Specific Phobias Diagnosis

  • Diagnosis

    Specific phobia is a persistent, irrational fear of particular objects or situations. Specific phobias are the most common of the anxiety disorders, affecting approximately 7.0% of women and 4.3% of men during any six-month period.

    Most specific phobias, such as the fear of large animals, the dark, or strangers, begin in childhood. Many of these phobias cease as people get older. Some phobias, such as the fear of rodents, insects, storms, water, heights, flying, or enclosed spaces, typically develop later in life. Phobias of a traumatic origin can occur at any time during a person's life.

    Although people with specific phobia can often cope by avoiding the feared object or situation, specific phobia is cured by exposure therapy. Antianxiety drugs give individuals temporary control over a phobia, but do not cure it. Insight-oriented psychotherapy may help to identify the conflict that underlies a specific phobia.

    Specific phobia develops as people use defense mechanisms to deal with a situation that causes them stress, fear, and anxiety. Oftentimes, a phobia has no explanation. Specific phobias are occasionally traced to a traumatic experience, or may develop from a general tendency to be anxious.

    Specific phobia usually starts in childhood when exposure to a feared object or situation provides an immediate anxiety response.

    Specific phobia is marked by a persistent fear of a discrete object or situation Table 01. A person with specific phobia will experience symptoms of anxiety, including dizziness, rapid heartbeat, sweating, and shortness of breath.

    Adolescents and adults with specific phobia can most likely recognize that their fear is excessive or unreasonable; however, children cannot.

    Table 1.  Symptoms of Specific Phobia

    Dizziness and feeling faint
    Palpitations, abnormally rapid heartbeat
    Sweating, trembling, and nausea
    Shortness of breath
    Avoidance of the feared object or situation

    The level of anxiety or fear usually varies according to the proximity of the feared object or situation and the degree to which escape from the source of fear is possible. People who have specific phobias will experience fear that intensifies as the feared object approaches, and decreases as the feared object moves away from them. Those who recognize that certain objects or situations cause them fear and anxiety tend to avoid those triggers.

    People who have a blood-injection injury type-phobia may experience a fainting response. Approximately 75% of patients with blood-injection injury type specific phobia will faint when confronted with their fear. Patients who experience the fainting response have accelerated heart rates followed by a deceleration in heart rate and a drop in blood pressure.

    There are several common subtypes of specific phobia Table 02.

    Table 2.  Subtypes of Specific Phobia

    Subtype Characteristics
    Animal Fear of animals; childhood onset
    Natural environment Fear of storms, heights, or water; usually onset later in life
    Blood-injection injury Fear of invasive medical procedures, blood, or injections; highly familial
    Situational Fear of public transportation, tunnels, bridges, elevators, flying, driving, or enclosed spaces; peaks in childhood and in the mid-twenties
    Other Fear of other objects or situations such as choking, vomiting, contracting an illness, loud sounds, or costumed characters (children)

    Children and young people in their mid-twenties who are exposed to a traumatic event have the greatest risk of developing specific phobia. Factors that predispose individuals to specific phobia include observed or experienced traumatic events, unexpected panic attacks associated with the phobic stimulus, and hearing of dramatic news (e.g., airplane crashes or a fire) through the media or through friends and family.

    Women are more likely than men to suffer from specific phobias. The gender gap, however, is different depending on the type of specific phobia. For example, between 75% and 90% of people with animal, situational, or natural environment phobias are women, while only 55% to 70% of people with phobias involving heights, blood, or injections are women.

    A doctor will only diagnose specific phobia in cases where the symptoms interfere significantly with the person's daily routine, occupation, or social life. Many people have a mild degree of fear or discomfort in any challenging situation, which is normal. However, when the fear or anxiety becomes uncontrollable and affects your daily life, it is diagnosed as a phobia, and requires medical attention.

    In people under 18 years of age, the symptoms of anxiety must persist for at least 6 months before specific phobia can be diagnosed.

    A doctor can only diagnose specific phobia in adults if the fear is unreasonable and uncontrollable. Adults usually recognize that the fear they experience in response to an object or a situation is not normal, rational, or controllable. Childrens' fears, however, need not be reasonable or uncontrollable for doctors to make a diagnosis.

    Your doctor will rule out a diagnosis of specific phobia if you also have obsessive-compulsive disorder, posttraumatic stress disorder, separation anxiety disorder, social phobia, or panic disorder (with or without agoraphobia).

  • Prevention and Screening

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