Psychological medicine

Specific Phobia

  • Persistent and irrational fear and avoidance of a specific object or situation
  • Leads to avoidance or intense anxiety on exposure to feared stimulus
  • Fear recognised as excessive
  • Disruptive to functioning (important – who cares about a snake phobia in NZ)
  • Can also be anxious about fear reaction
  • Usually related to animals (mice, snakes, spiders), natural environment (earthquakes), blood, injection or injury; specific situations (eg claustrophobia)

· Develop due to:

  • Direct conditioning through personal experience
  • Verbal or vicarious transmission (eg develop shark phobia after watching Jaws)

· Treatment:

  • Graded exposure
  • Cognitive restructuring
  • Physiological control: relaxation and medication (short-term only)

Social Phobia

  • Fear of negative evaluation of performance in social situations. Fear they will do or say something embarrassing or humiliating. Fear visible anxiety symptoms
  • Probability and cost of negative evaluation is over-estimated
  • Early onset
  • Leads to avoidance of social gatherings, public travel, etc
  • Epidemiology: 6 month prevalence is 2 per 100, more females, onset in teens through to 35 ® social isolation
  • Aetiology: ?conditioned response, genetics