The fourth Diagnostic and Statistical Manual (DSM IV) (American Psychiatric Association, 2000, p. 443) describes 'specific phobias', hitherto 'simple phobias', as 'marked and persistent fear of clearly discernible, circumscribed objects or associations.' The subject's response to such objects can include panic attacks and avoidance if possible. The phobia causes significant interference with the subject's 'daily routine, occupational functioning or social life' and even serious ill health such as cardiovascular disease (Bowen et al., 2000). Theories of causation are reviewed by Merckelbach et al. (1996) and Ollendick et al. (2002) for adults and children respectively.

The attention given to specific phobias has varied over the years. Compare early surveys (such as Marks, 1975), where many studies were of spider phobias, with later reviews (such as Davey, 1997) in which agoraphobia, panic disorder and social phobia receive more attention. Furthermore, the emphasis has shifted from specific phobias, providing opportunities to test hypotheses about treatment of phobia (Kazdin, 1978) almost regardless of its nature, to studies specific to each different fear, such as social phobia. In addition, the emphasis in reviews has shifted from studies of theoretical interest to phobias that can have a major clinical impact on subjects. These include phobias of medical and dental treatment. Uncommon fears, for example of buttons, owls and choking, continue to be documented in case studies.

Nevertheless, specific phobias are still exploited for interests that could be common to all fears such as the return of fear after being diminished by treatment (Rose & McGlynn, 1997), the correspondence among different measures of anxiety (Forsyth & Eifert, 1996), new methods of treatment such as eye-movement desensitisation (Muris et al., 1998) or delivery of treatment by computer (Dewis et al., 2001) or more veridical ways of presenting fear-provoking objects (Maltby et al., 2002). Any scientific study of hypnosis (Kirsch et al., 1995), which has a long history as a treatment for the specific phobia of dentistry, could be innovative because of the scarcity of such studies.

Handbook of Evidence-based Psychotherapies: A Guide for research and practice. Edited by C. Freeman & M. Power. Copyright © 2007 John Wiley & Sons, Ltd.

Anxiety and Panic Attacks

Anxiety and Panic Attacks

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