Phobias

Last reviewed: 7 Jun 2022
Last updated: 18 May 2022

Summary

Definition

History and exam

Key diagnostic factors

  • anticipatory anxiety
  • behavioural avoidance
More key diagnostic factors

Other diagnostic factors

  • onset during childhood
  • onset during early adulthood
  • nausea
  • dizziness
  • disgust
  • fainting
  • tachycardia
  • hyperventilation
  • exaggerated startle
  • sleep disruption
Other diagnostic factors

Risk factors

  • somatisation disorder
  • anxiety disorders
  • mood disorders
  • first-degree relative with phobia
  • twin with phobia
  • aversive experiences
  • stress and negative life events
  • female sex
  • white ethnicity
  • parental anxiety and overprotectiveness
  • negative affectivity and behavioural inhibition
  • cognitive/attentional bias
More risk factors

Diagnostic investigations

1st investigations to order

  • self-report
  • behavioural observation and approach tests
More 1st investigations to order

Investigations to consider

  • structured/semi-structured clinical interview
More investigations to consider

Treatment algorithm

ONGOING

adults with subclinical symptoms and infrequent interference with usual activities

adults with frequent symptoms interfering with usual activities

children with ongoing symptoms interfering with usual activities

Contributors

Authors

Amy Huberman, MD

Instructor of Psychiatry

Johns Hopkins University School of Medicine

Baltimore

MD

Disclosures

AH declares that she has no competing interests.

Acknowledgements

Dr Amy Huberman would like to gratefully acknowledge Dr Eve Friedl, Dr E. Blake Zakarin, Dr Craig N. Sawchuk, and Dr Bunmi O. Olatunji, previous contributors to this topic.

Disclosures

EKF and EBZ declare that they have no competing interests. CNS is an author of a reference cited in this topic. BOO is an author of a reference cited in this topic.

Peer reviewers

Jeffrey M. Lohr, PhD

Professor

Clinical Training Program

Department of Psychology

University of Arkansas

Fayetteville

AR

Disclosures

JML declares that he has no competing interests.

David F. Tolin, PhD

Associate Professor

Institute of Living

Yale University

New Haven

CT

Disclosures

DFT declares that he has no competing interests.

  • Differentials

    • Agoraphobia
    • Panic disorder
    • Social anxiety disorder (social phobia)
    More Differentials
  • Guidelines

    • Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders
    • Generalised anxiety disorder and panic disorder in adults: management
    More Guidelines
  • Patient leaflets

    Phobias

    More Patient leaflets
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