Specific phobia, or simple phobia, is an intense and persistent fear caused by the presence or anticipation of a specific object or situation. It causes an immediate anxiety response and often leads to avoidance. Phobias are classified into subtypes including situational, animal, blood-injury, and natural environment. They typically onset in childhood or adolescence. Signs include crying, clinging, avoidance, or panic symptoms. Treatment involves exposure therapy, desensitization, modeling, and in some cases medication to help individuals gradually face their fears.

1. SPECIFIC PHOBIA
Presented by:
Shaista Butt

2. Definition
Specific phobia, or simple phobia, is an intense,
unreasonable, and persistent fear caused by the presence
or anticipation of a specific object or situation.
It provokes an immediate anxiety response that can
sometimes take the form of a panic attack.
This intense fear often leads to avoidance, and causes
severe distress when the situation can’t be avoided
(Bernstein, 1997).

3. Subtype of specific phobia
Phobias are classified into different subtypes.
– Situational type: concerns a specific situation, such as the fear
of flying, bridges, elevators, driving, etc.
– Blood-injection-injury type: also includes any invasive
medical procedure. This kind of phobia is often associated with
fear of seeing blood or wounds, having injection and other
medical procedures.

4. Subtype (Cont..)
– Animal type: fear of insects, dogs, snakes, rodents, spiders,
etc.
– Other type: phobias can be caused by a wide variety of objects
or situations that don’t fit the categories listed above. These
include a fear of choking, loud noises, contracting an illness,
vomiting, etc.
Animal phobia is most common in childhood, while
blood-injury phobias are most common in adolescents.
(Silverman, & Moreno, 2005).
‾ Natural environment type:
fear of storms, heights, the dark,
water, etc.

5. Age of Onset
The usual age of onset is childhood to adolescence.
Symptoms usually peak between 10 and 13 years of
age.
The onset of phobias differed between groups: hardly
any phobias of animals had started after age 5, while
most phobias of the other varieties started after age 10
(Jackson, 2002).

6. Signs and Symptoms
Children with phobia show different symptoms when
confront phobic objects or situations. The anxiety response
occurs immediately when the child is confronted with the
feared object.
The child may respond by
– crying,
– cringe,
– clinging to parents,
– avoidance, aggression,
– running away,
– shaking, or immobilization. (Muris, Merckelbach, & Ollendick,
2002).

7. Signs and Symptoms (Cont..)
Anxiety can sometimes cause symptoms of panic, such as
– rapid heart rate,
– dizziness, light-headedness, and
– the fear of dying, losing control,
– sweating,
– trembling, or
– a choking sensation.
Phobias disrupt a child’s daily routines, work efficiency,
and/or social relationships (Muris, Merckelbach, &
Ollendick, 2002)..

8. DSM V Criteria
 Marked and out of proportion fear within an
environmental or situational context to the presence or
anticipation of a specific object or situation.
 Exposure to the phobic stimulus provokes an
immediate distress or anxiety response, which may
take the form of a panic attack.
 The avoidance, anxious anticipation or distress in the
feared situation(s) interferes significantly with the
child’s normal routine, academic functioning, or social
relationships.
 The symptoms must have duration of at least 6 months
(APA, 2013).

9. Co morbidity
Specific phobia is co-morbid with a number of disorders
including:
– major depression,
– Somatoform disorder, and
– attention-deficit hyperactivity disorder (Peterman, 2000),.

10. Prevalence and Epidemiology
According to the various studies, specific phobias affect
7% to 11% of the population at some point in their life,
Generally more common among women, with
percentages varying depending on the type of phobia.
It is interesting to note that the objects of phobias vary
from culture to culture (Becker, et al. 2007).

11. Etiology and Pathogenesis
The etiology of specific phobia is partly unknown.
Studies demonstrate that both biological and
environmental factors play a role.
 Genetics:
Relatives of children with phobias have greater
likelihood of having phobias.
Moreover, type of feared stimuli may run in families For
instance, if one family member has situational phobia its
more likely that other members will have situational
phobia (Ollendick, Hagopian, & King. 1997).

12. Learning and conditioning:
Development of phobias can be explained by
conditioning.
– Phobia can be developed by classical conditioning, when a
natural fear response to natural feared object is paired with a
neutral object. For example, a child who has been attacked
(natural object) by a dog will have a fearful response (natural
fear response) to the presence of any dog (neutral stimulus)
nearby.
– In operant conditioning, phobia may be developed due to
contingencies (i.e. rewarding child for phobia behavior) e.g. a
child who fears dog may be rewarded by parental attention
(Jackson, 2002).

13. Traumatic experiences:
Someone who has, for example, witnessed or
experienced a traumatic event (e.g. being bitten by an
animal or trapped in an enclosed space) may feel
extremely fearful of situations or objects associated with
the event afterwards.
By avoiding these, even when they are in a non-
threatening situation, they may develop a specific phobia
(Essau, Conradt, & Petermann, 2000).

14. Psychodynamic causes:
Psychodynamic theorists explain that phobias emerge
because individuals have impulses that are unacceptable,
and they repress these impulses.
When repression does not work, individuals with
phobias displace their anxiety connected to the
unresolved conflict upon a situation or object that is less
relevant. The feared situation or object symbolizes the
source of the conflict.
– For example, a specific phobia may be connected to an
individual's conflict about aggressive thoughts and feelings. A
phobia protects individuals from realizing their emotional
issues (Jackson, 2002).

15. Treatment
A variety of treatment options exists, including
cognitive-behavioral therapy (CBT), exposure therapy,
anxiety management, relaxation techniques, and
medications. One or a combination of these may be
recommended (Ollendick, Hagopian, & King. 1997).
• Psychotherapy:
The psychotherapy in form of “exposure” and
“systematic desensitization” are effective treatments for
specific phobia, in which the feared situation is faced
directly or through imagery.

16. Exposure therapy:
The most effective way to overcome phobia is gradual
and repeated exposure to the feared object in a safe and
controlled way until it no longer triggers the fear
response. This can be done via
– “imaginal exposure” i.e. imagining confronting the feared
situation in one’s mind, or via
– “in vivo exposure”-confronting the feared situation in real life.
Through repeated experiences facing fear, child begins
to realize that the worst isn’t going to happen and feels
more confident and the phobia begins to lose its power.
The child works moving up the fear ladder (Foe &
Kozak, 1986).

17. For example:
1. look at picture of dog,
2. watch video with dogs in it,
3. look at a dog through window,
4. stand across the street from a dog on a leash,
5. stand beside a dog on a leash,
6. pet a small dog that someone is holding the street
from a dog on a leash,
7. stand 5 feet away from a dog,
8. stand beside a dog on a leash,
9. pet a small dog that someone is holding, and
10. pet a large dog on a leash.

18. Desensitization:
Desensitization pairs gradual exposure to phobic stimuli
with relaxation methods.
– Systematic desensitization exposes the child to imagined
stimuli, while
– in in-vivo desensitization exposes child to actual stimuli.
Desensitization begins with the hierarchy of anxiety
provoking stimuli (Davis & Ollendick, 2005).

19. For example:
If child is afraid of dogs, hierarchy might include:
1. looking at picture of dog,
2. looking at a dog through window,
3. standing across the street from a dog on a leash,
4. stand beside a dog on a leash and so on.
The child is taught relaxation techniques for dealing
with fear (Davis & Ollendick, 2005).

20. Modeling:
In modeling, the child observes others (the “models”) in
the presence of the phobic stimulus who is responding
with relaxation rather than fear.
In this way, the patient is encouraged to imitate the
model(s) and thereby relieve their phobia.
Combining live modeling with personal imitation is
sometimes called participant modeling (Bernstein,
1997).

21. Medication
There is little research on the use of medication and specific
phobias.
However, some people with situational-type phobias (i.e.
flying) do note some benefit in taking anti-anxiety
medications (i.e. Ativan) or serotonin reuptake inhibiters
(i.e. Paxil) before confronting the feared situation.
Thus, they should be used with caution and sparingly,
because they can cause tolerance and addiction problems.
(Davis & Ollendick, 2005).

22. References
American Psychiatric Association (2000). Diagnostic and
Statistical Manual of Mental Disorders (4th ed, text
revision). Washington, DC: American Psychiatric
Association.
Becker, E., Rinck, M., & Turke, V., et al. (2007). Epidemiology of
specific phobia subtypes: findings from the Dresden
Mental Health Study. Europe Psychiatry, 22, 69-74.
Bernstein, D. (1997). Psychology (4th ed.). New York: Houghton
Mifflin.