An advertising campaign for the seventh season of the popular horror anthology, "American Horror Story: Cult," has been giving people panic attacks with its disturbing, hole-covered imagery, to which people are reportedly having visceral reactions.

The underlying cause for the reactions and the panic is quite intense and serious condition that scientists have been trying to figure out over the years. (This post below contains images that may disturb people with trypophobia)

Trypophobia or the fear of clustered holes, bumps, and similar patterns — such as the head of a lotus pod or the body of a strawberry — affects around 15 percent of the general population.

Some researchers suggest the fear or the phobia is an evolutionary instinct that is ingrained in humans already, in order to avoid dangerous and hole-covered formations in nature and around them, such as bee-hives or other poisonous structures.

Among the first researchers to study this fear were psychological scientists Arnold J. Wilkins and Geoff Cole of the University of Essex in Colchester, the United Kingdom. They published a paper on the phobia in 2013 in which they suggested a theory that aversion towards holes or hole-covered formations could be some kind of innate flight-fight response to dangerous and poisonous animals like alligators, crocodiles, snakes, who have clusters of bumps or holes on their skin.

"Holes have shadows. The cluster of holes with shadows provides an image with properties that are intrinsically uncomfortable by virtue of their spatial arrangement of high contrasts. They differ from most natural images (which the brain processes relatively efficiently) in that they have maximum contrast at spatial scales that the visual system is most sensitive to. In other words, they are physiologically strong stimuli," Wilkins told the International Business Times.

In its seventh season that premiered Sept. 5, The "American Horror Story: Cult" features actress Sarah Paulson who suffers from trypophobia in the show. Her fear of holes shown in the first episode, while looking at her souffle and a piece of coral at her therapist's office appeared to have affected viewers extensively, who suffer from the same condition, according to CNN.

The American Psychiatric Association’s "Diagnostic and Statistical Manual," (DSM-5) however, does not recognize trypophobia as an official phobia yet. 

According to a paper on trypophobia and its analysis by Wilkins and Cole in 2015, obtained by IBT, the symptoms are triggered when a person views an object with small clusters of holes or shapes that resemble holes. When people with trypophobia see a cluster of holes, they tend to react with disgust and fear. Various symptoms include:

  • Feeling sick or nauseous
  • Feeling repulsive
  • Feeling uncomfortable and uneasy
  • Anxiety 
  • Sweating, stomach ache
  • Visual discomfort

Trypophobia may have some psychological impact on the person suffering from it. "Most people can deal with it, but in a few, it interferes with life. Trypophobic images increase the oxygenation of the visual part of the brain and increase heart rate in individuals who are trypophobic," Wilkins told IBT.

Some evolutionists have suggested that numerous closely clustered objects might accidentally trigger fear of poisonous animals in people, which possess the clustered patterns. Wilkins explained saying, "There is often (but not always) a history of an incident, often in childhood, which began the phobia. For example, I heard a story from someone who was stung by bees and became averse to honeycombs and other similar shapes."

Thus, the origin of the phobia is not clearly known and more research is required to understand the full scope of the phobia and the causes of the condition. Treatment for the phobia is quite similar to that of other phobias. "I cannot see a means of prevention. Treatment is similar to that for other phobias. Desensitization by gradual exposure to progressively more intense patterns," Wilkins said.

Not much has been discovered or is known about the risk factors associated with trypophobia. A study published earlier this year by the National Center for Biotechnology Information found a probable link between trypophobia and major depressive disorder and generalized anxiety disorder (GAD).