Specific Phobia
Specific phobia is an intense fear of a specific thing. The person with the phobia will go to great lengths to avoid being exposed to that thing or will have an intense reaction if they are exposed to it.
Specific phobias are common, often co-occur with other anxiety disorders, and tend to emerge by age 12. Many people with specific phobias will have more than one feared object.
Symptoms
- Marked fear or anxiety about a specific object or situation. In children, fear may be expressed by crying, tantrums, freezing or clinging.
- The child experiences immediate fear or anxiety when exposed to the object.
- The child tries to actively avoid the feared object or endures it with intense anxiety.
- The fear or anxiety is out of proportion to the actual danger posed by the object.
Types
- Animals, insects
- Environmental - thunder, water, heights
- Blood, injection or other suspected painful event
- Situational - tunnels, bridges, elevators
DSM-5 Criteria
Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
The phobic object or situation almost always provokes immediate fear or anxiety.
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
The phobic object or situation is actively avoided or endured with intense fear or anxiety.
The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC
Disorder-specific treatment strategies
Exposure-based therapies are first line treatment for specific phobia.
The idea with exposure therapy is break down the feared experience into graded steps and practice exposure/tolerating the experience from the mildest step and working up to the most feared step.
A child who is afraid of dogs might move through the following steps:
- start by looking at pictures of dogs
- looking at videos of dogs
- looking at a dog at a distance behind a fence
- looking at a dog up close but behind a fence
- looking at a dog on a leash outside the fence
- approaching and and letting the dog smell the child's hand
- touching the dog
