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Specific phobias have a one-year prevalence of 8.7% in the USA with 21.9% of the cases being severe, 30.0% moderate and 48.1% mild. The usual age of onset is childhood to adolescence. Women are twice as likely to suffer from specific phobias as men.
Evolutionary psychology argues that infants or children develop specific phobias to things that could possibly harm them, so their phobias alert them to the danger.
The most common co-occurring disorder for children with a specific phobia is another anxiety disorder. Although comorbidity is frequent for children with specific phobias, it tends to be lower than for other anxiety disorders.
Onset is typically between 7 and 9 years of age. Specific phobias can occur at any age but seem to peak between 10 and 13 years of age.
According to Child and Adolescent Mental Health, approximately 5 percent of children suffer from specific phobias and 15 percent seek treatment for anxiety-related problems. In recent years the number of children with clinically diagnosed phobias has gradually increased. Researchers are finding that the majority of these diagnoses come anxiety related phobias or society phobias.
Specific phobias are more prevalent in girls than in boys. Likewise, specific phobias are also more prevalent in older children than younger.
Though some fears are inborn, the majority are learned. Phobias develop through negative experiences and through observation. One way children begin to develop fears is by witnessing or hearing about dangers. Ollendick proposes while some phobias may originate from a single traumatizing experience, others may be caused by simpler, or less dramatic, origins such as observing another child’s phobic reaction or through the exposure to media that introduces phobias.
- 2% of parents linked their child’s phobia to a [direct conditioning episode]
- 26% of parents linked their child’s phobia to a [vicarious conditioning episodes]
- 56% of parents linked their child’s phobia to their child’s very first contact with water
- 16% of parents could not directly link their child’s phobia
In addition to asking about the origins of a child’s fear, the questionnaire asked if parents believed that “information associated with adverse consequences was the most influential factor in the development of their child’s phobia.” The results were as followed:
- 0% of parents though it was the most influential factor
- 14% of parents though it was somewhat influential
- 86% of parents though it had little to no influence
BII phobia is one of the more common psychiatric disorders, affecting about 3 to 4% of the general population, and in about 80% of the BII phobia cases, the patient experiences syncope or presyncope. After a random survey was completed in Aligarh, India, with 1648 male and 1613 female, it was found that a significantly higher percentage of females compared to males had BII phobia; 23.36% of females were diagnosed with BII phobia while only 11.19% of males were diagnosed. Females also fainted more often than males, at 64.09% compared to a male rate of 39.4%.
Furthermore, only 5.3% of BII phobia patients reported to have visited the hospital once or twice for consultation about BII phobia, however, without engaging in any kind of treatment.
Another study, involving participants from all 50 states and the District of Columbia, ages 65 years and older, found that a total of 386 participants disclosed having BII Phobia throughout their whole lifetime, 90% of those cases consisted of patients dealing with BII Phobia as well as other lifetime fears.
Phobias are a common form of anxiety disorders and distributions are heterogeneous by age and gender. An American study by the National Institute of Mental Health (NIMH) found that between 8.7 percent and 18.1 percent of Americans suffer from phobias, making it the most common mental illness among women in all age groups and the second most common illness among men older than 25. Between 4 percent and 10 percent of all children experience specific phobias during their lives, and social phobias occur in one percent to three percent of children and adolescents.
A Swedish study found that females have a higher incidence than males (26.5 percent for females and 12.4 percent for males). Among adults, 21.2 percent of women and 10.9 percent of men have a single specific phobia, while multiple phobias occur in 5.4 percent of females and 1.5 percent of males. Women are nearly four times as likely as men to have a fear of animals (12.1 percent in women and 3.3 percent in men) — a higher dimorphic than with all specific or generalized phobias or social phobias. Social phobias are more common in girls than in boys, while situational phobia occurs in 17.4 percent of women and 8.5 percent of men.
Many people report stress-induced speech disorders which are only present during public speech. Some individuals with glossophobia have been able to dance, perform in public, or even to speak (such as in a play), or sing if they cannot see the audience, or if they feel that they are presenting a character or stage persona other than themselves. Being able to blend in a group (as in a choir or band) has been reported to also alleviate some anxiety caused by glossophobia.
It has been estimated that 75% of all people experience some degree of anxiety/nervousness when it comes to public speaking. In fact, surveys have shown that most people fear public speaking more than they fear death. If untreated, public speaking anxiety can lead to serious detrimental effects on one's quality of life, career goals and other areas. For example, educational goals requiring public speaking might be left unaccomplished. However, not all persons with public speaking anxiety are necessarily unable to achieve work goals, though this disorder becomes problematic when it prevents an individual from attaining or pursuing a goal they might otherwise have - were it not for their anxiety.
A recent study conducted by Garcia-Lopez, Diez-Bedmar, and Almansa-Moreno (2013) has reported that previously trained students could act as trainers to other students and help them to improve their public speaking skills.
The telephone is important for both contacting others and accessing important and useful services. As a result, this phobia causes a great deal of stress and impacts people's personal lives, work lives and social lives. Sufferers avoid many activities, such as scheduling events or clarifying information. Strain is created in the workplace because use of phones may play a crucial role within a career.
The cause of BII phobia is not well known. Some studies show that specific genes make one more vulnerable to the phobia. Other studies suggest that just like any other phobia, BII phobia could be caused by a traumatic experience (Chapman). It has been proved that social stress amplifies BII symptoms, however, it is not a main cause.
There are three major categories of driving phobia, distinguished by their onset.
The first and most common cause of a fear of driving is traffic accidents. These situations cause PTSD driving phobia, where the fear develops in response to a traumatic event. Usually, situations like these trigger a fear of driving in only specific situations related to the original cause, though it also can trigger a fear of driving entirely.
The second most common form is driving phobia as a specific phobia. Because driving does involve some danger and the possibility of a collision, there does exist some fear or caution in many rational people. However, for some the fear of crashing, losing control over the car, being criticized or being in a dangerous situation will cause panic. It is classified as a phobia when the anxiety does not rationally reflect the amount of danger.
The least common category is an extension of agoraphobia, the anxiety of having a panic attack while being in crowds or public places. One manifestation of agoraphobia is the inability to travel long distances away from home. When driving, an agoraphobe may feel that he is putting himself into a fearful situation, and driving phobia may develop.
Though scopophobia is a solitary disorder, many individuals with scopophobia also commonly experience other anxiety disorders. Scopophobia has been related to many other irrational fears and phobias. Specific phobias and syndromes that are similar to scopophobia include erythrophobia, the fear of blushing (which is found especially in young people), and an epileptic's fear that being looked which may itself precipitate such an attack. Scopophobia is also commonly associated with schizophrenia and other psychiatric disorders. It is not considered indicative of other disorders, but is rather considered as a psychological problem that may be treated independently.
Sociologist Erving Goffman suggested that shying away from casual glances in the street remained one of the characteristic symptoms of psychosis in public. Many scopophobia patients develop habits of voyeurism or exhibitionism. Another related, yet very different syndrome, scopophilia, is the excessive enjoyment of looking at erotic items.
There is a strong agreement in the scientific community that there is no specific cause of emetophobia. Some emetophobics report a traumatic experience with vomiting, almost always in childhood, but many do not. Some suggest that sufferers are victims of childhood abuse – sexual or physical. While this is occasionally true, it seems to be no more prevalent than in the general population. (Christie, 2004) Some experts believe that emetophobia may be linked to worries about lack of control. Many people try to control themselves and their environment in every possible way, but vomiting is difficult or impossible to control.
There are many factors that can cause a legitimate case of emetophobia. It can affect the minds of young children, but emetophobia can also affect a person at any age. While some emetophobics are indeed severely mentally ill, many are not and have been diagnosed as such and treated inappropriately.
Dr. Angela L. Davidson "et al". conducted an experiment where it was concluded through various surveys that people suffering from emetophobia are more likely to have an internal locus of control pertaining to their everyday life as well as health-related matters. A locus of control is an individual's perception of where control comes from. Having an internal locus of control means that an individual perceives that they have their own control over a situation whereas an external locus of control means that an individual perceives that some things are out of their control.
She explains how this phobia is created through the locus of control by stating, "Thus far, it seems reasonable to stipulate that individuals with a vomiting phobia deem events as being within their control and may therefore find it difficult to relinquish this control during the act of vomiting, thus inducing a phobia."
In an internet survey conducted by Dr. Joshua D. Lipsitz et al. given to emetophobic people, respondents gave many different reasons as to why they became emetophobic. Among some of the causes listed were severe bouts of vomiting as children and being firsthand witnesses to severe vomiting in others due to illness, pregnancy, or alcoholism.
Bruce and Sanderson also state that animal phobias are more common in females than males. Furthermore, Dr. B.K. Wiederhold, a psychiatrist investigating virtual reality therapy as a possible method of therapy for anxiety disorders, goes on to provide data that although prevalent in both men and women, 75% to 90% of patients reporting specific phobias of the animal subtype are women.
In 2007 scientists found astraphobia is the third most prevalent phobia in the US. It can occur in people of any age. It occurs in many children, and should not be immediately identified as a phobia because children naturally go through many fears as they mature. Their fear of thunder and lightning cannot be considered a fully developed phobia unless it persists for more than six months. In this case, the child's phobia should be addressed, for it may become a serious problem in adulthood.
To lessen a child's fear during thunderstorms, the child can be distracted by games and activities. A bolder approach is to treat the storm as an entertainment; a fearless adult is an excellent role model for children.
Autophobia can be derived from social anxiety. When people with this phobia are left alone, they will often experience panic attacks, which is a common reaction in those suffering from social anxiety. This disease can also stem from depression because when people become seriously autophobic, they start to find certain tasks and activities almost impossible to complete. This usually occurs when autophobes are faced with a possibility of going into a public place where there are lots of people or simply a place that is uncomfortable or unfamiliar to them. This phobia can also be closely related to agoraphobia, which leads to lowered self-confidence and uncertainty of their ability to finish certain activities that need to be done alone. People suffering from this phobia tend to imagine the worst possible scenario. For example, they might have a panic attack and then think that they are going to die from this event.
Another experience that doctors believe leads individuals to develop this phobia is children being abandoned, usually by their parents, when they are very young. This first causes childhood trauma that then persists to effect them as they grow up. This turns into autophobia because they are now afraid that all of the important people in their lives are going to leave or abandon them. Therefore, this particular phobia can come from behavior and experiences that these people have had when they were growing up. However, abandonment does not necessarily mean being left alone physically, this also includes being isolated financially or emotionally. Having drastic, life-altering experiences, particularly causes more trauma which makes this phobia worse. People that have very high anxiety and in this case are more “high strung,” are more susceptible to this phobia.
Although this phobia is often developed at a young age, it can develop later in life as well. Individuals sometimes develop this fear with the death of a loved one or the ending of an important relationship. Autophobia can also be described as the fear of being without a specific person. Tragic events in a person's life may create this fear of being without one specific person, but this often will eventually progress into a fear of being secluded in general.
Telephone phobia (telephonophobia, telephobia, phone phobia) is reluctance or fear of making or taking phone calls, literally, "fear of telephones". It is considered to be a type of social phobia or social anxiety. It may be compared to glossophobia, in that both arise from having to engage with an audience, and the associated fear of being criticized, judged or made a fool of.
As is common with other fears and phobias, there is a wide spectrum of severity of the fear of phone conversations and corresponding difficulties. In 1993 it was reported that about 2.5 million people in Great Britain have telephone phobia.
The term "telephone apprehension" refers to a lower degree of telephone phobia, in which sufferers experience anxiety about the use of telephones, but to a less severe degree than that of an actual phobia.
Sufferers may have no problem communicating face to face, but have difficulty doing so over the telephone.
The causes of glossophobia may vary. Often, it can be linked to traumatic experiences, or fearful events occurring during childhood, adolescence and early adulthood in which the speaker endured a traumatic childhood experience related to the public speaking. Genetics may also play a role, as might evolutionary factors. In addition, other key causes of this anxiety have been identified as the novelty of the experience, the characteristics of the audience, the illusion of transparency and the degree to which the speaker identifies public speaking as a performance as opposed to an act of communication.
An uncommon cause for glossophobia may come from a medical condition or a health concern. A serious brain injury can lead to different phobias, including glossophobia.
Scopophobia is unique among phobias in that the fear of being looked at is considered both a social phobia and a specific phobia, because it is a specific occurrence which takes place in a social setting. Most phobias typically fall in either one category or the other but scopophobia can be placed in both. On the other hand, as with most phobias, scopophobia generally arises from a traumatic event in the person's life. With scopophobia, it is likely that the person was subjected to public ridicule as a child. Additionally, a person suffering from scopophobia may often be the subject to public staring, possibly due to a deformity or physical ailment.
According to the Social Phobia/Social Anxiety Association, U.S. government data for 2012 suggests that social anxiety affects over 7% of the population at any given time. Stretched over a lifetime, the percentage increases to 13%.
Jeanette M. Bruce and William C. Sanderson, in their book "Specific Phobias", concluded that the age of onset for animal phobias is usually early childhood, between the ages of five and nine. A study done in South Africa by Drs. Willem A. Hoffmann and Lourens H. Human further confirms this conclusion for patients suffering from cynophobia and additionally found dog phobia developing as late as age 20.
Autophobia, also called monophobia, isolophobia, or eremophobia, is the specific phobia of isolation; a morbid fear of being egotistical, or a dread of being alone or isolated. Sufferers need not be physically alone, but just to believe that they are being ignored or unloved. Contrary to what would be implied by a literal reading of the term, "autophobia" does not describe a "fear of oneself". The disorder typically develops from and is associated with other anxiety disorders.
Autophobia can be associated with or accompanied by several other phobias such as agoraphobia, and is generally considered to be a part of the agoraphobic cluster. This means that autophobia has a lot of the same characteristics as certain anxiety disorders and hyperventilation disorders. The main concern of people with phobias in the agoraphobic cluster is getting help in case of emergency. This means people might be afraid of going out in public, being caught in a crowd, being alone, or being stranded.
Autophobia is not to be confused with agoraphobia (fear of being in public, or caught in large crowds), self-hatred, or social anxiety although it can be closely related to these things. It is its own phobia that tends to be accompanied by other anxiety disorders and phobias.
The most common treatment for serious cases is behavior therapy—specifically, systematic desensitization.
Several other self-help treatments exist, mainly involving exposure therapy and relaxation techniques while driving. Additional driving training and practice with a certified teacher also help many to become more confident and less likely to suffer from anxiety.
One of the emerging methods of treating this fear is through the use of virtual therapy.
With repeated exposure, all of the subjects displayed significantly less variance from normal in heart rate acceleration, depression readings, subjective distress, and post-traumatic stress disorder ratings.
Factors that can cause reluctance to attend school can be divided into four categories. These categories have been developed based on studies in the United States under the leadership of Professor Christopher Kearney. Some students may be affected by several factors at once.
- The child might want to be free.
- The child possibly wants to avoid school-related issues and situations that cause them to experience unpleasant feelings, such as anxiety, depression, or psychosomatic symptoms. The reluctance to attend school is one symptom that can indicate the presence of a larger issue, such as anxiety disorder, depression, learning disability, sleep disorder, separation anxiety or panic disorder.
- The child may want to avoid tests, presentations, group work, specific lessons, or interaction with other children. The child should be assessed for learning disabilities if academic performance is average or low.
- The child may want attention from significant people outside of school, such as parents or older acquaintances.
- The child possibly wants to do something more enjoyable outside of school, like practice hobbies, play computer games, watch movies, play with friends such as riding bikes, etc., or learn autodidactictally.
Other factors can be:
- Anxiety about academic achievement and being tested can arise on the basis of inflated claims by teachers and/or parents, but also unrealistic ambitions of the upset child themselves.
- School refusal may arise as a response to bullying or peer rejection.
- Shyness or a social phobia can contribute to school refusal.
- The child might worry about parents or siblings, for instance, a parent with substance abuse, or a parent who physically abuses other family members.
- Some students may refuse to go to school due to anxiety or fears of emergency drills, such as fire, lockdown, and tornado drills.
Social anxiety disorder is known to appear at an early age in most cases. Fifty percent of those who develop this disorder have developed it by the age of 11, and 80% have developed it by age 20. This early age of onset may lead to people with social anxiety disorder being particularly vulnerable to depressive illnesses, drug abuse and other psychological conflicts.
When prevalence estimates were based on the examination of psychiatric clinic samples, social anxiety disorder was thought to be a relatively rare disorder. The opposite was found to be true; social anxiety was common, but many were afraid to seek psychiatric help, leading to an underrecognition of the problem.
The National Comorbidity Survey of over 8,000 American correspondents in 1994 revealed 12-month and lifetime prevalence rates of 7.9 percent and 13.3 percent, respectively; this makes it the third most prevalent psychiatric disorder after depression and alcohol dependence, and the most common of the anxiety disorders. According to U.S. epidemiological data from the National Institute of Mental Health, social phobia affects 15 million adult Americans in any given year. Estimates vary within 2 percent and 7 percent of the U.S. adult population.
The mean onset of social phobia is 10 to 13 years. Onset after age 25 is rare and is typically preceded by panic disorder or major depression. Social anxiety disorder occurs more often in females than males. The prevalence of social phobia appears to be increasing among white, married, and well-educated individuals. As a group, those with generalized social phobia are less likely to graduate from high school and are more likely to rely on government financial assistance or have poverty-level salaries. Surveys carried out in 2002 show the youth of England, Scotland, and Wales have a prevalence rate of 0.4 percent, 1.8 percent, and 0.6 percent, respectively. In Canada, the prevalence of self-reported social anxiety for Nova Scotians older than 14 years was 4.2 percent in June 2004 with women (4.6 percent) reporting more than men (3.8 percent). In Australia, social phobia is the 8th and 5th leading disease or illness for males and females between 15–24 years of age as of 2003. Because of the difficulty in separating social phobia from poor social skills or shyness, some studies have a large range of prevalence. The table also shows higher prevalence in Sweden.
Blood phobia is often caused by direct or vicarious trauma in childhood or adolescence. Though some have suggested a possible genetic link, a study of twins suggests that social learning and traumatic events, rather than genetics, is of greater significance.
The inclusion of “blood-injury phobia” within the category of specific or simple phobias in classificatory systems reflects a perception that fear has a primary role in the disorder. Consistent with this assumption, blood-injury phobia appears to share a common etiology with other phobias. Kendler, Neale, Kessler, Heath, and Eaves (1992) have argued from data comparing monozygotic with dizygotic twins that the genetic factor common to all phobias (agoraphobia, social phobia, and specific phobias), strongly predisposes a person to specific phobias.
The recognition of an inherited vulnerability common to all phobias is consistent with the notion that elevated trait anxiety predisposes one to anxiety disorders. Trait anxiety provides a background of affective arousal that permits a more rapid activation of the fight or flight response. With respect to specific activating events, conditioning is one way that stimuli become able to elicit anxiety (Rachman, 1991).
Accordingly, painful experiences can condition fear to blood-injury stimuli. Investigators typically classify around 60% of self-reported onsets of blood-injury phobia as beginning with conditioning experiences (Ost, 1991; Ost,
1992; Ost & Hugdahl, 1985; Thyer et al., 1985). However, examinations of available case-by-case verbal summaries call into question the conclusion that conditioning episodes are as prevalent as reported (see Mattick, Page, & Lampe, in press). For example, Thyer et al. (1985) identified a conditioning episode when a “patient received an injection at age 13 and fainted” (p. 455), and in another person when ‘at age six she heard her elementary school teacher give a talk on the circulatory system. This frightened the patient to the
point of syncope” (Thyer et al., 1988.)
In the past, when the prevalence was estimated by sampling the psychiatric clinical cases, social phobia was thought to be a rare disorder. It is now recognized that this way of estimating is inappropriate, because people with social phobia rarely seek psychiatric help by the very nature of their disorder. A more reliable source used now is community surveys.
Various surveys show that the syndrome of glossophobia is the most prevalent type. An article based on a National Comorbidity Survey reported that 1/3 of people with lifetime social phobia suffered from glossophobia Another survey of a community sample from a Canadian city reported that of people who believed being anxious in one or several social situations 55% feared speaking to a large audience, 25% feared speaking to a small group of familiar people, 23% feared dealing with authority, 14.5% feared social gatherings, 14% feared speaking to strangers, 7% feared eating and 5% feared writing in public.
Mental health professionals often distinguish between generalized social phobia and specific social phobia. People with generalized social phobia have great distress in a wide range of social situations. Those with specific social phobia may experience anxiety only in a few situations. The term "specific social phobia" may also refer to specific forms of non-clinical social anxiety.
The most common symptoms of specific social phobia are glossophobia, the fear of public speaking and
the fear of performance, known as stage fright. Other examples of specific social phobia include fears of intimacy or sexual encounters, internet phobia, using public restrooms (paruresis), attending social gatherings, and dealing with authority figures.
Specific social phobia may be classified into performance fears and interaction fears, i.e., fears of acting in a social setting and interacting with other people, respectively. The cause of social phobia is not definite.
Symptoms of social phobia can occur in late adolescence when youths highly value the impressions they give off to their peers. Clinical experience of the prognosis of social phobia shows that it can prolong for many years but that it improves by mid life.