PHOBIAS

Specific phobia

See also: arachnophobia

Phobias are the most common mental disorders: they have a prevalence of 11% and are more frequent (double) in males than in females. The onset involves the young adult, although some phobias begin in childhood, such as for example fear of blood The phobias of children are very frequent (for example that of the dark, lightning and animals), so much so that they are considered almost normal if they are appreciated between 2 and 5 years.
A phobia is the intense, marked, unreasonable and persistent fear of an object or a situation that is instead devoid of a real objective danger, and precisely in this sense the phobia is distinguished from fear, which is a feeling that the individual manifests in the face of a real threat. Even in specific phobia, as a consequence of the disorder, an "anticipatory anxiety with relative avoidance behaviors can be established and, in particular cases, the anxiety can reach the extent of the" panic attack, because the " exposure to the phobic stimulus almost always causes an immediate anxious response.
There are an almost unlimited number of phobias, as any object or situation can be involved. The most common forms are phobias for: animals, blood, heights, closed places, darkness, death, means of transport, dirt, diseases, atmospheric agents. Those affected, except children, are aware of how the problem that afflicts them is unreasonable or excessive; despite this, the disorder more or less significantly compromises their existence.
In order to speak of a specific phobia in adults, the phobic manifestations must have a minimum duration of at least six months.
The avoidance developed by these subjects becomes lasting and difficult to eliminate: this depends on the fact that the reduction of anxiety, which is obtained by avoiding feared objects and situations, leads to a stable reinforcement of these strategies precisely because they are effective in preventing the "anxiety attack. If" avoidance becomes a "habit, the subject will then develop real phobic traits.
Generally phobias undergo a clear reduction after childhood; cases that persist in adults are less favorable from the point of view of recovery, because it occurs only in 20% of them. A possible consequence of the phobia is the interference that it creates in working life and in that of relationships because, especially in the most serious forms, the person must model his behavior based on the things or situations to be avoided, facing limitations of the one's career and in emotional ties.
The treatment of this disease is essentially based on psychotherapy. Some advantages can be had with drugs, such as b-blockers (which reduce tachycardia, sweating and dyspnoea) and some antidepressants, but these are marginal advantages. The most effective psychotherapeutic technique seems to be that of exposing the subject "live" or "in imagination" to the feared objects and situations in a gradual or massive way, in order to allow him to learn to manage anxiety and fear.

Social phobia

It has a prevalence of about 8% and mainly affects women, with an onset that occurs more frequently between 10 and 20 years.
Social phobia consists of the fear of manifesting anxiety, up to a panic attack, when we are together with people, usually unfamiliar, in potentially embarrassing situations, from simply being with others, to social events in which the subject is a service is required. The fear of these individuals is that of manifesting, in similar circumstances, due to anxiety, behaviors that determine the negative judgment of the people present. As a consequence of this, behaviors of avoidance, anticipatory anxiety or discomfort are established, in conjunction with social situations or feared performances, such as blushing in public or experiencing a notable sense of tension. Among the clinical pictures that characterize social phobia are: public speaking, that is the so-called "stage fright", which seems to be the most common form; talking to important people; take exams; participate in parties or lunches; resist pressure or express disagreement with people not little known, for example salespeople; look others in the eye; work or write while being watched.
The treatment consists in psychotherapy or, even if less effectively, in the use of antidepressant or b-blocking drugs.