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Diagnosing a Phobia

Diagnostic Criteria for Phobias

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Updated October 24, 2011

When diagnosing a phobia, mental health professionals must use clinical skills and judgment alongside the written list of diagnostic criteria found in the Diagnostic and Statistical Manual (DSM-IV; 4th Ed.). Many of the symptoms of phobias are very similar to those of other mental disorders as well as physical illnesses. A phobia can be defined as an intense and irrational fear. There are three types of phobias, as defined by the DSM-IV: specific phobia, social phobia and agoraphobia. Each type of phobia has its own unique diagnostic criteria.

Differential Diagnosis

One of the most important steps in diagnosing a phobia is deciding whether the symptoms are better explained by another disorder. Phobias can be traced to specific, concrete fears that adult sufferers recognize as irrational.

The fact that the fear is concrete separates phobias from disorders such as generalized anxiety disorder, in which the anxiety is more broad-based. Phobia sufferers are able to pinpoint an exact object or situation that they fear.

Being able to recognize the fear as irrational separates anxiety disorders from the psychotic disorders such as schizophrenia. People who suffer from psychotic disorders genuinely believe that the fear is based on a real danger, though the nature of the danger appears illogical to others.

Common Criteria

Each type of phobia has its own unique set of diagnostic criteria. However, there are some overlaps. Diagnostic criteria that are similar to all phobias include:

Life-Limiting: A phobia is not diagnosed unless it significantly impacts the sufferer’s life in some way.

Avoidance: Some people with clinically diagnosable phobias are able to endure the feared situation. However, attempts to avoid the feared situation are an important criterion for diagnosing a phobia.

Anticipatory Anxiety: People with phobias tend to dwell on upcoming events that may feature the feared object or situation.

Diagnosing a Specific Phobia

In order for a specific phobia to be diagnosed, one or more objects or situations must be identified as the cause of fear. People with specific phobias often have other anxiety disorders as well, making it difficult to accurately pinpoint the diagnosis.

Diagnosing Social Phobia

Social phobia is a phobia of interacting with strangers in social situations. Social phobia may relate to only one type of situation, or it may be generalized to include all or most social settings. The symptoms of severe social phobia are often quite similar to those of agoraphobia. The difference is in the exact cause of the fear.

Diagnosing Agoraphobia

Agoraphobia is a fear of being trapped in situation where help or escape is not easily available in the event of a panic attack. The condition can be tricky to diagnose, particularly in people who do not meet the diagnostic criteria for panic disorder.

Source:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th Ed.). Washington, DC: Author.

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