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Pediatric Specific Phobia Workup

  • Author: William R Yates, MD, MS; Chief Editor: Caroly Pataki, MD  more...
Updated: Dec 04, 2015

Approach Considerations

Fears and phobias are common in young children; thus, preschool children are rarely referred and diagnosed as phobic. Common fears of childhood need to be distinguished from specific phobia, as the latter is irrational, interferes more with daily routines, and leads to maladaptive behaviors.

Assessments generally consist of structured or semistructured interviews by the practitioner with the child and his or her parents. Various rating scales are also available to assess anxiety disorders.


Diagnostic Criteria

Diagnostic criteria for specific phobia is found in the Diagnostic and Statistical Manual of Mental Disorders,FifthEdition (DSM-5).[8] This revision made no significant criteria changes for the diagnosis of pediatric specific phobia.

The specific DSM-5 criteria for specific phobia are as follows:[8]

  • Marked fear or anxiety about a specific object or situation (eg, flying, heights, animals, receiving an injection, or seeing blood); in children, this fear or anxiety may be expressed by crying, tantrums, freezing or clinging
  • The phobic object or situation almost always provokes immediate fear or anxiety
  • The phobic object or situation is actively avoided or endured with intense fear or anxiety
  • The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context
  • The fear, anxiety, or avoidance persists, typically for 6 months or longer
  • The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
  • The disturbance cannot be better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with paniclike symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder [OCD]); reminders of traumatic events (as in posttraumatic stress disorder [PTSD]); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder)

The following specifiers are used, according to the phobic stimulus present:[8]

  • Animal - Fear of dogs (cynophobia), cats (ailurophobia), bees (apiphobia), spiders (arachnophobia), snakes (ophidiophobia), or other animals
  • Natural environment - Fear of heights (acrophobia), water (hydrophobia), or thunderstorms (astraphobia)
  • Blood-injection-injury - Fear of needles or invasive medical procedures
  • Situational - Fear of flying, elevators, or enclosed spaces
  • Other - Fear of situations that may lead to choking or vomiting; in children, loud sounds or costumed characters
Contributor Information and Disclosures

William R Yates, MD, MS Research Psychiatrist, Laureate Institute for Brain Research; Professor of Research, Department of Psychiatry, University of Oklahoma College of Medicine at Tulsa

William R Yates, MD, MS is a member of the following medical societies: American Academy of Family Physicians

Disclosure: Nothing to disclose.


Kerim M Munir, MD, MPH, DSc Director of Psychiatry, Division of General Pediatrics, Developmental Medicine Center, Children's Hospital Boston

Kerim M Munir, MD, MPH, DSc is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Chet Johnson, MD Professor of Pediatrics, Associate Director and Developmental-Behavioral Pediatrician, KU Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies; Assistant Dean, Faculty Affairs and Development, University of Kansas School of Medicine

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Sandra L Friedman, MD, MPH and Marilyn T Erickson, PhD, to the development and writing of the source article.

  1. Lahey BB, Van Hulle CA, Singh AL, Waldman ID, Rathouz PJ. Higher-order genetic and environmental structure of prevalent forms of child and adolescent psychopathology. Arch Gen Psychiatry. 2011 Feb. 68(2):181-9. [Medline]. [Full Text].

  2. Biel MG, Klein RG, Mannuzza S, et al. Does major depressive disorder in parents predict specific fears and phobias in offspring?. Depress Anxiety. 2008. 25(5):379-82. [Medline].

  3. Cooke LJ, Haworth CM, Wardle J. Genetic and environmental influences on children's food neophobia. Am J Clin Nutr. 2007 Aug. 86(2):428-33. [Medline].

  4. NIMH. Anxiety disorders. National institutes of Mental Health. Available at http://Available at Accessed: January 13, 2006.

  5. Kroll W, Postius S, Schneider F. Proliferation kinetics and metabolic features of in vitro grown Ehrlich ascites tumor cells in the presence of exogenous pyruvate. Z Naturforsch C. 1986 Jul-Aug. 41(7-8):787-94. [Medline].

  6. Burstein M, Georgiades K, He JP, et al. Specific phobia among U.S. adolescents: phenomenology and typology. Depress Anxiety. 2012 Dec. 29(12):1072-82. [Medline].

  7. Robinson J, Sareen J, Cox BJ, Bolton J. Self-medication of anxiety disorders with alcohol and drugs: Results from a nationally representative sample. J Anxiety Disord. 2009 Jan. 23(1):38-45. [Medline].

  8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013.

  9. Zlomke K, Davis TE 3rd. One-session treatment of specific phobias: a detailed description and review of treatment efficacy. Behav Ther. 2008 Sep. 39(3):207-23. [Medline].

  10. Liber JM, Van Widenfelt BM, Utens EM, et al. No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trial. J Child Psychol Psychiatry. 2008 Aug. 49(8):886-93. [Medline].

  11. Simon GE, Savarino J, Operskalski B, Wang PS. Suicide risk during antidepressant treatment. Am J Psychiatry. 2006 Jan. 163(1):41-7. [Medline].

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