Fears and Phobias

Fear is a normal human emotion which is in response to a stimulus of perceived threat. This may cause one to fight, flight or freeze. Fears can be rational or irrational.

Woman with phobia of cockroaches screaming at seeing one

Phobia is a type of anxiety disorder. One experiences persistent or irrational fear of an object or situation and goes to great lengths to avoid it. This interferes with ones daily life.

This is the most common form of anxiety disorder. The prevalence of all phobias is 8%, with many patients having more than one. Phobias are most likely to begin in late childhood and continue into adulthood if left untreated. Women have twice the prevalence of most phobias than men.

Categorization

Phobias are categorized as

  • Specific Phobia (fear of specific object or situation e.g. Animal or blood)
  • Agoraphobia (fear that escape is not possible)
  • Social Phobia (fear of others judging you)

Symptoms

Symptoms of Phobias according to DSM 5

  • Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
    Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or cleaning.
  • 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 cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Have you felt very nervous when faced with a specific object or situation? For example:

Woman scared of flying exhibiting specific phobia
A woman is afraid to fly. She looks at the plane. Focus on reflection of airplane.
  • flying on an aeroplane
  • being exposed to heights
  • going near an animal
  • receiving an injection

Have you avoided a situation because of your phobia? For example, have you:

  • not gone to certain places
  • changed work patterns
  • avoided health check-ups
  • found it hard to go about your daily life (e.g. working, studying or seeing friends and family) because you are trying to avoid such situations?

If you have answered yes, you may be experiencing a specific phobia​.

Treatments

Treatments approved by the APS:

  1. Exposure Therapy
  2. Systematic Desensitization
  3. CBT
  4. Relaxation Therapy
  5. Modelling Behaviour

Duration and Intensity

Phobias usually arise in late childhood can last a long time unless treated. Intensity is to the extent the phobia affects normal functioning and daily life.

Comorbidity

Phobias can co occur with anxiety disorders, depression, obsessive compulsive disorders and substance use etc. High intensity can lead to total avoidance of the feared object or situation.

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