Last reviewed: July 2019
Last updated: April  2019

Summary

Definition

History and exam

Key diagnostic factors

  • anticipatory anxiety
  • behavioural avoidance

Other diagnostic factors

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

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

Diagnostic investigations

1st investigations to order

  • self-report
  • behavioural observation and approach tests
Full details

Investigations to consider

  • structured/semi-structured clinical interview
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Instructor of Psychiatry

Johns Hopkins University School of Medicine

Co-Director

Johns Hopkins Hospital Anxiety Disorders Clinic

Johns Hopkins University Medical Institute

Baltimore

MD 

Disclosures

AH declares that she has no competing interests.

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.

Peer reviewers VIEW ALL

Professor

Clinical Training Program

Department of Psychology

University of Arkansas

Fayetteville

AR

Disclosures

JML declares that he has no competing interests.

Associate Professor

Institute of Living

Yale University

New Haven

CT

Disclosures

DFT declares that he has no competing interests.

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