Specific phobia

Question 1

Specific phobia - dx

Answer 1

A. Marked fear or anxiety about a specific object or situation (e.g. flying, heights, animals, receiving an injection, seeing blood) - in children, the fear or anxiety may be expressed by crying, tantrums, freezing or clinging
B. The phobic object or situation almost always provokes immediate fear or anxiety
C. The phobic object or situation is actively avoided or endured with intense fear or anxiety
D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context
E. The fear or anxiety is persistent, lasting for 6mo or more
F. Causes clinically significant distress or functional impairment (e.g. social, occupational)
G. Not better explained by another mental disorder (e.g. agoraphobia, OCD, PTSD, separation anxiety disorder, social anxiety disorder)

Question 2

Specific phobia - mx (3)

Answer 2

Psychological interventions = mainstay of tx

1. Education and support, discussion with patient and family
2. CBT

Pharmacological tx
3. Almost no place in treating specific phobia. May be used in situations where a specific phobia needs to be overcome for a particular event or at a particular time (e.g. claustrophobia + MRI examination). Can give diazepam as a single dose to control anxiety