Clinical Description

• Extreme and irrational fear of a specific object or situation

• Feared situation almost always provokes anxiety

• Significant impairment or distress

• Statistics

  • 12.5% (life); 8.7% (year)

  • Female : Male = 4:1

  • Chronic course

  • Onset = Most often childhood

Diagnostic Criteria

• Marked Fear or anxiety about a specific object or situation

• Phobic object or situation almost always provokes immediate fear or anxiety

• Phobic object/situation is actively avoided

• Phobic object/situation out of proportion to actual danger

• Lasts more than 6 months

• Clinically significant distress

• Not better explained by symptoms of another mental disorder

Blood Injection Injury Phobia

• Decreased heart rate and blood pressure when seeing blood, injections, or injury

• Fainting

• Inherited vasovagal response

• Onset = usually in childhood

Situational Phobia

• Fear of specific situations

  • E.g., Flying, driving

• No uncued panic attacks

• Fear centers around risks of the situation (e.g. Plane crashing), not having a panic attack

• Onset = early to mid 20s

Natural Environment Phobia

• Heights, storms, water

• May cluster together

• Associated with real dangers

• Onset = usually in childhood

Animal Phobia

• Dogs, snakes, mice, insects

• May be associated with real dangers

• Onset = usually in childhood

Causes

• Direct experience

• Vicarious experience – seeing someone else encounter a feared object

• Information transmission – learning about a situation/object being dangerous

• “Preparedness”

Treatment

• Cognitive-behavior therapies

• Exposure

  • Graduated

  • Structured

• Relaxation – used to be practiced more, now often not a part of empirically supported treatment