Materiały źródłowe

• #1 Specific Phobia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499923/

  Specific phobia is a common anxiety disorder. Patients with specific phobias experience anxiety and panic attacks along with unreasonable fear of exposure or anticipated exposure to a phobic stimulus. […] The intensity of the fear is often disproportionate to the actual danger posed by the phobic stimulus. […] Advancements in neuroscience and the role of the amygdala in fear processing contribute to the contemporary understanding of specific phobias. […] The amygdala is classically associated with provoking a fear response when stimulated. The amygdala and other fear-related neurocircuitry may share a similar neuroanatomy to anxiety neurocircuitry. […] The activation of fear neurocircuitry, with presumed anxiety neurocircuitry overlap, involves the release of various neurochemicals that lead to sympathetic stimulation. […] Low activity of postsynaptic serotonin 5-HT1A receptors contributes to pathological anxiety, which has led to the development of pharmacotherapy attempting to modulate these receptors to reduce anxiety.

• #2 Specific phobia in adults: Epidemiology, clinical manifestations, course, and diagnosis – UpToDate

  https://www.uptodate.com/contents/specific-phobia-in-adults-epidemiology-clinical-manifestations-course-and-diagnosis/print

  Specific phobia is an anxiety disorder characterized by clinically significant fear of a particular object or situation that typically leads to avoidance behavior. Phobic fears include animals, insects, heights, water, enclosed places, driving, flying, seeing blood, getting an injection, and choking or vomiting. […] The phobic anxiety may be triggered by anticipation of the stimulus, actual exposure to the stimulus, and even hearing the stimulus name spoken aloud (eg, hearing the word spider for an individual with spider phobia). The focus of fear may include disgust, danger of harm, and/or the experience of physical symptoms in the phobic situation. […] This topic describes the epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of specific phobia in adults.

• #3 Specific phobia – Wikipedia

  https://en.wikipedia.org/wiki/Specific_phobia

  Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. […] The exact cause of specific phobias is not known. The mechanisms for development of specific phobias can be distinguished between innate (genetic and neurobiological) factors, and learned factors. […] In neurobiology, one explanation proposed for specific phobia is that the typical activation of the amygdala in response to stimuli may be exaggerated due to pathological changes. According to this theory, a deficiency in amygdala habituation may also contribute to the persistence of non-experiential phobia. […] Certain phobias that are less lethal (e.g. dogs) seem to be more frequently observed and easily acquired in comparison to potentially lethal fears which are more relevant to developed human society (e.g. cars and guns). […] The classical conditioning model of learning has also been used to suggest that a phobia will be learned when an event that causes a fear or anxiety reaction is paired with a neutral event. […] An alternative proposed mechanism of association is through observational learning.

• #4 Phobia – Wikipedia

  https://en.wikipedia.org/wiki/Phobia

  Specific phobias may be caused by a negative experience with the object or situation in early childhood to early adulthood. […] There are multiple theories about how phobias develop and likely occur due to a combination of environmental and genetic factors. […] Rachman proposed three pathways for the development of phobias: direct or classical conditioning (exposure to phobic stimulus), vicarious acquisition (seeing others experience phobic stimulus), and informational/instructional acquisition (learning about phobic stimulus from others). […] Much of the progress in understanding the acquisition of fear responses in phobias can be attributed to classical conditioning (Pavlovian model). […] The amygdala’s ability to respond to fearful stimuli occurs through fear conditioning. […] The amygdala is responsible for recognizing certain stimuli or cues as dangerous and plays a role in the storage of threatening stimuli to memory. […] Damage to the cortical areas involved in the limbic system, such as the cingulate cortex or frontal lobes, has resulted in extreme emotion changes. […] The amygdala’s role in learned fear includes interactions with other brain regions in the neural circuit of fear.

• #5 Pulsenotes | Specific phobia

  https://app.pulsenotes.com/specialities/psychiatry/notes/specific-phobia

  Specific phobias usually begin in childhood and can persist throughout an individuals life. […] The aetiology of most anxiety disorders is thought to be a complex interaction between environmental factors, genetic factors, and psychological traits of an individual. […] Phobias may be learned from having observed a parent or caregiver react with disproportionate and irrational fear to the phobic object. The individual may have had a previous direct negative experience with the phobic object that led to the development of excessive fear.

• #6 Specific Phobia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/29262

  Specific phobia is an anxiety disorder characterized by excessive and irrational fear of a particular object, situation, or activity. The intensity of the fear is often disproportionate to the actual danger posed by the phobic stimulus. […] Advances in neuroscience and research have contributed to a better understanding of the neural mechanisms underlying specific phobias, including insights into the role of the amygdala, a brain region involved in processing fear. […] The activation of fear neurocircuitry, with presumed anxiety neurocircuitry overlap, involves the release of various neurochemicals that lead to sympathetic stimulation. Classically characterized as a „fight-or-flight” reaction, this sympathetic response evolved to be adaptive and for a prompt behavioral response to avoid actual or perceived danger.

• #7 Specific Phobia: Diagnosis and Treatment

  https://crownviewpsych.com/blog/specific-phobia-treatment/

  Anxiety disorders are the most common mental illnesses in the United States, including a category of anxiety called specific phobias. […] Somewhat surprisingly, the under-researched category includes the most common of all the anxiety disorders: specific phobias. […] The good news about specific phobia is that it’s a treatable condition. The even better news is that recent research efforts and more effective neuroimaging techniques have improved our understanding of this common yet complex mental health concern. […] Garcia reported studies involving animals and neuroimaging tests on humans support the involvement of the amygdala in the development of fear and specific phobia. He also discusses research documenting a possible link between abnormal production and functioning of neurotransmitters such as γ-aminobutyric acid (GABA), serotonin, dopamine, and norepinephrine with specific phobia.

• #8 Neurobiology of fear and specific phobias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5580526/

  Fear processing can lead to psychiatric disorders in which fear outweighs the danger or possibility of harm. […] The neurobiological basis of normal and pathological fear reactions is reviewed in this article. Innate and learned fear mechanisms, particularly those involving the amygdala, are considered. […] Poor habituation and poor extinction are presented as dysfunctional mechanisms contributing to persistence of nonexperiential and experiential phobias, respectively. […] Nonexperiential or nonassociative specific phobia is caused and activated by stimuli that arouse fear without previous direct or indirect associative learning. […] In nonexperiential phobia, it is suggested to be supported by dysfunction in learning-independent fear circuits (i.e., circuits that include the amygdala and drive defensive behavior without prior learning).

• #9 Phobic Disorders: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/288016-overview

  Several biologic theories are postulated for the pathogenesis of phobic disorders, most focusing on the dysregulation of endogenous biogenic amines. Sympathetic nervous system activation is common in phobic disorders, resulting in elevations in heart rate and blood pressure, as well as symptoms such as tremor, palpitations, sweating, dyspnea, dizziness, and paresthesias. […] Genetic factors seem to play a role in both social anxiety disorder (social phobia) and specific phobia. On the basis of family and twin studies, the risks for specific phobia and social anxiety disorder appear to be moderately heritable. […] Preliminary neuroimaging evidence indicates that while different patterns of brain activation might be associated with the different phobias, there is an overall increased activation in the prefrontal and orbitofrontal cortex, anterior cingulate cortex, insula, and amygdala in phobic patients exposed to phobia-related triggers compared with healthy controls.

• #10 SciELO Brasil – Neuroimaging in specific phobia disorder: a systematic review of the literature Neuroimaging in specific phobia disorder: a systematic review of the literature

  https://www.scielo.br/j/rbp/a/LsPBjFcQHHdQ6tC3B3C5cYK/?lang=en

  Specific phobia (SP) is characterized by irrational fear associated with avoidance of specific stimuli. […] The neuroimaging techniques, in particular, have helped to deepen the understanding of the neural circuitry underlying SP. […] The search showed that studies in this area were published recently and that the neuroanatomic substrate of SP has not yet been consolidated. […] In spite of methodological differences among studies, results converge to a greater activation in the insula, anterior cingulate cortex, amygdala, and prefrontal and orbitofrontal cortex of patients exposed to phobia-related situations compared to controls. These findings support the hypotheses of the hyperactivation of a neuroanatomic structural network involved in SP. […] Although a central role in the pathophysiology of SP has been attributed to the amygdala, some studies have investigated the relationship among other brain regions in SP.

• #11 SciELO Brasil – Neuroimaging in specific phobia disorder: a systematic review of the literature Neuroimaging in specific phobia disorder: a systematic review of the literature

  https://www.scielo.br/j/rbp/a/LsPBjFcQHHdQ6tC3B3C5cYK/?lang=en

  The increased activation in the anterior insula observed in SP studies is consistent with the role attributed to the structure, which may be related to the representation of internal bodily states. […] The different techniques used in neuroimaging studies showed consistent results regarding the role of the amygdala, insula, cingulate cortex, prefrontal and orbitofrontal cortices, thus, reinforcing the hypothesis that there is a specific brain circuit, consisting of cortical and limbic areas, that is involved in the disorder due to a dysfunction.

• #12 Specific Phobia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/29262

  However, this response can be conditioned to over-activate, leading to pathological anxiety even when exposure to threat is low or should be low. […] The neurochemicals involved in producing a fight-or-flight response are numerous and include norepinephrine, epinephrine, cortisol, neurosteroids, and vasopressin. […] Low activity of postsynaptic serotonin 5-HT1A receptors contributes to pathological anxiety, which has led to the development of pharmacotherapy attempting to modulate these receptors to reduce anxiety.

• #13 Specific Phobias | Concise Medical Knowledge

  https://www.lecturio.com/concepts/specific-phobias/

  Genetics Genetics Genetics is the study of genes and their functions and behaviors. Basic Terms of Genetics: 1st-degree relatives of individuals with specific phobias Phobias Neurological Examination have an increased risk (up to 31%) of having the disorder, but with a different stimulus. […] Twin studies point to a stronger influence of environmental factors than genetic factors. […] Neurobiologic: Hyperactivation of the amygdala Amygdala Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the temporal lobe. The amygdala is part of the limbic system. Limbic System: Anatomy and insula (structures involved in negative emotional responses) has been associated with phobic disorders. […] Environmental factors: Traumatic events, the associated stress, prior and subsequent exposure to a stimulus, and the support obtained affect specific phobias Phobias Neurological Examination.

• #14 Causes of Phobias

  https://cogbtherapy.com/causes-of-phobias

  There is no one cause of phobias, also known as specific phobias. For some people with specific phobia, an apparent environmental cause or life event causes or triggers fear or anxiety, eventually resulting in a phobia. For others, there seems to be a stronger genetic predisposition to a phobic response. However, biology and environment likely come together to play a role in developing a phobia. […] Phobias are not only the result of past trauma. In reality, most people with phobias are not able to identify a causal trauma that provided the spark for the phobia. There is some evidence that phobias, to a large degree, are hardwired in our genes. […] In addition to evolutionary theory, other evidence supports the idea that genes and biology play a role in the risk of developing a phobia. Twin studies are very helpful in determining how much genetic factors influence a disorder or illness. Because identical twins share the same genes, we know that if one has a genetic disorder, the other will likely share the disorder. This has proven to be the case with phobias. Three in four sets of twins in which one has a phobia, both twins have the phobia. The most current research suggests that almost 50% of the development of phobia can be attributed to genetic loading. This explains why phobias tend to run in families.

• #15 Specific Phobia | Psychology Today

  https://www.psychologytoday.com/us/conditions/specific-phobia

  Evidence for a genetic basis for phobias exists, however, but presents more often as neuroticism or anxiousness, rather than as a specific phobia, according to research. It is also possible that phobias are inherited, but not through genes. Family attitudes and fears can be taught through the generations. […] Women are twice as likely to have specific phobias, compared to men, according to the DSM-5. Research shows that women are more likely than men to have animal phobias, situational phobias, and environmental phobias, while women and men have about the same rate of blood-injection phobias. […] The role human evolution plays in causing specific phobias is a topic of debate in the academic world. While many phobias concern organisms that could kill us, such as snakes, spiders, and heights, other phobias do not fit this bill. Phobias of lions, which could have killed paleolithic humans are rare, while phobias of slugs, which present much less evolutionary pressure, are more common. Arachnophobia is one of the most common phobias, but only 0.1 percent of spiders are dangerous. Other phobias, like those of flying or driving, simply didn’t exist in the minds of our evolutionary forebears. Some call the desire to explain modern phenomena through evolution the adaptive fallacy.

• #16 Phobic Disorders: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/288016-overview

  Psychological theories range from explaining anxiety as a displacement of an intrapsychic conflict (psychodynamic models) to conditioning (learned) paradigms (cognitive-behavior models). Many of these theories capture portions of the disorder. […] A behaviorist would see phobia as a learned, conditioned response resulting from a past association with a situation that had negative emotional valence at the time of association (eg, social situations are avoided because intense anxiety was originally experienced in that setting). Even if no danger is posed in most social encounters, an avoidance response has been linked to these situations. Treatment from this perspective aims to weaken and eventually separate the specific response from the stimulus. […] A psychoanalyst would likely conceptualize social anxiety as a symptom of a deeper conflictfor instance, low self-esteem or unresolved conflicts with internal objects. The treatment uses exploration with the goal of understanding the underlying conflict.

• #17 Specific Phobias | Concise Medical Knowledge

  https://www.lecturio.com/concepts/specific-phobias/

  Processes that lead to fear development: Direct conditioning: being hurt or frightened or having the feeling of helplessness leads to anxiety Anxiety Feelings or emotions of dread, apprehension, and impending disaster but not disabling as with anxiety disorders. Generalized Anxiety Disorder toward the situation/subject. […] Vicarious acquisition: observing someone with the fearful or anxious behavior. […] Informational transmission: obtaining information from others or through media (e.g., shark attacks, plane crashes).

• #18 Phobias: Specific Phobias Types and Symptoms

  https://www.webmd.com/anxiety-panic/specific-phobias

  The exact cause of specific phobias is not known, but most appear to be associated with a traumatic experience or a learned reaction. For example, a person who has a frightening or threatening experience with an animal, such as an attack or being bitten, can develop a specific phobia. Witnessing a traumatic event in which others experience harm or extreme fear can also cause a specific phobia, as can receiving information or repeated warnings about potentially dangerous situations or animals. […] Fear can be learned from others, as well. A child whose parents react with fear and anxiety to certain objects or situations is likely to also respond to those objects with fear.

• #19 What Are Phobias? – Family Psychiatry & Therapy

  https://familypsychnj.com/2019/08/what-are-phobias/

  The fear response becomes especially problematic when it becomes dysfunctional. Dysfunctional fear responses are the reason for a variety of psychiatric disorders, including phobias. […] Experiential-specific phobias are those that are derived from a negative experience with the stimulus. This type of phobia is further developed by fear conditioning. This is a phenomenon where fear is essentially learned through incorrectly associating neutral cues with the negative experience. […] Non-Experiential-specific phobias, also known as nonassociative specific phobias, are derived from a stimulus that causes fear without a direct experience or event. This type of phobia is usually the result of genetic, familial, environmental, or developmental factors. […] Furthermore, individuals with non-experiential-specific phobias generally have a deficiency in the part of the brain that regulates habituation. Habituation is the process of dispelling fear through repeated reduced emotional reactions.

• #20 Neurobiology of fear and specific phobias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5580526/

  A deficiency in this mechanism (i.e., amygdala habituation) may therefore contribute to the persistence of nonexperiential phobia. […] Behavioral abnormalities relative to experiential-specific phobia may therefore be supported by dysfunctions in these learning-dependent fear circuits and mechanisms. […] One possible dysfunction is deficiency in extinction (i.e., a failure to acquire a reduction of conditioned response through repeated presentations of a conditioned stimulus), explaining maintenance of experiential-specific phobia. […] Sensitization-associated increased amygdala activity is a key amygdala mechanism contributing to fear sensitization in nonexperiential phobia. […] This dysfunction may be part of mechanisms that provoke persistent fear in nonexperiential phobia. […] Poor habituation and poor extinction support, at least in part, fear dysfunction in phobia.

• #21 What Are Phobias? – Family Psychiatry & Therapy

  https://familypsychnj.com/2019/08/what-are-phobias/

  Nevertheless, both types of phobias indicate different ways the fear response can become dysfunctional. In the case of experiential-specific phobias, it is a specific event or experience which incorrectly interrupts and corrupts the fear response, while in non-experimental-specific phobias it is likely a deficiency in the habituation mechanism. […] Although these are just theories and modern science is still evaluating just how fear works within the body and how phobias and fear are related.

• #22 Specific Phobia (300.29) | Abnormal Psychology

  https://courses.lumenlearning.com/atd-herkimer-abnormalpsych/chapter/specific-phobia-300-29/

  There are two possible frameworks to view the development of SP: associative and nonassociative. The associative model of SP developed from animal models of fear, with some of the earliest work being done by John B. Watson using only classical conditioning (the famous or infamous Little Albert studies). […] Evolutionary preparedness is a nonassociative theory that we as a species may be genetically primed to fear certain stimuli, thanks to our evolutionary history. This would include commonly phobic objects such as snakes and reptiles, spiders, the dark, heights, and closed spaces. The theory is that, due to the inherent dangerousness of such things throughout the history of our species, those individuals with a natural tendency to avoid such things were more likely to survive and reproduce, passing on the genes related to such a behavioral expression. […] As such, the reality seems to be that it is not whether a given fear is associative or nonassociative, but instead how much learning is needed to evoke that particular fear.

• #23 Specific Phobia | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/specific-phobias/

  Many theories suggest that phobias develop through learning. Rachman (1977) proposed that phobias can be acquired through three major learning pathways. The first pathway is through classical conditioning. […] Interestingly, people are more likely to develop phobias of things that do not represent much actual danger to themselves, such as animals and heights, and are less likely to develop phobias toward things that present legitimate danger in contemporary society, such as motorcycles and weapons (hman Mineka, 2001). […] This theory argues that throughout our evolutionary history, our ancestors associated certain stimuli (e.g., snakes, spiders, heights, and thunder) with potential danger. As time progressed, the mind has become adapted to more readily develop fears of these things than of others. Experimental evidence has consistently demonstrated that conditioned fears develop more readily to fear-relevant stimuli (images of snakes and spiders) than to fear-irrelevant stimuli (images of flowers and berries) (hman Mineka, 2001).

• #24 Key factors behind various specific phobia subtypes | Scientific Reports

  https://www.nature.com/articles/s41598-023-49691-0

  While it has been suggested that more than a quarter of the whole population is at risk of developing some form of specific phobia (SP) during their lives, we still know little about the various risk and protective factors and underlying mechanisms. […] Our results show that the SPQ is a reliable screening tool. More importantly, we identified transdiagnostic (e.g., younger age, female gender, rumination, catastrophizing, positive refocusing) as well as phobia-specific factors that may contribute to the development and maintenance of SPs. […] Even in the absence of a proportional danger, phobias then manifest as extreme fear, and can be triggered even by the thought of the feared object. […] The possibility and likelihood of direct engagement with potential threats (e.g., spiders, snakes, storms, etc.) may affect the prevalence of SPs.

• #25 Key factors behind various specific phobia subtypes | Scientific Reports

  https://www.nature.com/articles/s41598-023-49691-0

  The factors that increase the likelihood of reaching an excessive level of fear, and potentially the development of phobia, might vary across SP subtypes. […] Consequently, there are overlaps but also unique characteristics of each SP in terms of the connected risk factors. […] These results together underscore that there might be differences in the socio-demographic, cognitive emotion regulatory, and personality factors behind various SPs. […] Mapping the underlying transdiagnostic and unique factors for each SP can be crucial for an effective intervention therapy and may also increase the efficiency of prevention to deal with SPs. […] Our results have shown that the questionnaire has sound psychometric properties and can be used in a different culture than it was developed. […] Our result suggests that positive refocusing, a putatively adaptive ER strategy also augments fears.

• #26 Phobias: What They Are, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/24757-phobias

  Women are twice as likely to have specific phobia than men. […] Diagnosing specific phobia or agoraphobia requires that your symptoms meet certain criteria. […] The fear or anxiety you experience is much more severe than the trigger should cause. […] Treating phobias can involve mental health therapy, medications, or a combination of the two. […] Cognitive behavioral therapy (CBT) is a common type of therapy that helps with this. […] Exposure therapy can happen in two ways: in vivo and imaginal. […] In some cases, certain medications can also help you with phobia symptoms.

• #26 Phobias: What They Are, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/24757-phobias

  Phobias are a type of anxiety disorder, and there’s one diagnosis for almost all of them: specific phobia. […] Phobias are when your brain takes fear and anxiety to extreme degrees. Under ordinary circumstances, these emotions can be protective and helpful. […] However, several factors and processes may contribute to having a phobia. These include traumatic experiences, genetics, informational transmission, and learned fears. […] People with specific phobia and agoraphobia have a higher risk of certain mental health conditions. […] Mental health conditions that are more likely in people with specific phobia or agoraphobia include anxiety disorders, bipolar disorder, depressive disorders, personality disorders, substance use disorders, and somatic symptom disorders. […] The rates for specific phobia can vary by age.

• #27 Specific Phobia DSM-5 Diagnostic Criteria

  https://www.verywellmind.com/diagnosing-a-specific-phobia-2671981

  A specific phobia is an intense and irrational fear of a specified object or situation. […] There are a number of different factors that can contribute to the development of specific phobias. These include: […] Research suggests that people who exhibit more behavioral inhibition have a higher risk for a variety of anxiety disorders, including specific phobias. […] People who have a family member with an anxiety disorder or phobia are more likely to also develop some type of phobia. […] Stressful or traumatic experiences can also play a role in the formation of a phobia. A single incidence of being bitten by a dog, for example, can play a role in the development of a fear of dogs. […] The DSM-5 states that people with specific disorders also have an elevated risk for suicide. These phobias also tend to commonly occur alongside other mental health conditions including panic disorder, post-traumatic stress disorder (PTSD), and substance use disorder.

• #28 The role of self-efficacy in specific fears | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283660

  However, the exact relationship between GSE and/or SSE and different specific fears and phobia subtypes has not been investigated so far. […] Our results indicate that SSE strongly contributes to fear and avoidance related to different fear categories. […] In support of the self-efficacy concept of anxiety, we showed that perceived inefficacy to cope with threatening situations might represent an etiological factor which contributes to the development and maintenance of specific fears and phobias. […] SSE seems to be especially relevant for certain types of fears, e.g. BII-related fears which are characterized by a decreased control over bodily reactions and/or belief of being unable to exert control over strong physiological reactions. […] Our findings can help to understand and enhance psychological treatments based on learning and the promotion of self-efficacy in the context of phobias and anxiety disorders.

• #29 Key factors behind various specific phobia subtypes | Scientific Reports

  https://www.nature.com/articles/s41598-023-49691-0

  We also wanted to investigate the unique pattern of risk factors associated with SPs, as there is great variability in prevalence, stimulus element triggering fear, the likelihood of impairment, comorbidity, and personality problems, cognitive ER strategies and brain activation pattern of SP subtypes. […] The unique predictor we found for BII phobia was marijuana consumption, and it was a protective factor.

• #30 Specific Phobia | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/specific-phobias/

  Phobia is a Greek word that means fear. A person diagnosed with a specific phobia (formerly known as simple phobia) experiences excessive, distressing, and persistent fear or anxiety about a specific object or situation (such as animals, enclosed spaces, elevators, or flying) (APA, 2013). […] Most phobic reactions cause a surge of activity in the sympathetic nervous system, increased heart rate, and blood pressure, and possibly a panic attack. However, people with blood-injury-injection (BII) type phobias usually experience a marked drop in heart rate and blood pressure and may even faint. In this way, those with blood-injury-injection (BII) phobias almost always differ in their physiological reaction from people with other types of phobia (Barlow Liebowitz, 1995; Craske, Antony, Barlow, 2006; Hofmann, Alpers, Pauli, 2009; Ost, 1992).

• #31 Associations of specific phobia and its subtypes with physical diseases: an adult community study | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0863-0

  Specific phobia is the most prevalent anxiety disorder in the community and is associated with substantial impairment. […] Comorbidity with physical diseases is assumed and has important implications for etiology, treatment, or prevention of the comorbid conditions. […] Specific phobia was associated with cardiac diseases, gastrointestinal diseases, respiratory diseases, arthritic conditions, migraine, and thyroid diseases (odds ratios between 1.49 and 2.53). […] Our analyses show that subjects with specific phobia have an increased probability for specific physical diseases. From these analyses etiological mechanisms of specific phobia and physical disease can be deduced. […] As subtypes differed in their patterns of associations with physical diseases, different etiological mechanisms may play a role.

• #32 Associations of specific phobia and its subtypes with physical diseases: an adult community study | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0863-0

  Knowledge of the comorbidity of specific phobia and physical diseases could influence research on the etiology of both physical diseases and specific phobia through the detection of possible etiological mechanisms. […] It has been suggested that certain pathophysiological mechanisms related to affective and anxiety disorders, such as sympathoadrenal hyperactivity, reduced heart-rate variability, heightened platelet activity, and endothelial dysfunction, may be of interest in the etiology of heart diseases, too. […] Additionally, it has been suggested that anxiety could lead to an irritation of the gastrointestinal system, leading to a gastrointestinal disease. […] The different patterns of associations between the subtypes and physical diseases may point toward different etiological mechanisms that need to be addressed in future studies.

• #33 Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveys | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1328-3

  Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. […] Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention. […] Importantly, persons with SP may have only a single fear, or they may have many (e.g., of spiders, storms, blood, and heights). Some evidence suggests that persons with multiple fears have a greater risk of comorbidity and impairment, suggesting that generalized SP may be a marker of particularly high internalizing vulnerability.

• #34 Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveys | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1328-3

  Childhood SP was strongly associated with prevalence, persistence, and severity of other internalizing disorders as well as with an early age of onset of these disorders. It was also associated with increased number of days out of role and SMI, as well as with suicidality. […] Respondents with 4+ subtypes also reported significantly more disability than those without childhood SP or with only 1 subtype and a much higher rate of lifetime suicide attempts than those without childhood SP or with only 1 subtype. […] The present study is a practical application of suggestions made in the Hierarchical Taxonomy Of Psychopathology (HiTOP) initiative, which aims to develop an empirically driven nosology of psychopathology. […] Our results suggest that childhood SP, particularly when generalized, is strongly associated with poor long-term outcomes in the internalizing domain.

• #35

  https://www.ijbcp.com/index.php/ijbcp/article/view/305

  Specific phobias are among the most common psychological problems both in men and women. […] Glucocorticoids and d-cycloserine (DCS) cause fear reduction when used in combination with exposure based therapy. Being a non-anxiolytic DCS accelerates fear reduction during exposure by facilitating memory consolidation during post-treatment phase. […] Adjuvant cortisol to exposure therapy also caused great reduction in fear in spider phobia. […] Quervian DJ, Aerni A, Shelling G. Glucocorticoids and the regulation of memory in health and disease. Frontiers Neuroendocrinol . 2009;30:358-70. […] Quervian DJ, Jurgen M. Glucocorticoids for the treatment of post-traumatic stress disorder and phobias: A novel therapeutic approach. European Journal of Pharmacology. 2008;583:365-71.

• #36 Specific Phobia: Diagnosis and Treatment

  https://crownviewpsych.com/blog/specific-phobia-treatment/

  This combination of experiential and internal factors is similar to what occurs when someone develops posttraumatic stress disorder (PTSD). Living through one or more traumatic events is a necessary precursor to developing PTSD – but many people who have a history of trauma never develop this disorder. […] Treatment options for specific phobia include prescription medication and therapy. Continued research into the neurobiology of this condition, other risk factors, and common co-occurring disorders will hopefully lead to improvements in both these elements of care. […] Previous research shows selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) – which are typically used to treat depression – are effective at reducing symptoms of specific phobia. In addition, the medication tiagabine, an anticonvulsant that precludes the reuptake of GABA, can be helpful. […] Determining which medications and therapies are right for you – or for someone in your life with specific phobia – is an individualized choice that requires input from the patient and the provider.

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