PHOBIA DISORDER
CLINICAL FEATURES
Recurring ,irrational fears of specific objects,activities,or situations,with subsequent avoidance behavior of the phobic stimulus.Diagnosis is made only when the avoidance behavior is a significant source of distress or interferes with social or occupational functioning.
1.AGORAPHOBIA : Fear of being in public places.May occur in absence of panic disorder,but is almost invariably preceded by that condition.
Agoraphobia is diagnosed in about 4% of women and 2% of men during any 12-month period. Most people with this modify amend it in their early 20s. Agoraphobia rarely develops after age 40.
Some people amend agoraphobia after experiencing a panic move in digit of these situations. Other people exclusive feel uneasy in these settings and may never, or exclusive later, amend panic attacks. Agoraphobia often interferes with daily living, sometimes so drastically that it makes people housebound.
2.SOCIAL PHOBIA:
Persistent irrational fear of ,and need to avoid,any situation where there is risk of scrutiny by others,with potential for embarassment or humiliation.Common examples include excessive fear of public speaking and excessive fear of social engagements.
Although some anxiety in ethnic situations is normal, grouping with ethnic phobia hit so much anxiety that they either avoid ethnic situations or withstand them with distress. About 13% of grouping hit ethnic phobia sometime in their life. The modify affects about 9% of women and 7% of men during any 12-month period. Men are more likely than women to hit the most severe modify of ethnic anxiety, avoidant personality modify (see Personality Disorders: Avoidant Personality). Some grouping are shy by nature and, early in life, exhibit timidness that after develops into ethnic phobia. Others first undergo anxiety in ethnic situations around the time of puberty.
3.SIMPLE PHOBIA:
Persistent irrational fears and avoidance of specific objects.Common examples include fear of heights ( acrophobia ),closed spaces ( claustrophobia ) and animals.
Some specific phobias cause lowercase inconvenience, while others seriously interfere with functioning. For example, a municipality dweller who is afraid of snakes may have no trouble avoiding them. However, a municipality dweller who fears small, winking places much as elevators may connexion them frequently.
Some specific phobias, much as emotion of large animals, the dark, or strangers, begin primeval in life. Many much phobias kibosh as people get older. Other phobias, much as emotion of rodents, insects, storms, water, heights, flying, or enclosed places, typically develop after in life.
TREATMENT
Agoraphobia is treated as for panic disorder.Beta blockers (e.g propranolol,20 to 40 mg orally 2 hour before the event ) are particularly effective in the treatment of 'performance anxiety '.Selective serotinin reuptake inhibitors are very helpful in trating social phobias.Social and simple phobias respond well to cognitive behavior therapy and relaxation techniques and to systemic desensitization and exposure treatment.
Because many phobic disorders refer avoidance, danger therapy, a form of psychotherapy, is the treatment of choice. With scheme and hold from a clinician who prescribes danger homework, patients seek out, confront, and remain in occurrence with what they emotion and avoid until their anxiety is gradually relieved through a impact called habituation. Exposure therapy helps > 90% of those who carry it discover faithfully and is almost ever the only treatment needed for limited phobias. Cognitive-behavioral therapy is effective for agoraphobia and social phobia. Cognitive-behavioral therapy involves teaching patients to recognize and control their distorted intellection and false beliefs as well as instructing them on danger therapy. For example, patients who describe speed of their hunch evaluate or shortness of respite in certain situations or places see by existence repeatedly exposed to those situations that their worries about having a hunch attack are unfounded and are taught to respond instead with slow, controlled breathing or other methods that encourage relaxation.
Very short-term therapy with a benzodiazepine (eg, lorazepam 0.5 to 1.0 mg po) or a β- blocker ( propranolol is generally preferred—10 to 40 mg po), ideally about 1 to 2 h before the exposure, is occasionally useful when exposure to an object or situation cannot be avoided (eg, when a mortal who has a phobia of flying must fly on short notice) or when cognitive-behavioral therapy is either unwanted or has not been successful.
Many grouping with agoraphobia also hit panic disorder, and many of them goodness from take therapy with an SSRI. SSRIs and benzodiazepines are effective for ethnic phobia, but SSRIs are probably desirable in most cases because, unlike benzodiazepines, they are unlikely to interfere with cognitive-behavioral therapy. β-Blockers are useful for phobias related to public performance....... READ MORE
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