Phobias

Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revisions (DSM-5-TR)[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Phobias can be diagnosed if the following American Psychiatric Association criteria are met:

• Marked and persistent fears that are cued by the presence or anticipation of specific objects or situations.

• Exposure to phobic stimuli almost invariably provokes immediate anxiety or fear responses. In children, anxieties may be expressed by crying, tantrums, freezing, or clinging.

• Phobic situations are avoided or endured with intense anxiety or fear.

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

• Avoidance, anxious anticipation, and/or distress of feared situations interferes significantly with normal routines, occupations or academic functions, social activities, and/or relationships.

• Symptoms have been present for at least 6 months in both children and adults.

• Symptoms are not better accounted for by other mental disorders.

Subtypes are specified based on the following phobia categories.

• Animal: dogs, snakes, insects, etc.

• Situational: driving, flying, enclosed spaces, etc.

• Natural environment: storms, heights, dark, etc.

• Blood-injection-injury: injections, blood draws, medical procedures, etc.

• Other: choking, vomiting, clowns, etc.

International classification of diseases and related health problems, version 11: mental and behavioural disorders[46]World Health Organization. ICD-11 International statistical classification of diseases and related health problems, 11th revision. Geneva: WHO; 2022. https://icd.who.int/en

Specific (isolated) phobias can be diagnosed if the following World Health Organization criteria are met:

• Marked and excessive fear or anxiety occurs consistently upon exposure, or anticipation of exposure, to one or more specific objects or situations.

• Anxiety is out of proportion to actual danger.

• Phobic situations are avoided, or else endured with intense fear or anxiety.

• Symptoms persist for at least several months.

• Symptoms are sufficiently severe to result in significant distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning.