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Anxiety Disorder – Simple/Specific Phobia
DSM IV-TR
Axis I – Clinical Disorders
Anxiety Disorders
Common Characteristics
Anxiety Disorders categorize a large number of disorders where the primary feature is
abnormal or inappropriate anxiety. Everybody has experienced anxiety. Think about the last
time a loud noise frightened you and remember the feelings inside your body. Chances are you
experienced an increased heart rate, tensed muscles, and perhaps an acute sense of focus as
you tried to determine the source of the noise. These are all symptoms of anxiety. They are
also part of a normal process in our bodies called the 'flight or flight' phenomenon. This means
that your body is preparing itself to either fight or protect itself or to flee a dangerous situation.
These symptoms become a problem when they occur without any recognizable stimulus or
when the stimulus does not warrant such a reaction. In other words, inappropriate anxiety is
when a person's heart races, breathing increases, and muscles tense without any reason for
them to do so. Once a medical cause is ruled out, an anxiety disorder may be the culprit.
Disorders in this Category
Acute Stress Disorder
Agoraphobia (with or without a history of Panic Disorder)
Generalized Anxiety Disorder [GAD]
Obsessive-Compulsive Disorder [OCD]
Panic Disorder (with or without Agoraphobia)
Phobias (including Social Phobia)
Posttraumatic Stress Disorder [PTSD]
Reproduced from: http://allpsych.com/disorders/anxiety/index.html
Individuals suffering from this Anxiety Disorder experience phobia or unreasonable fear or anxiety in
connection with exposure to specific objects or situations and because of this avoid them whenever
possible.
Examples include: claustrophobia, acrophobia (heights), and arachnophobia (spiders).
Diagnostic criteria for 300.29 Specific Phobia
A. 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).
B. 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.
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature
may be absent.
D. The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
E. 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.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The anxiety, Panic Attacks, 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.
Specify type:
Animal Type
Natural Environment Type (e.g., heights, storms, water)
Blood-Injection-Injury Type
Situational Type (e.g., airplanes, elevators, enclosed places)
Other Type (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting
an illness; in children, avoidance of loud sounds or costumed characters)
Reproduced from: http://www.behavenet.com/capsules/disorders/specphob.htm
ICD-10
Chapter V
Mental and behavioural disorders
Neurotic, stress-related and somatoform disorders
F40
Phobic anxiety disorders
A group of disorders in which anxiety is evoked only, or predominantly, in certain welldefined situations that are not currently dangerous. As a result these situations are
characteristically avoided or endured with dread. The patient's concern may be focused
on individual symptoms like palpitations or feeling faint and is often associated with
secondary fears of dying, losing control, or going mad. Contemplating entry to the
phobic situation usually generates anticipatory anxiety. Phobic anxiety and depression
often coexist. Whether two diagnoses, phobic anxiety and depressive episode, are
needed, or only one, is determined by the time course of the two conditions and by
therapeutic considerations at the time of consultation.
F40.2
Specific (isolated) phobias
Phobias restricted to highly specific situations such as proximity to particular animals,
heights, thunder, darkness, flying, closed spaces, urinating or defecating in public
toilets, eating certain foods, dentistry, or the sight of blood or injury. Though the
triggering situation is discrete, contact with it can evoke panic as in agoraphobia or
social phobia.
Acrophobia
Animal phobias
Claustrophobia
Simple phobia
Excludes:
dysmorphophobia (nondelusional) ( F45.2 )
nosophobia ( F45.2 )
Reproduced from: http://apps.who.int/classifications/apps/icd/icd10online/?gf40.htm+f402
F40.2 Specific (isolated) phobias
A. Either (1) or (2):
(1) marked fear of a specific object or situation not included in agoraphobia (F40.0) or social phobia
(F40.1);
(2) marked avoidance of such objects or situations.
Among the most common objects or situations are animals, birds, insects, heights, thunder, flying,
small enclosed spaces, sight of blood or injury, injections, dentists and hospitals.
B. Symptoms of anxiety in the feared situation at some time since the onset of the disorder, as
defined in criterion B for F40.0 (Agoraphobia).
Agoraphobia: Symptoms of anxiety in the feared situation at some time since the onset of the
disorder, with at least two symptoms present together, on at least one occasion, from the list below,
one of which must have been from items (1) to (4):
Autonomic arousal symptoms
(1) Palpitations or pounding heart, or accelerated heart rate.
(2) Sweating.
(3) Trembling or shaking.
(4) Dry mouth (not due to medication or dehydration).
Symptoms concerning chest and abdomen
(5) Difficulty breathing.
(6) Feeling of choking.
(7) Chest pain or discomfort.
(8) Nausea or abdominal distress (e.g. churning in stomach).
Symptoms concerning brain and mind
(9) Feeling dizzy, unsteady, faint or light-headed.
(10) Feelings that objects are unreal (derealization), or that one's self is distant or "not really here"
(depersonalization).
(11) Fear of losing control, going crazy, or passing out.
(12) Fear of dying.
General symptoms
(13) Hot flushes or cold chills.
(14) Numbness or tingling sensations.
C. Significant emotional distress due to the avoidance or the anxiety symptoms, and a
recognition that these are excessive or unreasonable.
D. Symptoms are restricted to or predominate in the feared situations or when thinking about them.
E. Most commonly used exclusion criteria: criterion A is not due to delusions, hallucinations, or other
symptoms of disorders such as organic mental disorders (F0), schizophrenia and related disorders
(F20-F29), affective disorders (F30-F39), or obsessive compulsive disorder (F42), and are not
secondary to
cultural beliefs.
C. Significant emotional distress due to the symptoms or the avoidance, and a recognition that these
are excessive or unreasonable.
D. Symptoms are restricted to the feared situation, or when thinking about it.
If desired, the specific phobias may be subdivided as follows:
- animal type (e.g. insects, dogs)
- nature-forces type (e.g. storms, water)
- blood, injection and injury type
- situational type (e.g. elevators, tunnels)
- other type
Reproduced from: http://www.who.int/classifications/icd/en/GRNBOOK.pdf
Anxiety Disorder – Specific Phobia
Anxiety: a feeling of apprehension, dread or uneasiness in response to an unclear or ambiguous
threat.
Anxiety Disorder: a mental disorder that involves feelings of extreme anxiety, accompanied by
physical and psychological symptoms, which prevents a sufferer from normal functioning.
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Normal Anxiety
Feel apprehension or dread
Can execute complex activities
Can learn new responses
Can plan appropriate responses
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Anxiety Disorder
Recurring, unrealistic and
intrusive fear
Avoidance behaviour
Pervasive feelings of stress,
insecurity, inferiority,
unhappiness and dissatisfaction
that cause dysfunction
Specific Phobia: an intense, irrational fear and avoidance of a particular object, activity or situation.
People affected by phobias recognise that their fears are unreasonable and excessive, but they
cannot control them. A phobia interferes with a person’s ability to function normally in everyday
situations.
Checklist for Specific Phobia
 Intense fear
 Irrational fear
 Avoids feat object, activity
or situation
 Cannot control fear
 Fear interrupts daily
functioning
 Overwhelming anxiety
Youtube links
Phobia information: http://www.youtube.com/watch?v=E2pbYxA-MzI
Fear of spiders: http://www.youtube.com/watch?v=zd1ZkK8W_gQ
Phobia sketch: http://www.youtube.com/watch?v=koNwUeG-iKE
Arachnaphobia Movie Trailer: http://www.youtube.com/watch?v=4aQ6vg3JB2U
Phobias Activity
The following list cites some common and some very unusual phobias experienced by people. See how
many you can identify from the choices provided by matching the phobia to its correct definition.
Name of Phobia
Definition
1. Acrophobia
Fear of water (especially drowning)
2. Agoraphobia
Fear of cats
3. Ailurophobia
Fear of high places
4. Algophobia
Fear of spiders
5. Arachibutyrophobia
Fear of open spaces
6. Aquaphobia
Fear of pain
7. Arachnophobia
Fear of dogs
8. Astraphobia
Fear of enclosed spaces
9. Claustrophobia
Fear of darkness
10. Cynophobia
Fear of peanut butter sticking to the roof of your mouth
11. Erythrophobia
Fear of writing
12. Gephydrophobia
Fear of crowds
13. Graphophobia
Fear of dirt
14. Hematophobia
Fear of strangers
15. Monophobia
Fear of crossing bridges
16. Mysophobia
Fear of lightning storms
17. Nyctophobia
Fear of animals
18. Ocholophobia
Fear of blushing
19. Ophidiophobia
Fear of being buried alive
20. Pantophobia
Fear of choking
21. Pnigophobia
Fear of everything
22. Siderodromophobia
Fear of the number thirteen
23. Taphophobia
Fear of railways
24. Thanatophobia
Fear of death
25. Triskaidekaphobia
Fear of being alone
26. Xenophobia
Fear of blood
27. Zoophobia
Fear of snakes