Psychology Online

Specific fear

Example: classic conditioning

Synonym in a broader sense

„isolated phobia", Archnophobia, fear of certain situations, fear of spiders, fear of syringes, animal phobia, fear of flying

English: Specific Phobia
Medical: specific fear

Frequent mix-ups With: Panic disorder, Agoraphobia, social phobia

definition

Specific fear (specific phobia, also known as isolated phobia) describes the pronounced and longer-lasting fear reaction that relates to specific objects (e.g. fear of a spider, med. Arachnophobia) or specific situations (e.g. fear of being in an elevator. Med. Claustrophobia ) relates. The fear of the person concerned relates either to the real presence of such a stimulus / situation, or to the expectation e.g. to see a spider.

As soon as the person is no longer in the fearful situation or no longer has contact with the objects that trigger fear, the person concerned no longer feels fear.

Features of the specific phobia

The confrontation (encounter) with the specific stimulus or the specific situation almost always leads to a strong fear reaction. This reaction can be similar to the reactions that occur in the context of a Panic attack can occur (e.g. palpitations, sweat, Tremors, shortness of breath, etc.). The specific situations or objects are largely avoided by the people concerned. If this is not possible, they will only get through with clearly pronounced fear or a feeling of malaise. The fear experienced and reported and the resulting reactions are greatly exaggerated and not appropriate for the respective situation.
At some point in the course of the disease, the affected person will also notice that the fear responses are inadequate and exaggerated.
However, the exaggeration and inappropriateness of the behavior in the specific situations can hardly be recognized in the situations by the persons concerned. The people are not able to control or reduce the fear reactions independently.
The life of the affected person is clearly restricted. The people concerned often complain of severe impairments in the social (interpersonal), professional and private (e.g. leisure) area that have arisen from the fears they have experienced.
If the signs of a specific phobia appear before the age of 18, these must be for a period of at least six months exist so that the diagnosis can be made.
Since the above-mentioned characteristics of the phobia (avoidance behavior, feeling of fear / discomfort, etc.) also apply to other diseases to some extent, it must be ruled out that another disease is a reliable diagnosis mental illness present.

Other possible conditions that should be considered alternatively include:

Obsessive-compulsive disorder
Post-traumatic stress disorder
social phobia
Panic disorder with agoraphobia or
Agoraphobia
You can also find more on this topic under: Agorarphobia

The following types of specific phobia are distinguished:

Animal phobia: e.g. Scared of spiders (Arachnophobia); The beginning is often in childhood.
You can also find more on this topic under: Arachnophobia
Phobias about situations in the natural environment: e.g. Fear of storm, water, thunderstorm, heights (Bathophobia). It usually begins in childhood.
Blood injection phobia: e.g. Fear of seeing blood, one's own or someone else's (Hematophobia), Fear of medical interventions (e.g. injections).
Situational phobias: The fear of certain situations, for example of elevators, airplanes or of flying (fear of flying, Aviophobia), Driving a car etc .. The start is usually in childhood, or between 20 and 30. Age.
You can find more on this topic under our topic: fear of flying
Other Phobia: There are a variety of other phobias. The fear mostly relates to a stimulus or a specific situation. Other types would be: fear of suffocation, fear of treatment by the dentist (dental phobia) etc.

Several phobias can also occur together. For example, a person may have attended a Spider phobia (Arachnophobia) Suffer. A social phobia was then additionally diagnosed in the person in early adulthood. Since the spider phobia was not treated, the person now has two different phobias.
The fear or fear reaction can on three occur at different levels:

subjective: the person reports verbally, for example, about the fear they experienced.
in behavior: fearful place or objects are avoided, etc ..
physical: The person concerned shows physical reactions (sweating, tremors, accelerated heartbeat etc.) that are related to the specific object / situation.

Epidemiology / Occurrence

A specific fear (specific phobia) occurs most frequently in the population compared to the other anxiety disorders (social phobia, agoraphobia etc.). Within the specific phobia, the following types are more common:

Animal phobias (especially arachnophobia)
Thunderstorm phobias (fear of thunderstorms)
Altitude phobias (fear of great altitude)
Blood phobias (fear of blood and injections)
Injury phobias.

Studies have shown that 5-20% of German citizens fall ill every year. There are also gender-specific differences, as women are much more likely to develop a specific phobia than men.

Only a few are treated!

Even if the specific phobia is so widespread, in clinical practice you hardly ever come across those affected, as only a few do anything about their fears.

In the case of specific phobias, in contrast to the social phobia (fear of coming into contact with people), it is still possible to avoid the fearful stimuli (e.g. elevators).
Depending on the type of phobia, the onset of the disease is differently far back. For example, an animal phobia can begin at the age of seven. Situation-specific phobias usually begin in adulthood.

causes

Specific phobias usually only develop in the course of life and can be explained by many factors:
The various factors can be summarized in three groups:

Learning theoretical factors
Neurobiological factors
individual differences

Learning theory explanations

1. Classical conditioning

The affected person experiences a traumatic event in a certain person. From this point on, the originally neutral situation is filled with fear. The situation will therefore always be associated with feelings of fear in the future.

Example: classic conditioning

Ms. S., who has never been afraid of contact with dogs before, is bitten by a dog one day. In this situation, Ms. S. showed strong fear reactions. From now on, Ms. S. combines this fear from the unique situation with the encounter with all kinds of dogs. Ms. S. changes the side of the street every time she meets a dog. She never comes into contact with other dogs again and can therefore no longer have positive experiences with dogs. Since Ms. S. shows a physical fear reaction (e.g. sweating, racing heart, etc.) as soon as she only thinks about the situation or comes into contact with a dog, this leads to a subjective interpretation of the danger. This creates a vicious circle that Ms. S. can hardly escape without help.

2. Learning on the model

Often, the fears and fears are taken over by parents, relatives and friends. For example, the affected persons observe at a young age that the mother avoids narrow spaces (elevators) out of fear and shows strong fear reactions. Over the years, the person acquires the mother's behavior and often suffers from the same fears later on. But even in adulthood, fears from other people close to you can automatically be taken over.

Neurobiological Amplifiers

In addition to what has been learned, there is also an explanatory approach that sees the causes for the development of such a phobia inside the person. Since the autonomic nervous system i.a. is responsible for the heart and breathing (here the fear reactions are shown very clearly), it is assumed that people who suffer from a phobia have a very unstable autonomic nervous system, which is hardly resilient. Thus, symptoms of anxiety show up much more easily. The inheritance of such an unstable nervous system has also been discussed, but so far there is no real evidence for this.

Individual differences

In the last century, the opinion was held for a very long time that the existence of mental illnesses could be explained by a very strong expression of personality traits.
This thought leads to the idea that there could be a connection between the presence of certain personality traits and the development of a mental illness. In the case of specific fear (specific phobia), one should assume that people who are generally fearful are also more likely to develop an anxiety disorder. This could also be confirmed in animal experiments with rats. Overall, it is assumed that individual differences in personality and previous experience contribute significantly to the development of a mental illness (here: an anxiety disorder).
If one considers all three areas (learning experiences, neurobiological reactions, individual differences), one can assume that the interaction of the factors leading to the development of a fear (phobia) can be used as an explanation.

diagnosis

A doctor can diagnose a specific phobia in a personal interview. During the conversation he tries to identify the patient's exact fears. This is done with the help of a standardized questionnaire, which enables the doctor to ask specific questions.

1. Clinical interview

A recognized and widely used procedure is the structured clinical interview (SKID). With the help of this interview, the diagnosis can be made on the basis of standardized criteria (criteria with the help of which the diagnosis for a certain disease can be made). This interview is mostly used by experienced therapists.
In the first part of the interview, general information about the person concerned is collected. Among other things, the course of the symptoms is also asked in detail. This is done with the help of a set of guidelines that guides the therapist through the interview so that the therapist can ask the right questions.
This is followed by the actual “structured” part of the interview. Step by step, the person is asked about various areas of the problem.
It becomes after the presence of affective symptoms (Depression) asked. If this is not the case, the next area (psychotic symptoms) he asks. A total of ten different disease areas can be tested through the interview.
Depending on the answer from the person with whom the interview is conducted, the therapist may or may not exclude a criterion for a clinical picture

2. Self-assessment

With the help of a special questionnaire, the patient also has the opportunity to assess his own behavior by carefully observing his symptoms and then writing them down in detail. The attending physician can thus get an even more precise picture of the patient's complaints.
With the help of such a procedure, other conditions that need to be considered (e.g. social phobia, Agoraphobia etc.).