Many people experience intense, persistent fears of certain objects, events, or situations. Examples of feared stimuli include spiders, snakes, dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, doctors, and injuries involving blood. Although most people are afraid of some types of stimuli, the phobic individual's fear is excessive or irrational. For example, although most people would be expected to fear large, poisonous, or dangerous snakes, an individual with a spider phobia would typically also be afraid of small, harmless, nonpoisonous snakes. Adults with phobias realize their fears may be excessive or irrational (children with a phobia may not recognize this). Despite this realization, however, it is often difficult for the phobic individual to confront, or even thinking about confronting, the feared object or situation, and whenever possible they will avoid it. When avoidance is impossible, confrontation with the feared stimulus often brings about severe anxiety and sometimes a panic attack.
Specific phobias are fairly common: more than 1 in 10 people have a phobia. Individuals with one phobia are more likely to have additional phobias. The cause of phobias is not known for certain. They seem to run in families and are somewhat more prevalent in women. Phobias typically first appear in adolescence or adulthood. They often start fairly suddenly, sometimes as the result of a negative experience. Phobias in adults are usually more persistent than childhood phobias; only about 20% of adult phobias diminish on their own, without treatment. For children, on the other hand, it is more typical for fears to disappear over time, although they may continue into adulthood.
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of the presence of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.
The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
Symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning.
Symptoms are not caused by another psychological disorder, or by the physiological effects of a substance (e.g., drug, medication) or a medical condition (e.g., hyperthyroidism).
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.