F40.2 Specific (Isolated) Phobias

These are phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, the sight of blood or injury, and the fear of exposure to specific diseases. Although the triggering situation is discrete, contact with it can evoke panic as in agoraphobia or social phobias. Specific phobias usually arise in childhood or early adult life and can persist for decades if they remain untreated. The seriousness of the resulting handicap depends on how easy it is for the sufferer to avoid the phobic situation. Fear of the phobic situation tends not to fluctuate, in contrast to agoraphobia. Radiation sickness and venereal infections and, more recently, AIDS are common subjects of disease phobias.

Diagnostic Guidelines

All of the following should be fulfilled for a definite diagnosis:

(a) the psychological or autonomic symptoms must be primary manifestations of anxiety, and not secondary to other symptoms such as delusion or obsessional thought;
(b) the anxiety must be restricted to the presence of the particular phobic object or situation; and
(c) the phobic situation is avoided whenever possible.

Includes:
* acrophobia
* animal phobias
* claustrophobia
* examination phobia
* simple phobia

Differential Diagnosis
It is usual for there to be no other psychiatric symptoms, in contrast to agoraphobia and social phobias. Blood-injury phobias differ from others in leading to bradycardia and sometimes syncope, rather than tachycardia. Fears of specific diseases such as cancer, heart disease, or venereal infection should be classified under hypochondriacal disorder, unless they relate to specific situations where the disease might be acquired. If the conviction of disease reaches delusional intensity, the diagnosis should be delusional disorder. Individuals who are convinced that they have an abnormality or disfigurement of a specific bodily (often facial) part, which is not objectively noticed by others (sometimes termed dysmorphophobia), should be classified under hypochondriacal disorder or delusional disorder, depending upon the strength and persistence of their conviction.