Phobia Introduction

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Phobias are part of the anxiety disorder spectrum.
Anxiety can be defined as a feeling of fear or apprehension.

Often accompanied by autonomic disturbance.

The symptoms of anxiety are psychological and physical.
DSM-IV describes several different anxiety syndromes:
Acute stress disorder

Generalised anxiety disorder

Anxiety disorder due to General Medical Condition

Substance-induced Anxiety Disorder

Panic Disorder =/- Agoraphobia

Agoraphobia without history of Panic Disorder

Specific Phobia

Social Phobia

Obsessive-Compulsive Disorder

Post-Traumatic Stress disorder

Anxiety Disorder not otherwise specified.
These are not water-tight. For example flying phobia may have both specific and social components. As always, accurate history-taking and problem formulation is the key to effective and efficient management.

Two clusters of symptoms are common to many of the Anxiety Disorders and are described separately in DSM-IV. They are Panic Attack and Agoraphobia.

In a Panic Attack there is a sudden onset of severe anxiety, with intense apprehension, fearfulness or terror, often associated with feelings of impending doom. During these attacks the physical symptoms which occur include hyperventilation, shortness of breath, palpitations, chest pains, choking sensations and the fear of ‘going crazy’ or losing control.

Agoraphobia is anxiety about, or avoidance of, places or situations from which escape might be difficult or embarrassing, or in which help may not be available in the event of having a Panic Attack or panic-like symptoms.

The anxiety and stress-management techniques previously discussed are useful in these conditions.

Irrational fear of a specific object, activity or situation. (Les Brann)
Marked and persistent fear that is excessive and unreasonable, and often recognized by the patient as such. Seligman and Rosenhan (1998)

(This may not be true of children)

Cued by presence or anticipation of specific object or situation.

Consistent. Exposure, or threat of exposure produces response.

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