Phobias are one of the most common and treatable psychiatric conditions.
Marked by fear or anxiety in the presence of a specific object or situation.
Assessments are based on self-reports, clinical interviews, and behavioral observations.
Cognitive behavioral therapy, especially exposure therapy, is considered first-line treatment for patients with frequent symptoms.
Therapy can also be delivered through self-help, internet-assisted, and/or therapist-assisted modalities.
Patient motivation and available resources are important to consider when reviewing treatment options.
Phobias involve intense fears of specific objects or situations that are triggered upon actual or anticipated exposure to phobic stimuli. Situations in which phobic cues are present are usually avoided or endured with intense anxiety. Excessive fears can cause functional impairments or lifestyle disruptions.
History and exam
Key diagnostic factors
- anticipatory anxiety
- behavioral avoidance
Other diagnostic factors
- onset during childhood
- onset during early adulthood
- exaggerated startle
- sleep disruption
- somatization 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 behavioral inhibition
- cognitive/attentional bias
1st investigations to order
- behavioral observation and approach tests
Investigations to consider
- structured/semi-structured clinical interview
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
- Panic disorder
- Social anxiety disorder (social phobia)
- Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders
- Exposure-based interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research
PhobiasMore Patient leaflets
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