Mental health articles

A simple phobia is an unrealistic fear of a specific stimulus. DSM-IV-TR states the following criteria for this diagnosis to be met:

Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation.

Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a panic attack.

The person recognizes that the fear is excessive or unreasonable.

The phobic situation is avoided or endured with intense anxiety or distress.

The avoidance, anxious anticipation or distress in the feared situation(s) interferes signifi cantly with the person’s normal routine or they experience distress about having the phobia.

In individuals under age 18 years, the duration is at least 6 months.

The DSM further notes that phobic responses can occur in response to a variety of types of stimuli, including animals, natural environmental factors (heights, water), blood-injectioninjury, specific situations (aeroplanes, lifts), and ‘other’ situations including fear of vomiting, contracting an illness, and so on. More complex disorders, such as a phobic fear of social situations and agoraphobia receive separate diagnoses. Agoraphobia is linked to panic disorder, and will be discussed later in the chapter. In the US, about 9 per cent the population are likely to experience a phobia of some kind at some time in their life, with the highest prevalence among young, female, low income, or Hispanic and Asian individuals – although among Chinese people living in China, the prevalence of phobias is much lower. The most prevalent fear is that of snakes, affecting about 25 per cent of the population. Between 90 and 95 per cent of people with an animal phobia are women – other phobias, such as blood-injury phobia, are less gender-specific. Age of onset tends to follow a particular pattern, with phobias relating to animals, blood-injury, dentists and natural environments beginning in childhood, while others such as claustrophobia and agoraphobia typically start in adolescence and early adulthood.

Phobias such as a fear of snakes or spiders seem universal. The nature and prevalence of other phobias, however, appear to be influenced by cultural factors. Agoraphobia, for example, is much more common in theUSAandEuropethan in other areas of the world. A very specific social phobia common inJapanbut almost non-existent in the West is known as taijin kyofusho. This involves an incapacitating fear of offending or harming others through one’s own awkward social behaviour, glancing at their genital areas or imagined physical defect. The focus of this phobia is on the harm to others, not on embarrassment to self as in social phobias in the West. As such, it appears to be a pathological exaggeration of the modesty and sensitive regard for others that, at lower levels, are considered proper inJapan.

Tags: phobias, simple phobias