Psych · General adult psychiatry — anxiety disorders
Specific phobia
Also known as Simple phobia (historical) · Phobic disorder — specific · Animal phobia · Blood-injection-injury phobia · Situational phobia · One-session treatment / Öst OST
Exam-exhaustive fellowship reference on specific phobia — DSM-5-TR and ICD-11 criteria; five type specifiers; epidemiology; fear acquisition and maintenance; blood-injection-injury physiology and applied tension; in vivo exposure and one-session treatment; limited pharmacotherapy role; differentials from SAD, panic/agoraphobia, OCD and PTSD; NICE/Canadian/WFSBP/ANZ stepped care. FRANZCP-primary, globally tagged.
Practise this topic
On this page
Study tools
Your progress
Saved on this device.
Target exams
Red flags
- Healthcare or dental avoidance with untreated medical disease, missed screening, or delayed procedures — treat as functional emergency, not trivial 'needle fear'
- Vasovagal syncope during blood draws or injury cues — teach applied tension, safe positioning, and medical support; do not use pure relaxation as the BII plan
- First late-life or abrupt 'phobia' with neurological, cardiac, vestibular or substance clues — exclude organic causes before a pure specific-phobia label
- New or worsening suicidal ideation with comorbid depression — same-day risk review; do not dismiss as 'just a phobia'
- Chronic benzodiazepines as the only 'treatment' blocking extinction learning and risking dependence
- Mislabeling agoraphobia or social anxiety as a single situational or performance phobia
Meet the patient
A 34-year-old executive has routed every deal through video calls for a decade to dodge flying — and the promotion now demands a Sydney to London nonstop. Or a 28-year-old who faints at every blood draw, just told she needs fortnightly anticoagulant monitoring. Or the eight-year-old who screams at the dentist, now sitting in your clinic with a swollen face from an abscessed molar.[2][4][17]
Three patients, one syndrome, one question that pays at every exam: "What is first-line, and why is it not an SSRI?" Specific phobia is the cleanest "exposure first, drugs limited" teaching example in the anxiety chapter — and the one juniors most often medicate by reflex.[4][11]
References18ShowHide
- [1]LeBeau RT, Glenn D, Liao B, Wittchen HU, et al. Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V Depress Anxiety, 2010.PMID 20099272
- [2]Wardenaar KJ, Lim CCW, Al-Hamzawi AO, Alonso J, et al. The cross-national epidemiology of specific phobia in the World Mental Health Surveys Psychol Med, 2017.PMID 28222820
- [3]Craske MG, Stein MB Anxiety Lancet, 2016.PMID 27349358
- [4]Choy Y, Fyer AJ, Lipsitz JD Treatment of specific phobia in adults Clin Psychol Rev, 2007.PMID 17112646
- [5]Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ Psychological approaches in the treatment of specific phobias: a meta-analysis Clin Psychol Rev, 2008.PMID 18410984
- [6]Ost LG One-session treatment for specific phobias Behav Res Ther, 1989.PMID 2914000
- [7]Zlomke K, Davis TE 3rd One-session treatment of specific phobias: a detailed description and review of treatment efficacy Behav Ther, 2008.PMID 18721635
- [8]Ollendick TH, Ost LG, Reuterskiöld L, Costa N, et al. One-session treatment of specific phobias in youth: a randomized clinical trial in the United States and Sweden J Consult Clin Psychol, 2009.PMID 19485591
- [9]Ost LG, Fellenius J, Sterner U Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia Behav Res Ther, 1991.PMID 1684704
- [10]Ost LG, Sterner U, Fellenius J Applied tension, applied relaxation, and the combination in the treatment of blood phobia Behav Res Ther, 1989.PMID 2564772
- [11]Katzman MA, Bleau P, Blier P, Chokka P, et al. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders BMC Psychiatry, 2014.PMID 25081580
- [12]Bandelow B, Allgulander C, Baldwin DS, Costa DLDC, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part I: Anxiety disorders World J Biol Psychiatry, 2023.PMID 35900161
- [13]van Dis EAM, van Veen SC, Hagenaars MA, Batelaan NM, et al. Long-term Outcomes of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Systematic Review and Meta-analysis JAMA Psychiatry, 2020.PMID 31758858
- [14]Thng CEW, Lim-Ashworth NSJ, Poh BZQ, Lim CG Recent developments in the intervention of specific phobia among adults: a rapid review F1000Res, 2020.PMID 32226611
- [15]Choy Y, Fyer AJ, Goodwin RD Specific phobia and comorbid depression: a closer look at the National Comorbidity Survey data Compr Psychiatry, 2007.PMID 17292703
- [16]Depla MF, ten Have ML, van Balkom AJ, de Graaf R Specific fears and phobias in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) Soc Psychiatry Psychiatr Epidemiol, 2008.PMID 18060338
- [17]Oosterink FM, de Jongh A, Hoogstraten J Prevalence of dental fear and phobia relative to other fear and phobia subtypes Eur J Oral Sci, 2009.PMID 19320722
- [18]Davis TE 3rd, Ollendick TH, Öst LG One-Session Treatment of Specific Phobias in Children: Recent Developments and a Systematic Review Annu Rev Clin Psychol, 2019.PMID 30550722