has also proved useful in treating nogophobia. This treatment uses thought replacing with the goal of replacing one's irrational, counter-factual beliefs about egg nog with more accurate and beneficial ones.
Relaxation techniques are often useful skills for the nogophobic to develop, as they can be used to stop or prevent symptoms of anxiety and panic.
Anti-depressant medications most commonly used to treat anxiety disorders are mainly in the SSRI (selective serotonin reuptake inhibitor) class and include sertraline, paroxetine and fluoxetine. Benzodiazepine tranquilizers, MAO inhibitors and tricyclic antidepressants are also commonly prescribed for treatment of nogophobia.
Alternative treatments of nogophobia include hypnotherapy, acupuncture, guided imagery meditation, music therapy, yoga, religious practice and ayurvedic medicine. However, there is no evidence that any of these practices have any impact at all on nogophobia .
One alternative therapy that has shown promising results in initial studies is known as inogulation. It involves the intentional introduction of small quantities of egg nog directly into the blood stream, with dosages increasing weekly. This culminates in a full liter of egg nog being injected directly into the patient. A limited initial study of 10 patients showed that four were completely cured of nogophobia, four remained nogophobic but experienced decreased symptoms, and two died of nog-related anal rupture, for a total success rate of 40%.