Phobia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Phobia is also used in a non-medical sense for aversions of all sorts. These terms are usually constructed with the suffix -phobia. A number of these terms describe negative attitudes or prejudices towards the named subjects. See Non-clinical uses of the term below.

The word “phobia” may also signify conditions other than fear. For example, although the term hydrophobia means a fear of water, it may also mean inability to drink water due to an illness, or may be used to describe a chemical compound which repels water. Likewise, the term photophobia may be used to define a physical complaint (i.e. aversion to light due to inflamed eyes or excessively dilated pupils) and does not necessarily indicate a fear of light.

It is possible for an individual to develop a phobia over virtually anything. The name of a phobia generally contains a Greek word for what the patient fears plus the suffix-phobia. Creating these terms is something of a word game. Few of these terms are found in medical literature. However, this does not necessarily make it a non-psychological condition.

A number of terms with the suffix -phobia are primarily understood as negative attitudes towards certain categories of people or other things, used in an analogy with the medical usage of the term. Usually these kinds of “phobias” are described as fear, dislike, disapproval, prejudice, hatred, discrimination, or hostility towards the object of the “phobia”. Often this attitude is based on prejudices and is a particular case of general xenophobia.

Class discrimination is not always considered a phobia in the clinical sense because it is believed to be only a symptom of other psychological issues, or the result of ignorance, or of political or social beliefs. In other words, unlike clinical phobias, which are usually qualified with disabling fear, class discrimination usually have roots in social relations.

Below are some examples:

• Chemophobia, prejudice against artificial substances in favour of ‘natural’ substances.
• Christianophobia, fear or hatred of Christians or Christianity.
• Ephebophobia, fear of youth or adolescents
• Islamophobia, fear-induced prejudice against Muslims or Islam|Islamic culture.
• Xenophobia, fear or dislike of strangers or the unknown, sometimes used to describe nationalistic politics|political beliefs and movements. It is also used in fictional work to describe the fear or dislike of the space aliens.
• Mailophobia, fear-induced by having to check/get mail.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Most psychologists and psychiatrists classify most phobias into three categories: [3][4]

• Social phobia, also known as social anxiety disorder – fears involving other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Social phobia may be further subdivided into
  • Generalized social phobia, and
  • Specific social phobia, which are cases of anxiety triggered only in specific situations. ^[1] The symptoms may extend to psychosomatic manifestation of physical problems. For example, sufferers of paruresis find it difficult or impossible to urinate in reduced levels of privacy. That goes beyond mere preference. If the condition triggers, the person physically cannot empty their bladder.
• Specific phobias – fear of a single specific panic trigger such as spiders, snakes, dogs, elevators, water, flying, catching a specific illness, etc.
• Agoraphobia – a generalized fear of leaving home or a small familiar ‘safe’ area, and of possible panic attacks that might follow.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), social phobia, specific phobia, and agoraphobia are sub-groups ofanxiety disorder.

Many of the specific phobias, such as fear of dogs, heights, spiders and so forth, are extensions of fears that a lot of people have. People with these phobias specifically avoid the entity they fear.

Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer only relatively mild anxiety over that fear. Others suffer fully-fledged panic attacks with all the associated disabling symptoms. Most individuals understand that they are suffering from an irrational fear, but are powerless to override their initial panic reaction.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

It is generally accepted that phobias arise from a combination of external events and internal predispositions. In a famous experiment, Martin Seligman used classical conditioning to establish phobias of snakes and flowers. The results of the experiment showed that it took far fewer shocks to create an adverse response to a picture of a snake than to a picture of a flower, leading to the conclusion that certain objects may have a genetic predisposition to being associated with fear^[1]. Many specific phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age. Social phobias and agoraphobia have more complex causes that are not entirely known at this time. It is believed that heredity, genetics, and brain chemistry combine with life-experiences to play a major role in the development of anxiety disorders and phobias.

Common phobias include the fear of:

• Blood, injections, and other medical procedures
• Certain animals (for instance, dogs or snakes)
• Enclosed spaces
• Flying
• High places
• Insects or spiders
• Lightning

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [3]

Specific phobia must be differentiated from other diseases such as agoraphobia, eating disorders, OCD and panic disorder.^[1]

• Agoraphobia
• Eating disorders
• Obsessive-compulsive disorder
• Panic disorder
• Schizophrenia spectrum and other psychotic disorders
• Separation anxiety disorder
• Social anxiety disorder
• Trauma- and stressor-related disorders^[1]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [3]

The 12 month prevalence of specific phobia is 7,000-9,000 per 100,000 (7%-9%) of the overall population.^[1]

An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. ^[2] Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25.

Severe fears are present in about 10-15% of children and specific phobias are found in about 5% of children. Children with specific phobias experience an intense fear of an object or situation that does not go away easily and continues for an extended period of time.

Common specific phobias seen in children include:

• Dark
• Varieties of insects, spiders and bees
• Heights
• Water
• Choking
• Snakes, dogs, birds, and other animals

For many children, these fears and phobias interfere with their participation in and enjoyment of various activities. It may also interfere with their education, family life, or their social life. However, effective treatment is available for children who experience phobias.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [3]

Risk factors for specific phobia include behavioral inhibition, genetic predisposition, and parental loss and separation.^[1]

• Behavioral inhibition
• Genetic predisposition
• Negative affectivity (neuroticism)
• Parental over protectiveness
• Parental loss and separation
• Physical and sexual abuse^[1]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Possible complications are:

• Some phobias may have consequences that affect job performance or social functioning.
• Some anti-anxiety medications used to treat phobias, such as benzodiazepines, may cause physical dependence.

Phobias tend to be chronic, but they can respond to treatment.

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