Phobia

For other uses, see Phobia (disambiguation).

A phobia (from the Greek φόβος "fear"), is an irrational, persistent fear of certain situations, objects, activities, or persons. The main symptom of this disorder is the excessive, unreasonable desire to avoid the feared subject. When the fear is beyond one's control, or if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made.

Prevalence

Phobias (in the clinical meaning of the term) are the most common form of anxiety disorders. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25.

The ratio of phobias from men to women is 2:1, however this varies between different phobias. Also, the content varies within cultures e.g. fear of magic higher in cultures that believe in magic and it is also higher in lower socio-economic groups.

Causes

It is generally accepted that phobias arise from a combination of external events and internal predispositions. Some phobias such as arachnophobia (fear of spiders) and ophidiophobia (fear of snakes) however, may arise more easily due to an evolutionary trait that conditioned humans to fear certain creatures that could cause them harm. In a famous experiment, Martin Seligman used classical conditioning to establish phobias of snakes and flowers. The results of the experiment showed that it took far fewer shocks to create an adverse response to a picture of a snake than to a picture of a flower, leading to the conclusion that certain objects may have a genetic predisposition to being associated with fear. Many specific phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age. Social phobias and agoraphobia have more complex causes that are not entirely known at this time. It is believed that heredity, genetics, and brain chemistry combine with life-experiences to play a major role in the development of anxiety disorders and phobias.

Other uses of term

Phobia is also used in a non-medical sense for aversions of all sorts. These terms are usually constructed with the suffix -phobia. A number of these terms describe negative attitudes or prejudices towards the named subjects. See Non-clinical uses of the term below.

Clinical phobias

Most psychologists and psychiatrists classify most phobias into three categories: [1] [2]

• Social phobias - fears involving other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Social phobias may be further subdivided into
  • the general social phobia, also known as social anxiety disorder, and
    • specific social phobias, which are cases of anxiety triggered only in specific situations. The symptoms may extend to psychosomatic manifestation of physical problems. For example, sufferers of paruresis find it difficult or impossible to urinate in reduced levels of privacy. That goes beyond mere preference. If the condition triggers, the person physically cannot empty their bladder.
• Specific phobias - fear of a single specific panic trigger such as spiders, dogs, elevators, water, flying, catching a specific illness, etc.
• Agoraphobia - a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow. Agoraphobia is the only phobia regularly treated as a medical condition.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), social phobia, specific phobia, and agoraphobia are sub-groups of anxiety disorder.

Many of the specific phobias, such as fear of dogs, heights, spider bites and so forth, are extensions of fears that a lot of people have. People with these phobias specifically avoid the entity they fear.

Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer only relatively mild anxiety over that fear. Others suffer fully-fledged panic attacks with all the associated disabling symptoms. Most individuals understand that they are suffering from an irrational fear, but are powerless to override their initial panic reaction.

Phobias in children

Severe fears are present in about 10-15% of the population and specific phobias are found in about 5% of children. Children with specific phobias experience an intense fear of an object or situation that cannot does not go away easily and continues for an extended period of time. Children often have specific phobias of the dark, varieties of insects, spiders, bees, heights, water, choking, snakes, dogs, birds, and other animals. For many children, these fears and phobias interfere with their participation in and enjoyment of various activities. It may also interfere with their education, family life, or their social life. However, effective treatment is available for children who experience phobias. Currently, a promising one-session treatment is available for the treatment of specific phobias in children at the Child Study Center at Virginia Tech. This treatment is provided under the direction of Dr. Thomas Ollendick, a national expert in the treatment of childhood anxiety disorders.

Treatments

Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitisation therapy.

Cognitive behavioral therapy (CBT) can be beneficial. Cognitive behavioral therapy lets the patient understand the cycle of negative thought patterns, and ways to change these thought patterns. CBT may be conducted in a group setting. Gradual desensitisation treatment and CBT are often successful, provided the patient is willing to endure some discomfort and to make a continuous effort over a long period of time.

Anti-anxiety or anti-depression medications can be of assistance in many cases. Benzodiazepines could be prescribed for short-term use.

These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.

Non-psychological conditions

The word "phobia" may also signify conditions other than fear. For example, although the term hydrophobia means a fear of water, it may also mean inability to drink water due to an illness, or may be used to describe a chemical compound which repels water. Likewise, the term photophobia may be used to define a physical complaint (i.e. aversion to light due to inflamed eyes or excessively dilated pupils) and does not necessarily indicate a fear of light.

Non-clinical uses of the term

Main article: -phob-

It is possible for an individual to develop a phobia over virtually anything. The name of a phobia generally contains a Greek word for what the patient fears plus the suffix -phobia. Creating these terms is somewhat of a word game. Few of these terms are found in medical literature. However, this does not necessarily make it a non-psychological condition.

Terms indicating prejudice or class discrimination

A number of terms with the suffix -phobia are primarily understood as negative attitudes towards certain categories of people or other things, used in an analogy with the medical usage of the term. Usually these kinds of "phobias" are described as fear, dislike, disapproval, prejudice, hatred, discrimination, or hostility towards the object of the "phobia". Often this attitude is based on prejudices and is a particular case of general xenophobia.

Class discrimination is not always considered a phobia in the clinical sense because it is believed to be only a symptom of other psychological issues, or the result of ignorance, or of political or social beliefs. In other words, unlike clinical phobias, which are usually qualified with disabling fear, class discrimination usually have roots in social relations.

Below are some examples:

• Ephebophobia, fear of youth or adolescents
• Homophobia, fear, dislike, or hatred of homosexual people, often used pejoratively to describe a moral objection to homosexuality.
• Islamophobia, fear-induced prejudice against Muslims or Islamic culture.
• Xenophobia, fear or dislike of strangers or the unknown, often used to describe nationalistic political beliefs and movements

See also: List of anti-ethnic and anti-national terms

See also

• Angst
• Anxiety
• Disability
• List of phobias
• Panic
• Panic attack

References

• Lynne L. Hall, Fighting Phobias, the Things That Go Bump in the Mind, FDA Consumer Magazine, Volume 31 No. 2, March 1997 [3]

External links

• Diagnostic criteria for social phobia in the DSM-IV
• Diagnostic criteria for specific phobia in the DSM-IV
• List of anxiety disorders in the DSM-IV, which includes several agoraphobic disorders.