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Specific Phobias

Diagnostic criteria for specific phobias include:

 

  • Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation, (e.g., flying, heights, animals, receiving an injection, seeing blood).

  • Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response which may take the form of a panic attack. (In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.)

  • The person recognizes that the fear is excessive or unreasonable, but the phobic situation is either avoided or endured with intense distress.

  • The avoidance, anxious anticipation, or distress significantly interfere with routine functioning.

  • Specific phobias tend to cluster into three groups across all ages and both sexes: 1) animal phobia (snakes, dogs, spiders, rats); situational phobia (heights, flying, storms, claustrophobia, elevators, driving, bridges, tunnels); and, blood-injury-injection phobia, which has unique features including drops in heart rate and blood pressure that may cause faintness. (Maris, et al., 1999)

  • Fear of animals is most prevalent among women; fear of heights is most prevalent in men. Number of fears, independent of type, powerfully predicted impairment, co-morbid disorders and course of the anxiety disorder. (Curtis, et al., 1998)

  • Most phobics attributed the onset of their phobias to a specific terrifying experience, and, in many cases, to observing another person display intense fear in the situation. (Arnarson, 1998)

  • Phobias result from "...association of either a true or false alarm with an object or situation that has a high probability of acquiring phobic properties... Without anxious apprehension, the fear reaction would presumably fall into the category of normal fears experienced by over half the population, which cause some mild distress during direct confrontation, but are otherwise ignored and forgotten." (Barlow, 1988)

  • Most people with specific phobias do not present for treatment; those who do often actually have another anxiety disorder such as panic disorder or obsessive-compulsive disorder.

  • For the short term, specific phobias tend to be very responsive to treatment. However, 10-16 year follow-up after successful treatment suggested that 45-62% of phobics had significant avoidance or endurance with dread. There were no impressive predictors of outcome. (Lipsitz, et al., 1999)

  • Specific phobias do not seem to be inherently noncognitive and irrational as long assumed. Specific harm cognitions are frequent as is "ex-consequentia reasoning": "If I feel anxious, there must be danger." (Arntz, et al., 1995)

  • There is a consensus in the literature that graduated exposure is the preferred treatment for specific phobias. If you are sufficiently motivated, such exposure can be self-conducted. If this proves insufficient, ASDI has specialists who can help you plan and conduct a program of graduated exposure.

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