Phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, or the sight of blood or injury. Though the triggering situation is discrete, contact with it can evoke panic as in agoraphobia or social phobia.
An individual diagnosed with specific phobia needs to meet all of the following criteria:
Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.
The phobic object or situation almost always provokes immediate fear or anxiety.
The phobic object or situation is actively avoided or endured with intense fear or anxiety.
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance if not better explained by the symptoms of another mental disorder, including fear, anxiety and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
Most phobias respond robustly to in vivo exposure, but such exposure is associated with high dropout rates and low treatment acceptance. Response to systemic desensitization is more moderate. Virtual reality exposure may be effective in flying and height phobia. Cognitive behavioral therapy (CBT) [exposure with avoidant response prevention] is most helpful in claustrophobia. Blood-injury phobia is uniquely responsive to applied tension.
The limited research on medication treatment for this disorder has not been promising. Vitamins and dietary supplements are ineffective for this disorder.