PHOBIA
INTRODUCTION:
- Marked & persistent fear of objects or situations, exposure to which results in an immediate anxiety reaction.
- Patient avoids phobic stimulus impairing occupational or social functioning.
- Panic attacks triggered by phobic stimulus or emerge spontaneously.
- Anxiety is usually dealt with defense mechanism of repression.
- When repression fails to function adequately, other secondary defence mechanisms of ego like displacement come into action.
TYPES:
- Social phobia – irrational fear of activities or social interaction
- Shy-Bladder: fear of urinating in public lavatory
- Erythro phobia: Fear of blushing.
- Simple (specific) phobia – Irrational fear of objects or situations
- Claustro phobia- Fear of closed spaces
- Acrophobia – fear of high places.
- Algophobia – fear of pain
- Arachnophobia– fear of spiders
- Xeno phobia –fear of strangers
- Zoophobia – fear of animals
- Sito phobia – fear of eating
- Thanatophobia – fear of death
- Cynophobia: fear of dogs
- Mysophobia: fear of dirt & germs
- Pyrophobia: fear of fire
- Allurophobia: fear of cats.
Agoraphobia:
- Fear of places from where escape might be difficuft.
- ‘Extended definition’ of Agoraphobia includes:
- Fear of open spaces.
- Fear of public places.
- Fear of crowded places.
- Fear of enclosed places.
- Fear of travelling alone.
- Fear of using public transportations.
MANAGEMENT:
- Drugs used:
- Pharmacologic treatment is directed toward panic attacks & generalized anxiety.
- Anxiolytic drugs
- TCA
- SSRI
- MAO inhibitors
- Behavior therapy-
- Mainly exposure therapy.
- Most commonly used for specific phobia treatment.
- Systemic desensitization therapy:
- Best evidence in phobia treatment.
- Therapist usually desensitizes patient by gradual exposure to phobic stimulus.
- Relaxation & breathing control are important parts of treatment.
- Exposure & response prevention.
- Flooding
- Hypnosis:
- Used as method of relaxation when confronted with phobic stimulus.
- Supportive therapy:
- Helps patient actively confront phobic stimulus during treatment.
- Modelling (participant modeling):
- Patient asked to follow therapist and his activities.
- Psychodynamic therapy.
Exam Important
- The woman who cannot urinate in a restroom because of embarrassment is probably suffering from social phobia.
- Agoraphobia is a disorder characterized by Avoidance of situations in which it occurs ,Presence of panic symptoms, Avoidance of being outside alone
- Phobia is neurosis
- Commonest type of phobia seen in clinical practice is Agoraphobia
- Displacement is the defense mechanism in phobia
- Patient of contamination phobia was asked by therapist to follow behind and touch everything he touches in patients house Therapist kept talking quietly & calmly all the time .This procedure is called modelling
- Systemic de-sensitization therapy is used for phobia
- In Agoraphobia behavioural therapy is helpful
- Thanatophobia – fear of death
- Claustro phobia- Fear of closed spaces
- Acrophobia – fear of high places.
- Definitive treatment of all types of phobias is behavioural therapy
- Systemic desensitization,Psychodynamic therapy,Exposure therapy are the method of treating Agoraphobia
- SSRI is first line treatment for Panic disorder, Social phobia, Post traumatic stress disorder
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