A phobia
is a fear which is caused by a specific object or situation.
The fear may be by the actual presence of, or by, the anticipation
of the presence of that object or situation. Anxiety, triggered
by the fear, may approach the intensity of panic. See
Phobia Listing.
The patient experiences
a strong, persistent fear that is excessive or unreasonable. It
is cued by a specific object or situation that is either
present or anticipated.
The phobic stimulus
almost always immediately provokes an anxiety response, which
may be either
a panic attack or symptoms of anxiety that do not meet criteria
for a panic attack.
The fear is unreasonable
or out of proportion, and the patient realizes this.
The patient either
avoids the phobic stimulus or endures it with severe anxiety or
distress.
Patient is under
the age of 18, but must have had the symptoms for 6 months or
longer.
Either there is
marked distress about this fear or it markedly interferes with
the patient's usual routines or social, job or personal
functioning.
Specify
type:
Situational Type (airplane travel, being closed in)
Natural Environment Type (thunderstorms, heights, for example)
Blood, Injection, Injury Type
Animal Type (spiders, snakes)
Other Type (situations that might lead to illness, choking, vomiting)
Differential
Diagnosis:
Some disorders
have similar or even the same symptom. The clinician, therefore,
in his diagnostic attempt has to differentiate against the following
disorders which he needs to rule out to establish a precise
diagnosis.
Cause:
Phobias
frequently begin in childhood. Personal trauma and stress can
sometimes trigger a phobia in children and adults. As an example,
a person who was once trapped in a small room might later become
frightened of closed spaces. Genetic factors have also been associated
with phobias. Many people who have phobias have relatives with
similar phobias or symptoms such as fears and/or a tendency to
avoid certain situations.
Treatment:
The
treatment of phobias usually has a behavior therapy focus. In
some instances drug therapy may also be tried.
Counseling
and Psychotherapy [ See
Therapy Section ]:
In the safety of the therapeutic situation, people with phobias
are gradually introduced into the very situation that normally
causes them anxiety. They learn that they can control their anxiety
while gaining greater and greater exposure to their phobic situation.
Cognitive or behavior therapy may also be extremely effective
when used in conjunction with relaxation training.
Certain
people do well on medications such as monoamine oxidase inhibitors
(MAOIs) or imipramine. Also, mild tranquilizers, like benzodiazepines,
can be effective in helping people control the anxiety caused
by their phobia.