Simple/specific phobia

• Overview:

  • Fear of a specific object or situation
  • Animals e.g. spiders
  • Natural environment e.g. heights and water
  • Blood injection injury e.g. needles
  • Situational e.g. elevators
• Aetiology:

  • same as most anxiety disorders - complex interaction between environmental factors, genetic factors and psychological traits
  • Phobias have a boundary with normality, as some fears can be a normal part of development that lessen with time
  • Phobias may be learned from having observed a parent or caregiver react with disproportionate and irrational fear to the object
  • Person may have has a previous direct negative experience with the object that led to the development of excessive fear
• Both DSM-V and ICD-11 can be used as frameworks to aid the clinical diagnosis of specific phobias.
• Diagnosis:

  The fear or anxiety is:

  • Almost always provoked by the phobic object or situation.
  • Disproportionate to the actual threat posed by phobic object or situation.

  The phobic object or situation is:

  • Actively avoided OR,
  • Endured with intense fear or anxiety.
• The fear, anxiety, or avoidance behaviours are:

  • Persistent, lasting for >6 months.
  • Cause the individual significant distress or functional impairment (social, occupational, or other important aspects of functioning).
  • Not better explained by another mental disorder 
• Management:

  • CBT - behavioural aspect involves exposure therapy - systematic desensitisation where the patient is exposed to the least anxiety inducing object/situation and working their way up to the most anxiety inducing. Taught relaxation techniques. Should reduce fear response over time.
  • Pharmacological treatment generally not used, except in severe cases to reduce fear. This might reduce the efficacy of behaviour therapy