Specific phobia is part of a cluster of diagnoses called the anxiety disorders. Anxiety disorders are a group of psychiatric conditions that include:
These disorders are characterized primarily by the experience of excessive fear and anxiety. Children with generalized anxiety disorder spend a lot of time worrying about a lot of different things. Children with social anxiety disorder feel very anxious around other people, including their peers, because they are afraid of embarrassing themselves or being disliked. Children with panic disorder have sudden rushes of intense fear or discomfort called panic attacks. They often worry about having another panic attack and might avoid certain situations that might trigger a panic attack. Children with agoraphobia are afraid of going into certain situations because they are afraid it might be difficult to escape or because they might experience panic-like symptoms or embarrassing symptoms. Commonly avoided situations are using public transportation, being in open spaces like parking lots, being in enclosed places like movie theaters, or being in a crowd. Children with a specific phobia are very afraid of one or more objects or situations, such as flying, heights, animals, or seeing blood. Children with separation anxiety disorder are afraid of being away from a certain person or people, often a parent, often because they are afraid that something bad might happen to them or the other person if they are separated. Children with selective mutism do not speak in situations where it would be socially appropriate for them to speak, such as at school.
The anxiety disorders are characterized by excessive fear and anxiety, along with behavioral disturbances, like avoiding certain places, people, or situations. The anxiety disorders differ from each other in the target or focus of the fear. In some anxiety disorders, like specific phobia, the child is only excessively fearful of narrow range of objects or situations. In other anxiety disorders, like GAD, the child may feel anxious a great deal of the time or about a lot of different things.
Specific phobia is a relatively common psychiatric disorder that affects approximately 5% of children. Specific phobia is characterized by fear or anxiety about a specific object or situation. Most children with specific phobia fear more than one object or situation.
Some common specific phobias include:
For specific phobia to be diagnosed, the feared object or situation must almost always provoke immediate fear or anxiety. The child or adolescent actively avoids the object or situation or endures it with intense anxiety. To be diagnosed with specific phobia, the fear or avoidance also needs to be distressing (upsetting) or impairing (getting in the way of the person's life).
Specific phobia severity can range from mild to very impairing. In severe cases, specific phobia can lead to serious problems at school and recreational activities. For example, children with flying phobia may have difficulty traveling for family vacations. In severe cases, the child may insist that the family abandon the travel plans or leave the child behind with other caregivers
Specific phobia seems to be characterized by abnormalities in certain brain regions, particularly those related to emotion generation (e.g., the amygdala and insula), which are thought to contribute to symptoms. In addition, avoiding the feared object or situation is thought to contribute to the maintenance of the phobia. Blood-injection-injury phobia is often characterized by an exaggerated vasovagal response to the feared stimulus, which can result in lightheadedness, nausea, hot or cold flashes, visual disturbance, and/or loss of consciousness (vasovagal syncope). Specific phobia, especially blood-injection-injury phobias, may have a genetic component, although having a genetic predisposition does not necessarily mean that someone will develop specific phobia.
Specific phobia is treatable. Guidelines for treatment of specific phobia in children are provided by the Society of Clinical Child and Adolescent Psychology. Guidelines for treating pediatric anxiety, broadly defined, are provided by the Society of Clinical Child and Adolescent Psychology. The American Academy of Child and Adolescent Psychiatry offers historical practice parameters for child anxiety (last updated in 2007); new parameters are being developed.
Clinical research suggests that the following treatments are effective for specific phobia in children and adolescents:
Other Treatments to Consider
The following treatments have been shown to be effective in the treatment of specific phobia in adults. However, the efficacy and tolerability in children is unknown:
Clinical research suggests that the following treatments are effective for specific phobia in children and adolescents:
Other Treatments to Consider
The following treatments have been shown to be effective in the treatment of specific phobia in adults. However, the efficacy and tolerability in children is unknown: