What are the symptoms of Specific Phobia?

Specific Phobias usually fall into one of five categories:

  • Animal Type (dogs, bugs, snakes, etc.)
  • Natural Environment Type (storms, earthquakes, floods, fires, etc.)
  • Blood-Injection-Injury Type (getting shots, seeing blood or injuries)
  • Situational Type (flying, driving, heights, small spaces)
  • Other Type (anything else)

Core symptoms of Specific Phobia

Associated symptoms of Specific Phobia

  • Notable anxiety or fear about something specific
  • The situation or object nearly always results in immediate anxiety or fear
  • The situation or object is avoided actively or suffered with apparent distress
  • The fear, anxiety, or avoidance exceeds any actual danger
  • Tantrums or mood swings
  • Crying
  • Freezing
  • Clinging
  • Trembling
  • Dizziness
  • Sweating

How is Specific Phobia diagnosed?

A child-adolescent psychiatrist may diagnose a child or teen with Specific Phobia if they show extreme fear related to something that is not typically considered dangerous; the fear, anxiety, or avoidance that they experience is much more than what is normal for their age, and occurs nearly every time they come into contact with the feared object or situation; and their symptoms are persistent, lasting for six months or more, and result in significant impairment in other aspects of everyday life (e.g., social, familial, academic, etc.).

The child-adolescent psychiatrist may interview and/or assess both the child and a caregiver in order to determine the specific nature of the child’s fear(s), although many practitioners also use questionnaires or behavior/emotion rating form results to support the diagnosis and quantify the severity of the problem. The practitioner will also seek to determine that the child’s or teen’s fear is not related to something unforeseen.

Specific Phobia Facts

Worldwide frequency of the condition

Specific phobia is estimated to be present in about 6% of the European population, although estimates vary from 6-9% vary based on the subject of the phobia. Anxiety Disorders, in general, are estimated to be present in 6.5% of the world's population. While there is no recent, specific epidemiological data for Greece, a recent review of European countries reported a 7.9% frequency.

Burden of the condition in Greece

Anxiety accounts for 9.8% for all disability adjusted life years (DALYs) lost to health conditions in Greece for 5- to 14-year-old children and adolescents. It is the most prominent mental health condition adding to the health burden of the Greek child and adolescent population.

Gender ratio

Specific Phobia is diagnosed more frequently in females than males, with an estimated ratio of 2:1.

Peak age of onset

The peak age of onset for Specific Phobia is estimated to be 5.5 years. This is similar to the peak age of onset for anxiety disorders, in general, which is also 5.5 years.

Proportion of the condition that emerges before age 18

According to recent data, 75.0% of individuals with Specific Phobia will have been diagnosed by the time they are 18 years old.

What are the associated factors for Specific Phobia?

Some common factors associated with Specific Phobia are:

  • Genetic and familial factors. Predisposition toward an anxiety disorder most likely results from a combination of multiple genes that interact in a complex way with multiple environmental factors. Also, having a first-degree relative with a Specific Phobia places a child at higher risk of developing the same phobia.
  • Environmental factors. These include adverse experiences (e.g. trauma), parenting practices (e.g., overprotection, overcontrol, or reinforcement of avoidance behaviors), parental loss, and parental separation.

What other disorders co-occur with Specific Phobia?

Even though each child and adolescent is different, Specific Phobia is not commonly seen in the absence of other mental health conditions, and sufferers are at increased risk for other anxiety disorders (i.e., Generalized Anxiety Disorder, Separation Anxiety Disorder, multiple specific phobias), as well as depressive and bipolar disorders.

How is Specific Phobia treated?

Specific Phobia is treated with psychotherapy. Caregivers and other family members are an important part of treatment, since they can help kids and teens practice the skills they learn in therapy.

There are multiple therapies that have been shown to effectively treat symptoms of Specific Phobia, but the one with the most evidence is cognitive-behavioral therapy (CBT). CBT is an umbrella term that refers to a wide range of different cognitive and behavioral techniques. One CBT technique is called exposure and response prevention (ERP). This means that the child is slowly and gradually exposed to the thing they are afraid of over and over, until they learn that the threat is not as bad and their fear decreases. This treatment works very well for most children with Specific Phobia.

An example of that would be a child who is afraid of dogs. First steps could involve a child looking at a picture of a dog, then playing with a stuffed dog. Gradually, they would get closer to real small dogs and spend a few minutes with them.

Medication is not usually used to treat Specific Phobia.

Where to find more information

If you need more information on fears and reasons for concerns, you can also go to "Excessive fears" in our website.

To learn more about the technical work conducted to develop this guide, please consult our reference list here:

References

Clinical description, symptoms, and diagnostic information

  • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition Text Revision DSM-5-TR. American Psychiatric Association Publishing, Washington, DC.
  • Child Mind Institute. (2021, September 7). Specific Phobia in children: A quick guide. https://childmind.org/guide/quick-guide-to-specific-phobia/
  • World Health Organization. (2022, February). ICD-11 for mortality and morbidity statistics. 6B03 Specific Phobia. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/239513569

Facts

  • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition Text Revision DSM-5-TR. American Psychiatric Association Publishing, Washington, DC.
  • Institute for Health Metrics and Evaluation (IHME). (2019). GBD Compare Data Visualization. Seattle, WA: IHME, University of Washington, Available from http:// vizhub.healthdata.org/gbd-compare. (Accessed 11/15/2022)
  • Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345–365. https://doi.org/10.1111/jcpp.12381
  • Sacco, R., Camilleri, N., Eberhardt, J., Umla-Runge, K., & Newbury-Birch, D. (2022). A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-022-02131-2
  • Solmi, M., Radua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Il Shin, J., Kirkbride, J. B., Jones, P., Kim, J. H., Kim, J. Y., Carvalho, A. F., Seeman, M. V., Correll, C. U., & Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27(1), 281–295. https://doi.org/10.1038/s41380-021-01161-7
  • Somers, J. M., Goldner, E. M., Waraich, P., & Hsu, L. (2006). Prevalence and Incidence Studies of Anxiety Disorders: A Systematic Review of the Literature. The Canadian Journal of Psychiatry, 51(2), 100–113. https://doi.org/10.1177/070674370605100206

Associated factors

  • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition Text Revision DSM-5-TR. American Psychiatric Association Publishing, Washington, DC.
  • Capriola-Hall, N. N., Booker, J. A., & Ollendick, T. H. (2020). Parent- and Child-Factors in Specific Phobias: The Interplay of Overprotection and Negative Affectivity. Journal of Abnormal Child Psychology, 48(10), 1291–1302. https://doi.org/10.1007/s10802-020-00662-3
  • Kendler, K. S. (2013). What psychiatric genetics has taught us about the nature of psychiatric illness and what is left to learn. Molecular Psychiatry, 18(10), 1058–1066. https://doi.org/10.1038/mp.2013.50
  • Lawrence, P. J., Murayama, K., & Creswell, C. (2019). Systematic Review and Meta-Analysis: Anxiety and Depressive Disorders in Offspring of Parents With Anxiety Disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 58(1), 46–60. https://doi.org/10.1016/j.jaac.2018.07.898
  • Ståhlberg, T., Khanal, P., Chudal, R., Luntamo, T., Kronström, K., & Sourander, A. (2020). Prenatal and perinatal risk factors for anxiety disorders among children and adolescents: A systematic review. Journal of Affective Disorders, 277, 85–93. https://doi.org/10.1016/j.jad.2020.08.004

Co-occurring disorders

  • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition Text Revision DSM-5-TR. American Psychiatric Association Publishing, Washington, DC.
  • de Vries, Y. A., Al-Hamzawi, A., Alonso, J., Borges, G., Bruffaerts, R., Bunting, B., Caldas-de-Almeida, J. M., Cia, A. H., De Girolamo, G., Dinolova, R. V., Esan, O., Florescu, S., Gureje, O., Haro, J. M., Hu, C., Karam, E. G., Karam, A., Kawakami, N., Kiejna, A., … de Jonge, P. (2019). Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: Results from the World Mental Health Surveys. BMC Medicine, 17(1), 101. https://doi.org/10.1186/s12916-019-1328-3
  • Saha, S., Lim, C. C. W., Cannon, D. L., Burton, L., Bremner, M., Cosgrove, P., Huo, Y., & McGrath, J. (2021). Co‐morbidity between mood and anxiety disorders: A systematic review and meta‐analysis. Depression and Anxiety, 38(3), 286–306. https://doi.org/10.1002/da.23113

Interventions

  • Böhnlein, J., Altegoer, L., Muck, N. K., Roesmann, K., Redlich, R., Dannlowski, U., & Leehr, E. J. (2020). Factors influencing the success of exposure therapy for specific phobia: A systematic review. Neuroscience & Biobehavioral Reviews, 108, 796–820. https://doi.org/10.1016/j.neubiorev.2019.12.009
  • Correll, C. U., Cortese, S., Croatto, G., Monaco, F., Krinitski, D., Arrondo, G., Ostinelli, E. G., Zangani, C., Fornaro, M., Estradé, A., Fusar‐Poli, P., Carvalho, A. F., & Solmi, M. (2021). Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: An umbrella review. World Psychiatry, 20(2), 244–275. https://doi.org/10.1002/wps.20881
  • Schopf K, Mohr C, Lippert MW, Sommer K, Meyer AH, Schneider S. The role of exposure in the treatment of anxiety in children and adolescents: protocol of a systematic review and meta-analysis. Syst Rev. 2020;9(1):96. doi:10.1186/s13643-020-01337-2
  • Wang Z, Whiteside SPH, Sim L, et al. Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: A systematic review and meta-analysis. JAMA Pediatr. 2017;171(11):1049. doi:10.1001/jamapediatrics.2017.3036
  • Zhou, X., Zhang, Y., Furukawa, T. A., Cuijpers, P., Pu, J., Weisz, J. R., Yang, L., Hetrick, S. E., Del Giovane, C., Cohen, D., James, A. C., Yuan, S., Whittington, C., Jiang, X., Teng, T., Cipriani, A., & Xie, P. (2019). Different types and acceptability of psychotherapies for acute anxiety disorders in children and adolescents: A network meta-analysis. JAMA Psychiatry, 76(1), 41. https://doi.org/10.1001/jamapsychiatry.2018.3070

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