PHOBIC DISORDERS

Presented by
Zain Jamshaid
INTRODUCTION
 A phobia is an excessive and irrational fear
reaction.
Definition
 Fear cued by the presence of a specific
object or situation, exposure to which
invariably provokes an immediate anxiety
response or panic attack even though the
subject recognizes that the fear is excessive
and unreasonable. The phobic stimulus is
endured with marked distress.
 DIFFERENCE BETWEEN FEAR
AND PHOBIA
Fear
Fear is a natural emotion that protects
people from harm when they face real and
imminent danger.
Phobia
A phobia is an excessive fear or anxiety
related to specific objects or situations
that are out of proportion to the actual
danger they present.
TYPES OF PHOBIC DISORDERS
 Agoraphobia: fear of being in places from
which a person can not escape easily.

 Social phobia: fear of being at social

situations.

 Specific or simple phobias: fears of specific

objects like rats, snakes etc.
 EITIOLOGY OF PHOBIC
DISORDERS

 Attempts to explain specific phobias have a

long history and date back to the early days
of the psychoanalytical approaches
pioneered by Freud and the conditioning
views developed by the behaviorist J.B.
Watson.
PSYCHOANALYTIC ACCOUNTS
 Psychoanalytic theory saw phobias as a
defense anxiety produced by repressed id
impulses, and this fear became associated
with external events or situations that had a
symbolic relevance to that repressed id
impulse.
 Within Freud’s psychoanalytic theory the
function of phobias was to avoid
confrontation with the real underlying issue.
CLASSICAL CONDITIONING

 Attempts to explain phobias in terms of

classical conditioning date back to the
famous “Little Albert” study reported by
Watson and Rayner in 1920.
 As classical conditioning explain all phobias
resulting from traumatic conditioning
experiences. There are evidences that it is
true for some types of phobias not all.
DIAGNOSIS AND SYMPTOMS
DSM-5 CRITERIA
 Specific phobia
 Unreasonable, excessive fear: The person
exhibits excessive or unreasonable, persistent
and intense fear triggered by a specific object
or situation.
 Immediate anxiety response: The fear reaction
must be out of proportion to the actual danger
and appears almost instantaneously when
presented with the object or situation.
 Avoidance or extreme distress: The individual
goes out of their way to avoid the object or
situation, or endures it with extreme distress.
 Specific phobia
 Six months duration: In children and adults,
the duration of symptoms must last for at
least six months.
 Not caused by another disorder: Many
anxiety disorders have similar symptoms. A
doctor or therapist would first have to rule
out similar conditions such as agoraphobia,
obsessive compulsive disorder (OCD), and
separation anxiety disorder before diagnosing
a specific phobia.
 Life-limiting: The phobia significantly impacts
the individual’s school, work, or personal life.
DSM-5 CRITERIA
 Agoraphobia
 To meet the DSM-5 criteria for diagnosis,
patients must have marked, persistent (≥ 6
months) fear of or anxiety about ≥ 2 of the
following situations:
i. Using public transportation
ii. Being in open spaces (e.g, parking lot,
marketplace)
iii. Being in an enclosed place (e.g, shop,
theater)
iv. Standing in line or being in a crowd
v. Being alone outside the home
 Agoraphobia
 Fear must involve thoughts that escape from the
situation might be difficult or that patients would
receive no help if they became incapacitated by fear or
a panic attack. In addition, all of the following should
be present:
i. The same situations nearly always trigger fear or
anxiety.
ii. Patients actively avoid the situation and/or require
the presence of a companion.
iii. The fear or anxiety is out of proportion to the actual
threat (taking into account sociocultural norms).
iv. The fear, anxiety, and/or avoidance cause significant
distress or significantly impair social or occupational
functioning.
v. Also, the fear and anxiety cannot be more correctly
characterized as a different mental disorder.
SOCIAL PHOBIA
DSM-5 criteria for social anxiety disorder include:
 Persistent, intense fear or anxiety about specific
social situations because you believe you may be
judged negatively, embarrassed or humiliated
 Avoidance of anxiety-producing social situations
or enduring them with intense fear or anxiety
 Excessive anxiety that's out of proportion to the
situation
 Anxiety or distress that interferes with your
daily living
 Fear or anxiety that is not better explained by a
medical condition, medication or substance
abuse.
ASSESSMENT
1.Fear Questionnaire (FQ)(Phobia) Marks,
Matthews 1979.
It is a 24 item scale used to assess phobias in
adults.
2. Social Phobia Scale Mattick, Clarke 1995.
It is a 20 item self report measure assessing social
phobias in teens and adults.
3.Mobility Inventory For Agoraphobia (MIA) |
Chambless, Caputo, Jasin, Gracely, Williams
1985.
It is a 24 item inventory for the measurement of
self reported agoraphobic avoidance behavior.
ASSESSMENT
4. Severity Measure For Agoraphobia Craske,
Wittchen, Bogels, Stein, Andrews, Lebu
2013.
It is a 10 item measure that assesses the
severity of symptoms of agoraphobia in
individuals age 18 or above.
5. Severity Measure For Specific Phobia |
Craske, Wittchen, Bogels, Stein, Andrews,
Lebeu 2013.
It is a 5 point lickert scale used to assess
severity of specific phobias in adults.