Specific Phobias

Question 1

Most patients with specific phobia have. . .

Answer 1

. . . more than one phobic stimulus

Question 2

Which specific phobia is not like the others?

Answer 2

Phobia of blood/injection/needles

This is the only phobia that involves a vasovagal response rather than a sympathetic response, and often involves fainting.

It is also uniquely 50/50 between male and female individuals, which is unusual among phobias.

Question 3

Treatment for specific phobias

Answer 3

Psychotherapy, specifically CBT with exposure treatment, is the most beneficial treatment.

Pharmacotherapy is not often utilized, but can be if psychotherapy is not an option. Benzodiazepines should not be prescribed regularly, but can be used in certain situations when a phobic stimulus is infrequent can be anticipated/planned around. SSRIs have shown modest benefit if taken regularly, but are nowhere near as effective as psychotherapy.

Question 4

Flooding

Answer 4

Exposure to the phobic stimulus at its maximal intensity while in a controlled environment and utilizing relaxation techniques

One of the forms of exposure therapy

Question 5

Criteria for a diagnosis of specific phobia

Answer 5

• Marked fear or anxiety about a specific object or situation
• Phobic stimulus almost always provokes fear or anxiety
• Phobic stimlus is avoided or endured with fear or anxiety
• Fear or anxiety is out of proportion to actual danger
• Symptoms last more than 6 months
• Symptoms cause significant distress or impairment in social or occupational functioning

Question 6

Imaginal exposure

Answer 6

Having the patient imagine the feared stimulus as vividly as possible

Primarily used to help confront feared thoughts, images, or memories

Question 7

Interoceptive exposure

Answer 7

Designed to induced feared physiological sensations under controlled circumstances

Question 8

In vivo exposure

Answer 8

Involves helping patients to directly confront their feared objects, activities, and situations