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[[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.<ref name=hall>Hall, Lynne L. [http://www.fda.gov/fdac/features/1997/297_bump.html ''Fighting Phobias, the Things That Go Bump in the Mind''], FDA Consumer Magazine, Volume 31 No. 2, March 1997.</ref> <ref name="wolpe">{{cite book | last = Wolpe | first = Joseph | authorlink = | coauthors = | title = Psychotherapy by reciprocal inhibition. | publisher = Stanford University Press | date = 1958 | location = | pages = | url = http://www.springerlink.com/index/8452N0KP134NK203.pdf | doi = | id = | isbn = }}</ref> In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment.<ref name="wolpe"/><ref> {{cite journal|title=Is horror a necessary component of flooding (implosion)?|journal=Behaviour Research and Therapy|date=1977|first=Foa|last=E. B.|coauthors=Blau, J. S., Prout, M., & Latimer, P.|volume=|issue=15|pages=397-402|id= |url=|format=|accessdate=2009-08-16 }}</ref> <ref>{{cite book | last = Craske | first = Michelle | authorlink = | coauthors = Martin M. Antony, David H. Barlow | title = Mastering your fears and phobias, | publisher = Oxford University Press | date = 2006 | location = US | pages = | url = http://books.google.com.ar/books?id=ndcxMZ7NEcsC&dq=Foa;+Blau,+J.+S.,+Prout,+M.,+%26+Latimer,+P.+(1977).+%22Is+horror+a+necessary+component+of+flooding+(implosion)%3F%22&source=gbs_navlinks_s | doi = | id = | isbn = 978-0195189179 }}</ref> <ref>{{cite book | last = Eysenck | first = Hans | authorlink = | coauthors = | title = You and Neurosis | publisher = | date = 1977 | location = | pages = | url = | doi = | id = | isbn = }}</ref>
[[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.<ref name=hall>Hall, Lynne L. [http://www.fda.gov/fdac/features/1997/297_bump.html ''Fighting Phobias, the Things That Go Bump in the Mind''], FDA Consumer Magazine, Volume 31 No. 2, March 1997.</ref> <ref name="wolpe">{{cite book | last = Wolpe | first = Joseph | authorlink = | coauthors = | title = Psychotherapy by reciprocal inhibition. | publisher = Stanford University Press | date = 1958 | location = | pages = | url = http://www.springerlink.com/index/8452N0KP134NK203.pdf | doi = | id = | isbn = }}</ref> In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment.<ref name="wolpe"/><ref> {{cite journal|title=Is horror a necessary component of flooding (implosion)?|journal=Behaviour Research and Therapy|date=1977|first=Foa|last=E. B.|coauthors=Blau, J. S., Prout, M., & Latimer, P.|volume=|issue=15|pages=397-402|id= |url=|format=|accessdate=2009-08-16 }}</ref> <ref>{{cite book | last = Craske | first = Michelle | authorlink = | coauthors = Martin M. Antony, David H. Barlow | title = Mastering your fears and phobias, | publisher = Oxford University Press | date = 2006 | location = US | pages = | url = http://books.google.com.ar/books?id=ndcxMZ7NEcsC&dq=Foa;+Blau,+J.+S.,+Prout,+M.,+%26+Latimer,+P.+(1977).+%22Is+horror+a+necessary+component+of+flooding+(implosion)%3F%22&source=gbs_navlinks_s | doi = | id = | isbn = 978-0195189179 }}</ref> <ref>{{cite book | last = Eysenck | first = Hans | authorlink = | coauthors = | title = You and Neurosis | publisher = | date = 1977 | location = | pages = | url = | doi = | id = | isbn = }}</ref>

[[Eye Movement Desensitization and Reprocessing]] (EMDR) has been demonstrated in peer-reviewed clinical trials to be effective in treating some phobias. Mainly used to treat [[Post-traumatic stress disorder]], EMDR has been demonstrated as effective in easing phobia symptoms following a specific trauma, such as a fear of dogs following a dog bite.<ref>De Jongh A; Ten Broeke E; Renssen M R. (1999)
Treatment of specific phobias with Eye Movement Desensitization and Reprocessing (EMDR): protocol, empirical status, and conceptual issues.
Journal of anxiety disorders 1999;13(1-2):69-85.</ref>


[[Hypnotherapy]] coupled with [[Neuro-linguistic programming]] can also be used to help remove the associations that trigger a phobic reaction. However, lack of research and scientific testing compromises its status as an effective treatment.
[[Hypnotherapy]] coupled with [[Neuro-linguistic programming]] can also be used to help remove the associations that trigger a phobic reaction. However, lack of research and scientific testing compromises its status as an effective treatment.

Revision as of 20:06, 22 October 2009

For other uses, see Phobia (disambiguation).
See also: List of phobias

A phobia (from the Greek: φόβος, phóbos, fear or morbid fear), is an irrational, intense, persistent fear of certain situations, activities, things, or people. The main symptom of this disorder is the excessive, unreasonable desire to avoid the feared subject. When the fear is beyond one's control, and if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made.[1]

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.[2] 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.

Causes

It is generally accepted that phobias arise from a combination of external events and internal predispositions. 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.[3] 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 combined with life-experiences play a major role in the development of anxiety disorders, phobias and panic attacks.

The anatomical side of phobias

Phobias are more often than not linked to the amygdala, an area of the brain located behind the pituitary gland in the limbic system. The amygdala secretes hormones that control fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, in which they are ready to move, run, fight, etc.[4] This defensive "alert" state and response is generally referred to in psychology as the fight-or-flight response.

Clinical phobias

Psychologists and psychiatrists classify most phobias into three categories[5][6] and, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), such phobias are considered to be sub-types of anxiety disorder. The three categories are:

  • Social phobia - 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 phobia may be further subdivided into
    • generalized social phobia (also known as social anxiety disorder) and
    • specific social phobia, in which anxiety is triggered only in specific situations.[7] 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. This goes far beyond mere preference: when the condition triggers, the person physically cannot empty their bladder.
  • Specific phobias - fear of a single specific panic trigger such as spiders, snakes, dogs, water, heights, flying, catching a specific illness, etc. Many specific phobias involve fears that a lot of people have to a lesser degree. People with the phobias specifically avoid the entity they fear.
  • Agoraphobia - a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow.

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.

Treatments

Various methods are claimed to treat phobias. Their proposed benefits may vary from person to person.

Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitization 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.[8] [9] In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment.[9][10] [11] [12]

Eye Movement Desensitization and Reprocessing (EMDR) has been demonstrated in peer-reviewed clinical trials to be effective in treating some phobias. Mainly used to treat Post-traumatic stress disorder, EMDR has been demonstrated as effective in easing phobia symptoms following a specific trauma, such as a fear of dogs following a dog bite.[13]

Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction. However, lack of research and scientific testing compromises its status as an effective treatment.

Antidepressant medications such SSRIs, MAOIs may be helpful in some cases of phobia. Benzodiazepines may be useful in acute treatment of severe symptoms but the risk benefit ratio is against their long-term use in phobic disorders.[14]

Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, also considered to be pseudoscience by the mainstream medicine, is allegedly useful.

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 something 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

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

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 has roots in social relations. Below are some examples:


  • Androphobia - fear or dislike of men.
  • Chemophobia - prejudice against artificial substances in favour of "natural" substances.
  • Christianophobia - fear or dislike of Santa Claus or Christianity.
  • Ephebiphobia - fear or dislike of youth or adolescents.
  • Gynophobia - fear or dislike of women.
  • Heterophobia - fear or dislike of heterosexuality.
  • Homophobia - fear or dislike of homosexuality.
  • Xenophobia - fear or dislike of strangers or the unknown, sometimes used to describe nationalistic political beliefs and movements. It is also used in fictional work to describe the fear or dislike of space aliens.


References

  1. ^ Edmund J. Bourne, The Anxiety & Phobia Workbook, 4th ed, New Harbinger Publications, 2005, ISBN 1-57224-413-5.
  2. ^ Kessler et al., Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication, June 2005, Archive of General Psychiatry, Volume 20
  3. ^ Phobias: Causes and Treatment, AllPsych Journal
  4. ^ Winerman, Lea. "Figuring Out Phobia", American Psychology Association: Monitor on Psychology, August 2007.
  5. ^ AllPsych Journal | Phobias: Causes and Treatments
  6. ^ NIMH - The Numbers Count: Mental Disorders in America
  7. ^ Crozier, W. Ray; Alden, Lynn E. International Handbook of Social Anxiety: Concepts, Research, and Interventions Relating to the Self and Shyness, p. 12. New York John Wiley & Sons, Ltd. (UK), 2001. ISBN 0-471-49129-2.
  8. ^ Hall, Lynne L. Fighting Phobias, the Things That Go Bump in the Mind, FDA Consumer Magazine, Volume 31 No. 2, March 1997.
  9. ^ a b Wolpe, Joseph (1958). Psychotherapy by reciprocal inhibition (PDF). Stanford University Press. {{cite book}}: Cite has empty unknown parameter: |coauthors= (help)
  10. ^ E. B., Foa (1977). "Is horror a necessary component of flooding (implosion)?". Behaviour Research and Therapy (15): 397–402. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  11. ^ Craske, Michelle (2006). Mastering your fears and phobias,. US: Oxford University Press. ISBN 978-0195189179. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  12. ^ Eysenck, Hans (1977). You and Neurosis. {{cite book}}: Cite has empty unknown parameter: |coauthors= (help)
  13. ^ De Jongh A; Ten Broeke E; Renssen M R. (1999) Treatment of specific phobias with Eye Movement Desensitization and Reprocessing (EMDR): protocol, empirical status, and conceptual issues. Journal of anxiety disorders 1999;13(1-2):69-85.
  14. ^ Stein, Dan J (16 February 2004). Clinical Manual of Anxiety Disorders (1st ed.). USA: American Psychiatric Press Inc. p. 53. ISBN 978-1585620760. {{cite book}}: Cite has empty unknown parameter: |chapterurl= (help)

See also

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