Specific Phobia

Clinical Picture

A Specific Phobia, a type of anxiety disorder is an intense and persistent fear towards a precise object, situation, or activity. The people usually have extreme fear about certain situations or objects, and perceive it as a danger or threat even though it actually do not any threat. The amount of fear experienced may vary with proximity to the feared object or situation and may occur in anticipation or in the actual presence of the object or situation (DSM-5). Some individuals may even trigger social phobia even if they imagine or sight of the object or situation. For example someone who had a phobia of blood would react phobic if they saw blood on T.V.

The fear is persistent, excessive, irrational and irrelevant fear. It’s disproportionate to the actual danger posed and results in significant emotional distress, avoidance behavior and impairment in daily functioning. Individuals usually recognize that their fear is unresonable but they still find it difficul or imposible to control.

Most of the article found in the internet which clam that there are more than 250 subtypes of phobia; among which are hydrophobia (water), cluster phobia (open space), arachnophobia (fear of spiders), ophidiophobia (fear of snakes), cynnophobia (fear of dog) etc. 

Specific Phobia can be categorized into the following subcategories, which of them are as follows: 

• Animals (spiders, insects, dogs)
• Natural environment type (heights, storms, water)
• Blood injection injury type (needles, invasive medical procedures)
• Situational type (airplanes, elevators and enclosed spaces)
• Other types 

Diagnostic Criteria of Specific Phobia (DSM-5)

1. Marked with fear or anxiety about a specific object or situation (e.g., flying, heights, and animals, receiving an injection, seeing blood).
2. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.
3. The phobic object or situation almost always provokes immediate fear or anxiety.
4. The phobic object or situation is actively avoided or endured with intense fear or anxiety.
5. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the socio cultural context.
6. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
7. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
8. The disturbance is not better explained by the symptoms of another mental disorder.

Comorbidity

Specific Phobia is one of the most common type of phobia that exist. DSM-5 also claim that Specific Phobia is frequently associated with a range of other disorders, especially depression in older people.It’s also often linked with panic attacks, anxiety disorders, depressive and bipolar disorders, substance related disorders, somatic symptom and related disorders, and personality disorders are also common. Specific Phobia are also associated with cardiac diseases, gastrointestinal diseases, respiratory diseases and thyroid diseases (Witthauer, 2016). 

Epidemiology

Specific phobia is one of the major disoder among the teenagers. This fears occur in a majority of the population (Myers et al., 2015). In a large study (n=5877) higher prevalence of comorbid with depression, whereas other studies have found no association (Choy, Fyer & Goodwin, 2007).  The median age of onset for specific phobia is 7 years of age, the youngest of any anxiety disorder (except separation anxiety disorder (Kessler, Berglund et al., 2005).

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the year-long community prevalence estimate for specific phobias is approximately 7%-9%. The prevalence rate varies as per culture. In an another larger study (n=1000) it was found that females are more likely to develop phobia than male (Fredrikson, Annas, Fishcer & Wik, 1996). Specific phobia affects about 5% to 10% of the US population (Samra & Abdijadid, 2020).