Phobias

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Overview

A phobia is an anxiety disorder in which the affected person experiences an excessive or irrational fear of a specific situation, object or activity that disrupts their ability to function in normal daily activities. Fear occurs when the situation, object, or activity is anticipated or encountered and sometimes triggers a panic attack. Adults with phobias usually realize that their fear is irrational or excessive; however, having this insight is not typical in children with phobias.

The phobia produces symptoms of anxiety that can range from mild to severe. People with mild symptoms usually do not seek treatment because their phobia does not interfere with their ability to function in normal daily activities. Those who experience severe symptoms may become unable to function in their daily routine, such as being afraid to leave their home.

There are three types of phobia:

• Agoraphobia (fear of public places, in which a person feels trapped or fears having a panic attack in public)
• Social phobia (fear of social situations or public performance in which a person may be embarrassed by symptoms of anxiety or a panic attack)
• Specific phobias (fear of specific objects, situations, or activities that may cause a person harm, loss of emotional or physical control [e.g., screaming or fainting])

Incidence and Prevalence
Phobias are common psychiatric disorders. Nearly 11% of the U.S. population, about 25,000,000 people, may suffer from a phobia during their lifetime. Agoraphobia is diagnosed in 60% of the people who seek treatment for phobias, over half of whom are women. Social phobia affects men and women equally and occurs in about 2% of the U.S. population. Specific phobias are common in childhood and typically are outgrown by adulthood.

Risk Factors

Most individuals with agoraphobia have a history of panic disorder. There is also some evidence that agoraphobia may run in families. Also, a child who suffers separation anxiety (anxiety for being away from home and immediate family) may be predisposed to developing agoraphobia.

There appears to be a link between alcoholism and social phobia. The stress associated with social phobia is thought to create an increased risk for alcohol abuse (e.g., drinking to "calm the nerves"). Similarly, the depression caused by the low self-esteem and social isolation that results from social phobia may predispose a person to alcohol abuse and dependence. Conversely, people with alcoholism tend to withdraw and become inhibited and may develop fear of being embarrassed or humiliated in social situations.

A person who has a particularly frightening or threatening experience with an animal or in certain situations may put a person at risk for developing a specific phobia. Witnessing a traumatic event in which others experience harm or extreme fear is another risk factor for specific phobia. Receiving repeated information or warnings about potentially dangerous situations or animals is also a risk factor.

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