Specific Phobia

Specific phobias are characterized by the experience of high levels of anxiety or fear in response to specific objects or situations such as dogs, spiders, storms, heights, water, blood, closed spaces, tunnels, bridges and the like.

A specific phobia is a persistent irrational fear of a specific object, activity, or situation that leads to a desire for avoidance or actual avoidance of the object, activity, or situation.

Characteristically, phobic individuals experience overwhelming and crippling anxietyOpens in new window when faced with the object or situation provoking the phobic response. In these individuals, daily functioning is compromised, and phobic people go to great lengths to avoid the feared object or situation.

A phobic person may not be able to think about or visualize the object or situation without becoming severely anxious. The life of a phobic person becomes more restricted as activities are given up so that the phobic object can be avoided. All too frequently, complications ensue when sufferers try to decrease anxiety through self-medication with alcohol or drugs.

Consider the case of Daniel, who developed a profound fear of elevators after being trapped in one for 3 hours during a power outage. As his fear and anxiety intensified, it became necessary for him to use only stairs or escalators. He obsesses about the possibility that he will be forced to use an elevator in social situations and avoids attending events where this may occur. It has reached a point where even going inside closets or small storage rooms is unbearable. This fear of enclosed spaces is called claustrophobiaOpens in new window. Other common specific phobias are liste in Table 1.1.

Table 1.1 Clinical Names for Common Specific Phobias
Clinical Name Feared Object or Situation
AgoraphobiaOpen spaces
AstraphobiaElectrical storms
ClaustrophobiaClosed spaces
MonophobiaBeing alone
MysophobiaGerms or dirt

Specific phobias frequently occur concurrently with other anxiety disorders. Exposure to the phobic object or situation produces overwhelming symptoms of panic, including palpitation, sweating, dizziness and difficulty breathing.

In fact, these symptoms may occur in response to the individual’s merely thinking about the phobic object or situation. Invariably, the person recognized that the fear is excessive or unreasonable, but he or she is powerless to change, even though the individual may occasionally endure the phobic object or situation while experiencing intense anxiety.

Specific phobiasOpens in new window may begin at almost any age. Those that begin in childhood often disappear without treatment, but those that begin or persist into adulthood almost always require assistance with therapy.

Even though specific phobias are common in the general population, people seldom seek treatment unless the specific phobia interferes with ability to function. Obviously, the individual who has a fear of snakes but who lives on the twenty-third floor of an urban, high rise apartment-building, is not likely to be bothered by the phobia unless he or she decides to move to an area where snakes are prevent. On the other hand, a fear of elevators may very well interfere with this individual’s daily functioning.

Twelve-month prevalence rates for specific phobias in children, adolescents, and adults are 5%, 16%, and 8%, respectively. Females are affected twice as often as males.

Negative and traumatic experiences with the feared objects or situations lead to the fear. Phobic reactions tend to run in families. Having a first-degree relative with a specific phobia puts one at a greater risk for having the same specific phobia.

Few people are seen in healthcare settings for treatment of phobias. In general, they seek help for comorbid conditions including major depression, anxiety, substance use, somatic symptom disorders, and dependent personality disorder.