Whether trypophobia can be accurately described as a specific phobia might depend on whether the person mainly responds with fear or with disgust. Because phobias involve fear, a response to trypophobic imagery that is based mostly or solely on disgust renders its status as a specific phobia questionable.[1] In one study, most of the participants with trypophobia met the DSM-5 criteria for specific phobia, even though they experienced disgust instead of fear when shown imagery of clusters of holes; however, they did not meet the distress or impairment criterion.[3]