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What patients and families need to know
Specific Phobias
What are specific phobias?
Specific phobias are defined as intense, persistent, irrational fears of specific objects, situations, activities or people. This fear is often greater than the actual danger of the threat. Children and teenagers with specific phobias will actively avoid the object or situation they are afraid of to the point that it gets in the way in their lives.
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The most common symptoms of specific phobias in children and adolescents, ages six to 18, include:
- A persistent fear that is excessive or unreasonable that occurs by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood)
- Exposure to the feared item or situation almost always leads to an immediate anxiety response, which may take the form of a panic attack. In children, the anxiety may be expressed by crying, tantrums, freezing or clinging
- The person recognizes that the fear is excessive or out of proportion to the actual threat posed. In children, this feature may be absent.
- The phobic situation is avoided or else is endured with intense anxiety or distress
- The avoidance, anxious anticipation or distress during the feared situation interferes significantly with your child's normal routine, school functioning, social activities or relationships; or there is marked distress about having the phobia
There are four categories:
- Animal type (e.g. dogs, snakes or spiders)
- Natural environment type (e.g., heights, storms, water)
- Blood-injection-injury type (e.g. fear of seeing blood, receiving a blood test or shot, watching television shows that display medical procedures)
- Situational type (e.g., airplanes, elevators, driving, enclosed places)
- Other types (e.g., phobic avoidance of situations that may lead to choking, vomiting or contracting an illness; in children, avoidance of loud sounds like balloons popping or costumed characters like clowns)
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At Children’s National Hospital, child psychologists, psychiatrists and other mental health professionals may interview the child or adolescent and his or her parents. We may have the patient and family fill out questionnaires about different aspects of the child’s or adolescent’s life, including physical health concerns, difficulties at school or behavior with friends and family.
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Following a full assessment, a member of the Children’s National care team will discuss treatment options with the child or adolescent and his or her family. Both cognitive behavioral treatment (CBT) and certain types of medicines are effective in treating general anxiety disorder in youth.
- CBT includes working with a therapist to help the child or adolescent (and his or her family) learn how to cope with feelings of fear. During treatment, patients learn to gradually face their worries and learn how to manage their anxiety, especially with the use of exposure response prevention.
- Medications, such as selective serotonin reuptake inhibitors, may be recommended. These medicines affect neurotransmitters (nerve cells in the brain that carry signals) linked to anxiety.
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