Anxiety Disorders Ii: Specific & Social Phobias

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DSM Criteria for Specific Phobias

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Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation; exposure to the phobic stimulus provokes an immediate anxiety response; person recognizes that the fear is excessive; phobic situation is avoided or ended with intense anxiety; disrupts functioning or marked distress, before age 18, the duration is > 6 months

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Common types of specific phobias

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Blood-Injection-Injury (onset about 9 years old, 61% have family history)
Situational (enclosed places, claustrophobia, subways, airplanes, etc.) (onset early-mid twenties)
Animal (onset peaks at age 7)
Natural Environment, fear of events in nature (storms, heights, darkness) (peak about 7)
Others-choking, vomiting, contracting an illness, loud noises (in some children) costume characters, often occurs after an incident
Social Phobias-social performance situations, where they feel they're being judged, public speaking

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DSM criteria for social phobias

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marked and persistent fear of social performance situations with unfamiliar people or possible scrutiny by others; fears that he or she will act in a humiliating or embarrassing way; exposure to feared situation provokes anxiety; recognizes fear is excessive or unreasonable; situations are avoided or endured with distress; avoidance or distress disrupts functioning

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prevalence of phobias

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about 11% and 13% of the general population meet lifetime diagnostic criteria for specific and social phobia respectively

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higher prevalence of social phobia among this gender

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women

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most phobias begin at this time

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in childhood and early adulthood and are chronic

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etiology of specific phobias (how they are acquired)

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classical conditioning; observational learning; biological preparedness

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etiology of social phobias (how they are acquired)

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prepared to fear angry, critical, or rejecting people

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treatment of phobias

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primarily psychological
systematic desensitization
exposure (in vitro desensitization) graduated or flooding
modeling

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J Wolpe

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developed reciprocal inhibition

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reciprocal inhibition

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the notion that anxiety is inhibited by a feeling or response that is not compatible with a feeling of anxiety (if you're relaxed, you can't be anxious), heirarcy fo fears, in vivo vs. imaginal, progressive muscle relaxation