Fast Five Quiz: Common Phobias

Stephen Soreff, MD

Disclosures

October 20, 2020

All DSM-5 criteria for phobic disorders require that fear, anxiety, or avoidance causes clinically significant distress or impairment that is out of proportion to the actual danger posed. They also require excluding that the fears, anxiety, or avoidance can be directly attributed to a substance, other mental disorder, or other medical condition.

The specific DSM-5 criteria for social anxiety disorder (social phobia) are:

  • Marked fear or anxiety about one or more social situations in which the individual might be scrutinized by others, such as social interactions (eg, having a conversation or meeting unfamiliar people), being observed (eg, eating or drinking), and performing in front of others (eg, giving a speech); in children, the anxiety may occur in peer settings and not just during interactions with adults

  • The individual fears acting in a way or showing anxiety symptoms that will be negatively evaluated (eg, will be humiliating or embarrassing, will lead to rejection, or will offend others)

  • The social situation almost always provokes immediate fear or anxiety; in children, anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations

  • The social situations are actively avoided or endured with intense fear or anxiety

  • The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context

  • The fear, anxiety, or avoidance persists, typically for 6 months or longer

The specific DSM-5 criteria for specific phobia are:

  • Marked fear or anxiety about a specific object or situation (eg, flying, heights, animals, receiving an injection, or seeing blood); in children, this fear or anxiety may be expressed by crying, tantrums, freezing, or clinging

  • The phobic object or situation almost always provokes immediate fear or anxiety

  • The phobic object or situation is actively avoided or endured with intense fear or anxiety

  • The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context

  • The fear, anxiety, or avoidance persists, typically for 6 months or longer

The specific DSM-5 criteria for agoraphobia are:

  • Marked fear or anxiety about at least two of the following five situations: (1) using public transportation, (2) being in open spaces, (3) being in enclosed spaces, (4) standing in line or being in a crowd, and (5) being outside the home alone

  • The individual avoids these situations because of thoughts that escape might be difficult or help unavailable if panic-like symptoms or other embarrassing symptoms (eg, fear of falling in older adults or fear of incontinence) should develop

  • The agoraphobic situations almost always provoke immediate fear or anxiety

  • The agoraphobic situations are actively avoided, necessitate the presence of a companion, or are endured with intense fear or anxiety

  • The fear or anxiety is out of proportion to the actual threat posed by the agoraphobic situation and to the sociocultural context

  • The fear, anxiety, or avoidance persists, typically for 6 months or longer

Although agoraphobia may be associated with panic disorder, it is diagnosed irrespective of the presence of panic disorder. Thus, an individual may just have agoraphobia without experiencing moments of panic. In cases where the presentation meets the criteria for both panic disorder and agoraphobia, both diagnoses should be applied.

Read more about the presentation of phobic disorders.

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