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Chapter 6.3 - Specific Phobias

Published online by Cambridge University Press:  04 April 2024

David Kingdon
Affiliation:
University of Southampton
Paul Rowlands
Affiliation:
Derbyshire Healthcare NHS foundation Trust
George Stein
Affiliation:
Emeritus of the Princess Royal University Hospital
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Summary

Specific phobia is a condition characterised by an intense reaction of fear and avoidance to a situation or an object perceived as dangerous. Individuals might rationally understand the situation is not in reality dangerous, but often, even the thought of the specific situation or object evokes intense anxiety. Various studies report the lifetime prevalence of specific phobia, which ranges from 3 to 15 per cent, with incidence predominantly occurring during adolescence. This disorder often leads to a reduction in the quality of life and can cause significant functional impairment. Various theories from genetic to psychological, including those drawing inferences from psychodynamic and cognitive behavioural therapies, offer explanations about the aetiology of specific phobias. Exposure therapy and SSRIs are recognised treatment options for individuals with specific phobias.

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Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Marks, IM. Fears and Phobias. London: Heinemann Medical Books; 1969.Google Scholar
Craske, MG, Stein, MB. Anxiety. The Lancet. 2016;388(10063):3048–59.CrossRefGoogle ScholarPubMed
WHO. (World Health Organization). ICD-11 for Mortality and Morbidity Statistics. Mental, Behavioural or Neurodevelopmental Disorders. icd.who.int/browse11/l-m/en. (accessed 1 June 2019).Google Scholar
Faravelli, C, Paionni, A. Panic disorder: clinical course, etiology and prognosis. In: Nutt, DJ, Ballenger, JC, Lépine, J-P (eds.) Panic Disorder: Clinical Diagnosis, Management and Mechanisms. London: Martin Dunitz; 1999:2544.Google Scholar
Andrews, G, Slade, T. Agoraphobia without a history of panic disorder may be part of the panic disorder syndrome. The Journal of Nervous and Mental Disease 2002;190(9):624–30.CrossRefGoogle ScholarPubMed
Baldwin, DS, Birtwistle, J. The side effect burden associated with drug treatment of panic disorder. Journal of Clinical Psychiatry 1998;59(Suppl. 8):3944.Google ScholarPubMed
Magee, WJ, Eaton, WW, Wittchen, H-U, et al. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry 1996;53(2):159–68.CrossRefGoogle ScholarPubMed
Kessler, RC, Wittchen, H-U. Patterns and correlates of generalized anxiety disorder in community samples. Journal of Clinical Psychiatry 2002;63:410.Google ScholarPubMed
Batinic, B, Opacic, G, Ignjatov, T, et al. Comorbidity and suicidality in patients diagnosed with panic disorder/agoraphobia and major depression. Psychiatria Danubina 2017;29(2):186–94.CrossRefGoogle ScholarPubMed
Goodwin, RD. Anxiety disorders and the onset of depression among adults in the community. Psychological Medicine 2002;32(6):1121–4.CrossRefGoogle ScholarPubMed
Frandsen, FW, Simonsen, S, Poulsen, S, et al. Social anxiety disorder and avoidant personality disorder from an interpersonal perspective. Psychology and Psychotherapy: Theory, Research and Practice 2020;93(1):88104.CrossRefGoogle ScholarPubMed
Ballenger, JC, Davidson, JR, Lecrubier, Y, et al. Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety. Journal of Clinical Psychiatry 1998;59(17):54.Google Scholar
Francisco, A, Nestor, S, Pablo, V, et al. Madrid study on the prevalence and characteristics of outpatients with dual pathology in community mental health and substance misuse services. Adicciones 2013;25(2):118–27.Google Scholar
Kogan, CS, Stein, DJ, Maj, M, et al. The classification of anxiety and fear‐related disorders in the ICD‐11. Depression and Anxiety 2016;33(12):1141–54.CrossRefGoogle ScholarPubMed
Burkauskas, J, Pranckeviciene, A, Bunevicius, A. Thyroid Hormones, Brain, and Heart. In: Iervasi, G, Pingitore, A, Gerdes, AM (eds.) Thyroid and Heart: A Comprehensive Translational Essay. London: Springer International Publishing; 2020: 339–60.Google Scholar
Bispham, JA, Hughes, AS, Driscoll, KA, et al. Novel challenges in aging with type 1 diabetes. Current Diabetes Reports 2020;20(5):19.CrossRefGoogle ScholarPubMed
Willits, I, Keltie, K, de Belder, M, et al. Safety, effectiveness and costs of percutaneous mitral valve repair: a real-world prospective study. PLoS ONE. 2021;16(5):e0251463.CrossRefGoogle ScholarPubMed
Forbes, EJ, Byrne, GJ, O’Sullivan, JD, et al. Defining atypical anxiety in Parkinson’s disease. Movement Disorders Clinical Practice 2021;8(4):571–81.CrossRefGoogle ScholarPubMed
Lintel, H, Corpuz, T, Paracha, S-u-R, et al. Mood disorders and anxiety in Parkinson’s disease: current concepts. Journal of Geriatric Psychiatry and Neurology 2021;34(4):280–8.CrossRefGoogle ScholarPubMed
Brandel, J-P, Knight, R. Variant Creutzfeldt–Jakob disease. Handbook of Clinical Neurology 2018;153:191205.CrossRefGoogle ScholarPubMed
Brandt, C, Zvolensky, MJ, Woods, SP, et al. Anxiety symptoms and disorders among adults living with HIV and AIDS: a critical review and integrative synthesis of the empirical literature. Clinical Psychology Review 2017;51:164–84.CrossRefGoogle ScholarPubMed
Nascimento, I, Nardi, AE, Valença, AM, et al. Psychiatric disorders in asthmatic outpatients. Psychiatry Research 2002;110(1):7380.CrossRefGoogle ScholarPubMed
Raj, SR, Guzman, JC, Harvey, P, et al. Canadian cardiovascular society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Canadian Journal of Cardiology 2020;36(3):357–72.CrossRefGoogle Scholar
Safavi-Naeini, P, Razavi, M. Postural orthostatic tachycardia syndrome. Texas Heart Institute Journal 2020;47(1):57–9.CrossRefGoogle ScholarPubMed
Miller, AJ, Stiles, LE, Sheehan, T, et al. Prevalence of hypermobile Ehlers-Danlos syndrome in postural orthostatic tachycardia syndrome. Autonomic Neuroscience 2020;224:102637.CrossRefGoogle ScholarPubMed
Wagner, C, Isenmann, S, Ringendahl, H, et al. Anxiety in patients with postural tachycardia syndrome (PoTS). Fortschritte der Neurologie-psychiatrie 2012;80(8):458–62.Google ScholarPubMed
Agras, S, Sylvester, D, Oliveau, D. The epidemiology of common fears and phobia. Comprehensive Psychiatry 1969;10(2):151–6.CrossRefGoogle ScholarPubMed
Wardenaar, KJ, Lim, CC, Al-Hamzawi, AO, et al. The cross-national epidemiology of specific phobia in the World Mental Health Surveys. Psychological Medicine 2017;47(10):1744–60.CrossRefGoogle ScholarPubMed
Lépine, J-P, Lellouch, J. Classification and epidemiology of social phobia. European Archives of Psychiatry and Clinical Neuroscience 1995;244(6):290–6.CrossRefGoogle ScholarPubMed
Bandelow, B, Michaelis, S. Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience 2015;17(3):327.CrossRefGoogle Scholar
McLenon, J, Rogers, MAM. The fear of needles: a systematic review and meta-analysis. Journal of Advanced Nursing 2019;75(1):3042.CrossRefGoogle ScholarPubMed
Eaton, WW, Bienvenu, OJ, Miloyan, B. Specific phobias. The Lancet Psychiatry 2018;5(8):678–86.CrossRefGoogle ScholarPubMed
Noyes, R, Reich, J, Christiansen, J, et al. Outcome of panic disorder: relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry 1990;47(9):809–18.CrossRefGoogle ScholarPubMed
Batelaan, NM, Rhebergen, D, Spinhoven, P, et al. Two-year course trajectories of anxiety disorders: do DSM classifications matter? Journal of Clinical Psychiatry 2014;75(9):985–93.Google ScholarPubMed
Bas-Hoogendam, JM, Groenewold, NA, Aghajani, M, et al. ENIGMA-anxiety working group: rationale for and organization of large-scale neuroimaging studies of anxiety disorders. Human Brain Mapping 2022;43(1):83112.CrossRefGoogle Scholar
Kendler, KS, Neale, MC, Kessler, RC, et al. The genetic epidemiology of phobias in women: the interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry 1992;49(4):273–81.CrossRefGoogle ScholarPubMed
Kendler, KS, Myers, J, Prescott, CA, et al. The genetic epidemiology of irrational fears and phobias in men. Archives of General Psychiatry 2001;58(3):257–65.CrossRefGoogle ScholarPubMed
Wehry, AM, Beesdo-Baum, K, Hennelly, MM, et al. Assessment and treatment of anxiety disorders in children and adolescents. Current Psychiatry Reports 2015;17(7):52.CrossRefGoogle ScholarPubMed
Hughes, P. Dynamic Psychotherapy Explained. Abingdon: Radcliffe Medical Press; 1999.Google Scholar
Goodwin, GM. The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in Clinical Neuroscience 2015;17(3):249.CrossRefGoogle ScholarPubMed
Watson, JB, Rayner, R. Conditioned emotional reactions. Journal of Experimental Psychology 1920;3(1):1.CrossRefGoogle Scholar
Pavlov, IP. Conditioned Reflexes; an Investigation of the Physiological Activity of the Cerebral Cortex. London: Oxford University Press; 1927.Google Scholar
Eysenck, HJ. The Dynamics of Anxiety and Hysteria: an Experimental Application of Modern Learning Theory to Psychiatry. London: Routledge & Kegan Paul; 1957.Google Scholar
Spence, K, Haggard, D, Ross, L. Intrasubject conditioning as a function of the intensity of the unconditioned stimulus. Science. 1958;128(3327):774–5.CrossRefGoogle ScholarPubMed
Mowrer, OH. Learning Theory and Personality Dynamics. New York: The Ronald Press Company; 1950.Google Scholar
Buglass, D, Clarke, J, Henderson, A, et al. A study of agoraphobic housewives. Psychological Medicine 1977;7(1):7386.CrossRefGoogle ScholarPubMed
Goldstein, AJ, Chambless, DL. A reanalysis of agoraphobia. Behavior Therapy 1978;9(1):4759.CrossRefGoogle Scholar
English, HB. Three cases of the ‘conditioned fear response’. The Journal of Abnormal and Social Psychology 1929;24(2):221.CrossRefGoogle Scholar
Thorndike, EL. The Psychology of Wants, Interests and Attitudes. New York: Appleton-Century; 1935.Google Scholar
Emmelkamp, PM. Anxiety and fear. In: Emmelkamp, PM, Bellack, AS, Hersen, M, et al. (eds.) International Handbook of Behavior Modification and Therapy. Boston: Springer; 1982: 349–95.Google Scholar
Öhman, A. Face the beast and fear the face: animal and social fears as prototypes for evolutionary analyses of emotion. Psychophysiology 1986;23(2):123–45.CrossRefGoogle ScholarPubMed
Öhman, A, Fredrikson, M, Hugdahl, K, et al. The premise of equipotentiality in human classical conditioning: conditioned electrodermal responses to potentially phobic stimuli. Journal of Experimental Psychology: General 1976;105(4):313.CrossRefGoogle ScholarPubMed
Seligman, ME. Phobias and preparedness. Behavior Therapy 1971;2(3):307–20.CrossRefGoogle Scholar
Bienvenu, OJ, Eaton, WW. The epidemiology of blood-injection-injury phobia. Psychological Medicine 1998;28(5):1129–36.CrossRefGoogle ScholarPubMed
Beidel, DC. Social anxiety disorder: etiology and early clinical presentation. The Journal of Clinical Psychiatry 1998;59(Suppl 17):2732.Google ScholarPubMed
Beck, AT, Emery, G. Anxiety Disorders and Phobias: a Cognitive Perspective. New York: Basic Books; 1985.Google Scholar
Clark, DM. A Cognitive Model of Panic Attacks. In: Rachman, S, Maser, JD (eds.) Panic: Psychological Perspectives. Hillsdale, NJ: L. Erlbaum Associates; 1988: 7189.Google Scholar
Stern, R, Marks, I. Brief and prolonged flooding: a comparison in agoraphobic patients. Archives of General Psychiatry 1973;28(2):270–6.CrossRefGoogle ScholarPubMed
Emmelkamp, PM, Wessels, H. Flooding in imagination vs flooding in vivo: a comparison with agoraphobics. Behaviour Research and Therapy 1975;13(1):715.CrossRefGoogle ScholarPubMed
McDonald, R, Sartory, G, Grey, S, et al. The effects of self-exposure instructions on agoraphobic outpatients. Behaviour Research and Therapy 1979;17(1):83–5.CrossRefGoogle Scholar
Matthews, AM, Gelder, MG, Johnston, DW. Agoraphobia: Nature and Treatment. Abingdon: Routledge; 1981.Google Scholar
Ghosh, A, Marks, IM, Carr, A. Therapist contact and outcome of self-exposure treatment for phobias: a controlled study. The British Journal of Psychiatry. 1988;152(2):234–8.CrossRefGoogle ScholarPubMed
Öst, L-G, Salkovskis, PM, Hellström, K. One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia. Behavior Therapy 1991;22(3):407–22.CrossRefGoogle Scholar
Marks, IM. Living with Fear: Understanding and Coping With Anxiety. New York: McGraw-Hill; 1978.Google Scholar
Stern, RS, Drummond, LM. The Practice of Behavioural and Cognitive Psychotherapy. Cambridge: Cambridge University Press; 1991.Google Scholar
Wells, A, Papageorgiou, C. Worry and the incubation of intrusive images following stress. Behaviour Research and Therapy 1995;33(5):579–83.CrossRefGoogle ScholarPubMed
Mathews, AM, Gelder, MG, Johnston, DW, et al. Agoraphobia: Nature and Treatment. London: Tavistock; 1981.Google Scholar
Marks, IM. Cure and Care of Neuroses: Theory and Practice of Behavioral Psychotherapy. Chichester: John Wiley & Sons; 1981.Google Scholar
Burke, M, Drummond, LM, Johnston, DW. Treatment choice for agoraphobic women: exposure or cognitive‐behaviour therapy? British Journal of Clinical Psychology 1997;36(3):409–20.CrossRefGoogle ScholarPubMed
Wechsler, TF, Kümpers, F, Mühlberger, A. Inferiority or even superiority of virtual reality exposure therapy in phobias? – A systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia, and social phobia. Frontiers in Psychology 2019;10:1758.CrossRefGoogle ScholarPubMed
Park, MJ, Kim, DJ, Lee, U, et al. A literature overview of virtual reality (VR) in treatment of psychiatric disorders: recent advances and limitations. Frontiers in Psychiatry 2019;10:505.CrossRefGoogle ScholarPubMed
Oing, T, Prescott, J. Implementations of virtual reality for anxiety-related disorders: systematic review. JMIR Serious Games 2018;6(4):e10965.CrossRefGoogle ScholarPubMed
van Dis, EAM, van Veen, SC, Hagenaars, MA, et al. Long-term outcomes of cognitive behavioral therapy for anxiety-related disorders: a systematic review and meta-analysis. JAMA Psychiatry 2020;77(3):265–73.CrossRefGoogle ScholarPubMed
Böhnlein, J, Altegoer, L, Muck, NK, et al. Factors influencing the success of exposure therapy for specific phobia: a systematic review. Neuroscience & Biobehavioral Reviews 2020;108:796820.CrossRefGoogle ScholarPubMed
Zimmermann, M, Chong, AK, Vechiu, C, et al. Modifiable risk and protective factors for anxiety disorders among adults: a systematic review. Psychiatry Research 2020;285:112705.CrossRefGoogle ScholarPubMed
Marks, IM. Advances in behavioral-cognitive therapy of social phobia. Journal of Clinical Psychiatry 1995;56(Suppl 5):2531.Google ScholarPubMed
Coupland, NJ. Social phobia: etiology, neurobiology, and treatment. Journal of Clinical Psychiatry 2001;62:2535.Google ScholarPubMed
de Vries, YA, Harris, MG, Vigo, D, et al. Perceived helpfulness of treatment for specific phobia: findings from the World Mental Health Surveys. Journal of Affective Disorders 2021;288:199209.CrossRefGoogle ScholarPubMed
de Roos, NM, de Vries, JH, Katan, MB. Serum lithium as a compliance marker for food and supplement intake. American Journal of Clinical Nutrition 2001;73(1):75–9.CrossRefGoogle ScholarPubMed
Pompoli, A, Furukawa, TA, Imai, H, et al. Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta‐analysis. Cochrane Database of Systematic Reviews 2016;4(4):CD011004.Google ScholarPubMed
Williams, T, Hattingh, CJ, Kariuki, CM, et al. Pharmacotherapy for social anxiety disorder (SAnD). Cochrane Database of Systematic Reviews 2017;10(10):CD001206.Google ScholarPubMed
Khali, RB. Non-antidepressant psychopharmacologic treatment of specific phobias. Current Clinical Pharmacology 2015;10(2):131138.CrossRefGoogle Scholar
Nutt, D, Baldwin, D, Beaumont, G, et al. Guidelines for the management of social phobia/social anxiety disorder. Primary Care Psychiatry. 1999;5(4):147–55.Google Scholar

Further Reading

Drummond, LM. CBT for Adults. Cambridge: Cambridge University Press/Royal College of Psychiatrists; 2018.Google Scholar

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