Health Zone

Specific Phobia

Feeling anxious in certain situations, or with some animals, or things that are unfamiliar, is not unusual. Most people feel anxious when they see a snake. This is a natural protective response. For some people however, their response to situations or things is greatly exaggerated. People with a specific phobia are aware that their fear is irrational (such as the fear of going to the dentist), but they feel they have little to no control over their reaction. This type of phobia can also be associated with panic attacks.

Signs & symptoms

A person may be diagnosed with a specific phobia if they meet the following criteria:

Significant fear or anxiety about a certain objection or situation (such as seeing a dog, plane travel, being on water, heights, receiving an injection, seeing blood)
Situations where a person might encounter the phobic object are avoided (e.g., not going to parks where dogs are allowed)
The fear is disproportionate to the actual danger
The anxiety and avoidance makes day to day life difficult

Specific phobias are broken up into 5 types:

Animal phobias (e.g., spiders, insects, dogs)
Natural environment (e.g., heights, rain, thunder)
Blood-injection-injury (e.g., needles, invasive medical procedures), or with seeing blood
Specific situation (e.g., bridges, elevators, airplanes, enclosed places)
Other – any other specific phobia (e.g., fear of choking, fear of vomiting)

Prevalence

It is not known how many Australians experience specific phobias. In the United States and Europe around 6% of adults will be diagnosed with a specific phobia in a 12 month period. Females tend to experience more specific phobias than males, although rates are approximately equal for the blood-injection-injury type of phobia.

Main treatments

Psychological treatments have been found to be effective, and are the treatment of first choice. Cognitive Behavioural Therapy (CBT) is the most common approach used and explores and challenges the fearful cognitions (thoughts) to more realistic thinking. It also includes education, so a person can understand what is happening. Behavioural strategies such as breathing relaxation, is used to get some control over anxiety symptoms. Graduated exposure, gradual contact with the fear situation, is also part of this treatment. For example, in the fear of dogs, a person might start to look at pictures of puppies, and then dogs, then video of dogs, observing a real life dog at a safe distance and gradually getting closer to being able to touch it.

In severe situations medication may be used, however their use in the treatment of specific phobias is not clear. Benzodiazepines might be used very briefly as part of a comprehensive treatment plan. However due to the addictive nature of these medications they are use with care.