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This article is about the clinical psychology. For other uses, see Phobia (disambiguation).

A phobia (from the Template:Lang-el, Phóbos, meaning "fear" or "morbid fear") is, when used in the context of clinical psychology, a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational. In the event the phobia cannot be avoided entirely, the sufferer will endure the situation or object with marked distress and significant interference in social or occupational activities.[1]

The terms distress and impairment as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) should also take into account the context of the sufferer's environment if attempting a diagnosis. The DSM-IV-TR states that if a phobic stimulus, whether it be an object or a social situation, is absent entirely in an environment — a diagnosis cannot be made. An example of this situation would be an individual who has a fear of mice (Suriphobia) but lives in an area devoid of mice. Even though the concept of mice causes marked distress and impairment within the individual, because the individual does not encounter mice in the environment no actual distress or impairment is ever experienced. Proximity and the degree to which escape from the phobic stimulus is impossible should also be considered. As the sufferer approaches a phobic stimulus, anxiety levels increase (e.g. as one gets closer to a snake, fear increases in ophidiophobia), and the degree to which escape of the phobic stimulus is limited has the effect of varying the intensity of fear in instances such as riding an elevator (e.g. anxiety increases at the midway point between floors and decreases when the floor is reached and the doors open).[2]

Finally, a point warranting clarification is that the term phobia is an encompassing term and when discussed is usually done in terms of specific phobias and social phobias. Specific phobias are nouns such as arachnophobia or acrophobia which, as the name implies, are specific, and social phobia are phobias within social situations such as public speaking and crowded areas.

Clinical phobias

Psychologists and psychiatrists classify most phobias into three categories[3][4] and, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), such phobias are considered to be sub-types of anxiety disorder. The three categories are:

1. Social phobia: fears other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Overcoming social phobia is often very difficult without the help of therapy or support groups. Social phobia may be further subdivided into

2. Specific phobias: fear of a single specific panic trigger such as spiders, snakes, dogs, water, heights, flying, catching a specific illness, etc. Many people have these fears but to a lesser degree than those who suffer from specific phobias. People with the phobias specifically avoid the entity they fear.

3. Agoraphobia: a generalized fear of leaving home or a small familiar 'safe' area, and of possible panic attacks that might follow. It may also be caused by various specific phobias such as fear of open spaces, social embarrassment (social agoraphobia), fear of contamination (fear of germs, possibly complicated by obsessive-compulsive disorder) or PTSD (post traumatic stress disorder) related to a trauma that occurred out of doors.

Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer relatively mild anxiety over that fear. Others suffer full-fledged panic attacks with all the associated disabling symptoms. Most individuals understand that they are suffering from an irrational fear, but they are powerless to override their initial panic reaction.

Specific phobias

As briefly mentioned above, a specific phobia is a marked and persistent fear of an object or situation which brings about an excessive or unreasonable fear when in the presence of, or anticipating, a specific object; furthermore, the specific phobias may also include concerns with losing control, panicking, and fainting which is the direct result of an encounter with the phobia.[6] The important distinction from social phobias are specific phobias are defined in regards to objects or situations whereas social phobias emphasizes more on social fear and the evaluations that might accompany them.

The DSM breaks specific phobias into five subtypes: Animal, Natural Environment, Blood-Injection-Injury, Situational, and Other.[7] In children, phobias involving Animals, Natural Environment (darkness), and Blood-Injection-Injury usually develop between the ages of 7 and 9, and these are reflective of normal development. Additionally, specific phobias are most prevalent in children between ages 10 and 13.[8]

Diagnosis

The diagnostic criteria for 300.29 Specific Phobias as outlined by the DSM-IV-TR:

  1. Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
  2. 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.
  3. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
  4. The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
  5. The avoidance, anxious anticipation or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
  6. In individuals under the age of 18, the duration is at least 6 months.
  7. The anxiety, panic attack, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder, such as Obsessive-Compulsive Disorder (e.g., fear of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), Separation Anxiety Disorder (e.g., avoidance of school), Social Phobia (e.g., avoidance of social situations because of fear of embarrassment), Panic Disorder With Agoraphobia, or Agoraphobia Without History of Panic Disorder.

Social phobia

The key difference between specific phobias and social phobias is social phobias include fear of public situations and scrutiny which leads to embarrassment or humiliation in the diagnostic criteria. In social phobias, there is also a generalized category which is included as a specifier below. Unlike specific phobias which may develop before the age of 10, social phobias are typically not present until pubertal transition. After this transition, the prevalence of social phobia increases with age. Many adolescents who develop a social phobia consequentially become rejected by their peers. As interpersonal dysfunction is a risk factor for depression, there are some negative outcomes for adolescents with social phobia. For example, about 20% of adolescents diagnosed with a social phobia also suffer from depression and use alcohol or other substances.

Diagnosis

The diagnostic criteria for 300.23 Social Phobia as outlined by the DSM-IV-TR:

  1. A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Note: In children there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
  2. Exposure to the feared social situation almost invariably provokes anxiety, 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 shrinking from social situations with unfamiliar people.
  3. The person recognized that the fear is excessive or unreasonable. Note: In children this feature may be absent.
  4. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
  5. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
  6. In individuals under age 18, the duration is at least 6 months.
  7. The avoidance is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g. Panic Disorder With or Without Agoraphobia, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, Schizoid Personality Disorder).
  8. If a general medical condition or another mental disorder is present, the fear in Criterion A (Exposure to the social or performance situation almost invariably provokes an immediate anxiety response) is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
Specify if:
Generalized: if the fears include most social situations (also consider the additional diagnosis of Avoidant Personality Disorder).

Notice the severe overlap between specific and social phobias which is indicative of the nature between the two. The differences from specific phobias unanimously lay only in the word "social".

Etiology

Environmental

Much of the progress in understanding the acquisition of fear responses in phobias can be attributed to the Pavlovian Model which is synonymous with Classical Conditioning.[9] Myers and Davis (2007) describe the acquisition of fear as when a conditioned stimulus (e.g., a distinctive place) is paired with an aversive unconditioned stimulus (e.g. a electric shock) to an end result in which the subject exhibits a conditioned feared response to the distinctive place (CS+UCS=CR). For how this model works in the context of phobias, one simply has to look at the fear of heights, or acrophobia. In this phobia, the CS is heights such as the top floors of a high rise building or a roller coaster. The UCS can be said to originate from an aversive or traumatizing event in the person's life such as being trapped on a roller coaster as a child or in an elevator at the top floor of a building. The result of combining these two stimuli leads to a new association called the CR (fear of heights) which is simply the CS (heights) transformed by the aversive UCS (being trapped on a roller coaster or elevator) leading to the feared conditioned response. This model does not suggest that once you have a conditioned feared response to an object or situation you have a phobia. As listed above, to meet the criteria for being diagnosed with a phobia one also has to show symptoms of impairment and avoidance. In the example above, for the CR to be classified as a phobia it would have to exhibit signs of impairment due to avoidance. Impairment, which can be considered along the same lines as a disability from a clinician's standpoint, is defined as being unable to complete tasks in one's daily life whether it be occupational, academical, or social. In the recent example, an impairment of occupation could result from not taking on a job solely because its location happens to be at the top floor of a building, or socially not participating in a social event at a theme park. The avoidance aspect is defined as behavior that results in the omission of an aversive event that would otherwise occur with the goal of the preventing anxiety.[10] The above direct conditioning model, though very influential in the theory of fear acquisition, should not suggest the only way to acquire a phobia. Rachman proposed three main pathways to acquire fear conditioning involving direct conditioning, vicarious acquisition and informational/instructional acquisition.[11]

As experimentation with the aforementioned direct conditioning modeling continued, it became increasingly evident that more than just classical conditioning can influence the onset of a phobia. Rachman (1978) proposed that vicarious acquisition was a critical component to the etiology of phobias, so it was decided to include information and instruction from the parent and family members to better understand its onset. Of the research conducted in this area, one of the best examples of how vicarious conditioning, more specifically modeling, effects the acquisition of a phobia can be said to have come from Cook & Mineka's (1989) work on rhesus monkeys. In this experiment, Cook & Mineka, through the use of video, appraised 22 rhesus monkeys on their fear to evolutionary relevant stimuli (e.g. crocodiles and snakes), and evolutionary irrelevant stimuli (e.g. flowers and artificial rabbits) to see if fear conditioning using the direct conditioning model (Pavlov's model) leads to fear acquisition (or more specifically the conditioned fear response). The results of the research showed that after 12 sessions the rhesus monkeys acquired a fear to the evolutionary relevant stimuli and not to the evolutionary irrelevant stimuli; furthermore, the experiment also revealed that when they exposed monkeys to other monkeys that interacted with snakes without showing fear, this group did not acquire the fear which supports the theory of vicarious conditioning through modeling.[12] According to Pavlov's theory of classical conditioning, the experimenters should have been able to condition a feared response within the rhesus monkeys to the evolutionary irrelevant stimuli because the Pavlovian model posits that any UCS can elicit a CR. The result show the necessary augmentation of the Pavlov model with the vicarious acquisition model.

Regions of the brain associated with phobias[13]

Evolutionary

The circumstance that specific phobias tend to be directed disproportionately against certain objects such as snakes and spiders may have evolutionary explanations. In this view phobias are adaptations that may have been useful in the ancestral environment. On the savanna, unlike dangers such as large predators, snakes and spiders tend to be hidden from view until very close and may be a particular danger to infants and small children, favoring the development of an instinctive fearful response. This view does not necessarily hold that phobias are genetically inevitable. Instead, there may be a genetic predisposition to learn to fear certain things more easily than other things.[14] Similarly, primary agoraphobia may be due to its once having been evolutionary advantageous to avoid exposed, large open spaces without cover or concealment. Generalized social phobia may be due to its once being usually very dangerous to be confronted by a large group of staring, non-kin, unknown, and not smiling strangers.[15]

Neurobiology

Brain regions involved

Beneath the later fissure in the cerebral cortex, the insula, or insular cortex, of the brain has been identified as part of the limbic system, along with cingulated gyrus, hippocampus, corpus collosum, and other nearby cortices. This system has been found to play a role in emotion processing [16] and the insula, in particular, may contribute through its role in maintaining autonomic functions.[17] Studies by Critchley et al. indicate the insula as being involved in the experience of emotion by detecting and interpreting threatening stimuli.[18] Similar studies involved in monitoring the activity of the insula show a correlation between increased insular activation and anxiety.[16]

In the frontal lobes, other cortices involved with phobia and fear are the anterior cingulate cortex and the medial prefrontal cortex. In the processing of emotional stimuli, studies on phobic reactions to facial expressions have indicated these areas to be involved in processing and responding to negative stimuli.[19] The ventromedial prefrontal cortex has been said to influence the amygdala by monitoring its reaction to emotional stimuli or even fearful memories.[16] Most specifically, the medial prefrontal cortex is active during extinction of fear and is responsible for long term extinction. Stimulation of this area decreases conditioned fear responses and so it can be said that it’s role is in inhibiting the amygdala and its reaction to fearful stimuli.[20]

The hippocampus is a horseshoe shaped structure that plays an important part in the brain’s limbic system because of its role in forming memories and connecting them with emotions and the senses. When dealing with fear the hippocampus receives impulses from the amygdala that allows it to connect the fear with a certain sense, such as a smell or sound.

Amygdala's role in memory and fear responses

The amygdala is a “almond shaped” mass of nuclei that is located deep in the brain’s medial temporal lobe, which processes the events associated with fear, as well as being linked to anxiety disorders and social phobias. The amygdala's ability to respond to fearful stimuli occurs through the process of fear conditioning. Similar to classical conditioning, the amygdala learns to associate a conditioned stimulus with a negative or avoidant stimulus, creating a conditioned fear response that is often seen in phobic individuals. In this way the amygdala is responsible for not only recognizing ceratin stimuli or cues as dangerous, but plays a role in the storage of threatening stimuli to memory. The basolateral nuclei (or basolateral amygdala) and the hippocampus interact with the amygdala in the storage of memory, which suggests why memories are often remembered more vividly if they have emotional significance [21]

In addition to memory, the amygdala also triggers the secretion of hormones that affect fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, which prepares the individual to move, run, fight, etc.[22] This defensive "alert" state and response is generally referred to in psychology as the fight-or-flight response.

Inside the brain, however, this stress response can be observed in the hypothalamic-pituitary-adrenal axis (HPA).This circuit incorporates the process of receiving stimuli, interpreting it, and releasing certain hormones into the blood stream. The parvocellular neurosecretary neurons of the hypothalamus release corticotropin-releasing hormone (CRH) which is sent to the anterior pituitary. Here the pituitary releases adrenocorticotropic hormone (ACTH) which ultimately stimulates the release of cortisol. In relation to anxiety, the amygdala is responsible for activating this circuit, while the hippocampus is responsible for suppressing it. Glucocorticoid receptors in the hippocampus monitor the amount of cortisol in the system and through negative feedback can tell the hypothalamus to stop releasing CRH.[17]

Additionally, recent studies on mice engineered to have high concentrations of CRH showed higher levels of anxiety, while those engineered to have no or low amounts of CRH receptors were less anxious. In phobic patients, therefore, high amounts of cortisol may be present, or alternatively, there may be low levels of glucocorticoid receptors or even serotonin (5-HT).[17]

Disruption by damage

For the areas in the brain involved in emotion—most specifically fear— the processing and response to emotional stimuli can be significantly altered when one of these regions becomes lesioned or damaged. Damage to the cortical areas involved in the limbic system such as the cingulate cortex or frontal lobes have resulted in extreme changes in emotion.[17] Other types of damage include Klüver-Bucy Syndrome and Urbach-Wiethe disease. In Klüver-Bucy syndrome, a temporal lobectomy, or removal of the temporal lobes results in changes involving fear and aggression. Specifically, the removal of these lobes results in decreased fear, confirming its role in fear recognition and response. Bilateral damage to the medial temporal lobes, which is known as Urbach-Wiethe disease exhibits similar symptoms of decreased fear and aggression, but also an inability to recognize emotional expressions, especially angry or fearful faces.[17]

The amygdala’s role in learned fear includes interactions with other brain regions in the neural circuit of fear. While lesions in the amygdala can inhibit its ability to recognize fearful stimuli, other areas such as the ventromedial prefrontal cortex and the basolateral nuclei of the amygdala can affect the regions ability to not only become conditioned to fearful stimuli, but to eventually extinguish them. The basolateral nuclei, through receiving stimulus info, undergo synaptic changes which allow the amygdala to develop a conditioned response to fearful stimuli. Lesions in this area, therefore, have shown to disrupt the acquisition of learned responses to fear.[17] Likewise, lesions in the ventromedial prefrontal cortex (the area responsible for monitoring the amygdala) have shown to not only slow down the speed of extinguishing a learned fear response, but also how effective or strong the extinction is. This suggests there is a pathway or circuit among the amygdala and nearby cortical areas that process emotional stimuli and influence emotional expression, all of which can be disrupted when an area becomes damaged.[16]

Treatments

Various methods are claimed to treat phobias. Their proposed benefits may vary from person to person.

Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitization therapy.

Cognitive behavioral therapy (CBT) can be beneficial. Cognitive behavioral therapy allows the patient to challenge dysfunctional thoughts or beliefs by being mindful of their own feelings with the aim that the patient will realize their fear is irrational. CBT may be conducted in a group setting. Gradual desensitisation treatment and CBT are often successful, provided the patient is willing to endure some discomfort.[23][24] In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment.[24][25][26][27]

CBT is also an effective treatment for phobias in children and adolescents, and it has been adapted to be appropriate for use with this age. One example of a CBT program targeted towards children is the Coping Cat. This treatment program can be used with children between the ages of 7 and 13 to treat social phobia. This program works to decrease negative thinking, increase problem solving, and to provide a functional coping outlook in the child.[28] Another CBT program was developed by Ann Marie Albano to treat social phobia in adolescents. This program has five stages: Psychoeducation, Skill Building, Problem Solving, Exposure, and Generalization and Maintenance. Psycho education focuses on identifying and understanding symptoms. Skill Building focuses on learning cognitive restructuring, social skills, and problem solving skills. Problem Solving focuses on identifying problems and using a proactive approach to solving them. Exposure involves exposing the adolescent to social situations in a hierarchical approach. Finally, Generalization and Maintenance involves practicing the skills learned.[29]

Eye Movement Desensitization and Reprocessing (EMDR) has been demonstrated in peer-reviewed clinical trials to be effective in treating some phobias. Mainly used to treat Post-traumatic stress disorder, EMDR has been demonstrated as effective in easing phobia symptoms following a specific trauma, such as a fear of dogs following a dog bite.[30]

Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction.[31] However, lack of research and scientific testing compromises its status as an effective treatment.

Antidepressant medications such SSRIs, MAOIs may be helpful in some cases of phobia. Benzodiazepines may be useful in acute treatment of severe symptoms but the risk benefit ratio is against their long-term use in phobic disorders.[32]

There are also new pharmacological approaches, which target learning and memory processes that occur during psychotherapy. For example, it has been shown that glucocorticoids can enhance extinction-based psychotherapy.[33]

Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, also considered to be pseudoscience by the mainstream medicine, is allegedly useful.[citation needed]

Another method psychologists and psychiatrists use to treat patients with extreme phobias is prolonged exposure. Prolonged exposure is used in psychotherapy when the person with the phobia is exposed to the object of their fear over a long period of time. This technique is only tested[clarification needed] when a person has overcome avoidance of or escape from the phobic object or situation. People with slight distress from their phobias usually do not need prolonged exposure to their fear.[34]

For children and adolescents, one of the most effective treatments for specific phobias is participant modeling and reinforced practice. In this treatment method, the therapist models for the child how they should respond to their fears and then encourages the child to practice this behavior and reinforces their efforts.

These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.

Hypnosis

Hypnosis is a process to get you into a relaxed state of mind, where the brainwaves slow down and the subconscious mind can be engaged. It is a focused state of relaxation. When it comes to treatment, agoraphobic patients are highly resistant, therefore its up to the therapists to make important decision about the treatment programme and how to utilize the actions in order to effect change. The source of phobia tends to lie in the distant past and focuses on one or more traumatic event(s) in childhood. When using hypnoanalysis in hypnosis, it is important to encourage the patient to re-experience the traumatic events, but this must be done with care at all times. When using hypnosis it is recommended to employ a dissociative technique during the process: this might include, for example, the patient watching a younger version of themselves or watching a film or seeing a reflection. It is essential that the therapist should provide the patient with the opportunity to integrate the present with the past, traumatic experience and that the purpose of the hypnosis should be to help learn from the events and to become stronger as a result.

The psychodynamic psychotherapy at the beginning of each session is used to encourage the recall of stimuli in the hypnoanalysis. In the following weeks, the patient will recall several memories in the past, which would illustrate the roots of the phobia. Over a number of sessions, the patient will be encouraged to express these feelings to their family members. Also, the patients continue to practice the vivo exposure tasks in which they make a significant improvement.

Sometimes these types of sessions can be done in groups instead of a one to one with the therapist. Patients like to be with others that are facing the same situation so they join a support group. One of the steps for the therapist is to focus on reducing the panic attacks without the use of medication. Hypnosis was introduced as an extension to mediation, and patents were gradually able to respond adequately well to the therapist’s suggestions. During hypnosis the patient is given an ego strengthening to provide with the ability to function. For example, those who suffer from agoraphobic the therapist would provide the patient the ability function out of the house, and, using guided imagery, the patient began by sitting in the car, and worked towards on just driving around. This process of systematic desensitization was slow. Whenever the patient became anxious, the patient would raised their finger and were able to reduce their anxiety by taking deep breaths. These particular exercises were taped and were practiced religiously at home. As a result of all the work done in the consulting room, watching the tapes at home, and with continued support patients made a significant recovery. [35]

Hypnosis is a powerful addition to therapy. There have been several cases studies conducted and it demonstrated that it has been highly effective in helping patients in multiple steps. Number one to explore feared situations in a safe environment; second to reduce anxiety using desensitization; third to gain more control using anchoring, fantasy techniques and autogenic training; fourth to enhance coping strategies using ego strengthening and breathing techniques; and lastly to reduce affect using television screen imagery. Also, with the tapes help to encourage the patients to practice self-hypnosis at home for even much faster results. The use of hypnotherapy in clinical practice offers is more rapid and cost effective treatment for social and agoraphobia and it is recommended that is be used in conjunction with psychodynamic psychotherapy and/or in vivo exposure therapy. [36]

Epidemiology

Phobias are a common form of anxiety disorders. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias.[37] Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25. Between 4% and 10% of all children experience specific phobias during their lives,[8] and social phobias occur in 1% to 3% of children and adolescents. However, social phobias are more common in girls than in boys.[38]

Non-psychological conditions

The word phobia may also signify conditions other than fear. For example, although the term hydrophobia means a fear of water, it may also mean inability to drink water due to an illness, or may be used to describe a chemical compound which repels water. It was also once used as a synonym for rabies, as an aversion to water is one of its symptoms. Likewise, the term photophobia may be used to define a physical complaint (i.e. aversion to light due to inflamed eyes or excessively dilated pupils) and does not necessarily indicate a fear of light.

Non-clinical uses of the term

Main article: List of phobias

It is possible for an individual to develop a phobia over virtually anything. The name of a phobia generally contains a Greek word for what the patient fears plus the suffix -phobia. Creating these terms is something of a word game. Few of these terms are found in medical literature. However, this does not necessarily make it a non-psychological condition.

Terms for prejudice or discrimination

A number of terms with the suffix -phobia are used non-clinically but have gained public acceptance. Such terms are primarily understood as negative attitudes towards certain categories of people or other things, used in an analogy with the medical usage of the term. Usually these kinds of "phobias" are described as fear, dislike, disapproval, prejudice, hatred, discrimination, or hostility towards the object of the "phobia". Often this attitude is based on prejudices and is a particular case of most xenophobia.

Below are some examples:

  • Homophobia - Negative attitudes and feelings toward homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender (LGBT).
  • Biphobia - Negative attitudes and feelings towards bisexuality and bisexual people as a social group or as individuals.
  • Transphobia - Negative attitudes and feelings towards transsexualism and transsexual or transgender people, based on the expression of their internal gender identity.
  • Xenophobia – fear or dislike of strangers or the unknown, sometimes used to describe nationalistic political beliefs and movements.

See also

References

  1. ^ Bourne, Edmund J. (2011). The Anxiety & Phobia Workbook 5th ed. New Harbinger Publications. pp. 50–51. ISBN 572244135. {{cite book}}: Check |isbn= value: length (help)
  2. ^ Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington D.C.: American Psychiatric Association. 1994. p. 406. ISBN 0-89042-062-9.
  3. ^ "AllPsych Journal | Phobias: Causes and Treatments". Allpsych.com. Retrieved 2012-01-19.
  4. ^ "NIMH — The Numbers Count: Mental Disorders in America". Nimh.nih.gov. Retrieved 2012-01-19.
  5. ^ Crozier, W. Ray; Alden, Lynn E. International Handbook of Social Anxiety: Concepts, Research, and Interventions Relating to the Self and Shyness, p. 12. New York John Wiley & Sons, Ltd. (UK), 2001. ISBN 0-471-49129-2.
  6. ^ Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington D.C.: American Psychiatric Association. 1994. p. 405. ISBN 0-89042-062-9.
  7. ^ http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=162
  8. ^ a b Bolton, D., Eley, T. C., O'Connor, T. G., Perrin, S., Rabe-Hesketh, S., Rijsdijk, F., & Smith, P. (2006). Prevalence and genetic and environmental influences on anxiety disorders in 6-year-old twins. Psychological Medicine, 36(3), 335-344. doi:10.1017/S0033291705006537
  9. ^ Myers, K M (2007). "Mechanisms of fear extinction". Molecular Psychiatry. 12 (2): 120–150. doi:10.1038/sj.mp.4001939. PMID 17160066. Retrieved Retrieved April 25, 2011. {{cite journal}}: Check date values in: |accessdate= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  10. ^ Bolles, R. C. (1970). "Species-specific Defense Reactions and Avoidance Learning". Psychological Review. 77: 32–38. doi:10.1037/h0028589.
  11. ^ Rachman, S.J. (1978). Fear and Courage. San Francisco: WH Freeman & Co.
  12. ^ Cook, Michael (1989). "Observational conditioning of fear to fear-relevant versus fear-irrelevant stimuli in rhesus monkeys". Journal of Abnormal Psychology. 98 (4): 448–459. doi:10.1037/0021-843X.98.4.448. PMID 2592680. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  13. ^ "NIMH · Post Traumatic Stress Disorder Research Fact Sheet". National Institutes of Health.
  14. ^ Why do we think spiders and snakes are so scary? It just might be evolution, Mark Roth, Pittsburgh Post-Gazette Wednesday, March 07, 2007
  15. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/j.pnpbp.2006.01.008, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1016/j.pnpbp.2006.01.008 instead.
  16. ^ a b c d Tillfors, Maria (15). "Why do some individuals develop social phobia? A review with emphasis on the neurobiological influences". Nord J. Psychiatry. 58 (4). Taylor & Francis. doi:10.1080/0839480410005774. {{cite journal}}: Check date values in: |date= and |year= / |date= mismatch (help); Unknown parameter |month= ignored (help) Cite error: The named reference "Tillors" was defined multiple times with different content (see the help page).
  17. ^ a b c d e f Mark F. Bear, Barry W. Connors, Michael A. Paradiso, ed. (2007). Neuroscience: Exploring the Brain (Third ed.). Lippincott Williams & Wilkins. ISBN 9780781760034.{{cite book}}: CS1 maint: multiple names: editors list (link)
  18. ^ Straube, T. (2005). "Neuropsychobiology". Common and District Brain Activation to Threat and Safety Signals in Social Phobia. 52 (3): 163–168. doi:10.1159/000087987. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  19. ^ Etkin, Amit (2011). "Emotional processing in the anterior cingulate and medial prefrontal cortex". Trends Cogn Sci. 15 (2): 85–93. doi:10.1016/j.tics.2010.11.004. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  20. ^ Akirav, Irit (15). "The Role of the Medial Prefrontal Cortex-Amygdala Circuit in Stress Effects on the Extinction of Fear". Neural Plasticity. 2007. doi:10.1155/2007/30873. {{cite journal}}: Check date values in: |date= and |year= / |date= mismatch (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)CS1 maint: unflagged free DOI (link)
  21. ^ Paul J. Whalen and Elizabeth A. Phelps, ed. (2009). The Human Amygdala. New York: The Guilford Press.
  22. ^ Winerman, Lea. "Figuring Out Phobia", American Psychology Association: Monitor on Psychology, August 2007.
  23. ^ Hall, Lynne L. Fighting Phobias, the Things That Go Bump in the Mind, FDA Consumer Magazine, Volume 31 No. 2, March 1997.
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  26. ^ Craske, Michelle (2006). Mastering your fears and phobias,. US: Oxford University Press. ISBN 978-0-19-518917-9. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
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  28. ^ Kendall, P. C., Aschenbrand, S. G., & Hudson, J. L. (2003). Child-focused treatment of anxiety. In A. E. Kazdin, J. R. Weisz (Eds.) , Evidence-based psychotherapies for children and adolescents (pp. 81-100). New York, NY US: Guilford Press
  29. ^ Albano, A. (2003). Treatment of social anxiety disorder. In M. A. Reinecke, F. M. Dattilio, A. Freeman (Eds.) , Cognitive therapy with children and adolescents: A casebook for clinical practice (2nd ed.) (pp. 128-161). New York, NY US: Guilford Press.
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  32. ^ Stein, Dan J (16 February Fears are common in children and adolescents. However, for some youth, these fears persist and develop into specific phobias. A specific phobia is an intense, enduring fear of an identifiable object or situation that may lead to panic symptoms, distress, and avoidance (e.g., fears of dogs, snakes, storms, heights, costumed characters, the dark, and similar objects or situations). Moreover, phobias can affect a youngster's quality of life by interfering with school, family, friends, and free-time. It is estimated that 5% to 10% of youth will develop a phobia before reaching the age of 16. 2004). Clinical Manual of Anxiety Disorders (1st ed.). USA: American Psychiatric Press Inc. p. 53. ISBN 978-1-58562-076-0. {{cite book}}: Check date values in: |date= (help); Cite has empty unknown parameter: |chapterurl= (help)
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  35. ^ Kraft. D, Street. H. (2011). londonhypnotherapyuk. In THE PLACE OF HYPNOSIS IN PSYCHIATRY PART 4: ITS APPLICATION TO THE TREATMENT OF AGORAPHOBIA AND SOCIAL PHOBIA. Retrieved 3/4/13, from http://www.londonhypnotherapyuk.com/agoraphobia-social-phobia.asp.
  36. ^ Kraft. D, Street. H. (2011). londonhypnotherapyuk. In THE PLACE OF HYPNOSIS IN PSYCHIATRY PART 4: ITS APPLICATION TO THE TREATMENT OF AGORAPHOBIA AND SOCIAL PHOBIA. Retrieved 3/4/13, from http://www.londonhypnotherapyuk.com/agoraphobia-social-phobia.asp.
  37. ^ Kessler et al., Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication, June 2005, Archive of General Psychiatry, Volume 20
  38. ^ Essau, C. A., Conradt, J., & Petermann, F. (1999). Frequency and comorbidity of social phobia and social fears in adolescents. Behaviour Research And Therapy, 37(9), 831-843. doi:10.1016/S0005-7967(98)00179-X
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