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Phobophobia

Written by \"\"Naomi CarrMedically reviewed by \"\"Morgan Blair

Published on · Updated on

Phobophobia is a fear of phobias or of being afraid and can occur following a traumatic event or due to unknown causes. Treatment for phobophobia includes therapeutic interventions and medications.

\"A

Key takeaways

  • Phobophobia is an intense fear of fear itself, including anxiety sensations or the possibility of developing another phobia.
  • This fear can sustain anxiety and avoidance, and its prevalence remains uncertain because research is limited.
  • Therapeutic approaches used for phobias, sometimes with medication and self-care, may help improve functioning.

What is phobophobia?

Phobophobia describes a fear of becoming afraid. Some people become especially frightened of bodily sensations such as a racing heart or shortness of breath. Similar fear of panic symptoms can occur in panic disorder, so assessment should consider the person’s full pattern of symptoms⁠[1][2].

People with phobophobia become so afraid of the emotions or physical manifestations of fear that this becomes a phobia in and of itself. This phobia has the potential to cause persistent anxiety⁠[1][3].

Although not specifically mentioned in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), phobophobia is considered a specific phobia. Specific phobias are characterized by an irrational and disproportionate level of fear or anxiety when faced with a certain stimulus⁠[4].

\nCurrent research on phobophobia is limited, due to the fact that many people do not seek professional help for phobias and because symptoms often overlap with other disorders⁠[5]. As such, further research is needed to understand the causes and risk factors of the development of specific phobias such as phobophobia.\n

Subject matter expert

\"\"

Brian Thompson Ph.D.

Evidence-based care for anxiety

Symptoms of phobophobia

Fear and avoidance can interfere with daily life. Depending on the individual, difficulties may include:⁠[1][5][6]

  • Intense fear when anticipating anxiety-provoking situations.
  • Physical anxiety symptoms such as sweating, trembling, or a racing heart.
  • Avoiding situations associated with fear.
  • Difficulty with work, relationships, or everyday activities.

Causes of phobophobia

\nThe exact cause of phobophobia is not known and may vary from person to person. However, some research shows potential theories relating to the development of this phobia and certain factors that may increase the risk of a specific phobia.\n

\nResearch suggests that there is a strong familial link associated with the development of specific phobias. Studies have found that people with a specific phobia are more likely to have a relative with an anxiety disorder or phobia than those without a phobia, thereby suggesting that genetics can increase the risk⁠[7].\n

Brain functioning

\nResearch suggests that some people may be more sensitive to fear, thereby increasing their risk of developing a phobia. Studies have indicated that those with a specific phobia often have a difference in the activation and function of the fear response in the amygdala, suggesting that this could be a cause or contributing factor to specific phobias⁠[8].\n

Past traumatic experience

Both genes and stressful or traumatic experiences can contribute to phobias. Fear of the sensations of anxiety can also become a problem in its own right. A clinician can help distinguish a specific phobia from panic disorder and other anxiety conditions⁠[6][1][2].

Diagnosing phobophobia

\nSpecific phobias are often not diagnosed. Some choose to live with their fear and avoid the stimulus that causes it, while others may believe that they have a different condition such as Obsessive-compulsive disorder (OCD) or generalized anxiety disorder⁠[5].\n

However, if you think you have phobophobia, it is important to seek a diagnosis and receive appropriate treatment so that this phobia does not cause a negative impact on your quality of life or cause an avoidance of potentially anxiety-provoking situations.

\nTo diagnose phobophobia, you will be asked questions about your symptoms as they relate to diagnostic criteria. The diagnostic criteria for a specific phobia according to the DSM-5 includes⁠[4]:\n

    \n
  • Anticipating or facing a situation with the potential to cause fear causes intense feelings of anxiety, which may lead to prolonged or repeated avoidance of certain situations.
    • \n
  • The associated symptoms cause distress and impair social and/or professional functioning.
    • \n
  • The level of fear and anxiety is disproportionate to the potential danger or outcome.
    • \n
  • These symptoms have persisted for at least 6 months.
    • \n
  • These symptoms are not due to another condition, such as a personality disorder, posttraumatic stress disorder (PTSD), or social anxiety.
    • \n

Treatment for phobophobia

CBT is commonly used to treat phobias. Exposure therapy helps a person gradually approach feared objects or situations with professional support. Treatment should address the individual’s fears and any co-occurring conditions⁠[6].

Therapy

    \n
  • Behavioral therapy: Cognitive behavioral therapy (CBT) is generally effective at treating phobias and various types of anxiety, as it can help to adjust emotional responses and behaviors that have been learnt as a fear response, provide strategies and skills in distress tolerance, and teach helpful coping techniques⁠[5][9].
    • \n
  • Exposure and response prevention (ERP): For people with phobophobia, treatment may include ERP, to provide exposure to the physical sensations of anxiety and desensitize the individual, thereby reducing the fear of experiencing these sensations⁠[3].
    • \n
  • Other therapies: Therapies, such as family therapy or psychotherapy, can be useful for the individual to receive ongoing support and validation, while helping them manage the symptoms of anxiety and reduce the negative emotions that may occur due to their phobia⁠[9].
    • \n

Medications

\nAlthough there are no approved medications for the treatment of a specific phobia, medication can be prescribed to help reduce the symptoms of phobophobia, including⁠[5][8][9]:\n

    \n
  • Antidepressants: Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline, and tricyclic antidepressants (TCA) such as clomipramine, can be helpful in the treatment of phobophobia to reduce feelings of anxiety.
    • \n
  • Antihistamines: The FDA have approved the use of an antihistamine, hydroxyzine, to treat anxiety disorders such as specific phobias, as it is typically effective at reducing symptoms.
    • \n
  • Benzodiazepines: Diazepam can be used to treat acute anxiety and phobias as a short-term treatment but have the potential to cause abuse and addiction so are often not a first choice or are not used as a long-term treatment.
    • \n
  • Beta-blockers: Beta-blockers such as propranolol have been found to be effective at managing certain physical symptoms of acute anxiety, such as a rapid heart rate, and may also be useful in managing the symptoms of phobophobia.
    • \n

\nIt is crucial to take your medication exactly as your doctor has prescribed, because taking higher doses, missing doses, or suddenly stopping a medication can cause serious effects and can worsen your physical and mental health.\n

Self-care for phobophobia

\nIf you have phobophobia, you might find some self-help techniques to be useful in managing your symptoms, including⁠[9][10]:\n

    \n
  • Talking to others: Sharing your concerns and fears with friends and family or with a professional can help to reduce negative emotions and provide a space to rationalize your anxieties and fears.
    • \n
  • Relaxation exercises: Breathing exercises, yoga, mindfulness, and meditation have been shown to be effective at reducing anxiety symptoms. Breathing exercises can be especially helpful in reducing acute symptoms of a panic attack.
    • \n
  • Support groups: You may find it helpful to attend a support group to gain a better understanding and acceptance of your phobia, while having an opportunity to share your experiences with others who have a similar condition.
    • \n
  • General health: By taking care of your overall health you can reduce anxiety and stress that may occur with phobophobia. Ensure you get plenty of sleep, eat a healthy diet, and regularly engage in exercise.
    • \n

Frequently asked questions about phobophobia

How common is phobophobia?

\nDue to the limited research and reporting of the condition, the prevalence of phobophobia is not known. However, studies show that specific phobias are much more common in females than males and that between 1-10% of the population will have a debilitating phobia⁠[11].\n

What is the outlook for people with phobophobia?

Seek help when fear or avoidance disrupts everyday activities. Treatment can reduce symptoms and improve functioning, although the approach and pace differ between individuals⁠[1][6].

References

  1. van den Hout, M., & Griez, E. (1983). Some Remarks on the Nosology of Anxiety States and Panic Disorders. Acta Psychiatrica Belgica, 83(1), 33-42. PubMed. Accessed October 10 2026.
  2. National Institute of Mental Health. (2025). Panic Disorder: What You Need to Know. National Institutes of Health. National Institute of Mental Health. Accessed October 10 2026.
  3. Griez, E., & van den Hout, M.A. (1983). Treatment of Phobophobia by Exposure to CO2-Induced Anxiety Symptoms. The Journal of Nervous and Mental Disease, 171(8), 506–508. ovid.com. Accessed October 10 2026.
  4. American Psychiatric Association. (2013, text revision 2022). Anxiety Disorders – Specific Phobia. In The Diagnostic and Statistical Manual of Mental Disorders (5th ed. text rev.). APA. PsychiatryOnline.
  5. Samra, C.K., & Abdijadid, S. (2022). Specific Phobia. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. National Library of Medicine. Accessed January 12 2023.
  6. National Institute of Mental Health. (2025). Phobias and Phobia-Related Disorders. National Institutes of Health. National Institute of Mental Health. Accessed October 10 2026.
  7. Villafuerte, S., & Burmeister, M. (2003). Untangling Genetic Networks of Panic, Phobia, Fear and Anxiety. Genome Biology, 4(8), 224. Springer. Accessed October 10 2026.
  8. Garcia, R. (2017). Neurobiology of Fear and Specific Phobias. Learning & Memory (Cold Spring Harbor, N.Y.), 24(9), 462–471. learnmem.cshlp.org. Accessed October 10 2026.
  9. National Health Service. (2022). Treatment - Phobias. NHS. NHS. Accessed October 10 2026.
  10. Mind. (2021). Self-Care Tips for Phobias. Mind. Mind. Accessed October 10 2026.
  11. Wardenaar, K.J., Lim, C.C.W., Al-Hamzawi, A.O., Alonso, J., Andrade, L.H., Benjet, C., Bunting, B., de Girolamo, G., Demyttenaere, K., Florescu, S.E., Gureje, O., Hisateru, T., Hu, C., Huang, Y., Karam, E., Kiejna, A., Lepine, J.P., Navarro-Mateu, F., Oakley Browne, M., Piazza, M., …& de Jonge, P. (2017). The Cross-National Epidemiology of Specific Phobia in the World Mental Health Surveys. Psychological Medicine, 47(10), 1744–1760. Cambridge University Press. Accessed October 10 2026.

Medical Content

The Clinical Affairs Team at MentalHealth.com is a dedicated group of medical professionals with diverse and extensive clinical experience. They actively contribute to the development of content, products, and services, and meticulously review all medical material before publication to ensure accuracy and alignment with current research and conversations in mental health. For more information, please visit the Editorial Policy.

About MentalHealth.com

MentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life.

\"\"

Author

Naomi Carr

Writer

Naomi Carr is a writer with a background in English Literature from Oxford Brookes University.

Published
Updated
\"\"

Medical Reviewer

Morgan Blair, M.A.

MA, LPCC

Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.

Reviewed
\"\"

Related community

Anxiety

A welcoming place for questions and perspectives about anxiety in everyday life.

","text":"Home Library Phobias Phobophobia Phobophobia Written by Naomi CarrMedically reviewed by Morgan Blair Published on March 29, 2023 · Updated on August 13, 2025 Phobophobia is a fear of phobias or of being afraid and can occur following a traumatic event or due to unknown causes. Treatment for phobophobia includes therapeutic interventions and medications. Key takeaways Phobophobia is an intense fear of fear itself, including anxiety sensations or the possibility of developing another phobia. This fear can sustain anxiety and avoidance, and its prevalence remains uncertain because research is limited. Therapeutic approaches used for phobias, sometimes with medication and self-care, may help improve functioning. What is phobophobia? Phobophobia describes a fear of becoming afraid. Some people become especially frightened of bodily sensations such as a racing heart or shortness of breath. Similar fear of panic symptoms can occur in panic disorder, so assessment should consider the person’s full pattern of symptoms⁠[1][2]. People with phobophobia become so afraid of the emotions or physical manifestations of fear that this becomes a phobia in and of itself. This phobia has the potential to cause persistent anxiety⁠[1][3]. Although not specifically mentioned in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), phobophobia is considered a specific phobia. Specific phobias are characterized by an irrational and disproportionate level of fear or anxiety when faced with a certain stimulus⁠[4]. Current research on phobophobia is limited, due to the fact that many people do not seek professional help for phobias and because symptoms often overlap with other disorders⁠[5]. As such, further research is needed to understand the causes and risk factors of the development of specific phobias such as phobophobia. Subject matter expert Brian Thompson Ph.D. Evidence-based care for anxiety Symptoms of phobophobia Fear and avoidance can interfere with daily life. Depending on the individual, difficulties may include:⁠[1][5][6] Intense fear when anticipating anxiety-provoking situations. Physical anxiety symptoms such as sweating, trembling, or a racing heart. Avoiding situations associated with fear. Difficulty with work, relationships, or everyday activities. Causes of phobophobia The exact cause of phobophobia is not known and may vary from person to person. However, some research shows potential theories relating to the development of this phobia and certain factors that may increase the risk of a specific phobia. Genetics Research suggests that there is a strong familial link associated with the development of specific phobias. Studies have found that people with a specific phobia are more likely to have a relative with an anxiety disorder or phobia than those without a phobia, thereby suggesting that genetics can increase the risk⁠[7]. Brain functioning Research suggests that some people may be more sensitive to fear, thereby increasing their risk of developing a phobia. Studies have indicated that those with a specific phobia often have a difference in the activation and function of the fear response in the amygdala, suggesting that this could be a cause or contributing factor to specific phobias⁠[8]. Past traumatic experience Both genes and stressful or traumatic experiences can contribute to phobias. Fear of the sensations of anxiety can also become a problem in its own right. A clinician can help distinguish a specific phobia from panic disorder and other anxiety conditions⁠[6][1][2]. Diagnosing phobophobia Specific phobias are often not diagnosed. Some choose to live with their fear and avoid the stimulus that causes it, while others may believe that they have a different condition such as Obsessive-compulsive disorder (OCD) or generalized anxiety disorder⁠[5]. However, if you think you have phobophobia, it is important to seek a diagnosis and receive appropriate treatment so that this phobia does not cause a negative impact on your quality of life or cause an avoidance of potentially anxiety-provoking situations. To diagnose phobophobia, you will be asked questions about your symptoms as they relate to diagnostic criteria. The diagnostic criteria for a specific phobia according to the DSM-5 includes⁠[4]: Anticipating or facing a situation with the potential to cause fear causes intense feelings of anxiety, which may lead to prolonged or repeated avoidance of certain situations. The associated symptoms cause distress and impair social and/or professional functioning. The level of fear and anxiety is disproportionate to the potential danger or outcome. These symptoms have persisted for at least 6 months. These symptoms are not due to another condition, such as a personality disorder, posttraumatic stress disorder (PTSD), or social anxiety. Treatment for phobophobia CBT is commonly used to treat phobias. Exposure therapy helps a person gradually approach feared objects or situations with professional support. Treatment should address the individual’s fears and any co-occurring conditions⁠[6]. Therapy Behavioral therapy: Cognitive behavioral therapy (CBT) is generally effective at treating phobias and various types of anxiety, as it can help to adjust emotional responses and behaviors that have been learnt as a fear response, provide strategies and skills in distress tolerance, and teach helpful coping techniques⁠[5][9]. Exposure and response prevention (ERP): For people with phobophobia, treatment may include ERP, to provide exposure to the physical sensations of anxiety and desensitize the individual, thereby reducing the fear of experiencing these sensations⁠[3]. Other therapies: Therapies, such as family therapy or psychotherapy, can be useful for the individual to receive ongoing support and validation, while helping them manage the symptoms of anxiety and reduce the negative emotions that may occur due to their phobia⁠[9]. Medications Although there are no approved medications for the treatment of a specific phobia, medication can be prescribed to help reduce the symptoms of phobophobia, including⁠[5][8][9]: Antidepressants: Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline, and tricyclic antidepressants (TCA) such as clomipramine, can be helpful in the treatment of phobophobia to reduce feelings of anxiety. Antihistamines: The FDA have approved the use of an antihistamine, hydroxyzine, to treat anxiety disorders such as specific phobias, as it is typically effective at reducing symptoms. Benzodiazepines: Diazepam can be used to treat acute anxiety and phobias as a short-term treatment but have the potential to cause abuse and addiction so are often not a first choice or are not used as a long-term treatment. Beta-blockers: Beta-blockers such as propranolol have been found to be effective at managing certain physical symptoms of acute anxiety, such as a rapid heart rate, and may also be useful in managing the symptoms of phobophobia. It is crucial to take your medication exactly as your doctor has prescribed, because taking higher doses, missing doses, or suddenly stopping a medication can cause serious effects and can worsen your physical and mental health. Find support that fits you Explore people and care options near you. Find careSelf-care for phobophobia If you have phobophobia, you might find some self-help techniques to be useful in managing your symptoms, including⁠[9][10]: Talking to others: Sharing your concerns and fears with friends and family or with a professional can help to reduce negative emotions and provide a space to rationalize your anxieties and fears. Relaxation exercises: Breathing exercises, yoga, mindfulness, and meditation have been shown to be effective at reducing anxiety symptoms. Breathing exercises can be especially helpful in reducing acute symptoms of a panic attack. Support groups: You may find it helpful to attend a support group to gain a better understanding and acceptance of your phobia, while having an opportunity to share your experiences with others who have a similar condition. General health: By taking care of your overall health you can reduce anxiety and stress that may occur with phobophobia. Ensure you get plenty of sleep, eat a healthy diet, and regularly engage in exercise. Frequently asked questions about phobophobia How common is phobophobia? Due to the limited research and reporting of the condition, the prevalence of phobophobia is not known. However, studies show that specific phobias are much more common in females than males and that between 1-10% of the population will have a debilitating phobia⁠[11]. What is the outlook for people with phobophobia? Seek help when fear or avoidance disrupts everyday activities. Treatment can reduce symptoms and improve functioning, although the approach and pace differ between individuals⁠[1][6]. References van den Hout, M., & Griez, E. (1983). Some Remarks on the Nosology of Anxiety States and Panic Disorders. Acta Psychiatrica Belgica, 83(1), 33-42. PubMed. Accessed October 10 2026. National Institute of Mental Health. (2025). Panic Disorder: What You Need to Know. National Institutes of Health. National Institute of Mental Health. Accessed October 10 2026. Griez, E., & van den Hout, M.A. (1983). Treatment of Phobophobia by Exposure to CO2-Induced Anxiety Symptoms. The Journal of Nervous and Mental Disease, 171(8), 506–508. ovid.com. Accessed October 10 2026. American Psychiatric Association. (2013, text revision 2022). Anxiety Disorders – Specific Phobia. In The Diagnostic and Statistical Manual of Mental Disorders (5th ed. text rev.). APA. PsychiatryOnline. Samra, C.K., & Abdijadid, S. (2022). Specific Phobia. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. National Library of Medicine. Accessed January 12 2023. National Institute of Mental Health. (2025). Phobias and Phobia-Related Disorders. National Institutes of Health. National Institute of Mental Health. Accessed October 10 2026. Villafuerte, S., & Burmeister, M. (2003). Untangling Genetic Networks of Panic, Phobia, Fear and Anxiety. Genome Biology, 4(8), 224. Springer. Accessed October 10 2026. Garcia, R. (2017). Neurobiology of Fear and Specific Phobias. Learning & Memory (Cold Spring Harbor, N.Y.), 24(9), 462–471. learnmem.cshlp.org. Accessed October 10 2026. National Health Service. (2022). Treatment - Phobias. NHS. NHS. Accessed October 10 2026. Mind. (2021). Self-Care Tips for Phobias. Mind. Mind. Accessed October 10 2026. Wardenaar, K.J., Lim, C.C.W., Al-Hamzawi, A.O., Alonso, J., Andrade, L.H., Benjet, C., Bunting, B., de Girolamo, G., Demyttenaere, K., Florescu, S.E., Gureje, O., Hisateru, T., Hu, C., Huang, Y., Karam, E., Kiejna, A., Lepine, J.P., Navarro-Mateu, F., Oakley Browne, M., Piazza, M., …& de Jonge, P. (2017). The Cross-National Epidemiology of Specific Phobia in the World Mental Health Surveys. Psychological Medicine, 47(10), 1744–1760. Cambridge University Press. Accessed October 10 2026. Medical Content The Clinical Affairs Team at MentalHealth.com is a dedicated group of medical professionals with diverse and extensive clinical experience. They actively contribute to the development of content, products, and services, and meticulously review all medical material before publication to ensure accuracy and alignment with current research and conversations in mental health. For more information, please visit the Editorial Policy. About MentalHealth.com MentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life. Author Naomi Carr Writer Naomi Carr is a writer with a background in English Literature from Oxford Brookes University. Published March 29, 2023 Updated August 13, 2025 Medical Reviewer Morgan Blair, M.A. MA, LPCC Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University. Reviewed March 29, 2023 Related community Anxiety A welcoming place for questions and perspectives about anxiety in everyday life. Table of contentsChoose a section What is phobophobia? Symptoms of phobophobia Causes of phobophobia Diagnosing phobophobia Treatment for phobophobia Self-care for phobophobia Frequently asked questions about phobophobia View more","wordCount":1838},"schema":{"@context":"https://schema.org","@graph":[{"@type":"Organization","@id":"https://www.mentalhealth.com/#organization","name":"MentalHealth.com","url":"https://www.mentalhealth.com/","publishingPrinciples":"https://www.mentalhealth.com/publishing/editorial-policy"},{"@type":"WebSite","@id":"https://www.mentalhealth.com/#website","url":"https://www.mentalhealth.com/","name":"MentalHealth.com","inLanguage":"en-US","publisher":{"@id":"https://www.mentalhealth.com/#organization"}},{"@type":"BreadcrumbList","@id":"https://www.mentalhealth.com/library/phobophobia#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.mentalhealth.com/"},{"@type":"ListItem","position":2,"name":"Library","item":"https://www.mentalhealth.com/library"},{"@type":"ListItem","position":3,"name":"Phobias","item":"https://www.mentalhealth.com/library/phobias"},{"@type":"ListItem","position":4,"name":"Phobophobia","item":"https://www.mentalhealth.com/library/phobophobia"}]},{"@type":"ImageObject","@id":"https://www.mentalhealth.com/library/phobophobia#primaryimage","url":"https://www.mentalhealth.com/assets/optimized/29876d6cac8c39ce83d7da36.webp","contentUrl":"https://www.mentalhealth.com/assets/optimized/29876d6cac8c39ce83d7da36.webp","width":1200,"height":633,"encodingFormat":"image/webp","caption":"A person in a rust-colored sweater sits with hands clasped in their lap."},{"@type":"Person","@id":"https://www.mentalhealth.com/people/naomi-carr#person","name":"Naomi Carr","url":"https://www.mentalhealth.com/people/naomi-carr","jobTitle":"Writer","image":"https://www.mentalhealth.com/assets/optimized/47686b37ff1465ff6711c0b5.jpg","sameAs":["https://www.linkedin.com/in/naomi-carr-07784590/"],"memberOf":[{"@id":"https://www.mentalhealth.com/publishing#department"}]},{"@type":"Person","@id":"https://www.mentalhealth.com/people/morgan-blair#person","name":"Morgan Blair","url":"https://www.mentalhealth.com/people/morgan-blair","jobTitle":"MA, LPCC","image":"https://www.mentalhealth.com/assets/optimized/9f1be5c5cc2b412cfab5f6cc.jpg","sameAs":["https://www.linkedin.com/in/morgan-blair-5627aa88/"],"memberOf":[{"@id":"https://www.mentalhealth.com/clinical-affairs#department"}]},{"@type":"Article","@id":"https://www.mentalhealth.com/library/phobophobia#article","url":"https://www.mentalhealth.com/library/phobophobia","headline":"Phobophobia","description":"Phobophobia is an extreme fear of being afraid, a fear of fear. 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The Cross-National Epidemiology of Specific Phobia in the World Mental Health Surveys. Psychological Medicine, 47(10), 1744–1760. Cambridge University Press. 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