Phobia

Major Types of Anxiety Disorders

1.       Generalised Anxiety Disorder

2.       Panic Disorder

3.       Phobias

4.       Obsessive-compulsive Disorder

5.       Post-traumatic Stress Disorder (PTSD)

 

Definition

          “Irrational fears related to specific objects, interactions with others, and unfamiliar situations.” NCERT.

 

          A phobia is a persistent fear of some object or situation that presents no actual danger to the person or in which the danger is magnified out of all proportion to its actual seriousness (Coleman, 1988).

 

Key Feature of Phobia     

         

          The fear or anxiety is circumscribed to the presence of a particular situation or object.

 

Introduction   

          Phobia is one the types of anxiety disorders. It’s a kind of fear response. Unlike other anxiety disorders the phobia is related to specific objects, people, or situations. Phobias often develop gradually or begin with a generalised anxiety disorder. The object of phobia leads to dreaded and mortifying response from the individual. The people who suffer from phobia have a sense of realization that their fear is irrational, still they couldn’t do anything on it. Sometimes, the phobic fear is so intense that it can incapacitate the productivity of the individual by interfering in various domains of life.

 

Main Types of Phobia      

          Phobias can be grouped into three main types: -

(i)       Specific phobias,

(ii)      Social phobias (Social anxiety disorders), and

(iii)     Agoraphobia

 

Some Specific Phobia      

(i)       Acrophobia (high places),

(ii)      Astraphobia (pain),

(iii)     Claustraphobia (closed places)

(iv)     Hematophobia (blood),

(v)      Mysophobia (contamination or germs),

(vi)     Monophobia (being alone)

(vii)    Nycotophobia (darkness)

(viii)   Ocholophobia (crowds),

(ix)     Pathophobia (disease),

(x)      Pyrophobia (fire),

(xi)     Syphilophobia (syphilis),

(xii)    Zoophobia (animals), and

(xiii)   Nomobophobia (being without mobile phone).

 

Symptoms

(i)       Excessive, unreasonable, persistent feelings of fear or anxiety triggered by a particular object, activity or situation.

(ii)      Feelings are either irrational or out of proportion to any actual threat.

(iii)     Avoidance of the object, activity or situation that triggers the phobia.

(iv)     Anxiety-related physical symptoms such as tremors, palpitations, sweating, shortness of breath, dizziness, nausea etc.).

 

Causes

          Specific phobia usually develops in early childhood, with the majority of cases developing prior to age 10 years (DSM V). Amygdala plays a pivotal role in fear.

(i)       Experiencing a traumatic event.

(ii)      Observation of a traumatic event.

(iii)     Unexpected panic attack.

(iv)     Information transmission.

(ii)      Unfortunate experiences (Experiential-specific phobia).

(iii)     Genetic factors (25 to 65%).

(iv)     Environmental factors.

 

Proteins and Chemicals (Neurotransmitters) Responsible for Phobia

(i)       GABA  (Inhibition of  amygdala)

(ii)      Dopamine (Activate the amygdala)

(iii)     Norepinephrine (Activate the amygdala)

 

Risk and Prognostic Factors

(i)       Specific phobia was found to associate with cardiac diseases, gastrointestinal diseases, respiratory diseases, arthritic conditions, migraine, and thyroid diseases (Harvard Medical School).

(ii)      Impairment in psychosocial functioning and decreased quality of life

(iii)     Impairments in occupational and interpersonal functioning.

(iv)     Reduced mobility and reduced physical and social functioning due to

fear of falling.

 

Diagnostic Criterion

(i)       The fear or anxiety must be intense or severe.

(ii)      Fear or anxiety should evoke almost every time the individual comes into contact with the object of phobia (phobic stimulus).

(iii)     The fear or anxiety should occur immediately as the phobic object or situation is encountered.

(iv)     The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more, which helps distinguish the disorder from transient fears.

(v)      The specific phobia must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning in order for the disorder to be diagnosed.

(v)      Meticulous examination of symptoms and family history of mental disorders.

Note: Before diagnosing an individual with phobia sociocultural context should also be taken into account.

 

Characteristics of Phobia

(i)       The fear in the phobia is unrealistic and irrational.

(ii)      It is persistent and excessive.

(iii)     The fear causes overwhelming distress.

(iv)     The reaction to the stimuli is disproportionate.

(v)      Phobia results from exposure to objects or situations.

 

Certain Phobic Stimuli (DSM V)

(i)       Animal (e.g., spiders, insects, dogs).

(ii)      Natural environment (e.g., heights, storms, water).

(iii)     Blood-injection-injury (e.g., needles, invasive medical procedures).

(iv)     Situational (e.g., airplanes, elevators, enclosed places).

 

Treatment

          Treatment usually includes some combination of psychotherapy and medication depending on the type of phobia:

(i)       Desensitization or Exposure therapy (Mastering the fear through relaxation, and other yoga techniques).

(ii)      Cognitive Behaviour Therapy.

(iii)     Medications (Beta-blockers and antidepressants).

(iv)     Implosive technique.

 

References:

1.       Coleman, C. J. (1988). Abnormal psychology and modern life. Bombay, India: D. B. Taraporevala Sons & Co.

2.       NCERT. (XII). Psychology Book.

3.       DSM V Manual. Published by APA.

4.       https://www.health.harvard.edu/a_to_z/phobia-a-to-z.

 

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