Fear inoculation through medical exposure: A domain-specific analysis of medical fears in patients living with diabetes mellitus.

Medical fears are common and can interfere with medical care. While repeated exposure to fear-relevant stimuli can reduce fear, evidence from real-world settings remains limited. Consequently, we examined whether exposure to medical procedures in a natural setting is associated with lower levels of domain-specific medical fear in individuals with diabetes mellitus (DM). A total of 401 participants with type 1 or type 2 DM or insulin resistance completed the Medical Fear Survey, which assesses five domains: injections and blood draws, sharp objects, blood, examinations and symptoms, and mutilation. We analyzed associations using Bayesian multiple regression with model averaging, including injection frequency, examination frequency, DM type, sex, age, and time since diagnosis as predictors. DM type was found to be the most consistent predictor, with type 1 and type 2 DM being associated with lower fear in domains related to injections, blood, and sharp objects, compared to insulin resistance. Injection frequency showed a domain-specific association, predicting lower fear only for injections and blood draws. We did not find meaningful associations for examination- or mutilation-related fears. Sex differences were present, with women reporting higher fear, but these did not modify the associations between medical experience and fear. Our findings suggest that the associations between medical experience and fear are specific to the domain in question, which supports the idea that fear reduction is stimulus-bound. More extensive and invasive long-term medical exposure appears to be linked to broader reductions in related fears, whereas frequent exposure to specific procedures shows more localized associations.