Specific phobias - what can help us understand them?

Surely you know people who are afraid of dogs or being locked in an elevator. Such situations are very unlikely but still worry many people. We talk about specific phobias.

Specific phobias are associated with an extreme and irrational fear of a specific object or situation. There are almost countless number of specific phobias, from the strangest ones like coulrophobia (fear of clowns) to common ones like claustrophobia.

Traditionally, specific phobias fall into four categories: animal phobias, injection wound phobias, environmental phobias, and situational phobias. To diagnose a simple or specific phobia, specialists use the DSM-V or ICD-10 diagnostic criteria.

Specific phobias are among the most common anxiety disorders. There are enormous individual differences when it comes to the impact they have on a person's life. There are people whose phobias limit them very much and for others they are only a minor nuisance.

What features must be present for specific phobias to arise?

One of the difficulties in diagnosing specific phobias concerns the boundary between adaptive anxiety and phobic anxiety. There is more or less general agreement as to a number of features that indicate a phobic fear response:

• Fear is out of proportion to the situation.
• It cannot be explained or substantiated by the entity.
• It is beyond his conscious control.
• Fear prompts you to avoid a frightening situation.
• It lingers over time.
• It is maladaptive.
• It is not specific to any particular stage or age.

So what are the most important of these characteristics that help distinguish phobic from adaptive anxiety? Phobic anxiety is characterized by a persistence, size, and maladaptive nature that do not occur in adaptive anxiety.

Age of onset, gender prevalence and distribution

The prevalence of significant specific phobias ranges from approximately 3% to 12% in the general population. The age of onset may vary considerably. The highest incidence of specific phobias in children is between the ages of 10 and 13.

Specific phobias occur in 2-4% of children. However, only a small number of children come to the consultation. In addition, specific phobias are more common in girls than in boys, and symptoms appear in younger girls than in boys.

Clinical features

Patients do not seek help as often with specific phobias as with other phobias. On the other hand, the level of severity may be minimal, especially if the chances of confronting the phobic object are low.

Most people who seek help to overcome a phobia do so because of the following three factors:

Something has changed in the patient's life that makes the phobic stimulus more present or meaningful.

The sudden event triggered the emergence of certain fears that did not exist before and conditions their present lives.

A person is tired of living with a certain fear and decides to solve his problem.

The range of the stimuli that trigger a fear response in a person with a specific phobia is limited, but the nature of the stimuli that have the potential to trigger a phobic response is enormous.

Which will help us understand some specific phobias

Family studies suggest an increased risk of developing a similar one in first-degree relatives. However, specific phobias can also be acquired in contact with the environment through direct and aversive experience with a situation or object.

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It is believed that such an experience can over-activate the amygdala, a key structure involved in the development and coordination of the physiological expression of fear.

Animal phobia

Animal phobia is the feeling of isolated fear of certain animals that are not normally dangerous, such as birds, dogs, cats, etc. It is associated with fear and avoidance of the animals themselves, not disgust or fear of contamination. In these types of phobias, fear usually occurs while the animals are moving.

As a rule, people are afraid of one type of animal, and not other species. Only a few are also concerned about the damage that the animal can cause.

Even though it may seem strange, this type of phobia is similar to the fear of fear. After first contact with an animal, a person usually follows an avoidance strategy. This attitude, however, only strengthens her fear

As a consequence, a person tends to fear intense discomfort before possible exposure occurs, rather than the possibility of an attack by the animal.

Phobia at the sight of blood

A phobia at the sight of blood and wounds has several unique distinguishing features. The most important is the two-phase physiological cardiovascular response. It may even achieve a brief asystole. It is accompanied by nausea, sweating, paleness and sometimes fainting.

As with animal phobia, anxiety is more related to the anticipation of possible syncope than to the phobic stimulus itself.

Specific situational phobias

So-called situational phobias cover a diverse set of situations. Although the most representative phobias are related to airplanes, driving, crowded places, heights and bridges.

The most striking aspect is that it tends to occur both on its own and as part of the panic disorder linked to agoraphobia. Some authors even considered them to be a moderate form of agoraphobia.

The prevalence, epidemiology and course of specific phobias

The prevalence of significant specific phobias ranges from 3% to 12% of the general population. They can occur at any important time, but the average age seems to be between 7 and 16 years old, with a range between 3 and 67 years old.

The fear of animals and blood appears the earliest (between the ages of 7 and 9). On the other hand, fear of heights and claustrophobia, along with the phobia of driving, appear a little later (between 20 and 25 years of age).

People with common phobia outnumber agoraphobia and social phobia. Almost half of the social phobias and simple phobias are also characterized by agoraphobia. Despite the fact that they are very widespread, few people seek help.

As for specific phobias, the degree of the disorder can become tolerable. Specific phobias prevail in women compared to men in a ratio of 1: 1.7. First of all, it can be seen in the example of animal phobia.

What is the intervention for specific phobias?

The preferred intervention for this type of phobia combines exposure and systematic desensitization. Data collected in various studies tell us that the effects of such therapy last 6 to 12 months after treatment.

In therapy, the patient is exposed to a frightening stimulus, but gradually and slowly. This process is aimed at accustoming the person to the stimulus, forcing the reduction of the anxiety that naturally occurs in his presence.

A person can understand, in higher cognitive processing, that the stimulus is not really a threat. Thus, the aim of the intervention is to try to understand this fact also at a low level of reactivity.

Since specific phobias often occur under predictable and limited conditions, the use of a benzodiazepine, if necessary, may appear clinically appropriate in milder cases. However, studies with benzodiazepines did not show that the results of their administration are sustained over time.