A phobia (from the Greek: φόβος,phóbos, meaning "fear" or "morbid fear") is an irrational, intense and persistent fear of certain situations, activities, things, animals, or people. The main symptom of this disorder is the excessive and unreasonable desire to avoid the feared stimulus. When the fear is beyond one's control, and if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made.[1]
This is caused by what are called, neutral, unconditioned, and conditioned stimuli, which trigger either conditioned or unconditioned responses. An example would be a person who was attacked by a dog (the unconditioned stimulus) would respond with an unconditioned response. When this happens, the unconditioned stimulus of them being attacked by the dog would become conditioned, and to this now conditioned stimulus, they would develop a conditioned response. If the occurrence had enough of an impact on this certain person then they would develop a fear of that dog, or in some cases, an irrational fear of all dogs.
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.[2] 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.
Phobias are not generally diagnosed if they are not particularly distressing to the patient and if they are not frequently encountered. If a phobia is defined as "impairing to the individual", then it will be treated after being measured in context by the degree of severity. A large percent of the American population is afraid of public speaking, which could range from mild uncomfortability, to an intense anxiety that inhibits all social involvement.
Phobias are generally caused by an event recorded by the amygdala and hippocampus and labeled as deadly or dangerous; thus whenever a specific situation is approached again the body reacts as if the event were happening repeatedly afterward. Treatment comes in some way or another as a replacing of the memory and reaction to the previous event perceived as deadly with something more realistic and based more rationally. In reality most phobias are irrational, in the sense that they are thought to be dangerous, but in reality are not threatening to survival in any way.
Some phobias are generated from the observation of a parent's or sibling's reaction. The observer then can take in the information and generate a fear of whatever they experienced.
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Phobias are known as an emotional response learned because of difficult life experiences. Generally phobias occur when fear produced by a threatening situation is transmitted to other similar situations, while the original fear is often repressed or forgotten. The excessive, unreasoning fear of water, for example, may be based on a childhood experience of almost drowning. The individual attempts to avoid that situation in the future, a response that, while reducing anxiety in the short term, reinforces the association of the situation with the onset of anxiety.
Phobias are more often than not linked to the amygdala, an area of the brain located behind the pituitary gland in the limbic system. The amygdala may trigger secretion of hormones that affect fear and aggression. When the fear or aggression response is initiated, the amygdala may trigger the release of hormones into the body to put the human body into an "alert" state, in which they are ready to move, run, fight, etc.[3] This defensive "alert" state and response is generally referred to in psychology as the fight-or-flight response.
Psychologists and psychiatrists classify most phobias into three categories[4][5] 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:
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.
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 lets the patient understand the cycle of negative thought patterns, and ways to change these thought patterns. 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.[7][8] In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment.[8][9][10][11]
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.[12]
Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction. 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.[13]
Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, also considered to be pseudoscience by the mainstream medicine, is allegedly useful.
These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.
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.
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.
A number of terms with the suffix -phobia 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 general xenophobia.
Class discrimination is not a phobia in the clinical sense. Unlike clinical phobias, which are usually qualified with disabling fear, class discrimination usually has roots in social relations. Below are some examples:
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