Specific Phobia
DSM - IV (Diagnostic and Statistical Manual, 4th Ed.) provides diagnostic criteria for specific phobia:
Marked, Excessive Fear: A persistent and intense fear that is triggered by a specific object or situation.
Immediate Anxiety Response: The fear reaction appears almost instantaneously when the object or situation is presented. The response may resemble a panic attack.
Recognition That Fear Is Irrational: Adults with specific phobias recognize that their fears are out of proportion to reality. Children may not have this awareness.
Avoidance or Extreme Distress: The sufferer goes out of his or her way to avoid the object or situation, or endures it with extreme distress.
Life-Limiting: The phobia significantly impacts the sufferer’s school, work or personal life.
Six Months Duration: In children and teens, the symptoms must have lasted for at least six months.
Not Caused by Another Disorder: Many anxiety disorders have similar symptoms. The therapist will rule out other disorders before diagnosing a specific phobia.\
Risk factors:
Your age. Social phobia usually develops early in life, often before age 25. Specific phobias having to do with the environment or personal injury also first appear in childhood — as early as age 5. Fear of tunnels, elevators, bridges, flying, driving and other situational phobias usually develop by the mid-20s.
Your sex. Phobias affect both sexes, but women and girls are more likely to have specific or social phobias than are men and boys. Women are also more likely to be diagnosed with agoraphobia, but this may be because men tend to hide anxiety or mask it with alcohol. Men and boys may be less likely to seek help for emotional problems than women and girls.
Your family. If someone in your immediate family has a specific phobia, such as a fear of spiders or snakes, you're more likely to develop it also.
A traumatic event. Experiencing a traumatic event, such as being trapped in an elevator or attacked by an animal, may trigger the development of a phobia.
Causes:
Cognitive factors: People who suffer from specific phobia are usually the ones that pay attention to things more than other people do. For example, individuals with a spider phobia tend to notice the presence of a spider in a room before anybody else. Also, it is common for individuals with specific phobia to have distortions regarding memories that involve the phobic stimulus. They recall the phobic situation as more dangerous than it really was, or the feared animal larger, faster, or more aggressive than it was in reality. The memory distortions can be supported by impaired beliefs and interpretations attributed to feared objects or situations. The anxiety response experienced during a phobic situation can be maintained or increased by these impaired beliefs and interpretations.
Environmental factors: Specific phobia can be developed as a result of traumatic experience. This means that the individual was either directly exposed to the traumatic event, witnessed the traumatic event, or he only heard or read about the traumatic event. The first case of being directly exposed to the traumatic event means that the person develops the specific phobia as the result of being directly exposed to the traumatic event. For example, a person that gets stung by a bee develops a bee phobia. The second case of witnessing the traumatic event can be for example when a person witnesses somebody falling from a high building, he might develop a phobia of heights. The third case is that the individual has only heard or read about some kind of a traumatic event. For example if a person hears a lot about the plane crashes, he might develop a phobia of flying. However, experiencing a traumatic experience does not always result in the development of a specific phobia, and some individuals with specific phobia do not recall any obvious trigger, cause, or source of their phobia.
Treatments:
Specific phobia is the only anxiety disorder that is effectively treated with psychological approaches rather than medication. The most effective forms of psychotherapy are: cognitive behavioral therapy and behavioral therapy. Cognitive behavioral therapy combines two components (cognitive and behavioral component) for a better outcome. The cognitive component targets the individuals dysfunctional thinking patterns that supports and maintains the anxiety response, replacing them with more adaptive and realistic cognitions. The most effective technique is cognitive restructuring which challenges the irrational beliefs. This method is based on the theory that the unrealistic beliefs built when exposed to fear stimuli generate, maintain, and increase dysfunctional emotions and behaviors. The behavioral component targets the individual's reaction to the phobic stimulus. The most effective behavioral approach is exposure therapy where in a safe setting the individual gradually gets exposed to their feared stimulus, first using the imagination and then by direct confrontation. Behavioral therapy is another effective form of therapy that can treat specific phobia. The goal of behavioral therapy is to modify the fear-related behaviors and gain control over the dysfunctional behaviors. Two of the most effective behavioral techniques used to treat specific phobia are: learning a relaxation technique which allows the individual to control the anxiety, and exposure technique which gradually exposed the individual to feared stimuli. Medication, can be another treatment approach for individuals with specific phobia. However, medication has a limited utility in the treatment of specific phobia. In some cases, antidepressants (such as selective serotonin reuptake inhibitors - SSRIs) and tranquilizers (to reduce the anxiety) can be prescribed for individuals with specific phobia. Medication seems to be more effective when the individual with specific phobia has another coexistent anxiety disorder.
A specific phobia is an intense and irrational fear of a specified object or situation. There are four defined categories of specific phobias: natural, medical, animal and situational. Many people suffer multiple specific phobias simultaneously.
Marked, Excessive Fear: A persistent and intense fear that is triggered by a specific object or situation.
Immediate Anxiety Response: The fear reaction appears almost instantaneously when the object or situation is presented. The response may resemble a panic attack.
Recognition That Fear Is Irrational: Adults with specific phobias recognize that their fears are out of proportion to reality. Children may not have this awareness. Life-Limiting: The phobia significantly impacts the sufferer’s school, work or personal life.
Six Months Duration: In children and teens, the symptoms must have lasted for at least six months.
Not Caused by Another Disorder: Many anxiety disorders have similar symptoms. The therapist will rule out other disorders before diagnosing a specific phobia.\
Risk factors:
Your age. Social phobia usually develops early in life, often before age 25. Specific phobias having to do with the environment or personal injury also first appear in childhood — as early as age 5. Fear of tunnels, elevators, bridges, flying, driving and other situational phobias usually develop by the mid-20s.
Your sex. Phobias affect both sexes, but women and girls are more likely to have specific or social phobias than are men and boys. Women are also more likely to be diagnosed with agoraphobia, but this may be because men tend to hide anxiety or mask it with alcohol. Men and boys may be less likely to seek help for emotional problems than women and girls.
Your family. If someone in your immediate family has a specific phobia, such as a fear of spiders or snakes, you're more likely to develop it also.
A traumatic event. Experiencing a traumatic event, such as being trapped in an elevator or attacked by an animal, may trigger the development of a phobia.
Causes:
Biological factors: Specific phobia tends to run in the family so if somebody in your family suffered from this disorder, you are more likely to suffer from it, too. The research shows that first-degree relatives of individuals with specific phobia, animal type are more likely to have an animal phobia themselves, but they may not necessary fear the same animal. First-degree relatives of individuals with specific phobia, situational type, are likely to develop situational phobias.
Cognitive factors: People who suffer from specific phobia are usually the ones that pay attention to things more than other people do. For example, individuals with a spider phobia tend to notice the presence of a spider in a room before anybody else. Also, it is common for individuals with specific phobia to have distortions regarding memories that involve the phobic stimulus. They recall the phobic situation as more dangerous than it really was, or the feared animal larger, faster, or more aggressive than it was in reality. The memory distortions can be supported by impaired beliefs and interpretations attributed to feared objects or situations. The anxiety response experienced during a phobic situation can be maintained or increased by these impaired beliefs and interpretations.Treatments:
Specific phobia is the only anxiety disorder that is effectively treated with psychological approaches rather than medication. The most effective forms of psychotherapy are: cognitive behavioral therapy and behavioral therapy. Cognitive behavioral therapy combines two components (cognitive and behavioral component) for a better outcome. The cognitive component targets the individuals dysfunctional thinking patterns that supports and maintains the anxiety response, replacing them with more adaptive and realistic cognitions. The most effective technique is cognitive restructuring which challenges the irrational beliefs. This method is based on the theory that the unrealistic beliefs built when exposed to fear stimuli generate, maintain, and increase dysfunctional emotions and behaviors. The behavioral component targets the individual's reaction to the phobic stimulus. The most effective behavioral approach is exposure therapy where in a safe setting the individual gradually gets exposed to their feared stimulus, first using the imagination and then by direct confrontation. Behavioral therapy is another effective form of therapy that can treat specific phobia. The goal of behavioral therapy is to modify the fear-related behaviors and gain control over the dysfunctional behaviors. Two of the most effective behavioral techniques used to treat specific phobia are: learning a relaxation technique which allows the individual to control the anxiety, and exposure technique which gradually exposed the individual to feared stimuli. Medication, can be another treatment approach for individuals with specific phobia. However, medication has a limited utility in the treatment of specific phobia. In some cases, antidepressants (such as selective serotonin reuptake inhibitors - SSRIs) and tranquilizers (to reduce the anxiety) can be prescribed for individuals with specific phobia. Medication seems to be more effective when the individual with specific phobia has another coexistent anxiety disorder.
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