Pediatric Specific Phobia Workup

  • Author: William R Yates, MD, MS; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Mar 29, 2011
 

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.

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Diagnostic Criteria

Diagnostic criteria for specific phobia is found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.[5]

Criterion A

The patient has persistent or irrational fear that is unreasonable or excessive and is triggered by the presence or anticipation of a specific object or situation.

Criterion B

Exposure to the above noted event or object almost always results in an immediate anxiety response.

Criterion C

The person acknowledges this response to be unreasonable or excessive.

Criterion D

The person either avoids such situations or objects or else experiences exposure with intensive anxiety or distress.

Criterion E

The avoidance or distressful response significantly interferes with a person's daily functioning.

Criterion F

Duration is at least 6 months for individuals younger than 18 years.

Criterion G

The anxiety, distressful response, or avoidance is not accounted for by other mental disorders (see Diagnosis).

Subtypes of specific phobia

The patient must have 1 of the following 5 subtypes that best describe phobias:

  • Animal
  • Natural environment
  • Blood-injection injury
  • Situational
  • Other (must be distinguished from normal fear and anxiety)
  • Specific to the medical arena (eg, needle phobias, fear associated with dental care, dealing with claustrophobia for an adolescent who needs an MRI, children with needle phobias who require extended hospital care and needle exposure [eg, leukemia or burn unit patients])
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Contributor Information and Disclosures
Author

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 and American Psychiatric Association

Disclosure: Nothing to disclose.

Coauthor(s)

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 and American Psychiatric Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Chet Johnson, MD  Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center

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

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

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

Disclosure: Nothing to disclose.

References

  1. 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].

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

  3. NIMH. Anxiety disorders. National institutes of Mental Health. Available at http://www.nimh.nih.gov/health/publications/anxiety-disorders/complete-index.shtml. Accessed Last accessed January 13, 2006.

  4. 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. Mar 22 2008;[Medline].

  5. American Psychiatric Association. Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: APA; 1994:393-444.

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

  7. 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. Aug 2008;49(8):886-93. [Medline].

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

 
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