Specific Phobia

What is it?

Specific phobia is characterized by an excessive and irrational fear of an object or situation not normally considered dangerous, such as dogs, the dark, loud noises, etc. Children with specific phobia are only anxious when confronted with the particular thing that causes them terror. The fear can be triggered directly, by encountering the thing itself, or indirectly: hearing a song about it, for example, or seeing a photo.

Children with specific phobias will anticipate and whatever triggers their fear; this avoidance can interfere with normal activities. Though adults and adolescents realize that their fear is unwarranted, children may not. Specific phobias are more common among girls than boys.

Signs and Symptoms

A child with a specific phobia will show unreasonable fear when faced with a particular situation, object, event, or even the thought of encountering the object of her distress. She may cry or throw a tantrum to avoid the thing she fears. Physical symptoms may include trembling, dizziness, and sweating.

Diagnosis and Treatment

To be diagnosed with specific phobia a child will exhibit exceptional fear of something not normally considered dangerous. Avoiding the object of that fear severely interferes with normal functioning.  The fear or anxiety must occur every time the child encounters the stimulus, but the response may vary in intensity, from anticipatory dread to a full-blown panic attack. Indivuduals can have multiple specific phobias, each triggered by something different.

Specific phobias can be commonly classified in five categories:  animal type, if the phobia concerns animals or insects; natural environment type, if the phobia concerns objects such as storms, heights or water; blood-injection-injury type, if the phobia concerns receiving an injection or seeing blood or an injury; situational type, if the phobia concerns a specific situation like flying, driving, tunnels, bridges, enclosed space or public transportation; and other type, if the phobia concerns other stimuli such as loud sounds, costumed characters, choking, or vomiting.

Specific phobia is highly treatable through behavior therapy.  A typical method involves gradual, repeated exposure to the feared object, event or situation.  For example, a child afraid of dogs might start treatment by looking at a picture of a dog, then work up to playing with a stuffed dog and being in the same room with a small dog.  Therapy that teaches strategies for coping with fear and anxious thought patterns is another common option for older children.

What are the risk factors for children?

Children who have a first-degree relative with a particular category of specific phobia (i.e., the dark) are at higher risk for that phobia. Other risk factors include temperament (negative affectivity or behavioral inhibition), a traumatic event, and parental over protectiveness, loss, or abuse. Young people with specific phobias are also frequently diagnosed with other anxiety disorders.