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Specific Phobic Disorders

By John H. Greist, MD, University of Wisconsin, School of Medicine and Public Health

Specific phobic disorders involve persistent, unrealistic, intense anxiety about and fear of specific situations, circumstances, or objects.

  • The anxiety caused by a phobic disorder can interfere with daily living because people avoid certain activities and situations.

  • The diagnosis is usually obvious based on symptoms.

  • Treatment usually consists of exposure therapy.

Specific phobias are the most common anxiety disorders. People who have a specific phobia avoid specific situations or objects that trigger their anxiety and fear, or they endure them with great distress, sometimes resulting in a panic attack. However, they recognize that their anxiety is excessive and therefore are aware that they have a problem.

The most common specific phobias include fear of animals (zoophobia), fear of heights (acrophobia), and fear of thunderstorms (astraphobia or brontophobia).

During any 12-month period, about 13% of women and 4% of men have a specific phobia.

Some specific phobias cause little inconvenience. For example, a city dweller who is afraid of snakes may have no trouble avoiding them. Other specific phobias greatly interfere with functioning. For example, a city dweller who fears small, closed places such as elevators may encounter them frequently and may avoid them.

At least 5% of people are at least to some degree afraid of blood, injections, or injury. These people can actually faint because of a decrease in heart rate and blood pressure, which does not happen with other phobias or anxiety disorders. Many people with other phobias and anxiety disorders hyperventilate. Hyperventilating can cause them to feel as though they might faint, although they almost never faint.

Some Common Phobias

Phobia

Definition

Acrophobia

Fear of heights

Amathophobia

Fear of dust

Astraphobia

Fear of thunder and lightning

Aviophobia

Fear of flying

Belonephobia

Fear of needles, pins, or other sharp objects

Brontophobia

Fear of thunder

Claustrophobia

Fear of confined spaces

Eurotophobia

Fear of female genitals

Gephyrophobia

Fear of crossing bridges

Hydrophobia

Fear of water

Odontiatophobia

Fear of dentists

Phartophobia

Fear of passing gas in a public place

Phasmophobia

Fear of ghosts

Phobophobia

Fear of having fears or developing a phobia

Spargarophobia

Fear of asparagus

Triskaidekaphobia

Fear of all things associated with the number thirteen

Trypanophobia

Fear of injections

Zoophobia

Fear of animals (usually spiders, snakes, or mice)

There are over 500 named phobias, listed at the Phobia List web site. Most are extremely rare.

Diagnosis

  • A doctor's evaluation, based on specific criteria

Doctors diagnose a specific phobic disorder when people have fear of or anxiety that is all of the following:

  • Is intense and has been present 6 months or longer

  • Concerns a specific situation or object

  • Occurs immediately when the situation or object is encountered

  • Makes people change their behavior to avoid the situation or object

  • Is out of proportion to the actual danger

  • Causes significant distress or significantly impairs functioning

Also, doctors rule out other mental disorders that can cause similar symptoms, such as agoraphobia, social anxiety, or a stress disorder.

Treatment

  • Exposure therapy

Some people do well without treatment because the situation or object they fear is easy to avoid. Bats and caves are examples. If situations or objects (such as thunderstorms) are commonly encountered, treatment is often needed.

Exposure therapy, a type of psychotherapy, is the treatment of choice (see What Is Exposure Therapy?). Exposure therapy involves exposing people gradually and repeatedly—in their imagination or sometimes in reality—to whatever triggers their fear. Exposure therapy is repeated until people become very comfortable with the anxiety-provoking situation. A therapist can help ensure that the therapy is carried out correctly, although people can do it on their own.

Exposure therapy helps more than 90% of people who do it faithfully. It is almost always the only treatment needed for specific phobias. Even people with a phobia of blood or needles respond well to exposure therapy. For example, people who faint while blood is drawn can have a needle brought close to a vein and then taken away when the heart rate begins to slow down. Repeating this process allows the heart rate to return to normal. Eventually, people should be able to have blood drawn without fainting.

Drug therapy is not very useful in helping people overcome specific phobias. However, benzodiazepines (antianxiety drugs) may help people control a phobia for a short time, as when people who have a phobia of flying are told that must travel by plane with much advance warning.

Resources In This Article

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