300 Specific Phobia (300.29)
DSM-IV-TR Criteria
- A. Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., heights, blood, injections, animals). Specific anxiety and fear elicited by an object or situation and resulting in avoidance behaviors.
- B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed panic attack. Children can show affects and characteristics when it comes to specific phobias. Children can show anxiety by crying, throwing tantrums, experiencing freezing or clinging to the parent that they have the most connection to.
- C. The person recognizes that the fear is excessive or unreasonable. NOTE: In children, this feature may be absent.
- D. The phobic situation(s) is(are) avoided, or else endured with intense anxiety or distress.
- E. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, social activities or relationships, or there is marked distress about having the phobia.
- F. In individuals under age 18 years, the duration is at least 6 months.
- G. The phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder, such as obsessive-compulsive disorder (e.g., fear of dirt on someone with an obsession about contamination), post-traumatic stress disorder (e.g., avoidance of stimuli associated with a severe stressor), separation anxiety disorder (e.g., avoidance of school), social phobia (e.g., avoidance of social situations because of fear of embarrassment), panic disorder with agoraphobia, or panic disorder without agoraphobia.
The DSM-IV-TR categorizes five general types of SP:
- Animal Type: These include fears of animals such as dogs, snakes, cats, bears, etc.
- Natural Environment Type: These include fears of heights, storms, and being near a water source such as a river or lake.
- Blood-Injection-Injury (B-I-I) Type: These include fears of seeing blood; receiving a blood test or injection; for the more serious types of this phobia, seeing an injection on television or talking about the act.
- Situational Type: These include fears of situations such as driving, flying, elevators, and enclosed places.
- Other Type: These include other specific fears, including fear of choking or vomiting after eating certain foods, fear of balloons breaking or guns going off, fear of clowns or midgets.
There is controversy over these divisions, however. Some research has shown that SP instead may be better divided into three primary clusters of animal, B-I-I, and a combined situational/natural environment type, while other analyses have found only two clusters: B-I-I and all others. Still other researchers contend that dividing the categories based on the type of emoti