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  • Writer's pictureNicholas Nack

What are phobias and how are they treated?


Specific phobia is defined as fear or anxiety about a specific object or situation in which the object or situation almost always provokes immediate fear or anxiety, it is actively avoided or endured with intense fear or anxiety, it is out of proportion to actual danger, fear or avoidance last 6 months or longer, the fear, anxiety, or avoidance causes clinically significant distress or impairment in some aspect of life functioning, and that the symptoms are not better explained by some other diagnosable disorder (American Psychiatric Association, 2022, pp.224-225). Some common phobias are spiders, insects, dogs, heights, storms, water, needles, medical procedures, airplanes, elevators, enclosed spaces, and in children two common ones are loud noises and costumed characters. Many people have fears, but what makes something clinically diagnosable aside from the criteria people expect is the aspect of impairment. Someone can have a fear of airplanes but have no plans or need to go on one ever again, and it may not come across their mind frequently at all. In this way it is not impairing their ability to function socially, in work, or in some other area. In any given year in the United states, 8-12 percent of people will have some kind of specific phobia, and these rates are lower in older individuals. Women are more frequently impacted than men at a rate of almost 2 to 1. Sometimes these phobias develop during a traumatic event, observing a traumatic event, a panic attack in a feared situation, or even through media such as continually seeing media coverage of a plane crash. The majority of phobias develop in childhood. For children this may look different than adult presentation with crying, tantrums, freezing, and clinging being more typical for children (American Psychiatric Association, 2022, pp.224-229).

Phobias can stick around for years to decades for some. In terms of risk factors, it seems that the biggest one is being female. Other than that having lower educational attainment, being formerly married, genetics, and environment are also associated. Having a phobia puts people at increased risk for having other mental disorders as well. While phobias are quite common, only 10%-25% of people will receive treatment (Eaton et al., 2018, pp. 678-686).

The most common form of treatment for phobias is called exposure therapy. This involves making a hierarchy for things that trigger fear for a situation or object from least feared to most feared and slowly working through the hierarchy while building techniques for coping with the feared stimulus until the person is able to tackle the most feared situation and get through it without so much distress. It is important for people to not avoid the phobia as that actually reinforces the fear. Cognitive behavioral therapy can also help people overcome phobias by focusing on changing thoughts, feelings, and beliefs surrounding the fear ("Specific phobias - Diagnosis and treatment - Mayo Clinic," 2016).


References

  • American Psychiatric Association. (2022). DSM-5-TR(tm) classification. American Psychiatric Publishing.

  • Eaton, W. W., Bienvenu, O. J., & Miloyan, B. (2018). Specific phobias. The Lancet Psychiatry, 5(8), 678-686. https://doi.org/10.1016/s2215-0366(18)30169-x

  • Specific phobias - Diagnosis and treatment - Mayo Clinic. (2016, October 19). Mayo Clinic - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162#:~:text=The%20best%20treatment%20for%20specific,that%20has%20developed%20over%20time

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