Clinical characteristics, issues of classification + diagnosis

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What is the difference between 'fear' and 'anxiety

Fear - an emotional, physiological, cognitive and behavioural response to an clear source (e.g. a specific object)

Anxiety - used to descrive the response to an unclear or diffuse source of danger

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What characteristics are shared by all phobias?

  • An unreasonable and exaggerated reaction cued by the presence or anticipation of the fear. 
  • The individual will show an immediate anxiety/fear reaction to the stimulus. This may be a panic attack in adults and clinging/crying in children. 
  • The individual recognises the behaviour is irrational (not always in children). 
  • The individual will endure the situation with extreme anxiety or will avoid it. 
  • The avoidance behaviour will disrupt daily routine and will result in the individual planning around the phobia. 
  • In individuals under 18, the phobia must last more than 6 months. 
  • The phobia cannot be better accounted for by another mental disorder. 
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What is meant by a specific phobia?

A specific phobia is an persistent and irrational anxiety towards a particular situation or object.

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What type of phobia are males and females equally

Blood/injection type. 

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What type of phobias is considered to be the most

Agoraphobia - because this means the individuals have trouble finding a job or shopping for vital provisions. 

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How does social phobia differ from agoraphobia?

Social phobia - fearful of showing signs of humiliation such as hand tremors or blushing when exposed unfamiliar people

Agoraphobia - fearful of having an unexpected panic attack and where escape from a situation may be difficult and/or embarrassing. Fear of losing control.

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How can social phobia be distinguished from normal

A shy person may be excessively shy, but if it doesn't impair their lives then they wouldn't be diagnosed with social phobia. 

Someone with social phobia may only have a fear of one aspect of social situations (eating in public) but may be diagnosed because their inense anxiety causes them problems in their daily lives. 

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What is meant by co-morbidity?

Co-morbidity is when certain disorders co-exist with each other. For example, social phobia and depression are usually linked. 

  • Social phobia is a predictor of depression and can make the symptoms more severe. If social phobia is accurately diagnosed, depression can be prevented (Kessler et al. 1999)
  • Alcohol related disorders occur twice as often in those affected by social phobia as in those without (Schneier et al. 1991) 
  • 20% of those treated for alcohol abuse have social phobia (Randall et al. 2001)
  • If left too long, risk of rapid relapse is high since psychosocial treatments may be difficult or impossible to attend. 
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What challenges to clinicians face when a patient

  • If the individual has depression because of social withdrawal or avoidance or the other way round. 
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