What Are Phobias?
Phobias are a type of anxiety disorder characterized by significant, irrational, or excessive fear of a specific object or situation that causes a person to avoid the feared object or situation. Specific phobias often co-occur with other disorders, such as other anxiety disorders, mood disorders, and alcohol dependence.
The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) identifies five main types of specific phobias based on the nature of the fear-inducing stimulus:
- Animal (e.g., spiders, insects, dogs)
- Natural environment (e.g., heights, storms, water)
- Blood-injection-injury (e.g., needles, getting an injection, invasive medical procedures)
- Situational (e.g., airplanes, elevators, enclosed places)
- Other (e.g., situations that may lead to choking or vomiting; in children, e.g., loud sounds or costumed characters)
According to Fearof.Net, a website developed by an anxiety sufferer that acts as a clearinghouse for such information, the top 10 phobias include:
- Fear of open spaces: agoraphobia
- Fear of germs: mysophobia
- Fear of spiders: arachnophobia
- Fear of snakes: ophidiophobia
- Fear of heights: acrophobia
- Fear of thunderstorms: astraphobia
- Fear of small spaces: claustrophobia
- Fear of flying: aerophobia
- Fear of dogs: cynophobia
- Fear of holes: trypophobia
This ranking is non-scientific but is aggregated by the site author from different science reference sources and internet polling.
What Are Symptoms of Phobias?
Symptoms of phobia include:
- Significant, irrational, or excessive fear of a specific object or situation
- Inability to control the fear response
- Avoidance behaviors
- Crying, tantrums, freezing, or clinging (in children)
The effect of these behaviors may range from minimal impact on one’s life to severe impairment and disability.
Unlike normal fears, phobic fear:
- Is excessive and out of proportion to the situation
- Is not alleviated with rational explanations
- Cannot be voluntarily controlled by the person
- Leads to avoidance of the fear-producing objects or situations
- Strategies used to cope such as avoidance may relieve the anxiety and fear in the present moment but do not address the cause (maladaptive behaviors)
- Fears persistent over time
- Fears are not age or stage-specific
What Causes Phobias?
The cause of a specific phobia is due to an interaction of biological, psychological, and social/environmental factors.
- Genetics: specific phobias tend to run in families
- Neurobiological factors: certain neuroanatomical pathways have been associated with specific phobia
- Personality factors: people who have a tendency to experience disgust in response to certain stimuli may be more prone to specific phobias
- Cognitive factors: people who have specific phobia may have some cognitive biases that play a role in the development of their fear
- Social and environmental factors
- Experiencing a traumatic event in the phobic situation such as being hurt or frightened
- Observing someone behaving fearfully or witnessing a traumatic event in the phobic situation
- Learned fear from information obtained from others or through the media
How Are Phobias Diagnosed?
Specific phobias are diagnosed with an evaluation by a mental health professional. Usually people with specific phobias seek help when the phobias interfere with daily life, such as flying, being in enclosed spaces, or getting an injection.
A mental health professional will ask questions to determine the phobia and avoidance behaviors it provokes, and also determine whether there are co-existing conditions such as other anxiety disorders, mood disorders, and alcohol dependence.
The DSM-5 criteria for specific phobia include:
- Marked fear or anxiety about a specific object or situation
- The phobic object or situation almost always provokes immediate fear or anxiety.
- The phobic object or situation is actively avoided or endured with intense 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 fear, anxiety, or avoidance is persistent, typically lasting for six months or more.
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- 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).
What Is the Treatment for Phobias?
Treatment for phobia usually involves therapy and sometimes medication.
- Cognitive-behavioral therapy (CBT) for specific phobia consists of strategies designed to alter poor coping strategies that continue to sustain emotional distress
- The main component of CBT for specific phobia is exposure, which involves repeated, methodical confrontation of the feared stimulus to reduce fear through extinction and inhibitory learning
- In the beginning, patients are exposed to the fear-producing stimuli in a safe and controlled environment to gradually help a patient face and reduce fearful responses
- Other components of CBT include anxiety management and reduction of safety behaviors