Mental health articles

Prevalence studies on phobias suggest that 1–2 per cent of the general population suffer from agoraphobia, 1–2 per cent from social phobia and 7 per cent from specific phobias (ibid.). Phobia onset varies; specific phobias tend to develop in childhood and may be an exaggerated response of normal childhood developmental fears. For example, it is normal for children to fear heights when aged 2 months, strangers between the ages 6 months and 2 years and animals between the ages of 2 and 4. Agoraphobia usually develops between the ages of 18 and 35. Social phobia usually develops between the ages of 15 and 21. No singular causal model adequately explains why the age of onset of different phobias differs and also why some people develop phobias and others do not. It is generally agreed that a genetic, biological basis underlies the development of phobia. However, it is also agreed that developmental learning has a role to play through either: direct conditioning, vicarious conditioning (observing another persons fear), and by the transmission of information or instruction (for example, phobias of tuberculosis which became prevalent at the turn of the century following government information policies, later seen in the 1980s with the development of HIV/Aids phobias).

Phobias were first recognized as separate diagnostic categories using the International Classification of Diseases (ICD; World Health Organization 1992) and the Diagnostic and Statistical Manual in the late 1940s and early 1950s. Presently, DSM-IV has three classifications of phobic disorders:

1Agoraphobia. Defined by DSM-IV  as ‘anxiety about, or avoidance of, places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms’. The important issue within this definition is that there is usually a fear of having panic-like symptoms (a fear of fear) and being unable to or having difficulty obtaining immediate escape where panic may ensue (for example, hairdressers, buses, cinemas). 2Social phobia. A DSM-IV  definition of social phobia is ‘clinically significant anxiety provoked by exposure to certain types of social performance situations, often leading to avoidance behaviour’. This can include writing cheques in public, socializing at a party, public speaking, etc. The important issue within this definition is that there is a fear of one’s own social performance (for example, saying or doing something embarrassing). As such, a consequential fear of negative evaluation by others naturally follows. This differs from agoraphobia where being unable to escape a specific place causes the anxiety. 3Specific phobias. A DSM-IV definition of specific phobia is ‘clinically significant anxiety provoked by exposure to a specified feared object or situation, often leading to avoidance behaviour’. Specific fears can include: dogs, dental procedures, spiders, thunder and lightening, etc.

Tags: definitions, phobia