Emetophobia is an intense and persistent fear of vomiting that extends well beyond simple discomfort or aversion. For many people, this phobia affects daily functioning, relationships, appetite, and overall quality of life. Although emetophobia is relatively rare, it is often debilitating and can be difficult to treat. Research to date suggests that its presentation and maintenance are complex, and clinicians frequently note that standard treatment approaches do not always lead to significant improvement (Keyes et al., 2018).

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5 TR), emetophobia sits under the category of "Specific Phobia." A specific phobia involves a marked and persistent fear of a particular object or situation. In this case, the feared stimulus is vomiting or situations associated with vomiting. Anticipation of the trigger can provoke intense anxiety, leading to avoidance of foods, places, or scenarios perceived as risky. These avoidance behaviours can become extensive enough to interfere with daily life, social functioning, and health.

For those with emetophobia, these responses may be so severe that they avoid any situation where vomiting might occur or avoid specific foods, which can impact daily living in significant ways.

There is currently limited research examining emetophobia specifically within autistic populations. However, in my clinical work, I have observed emetophobia appearing more frequently in autistic adults than in allistic adults. The existing literature does not confirm a causal link. Even so, certain autism-related factors may help explain why the experience of emetophobia is particularly intense or persistent for some autistic individuals.

One of the diagnostic traits of autism involves hypo- or hyperreactivity to sensory input. Many autistic people experience distinct patterns of responsiveness across multiple sensory domains, including taste, smell, touch, sight, sound, proprioception, vestibular processing, and interoception. These responses can shift over time and may differ across environments.

Vomiting is a highly sensory experience. It involves strong tastes, intense smells, a surge of interoceptive cues, and significant physical sensations. For an allistic person, vomiting may be deeply unpleasant but tolerable. For an autistic person with heightened sensory sensitivity, this same experience may be overwhelming or even

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