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Specific Phobia

Reviewed by: HU Medical Review Board | January 2012

Specific Phobia (also called simple phobia) is an anxiety disorder that applies to an irrational and marked anxiety or fear consistently triggered by a single object or situation.

Fear of flying (aerophobia) is one of the most common specific phobias. Other common examples are the fears of such things as heights (acrophobia), spiders (arachnophobia), enclosed spaces (claustrophobia), and snakes (ophidiophobia).

Symptoms of Specific Phobia

  • The same item or situation always provokes marked fear or anxiety.
  • The phobic person actively avoids the trigger or endures it with intense fear or anxiety.
  • In adults, the person recognizes that the fear is irrational or disproportionate to any actual danger presented by the object or situation.
  • The fear, anxiety and avoidance cause significant distress and impairment in functioning.

There are some specific fear/anxiety situations that indicate other anxiety disorders such as Post-Traumatic Stress Disorder, Agoraphobia, Social Anxiety Disorder, etc. A 1990 survey found that phobias are the most common psychiatric disorders in the United States.

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According to the National Institute of Mental Health, specific phobias are twice as common in women as men and tend to begin in childhood and adolescence.

Examples of Specific Phobias and Their Symptoms

Cnidophobia is the fear of stings, usually triggered by stinging insects. Diane has this phobia, and the presence of a bee or wasp sends her into panic. If a wasp shows up in her kitchen, she will scream and flee to the bedroom, locking the door until her husband has killed or removed it. She is unable to spend much time outside for fear of bees. She has had severe and embarrassing panic attacks at summer social events when a bee or wasp got into a screened porch. Diane was occasionally stung by bees as a child, and is not allergic, but her fear of being stung grew with each successive sting.

Frank was a combat pilot so has no aerophobia. Yet he does suffer from acrophobia, the fear of heights. He shivers and shakes on even a six-foot ladder. Once he managed to get up onto his porch roof to perform a minor repair, and was all right on that flat surface as long as he was not near the edge, but it took 20 minutes of coaxing by others, while he sat shaking and shouting that he couldn’t do it, for him to put a foot over the edge to get off again. Once he got into an elevator in a basement parking garage, and only when it got above ground did he realize it had a glass wall to the outside. He had a panic attack and other passengers had to stop the elevator and help him off.

Treatment of Specific Phobia

Targeted psychotherapy has been found to be very effective in treating specific phobias. This generally includes desensitization techniques, that is, slow and careful exposure of the patient to the triggering objects or situations. Desensitization is frequently combined with relaxation and similar therapies.

Hypnosis is another therapy that has shown good effectiveness.

Anti-anxiety medications are often useful in helping patients cope with short-term situations that aren’t practical for desensitization, such as the fear of flying. This would not be a good treatment for our example subject Frank, however, as these medications can cause dizziness. SSRI antidepressants may be used to treat patients whose phobias could be triggered at any time, such our example subject Diane.

Specific Phobias and Migraine

Osmophobia is the fear of smells, and one study found that about 25% of all migraineurs have this phobia to some degree. The connection is traced to the presence of scent-triggered migraines.

A small 2006 study found that phobias were very common in their subjects who had chronic migraines. Almost 61% of their subjects had at least one clinically significant phobia, and those patients scored higher for depression and anxiety than patients with chronic migraine but without phobias.