Specific phobias

“Specific phobias” are disorders characterized by an excessive and irrational fear of an object or situation not normally considered dangerous. Children with specific phobias aren’t anxious in general; they only become so when confronted with the particular thing that causes them terror, whether it’s dogs, the dark, clowns, or loud noises. This confrontation can be direct or indirect: the thing itself or a song about it, for instance. Children with specific phobias will anticipate and avoid the thing that triggers their fear, which can interfere with normal activities. Though adults and adolescents realize that their fear is unwarranted, children often do not. Specific phobias are common among children, but should not be confused with other fears that do not rise to the level of a psychiatric disorder.

A child with a specific phobia will demonstrate unreasonable fear when faced with a particular situation, object, event, or even the thought of encountering the object of her distress. To avoid the thing she fears—dogs, say, or water, or bugs—she may cry or throw a tantrum. Physical symptoms may include trembling, dizziness, and sweating.

Researchers are unsure about the root causes of specific phobias, but studies show they are likely caused by a combination of genetic and environmental factors. Specific phobias can be triggered by a bad experience, or be learned from family members.

To be diagnosed with a specific phobia your child will exhibit exceptional fear of something not normally considered dangerous, and avoiding the object of that fear will cause significant impairment to her ordinary functioning. For example, a child who is afraid of dogs might refuse to visit her friend’s home even though her friend’s dog is known to be safe.

Specific phobias are commonly classified in five categories: Animal Type, if the phobia concerns animals or insects; Natural Environment Type, if the phobia concerns objects such as storms, heights or water; Blood-Injection-Injury Type, if the phobia concerns receiving an injection or seeing blood or an injury; Situational Type, if the phobia concerns a specific situation like flying, driving, tunnels, bridges, enclosed space or public transportation; and Other Type, if the phobia concerns other stimuli such as loud sounds, costumed characters, choking, or vomiting.

Treatment for specific phobias focuses on behavioral therapy; medication is not usually prescribed.

Psychotherapeutic: Fortunately, specific phobias are highly treatable through behavior therapy. A typical method involves gradual, repeated exposure to the feared object, event or situation. A child afraid of dogs might start treatment by looking at a picture of a dog, then work up to playing with a stuffed dog, being in the same room with a small dog, and so on. Therapy that teaches strategies for coping with fear and anxious thought patterns is another common option for older children.

Young people with specific phobias are also frequently diagnosed with other anxiety disorders.

Will my child grow out of it?
While many children grow out of their specific phobias, others will not without therapy. In the mean time, they suffer acute distress, and worry about exposure to the object they fear can seriously limit their activities. Children with unresolved specific phobias are also more likely to continue to experience them in adulthood.
Does medication help?
Medication is not usually prescribed to treat specific phobias, as behavioral therapy is very effective at treating the disorder. In some cases of extreme anxiety, however, a practitioner will prescribe medication to help a child or adolescent participate in the behavioral therapy.
What causes it?
Experts are unsure about the root causes of specific phobias. Phobias can be learned from family or may arise from a disturbing experience. There may also be a genetic factor to specific phobias.
Should I help my child to avoid the thing she is afraid of?
Abetting your child in avoiding the object of a phobia will not help her to overcome it. The relief derived from avoidance is temporary, and it may even make the irrational fear stronger. Therapists actually treat specific phobias through gradual, repeated exposure to the stressor.