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For other uses, see phobia (disambiguation)
Phobias (in the clinical meaning of the term) are the most common form of anxiety disorders. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. 1 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.
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Causes
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 fear2. 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, phobias and panic attacks.
The anatomical side of phobias
Phobias are more often than not linked to the amygdala, an area of the brain located behind the pituitary gland in the limbic system. The amygdala secretes hormones that control fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, in which they are ready to move, run, fight, etc.3 This defensive "alert" state and response is generally referred to in psychology as the Fight-or-flight response.
Clinical phobias
Most psychologists and psychiatrists classify most phobias into three categories: 4 5
- Social phobia, also known as social anxiety disorder - **specific social phobia, which are cases of anxiety triggered only in specific situations. It is a marked fear of public appearance in which embarrassment or humiliation is possible. People with social phobias are often deadly afraid of speaking, eating, or performing in public. 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. People with social phobias are concerned with drawing attention to themselves that goes beyond mere preference.
- Specific phobias - intense fear of objects, places, or situations that are greatly out of proportion to their actual threattrigger such as spiders, snakes, dogs, elevators, water, waves, flying, balloons, catching a specific illness, etc.
- Agoraphobia - fear of being in a place or situation from which escape is difficult or embarassing, or in which help is unavaliable in the event of a panic attack.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), social phobia, specific phobia, and agoraphobia are sub-groups of anxiety 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.
Phobias in children
Severe fears are present in about 10-15% of children and specific phobias are found in about 5% of children. Children that have 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. Children often have specific phobias of the dark, varieties of insects, spiders, 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.
Treatments
Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitization therapy.
Cognitive behavioral therapy (CBT) can be beneficial. Cognitive behavioral therapy lets the patient understand the cycle of negative thought patterns, and ways to change these thought patterns. CBT may be conducted in a group setting. Gradual desensitisation treatment and CBT are often successful, provided the patient is willing to endure some discomfort and to make a continuous effort over a long period of time. 6
Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction.
Anti-anxiety or anti-depression medications can be of assistance in many cases. Benzodiazepines could be prescribed for short-term use.
Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, considered to be pseudoscience by the mainstream medicine, is allegedly useful.
These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.
Non-psychological conditions
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.
Non-clinical uses of the term
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.
Terms indicating prejudice or class discrimination
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 has roots in social relations.
Below are some examples:
- Chemophobia - prejudice against artificial substances in favour of 'natural' substances.
- Christianophobia, fear or dislike of Christians or Christianity.
- Ephebiphobia - fear or dislike of youth or adolescents
- Gynophobia - fear or dislike of women
- Homophobia - fear or dislike of homosexuality
- Xenophobia - fear or dislike of strangers or the unknown, sometimes used to describe nationalistic political beliefs and movements. It is also used in fictional work to describe the fear or dislike of the space aliens.
See also
Notes and references
- ^ Kessler et al, Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication, June 2005, Archive of General Psychiatry, Volume 20
- ^ Phobias: Causes and Treatment in AllPsych Journal
- ^ Winerman, Lea. "Figuring Out Phobia", American Psychology Association: Monitor on Psychology, August 2007.
- ^ [1]
- ^ [2]
- ^ Hall, Lynne L. Fighting Phobias, the Things That Go Bump in the Mind, FDA Consumer Magazine, Volume 31 No. 2, March 1997.
External links
- Diagnostic criteria for social phobia in the DSM-IV
- Diagnostic criteria for specific phobia in the DSM-IV
Wikipedia content modification information:
- This page was last modified on 18 November 2008, at 17:23.
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