Evidence-based assessment/Simple phobia (disorder portfolio)

What is a "portfolio"?

 * For background information on what assessment portfolios are, click the link in the heading above.
 * Want more information? There's an extended version of this page here.

Diagnostic criteria for phobic anxiety disorders
ICD-11 Diagnostic Criteria

Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Inclusions


 * Simple phobia


 * Acrophobia


 * Claustrophobia

Exclusions


 * Body dysmorphic disorder


 * Hypochondriasis

Changes in DSM-5

The diagnostic criteria for simple phobia changed slightly from DSM-IV to DSM-5. Summaries are available here and here.

Base rates of simple phobia in different populations and clinical settings
This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice.
 * To see prevalence rates across multiple disorders, click here.

Psychometric properties of screening instruments for simple phobia
The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings.
 * Screenings are used as part of the prediction phase of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click here.


 * For a list of more broadly reaching screening instruments, click here.

Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings.

Likelihood ratios and AUCs of screening measures for simple phobia
Search terms: [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO
 * For a list of the likelihood ratios for more broadly reaching screening instruments, click here.

Interpreting specific phobia screening measure scores

 * For information on interpreting screening measure scores, click here.

Gold standard diagnostic interviews
For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), click here.

Recommended diagnostic instruments for simple phobia
Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings.

Process phase
The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the process phase of assessment. For more information of differences between process and outcome measures, see the page on the process phase of assessment.

Process measures
Two types of behavioral approach tests (BAT) can be used to observe patients in typically avoided situations.


 * 1) A progressive BAT gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded.
 * 2) A selective BAT allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear.

Outcome and severity measures
This table includes clinically significant benchmarks for simple phobia specific outcome measures
 * Information on how to interpret this table can be found here.
 * Additionally, these vignettes might be helpful resources for understanding appropriate adaptation of outcome measures in practice.
 *  For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,  see here.

Note: “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. Search terms: [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO

Treatment
Two treatments of specific phobia treatment include in-vivo exposure and virtual reality therapy. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates.


 * Please refer to the page on simple phobia for more information on available treatment or go to Effective Child Therapy for a curated resource on effective treatments for simple phobia.
 * For information on conducting Exposure Therapy for anxiety disordered youth, see www.BravePracticeForKids.com

External Resources

 * 1) ICD-10 diagnostic criteria
 * 2) Find-a-Therapist (a curated list of find-a-therapist websites where you can find a provider)
 * 3) NIMH entry about anxiety disorders
 * 4) Effective Child Therapy(guide about anxiety symptoms, treatment, and more)
 * 5) OMIM (Online Mendelian Inheritance in Man) for simple phobia
 * 6) 608251
 * 7) eMedicine entry about phobic disorders
 * 8) Society of Clinical Child and Adolescent Psychology
 * 9) EffectiveChildTherapy.Org information on fear, worry, and anxiety
 * 10) For information on conducting Exposure Therapy for anxiety disordered youth, see www.BravePracticeForKids.com