5. Phobias

Question 1

What is phobia?

Answer 1

Group of disorders in which anxiety is experience only in certain situations that are not dangerous - these situations are avoided or endured with dread

Disorder when = marked distress, impaired ability to function

Question 2

What types of phobias exist?

Answer 2

Agoraphobia = fear of crowds, travel, events away from home

Social = fear of -ve evaluation by others, can lead to avoidance of feared situations, use of safety behaviours, anticipatory anxiety

Specific = phobia restricted to specific situation (dentist, spiders)

Question 3

How does a phobia present?

Answer 3

Biological = tachy, vasovagal (brady), syncope

Psychological = anticipatory anxiety, inability to relax, avoidance, fear of dying

Agoraphobia is strongly linked to panic disorder

Question 4

How can you diff phobic anxiety from GAD?

Answer 4

SS, AA, AA

1) Phobic anxiety = Specific Situations
- agoraphobia
- social phobia

2) Anticipatory Anxiety = when prospect of encountering feared situation
3) Attempted Avoidance

Question 5

Name the questionnaires used to explore phobic anxiety

Answer 5

Social Phobia Inventory

Liebowitz Social Anxiety Scale

Question 6

What are the RF for phobias?

Answer 6

• aversive experiences
• stress and -ve life events
• other anxiety disorder
• mood disorders
• substance misuse
• FH

Question 7

How should a phobia be treated?

Answer 7

• Establish good rapport
• Advise avoidance of anxiety-inducing substances = caffeine
• Screen for substance misuse and personality disorders

Agoraphobia = CBT, graduated exposure and desensitisation, SSRIs

Social phobia = CBT, graduated exposure, SSRIs, SNRIs, MAOIs, psychodynamic psychotherapy for those that decline CBT/meds

Specific = exposure through CBT, benzo for short term