Chapter 12 PHOBIC AXINETY DISORDER

Introduction Phobias are characterized by intense, persistent, irrational and recurrent fear of specific object, place or situation that results in a compelling desire to avoid the dreaded place, activity or situation Epidemiology Lifetime prevalence of specefic phobia is 4% in men and 13% in women. Classification 1.Specific phobia 2.Social phobia 3.Agoraphobia

Definition of Specific Phobia Marked and persistent fear that is excessive or unreasonable, cued by presence or anticipation of a specific object or situation. Subtypes 1.Acrophobia (height) 2.Ailurophobia (cat) 3.Hydrophobia (water) 4.Clustrophobia (closed area) 5.Cynophobia (dog) 6.Mysophobia (dirt & germs) 7.Pyrophobia (fire) 8.Xenophobia (stranger) 9.Zoophobia (animal) Lifetime prevalence 12-16%; M:F = ratio variable

Social phobia (social anxiety phobia) Definition: marked and persistent fear of social or performance situations in which one is exposed to unfamiliar people or to possible scrutiny by others; fearing he/she will act in a way that may be humiliating or embarassing (e.g. public speaking, initiating or maintaining conversion, dating, eating in public) Lifetime prevalence may be as high as 13-16%; M<F Diagnostic Criteria for phobic sorder 1.Exposure to stimulus almost invariably provokes an immediate anxiety response; may present as a panic attack 2.Person recognizes fear as excessive or unreasonable 3.Situations are avoided or endured with anxiety/distress 4. significant inerference with daily routine, occupational/ social functioning and/or marked distress 5.If person is < 18 yrs, duration is at least 6 months

Treatment 1.Psychological Exposure therapy/desensitization, insight-oriented psychotherapy behavioural therapy is more efficacious than medication 2. Biological β blockers or benzodiazepines in acute situations (e.g. public speaking) SSRIs, MAOIs, clomipramine Prognosis chronic

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