Abstract
Phobias are a kind of anxiety disorder that can make an individual to experience extreme irrational fear regarding a situation, object, or living creature. Phobias should not be confused with normal fears since phobias are linked to a particular situation or object and they are persistent for 6 or more months. In this paper, we will describe what a phobia is and offer the differentiation of phobias from normal fear. We will then provide the diagnosis criteria for phobias as indicated in the DSM-5 manual. The 4Ds will be analyzed as they relate to phobia and the models of abnormality will be discussed. Treatment, history, culture, and prognosis will form the later part of the paper.

Description

According to Sutherland, Middleton, Ornstein, Lawson, and Vickers (2016) a phobia is defined as a type of anxiety disorder that makes an individual experience extreme irrational fear about a living creature, situation, place, or object. Phobias are more pronounced than fears and they will develop when an individual has an exaggerated or unrealistic sense of danger regarding a situation or object. An individual who experiences a phobia will often shape his or her life to avoid what they consider to be dangerous. According to the individual, the imagined threat is far greater than any actual threat that is posed by their cause of terror. In certain situations, a phobia can result in a restriction on the day-to-day life of the individual (Halldorsdottir & Ollendick, 2016). When faced with the source of their phobia, an individual will experience intense distress and this can prevent them from functioning normally. Sometimes a phobia can lead to panic attacks. It is estimated that in the United States about 17 million people have phobias. A phobia is more serious than a simple fear sensation. While most people are aware that their phobia is irrational most of them are not able to control the fear reaction they experience when faced by their phobia. The mere thought of the phobia is enough to prompt the individual to become anxious or panicky, which is referred to as anticipatory anxiety.

The worst part about phobias is that even when the situation does not regularly happen in the individual's life, they may find that they spend a considerable amount of time worrying about it appearing or trying to figure out how to avoid it. The American Psychology Association (APA) has recognized three types of phobias namely specific phobia, social phobia or social anxiety, and agoraphobia. Specific phobia is an intense irrational fear for a particular trigger. Specific phobia is referred to as simple phobias since they can be linked to a cause that is identifiable and might not occur frequently in the individual's everyday life like fear of snakes. Social phobia is the profound fear of public humiliation and being judged or being singled out by others in a social situation. An individual with social phobia will be terrified about the idea for a large social gathering. This should not be confused with shyness. Agoraphobia is the fear of situations that would be difficult for an individual to escape if they were to experience extreme panic like being in a lift. In most cases, people commonly misunderstand it as fear of open spaces but it can also apply for fear of being confined in a small space such as being in a lift or public transport. People who have agoraphobia have an increased risk of suffering a panic disorder. Social anxiety and agoraphobia are referred to as complex phobias since their triggers are not easily recognizable. People who suffer from complex phobias find it hard to avoid the triggers.

DSM-5 Application

The DSM-5 diagnostic criteria for phobias are:

· Having a marked fear about a specific object or situation.

· The phobic situation or object almost always provokes immediate fear.

· The phobic situation is avoided or endured with intense fear.

· The fear one experiences are out of proportion to the actual danger posed by the specific situation.

· The anxiety, fear, or avoidance is persistent and typically lasts 6 months or more.

· The anxiety, fear, or avoidance causes clinically significant distress or impairment in occupational, social, or other vital areas of functioning.

· The disturbance cannot be better explained by symptoms of another mental disorder.

The DSM-5 is used to diagnose psychiatric illnesses. To properly use the DSM-5 manual one should be well trained in how to use the manual to ensure that they offer their clients an adequate diagnosis. When making a diagnosis the clinician should ensure that they respect the client. Clinicians are supposed to be nonjudgmental in their diagnosis and using the DSM-5 manual can result in the clinician being judgmental (Sutherland et al., 2016). The diagnoses given by the manual seem to be judgmental since the clinician should indicate that a client has a certain ailment. However, under the principle of beneficence, the clinician can be termed as doing good and not be seen to be violating the respect of the client. Providing a diagnosis offers the client an opportunity to get appropriate and effective intervention. In order to make proper use of the manual, the clinician should be well trained and have the requisite minimum qualifications before they use the manual. This will ensure that one does maintain the ethics of their work and diagnosis. The issue arises in that many professionals are not aware that they need to be trained before they can make use of the manual.

Clients need to be involved in the diagnosis process. In most cases when a client is merely given the diagnosis, they are disempowered. This can be avoided by working with the client when conducting the diagnosis. The clinician should educate the client on the diagnostic process, which will allow the client to be a more equal partner in determining the conditions they may be experiencing. Ideally, the clinician will be offering the client information regarding a particular condition, which will include the indicators of the...…fear while being within the group, when one leaves the group and expresses the same phobia, people will be judgmental and recognize the irrational behavior.

Prognosis

It has been shown that most phobias will develop in late childhood and they might continue through adult life. If the individual does not seek treatment then they will continue to have the phobia. In cases where the phobic stimulus is easy to avoid most people will live their entire life avoiding the situation or object (Hirsch, 2018; Samson, Proyer, Ceschi, Pedrini, & Ruch, 2011). However, if the phobia is not easy to avoid, then the individual is likely to seek professional assistance to resolve the phobia. The prognosis with therapy has been found to be quite excellent for most types of phobias. The poor outcomes of therapy are mostly associated with poor compliance, understanding, or poor compliance or treatment procedures. There have been cases where interpersonal factors have interfered with treatment results. When there is a presence of more than one specific phobia it is associated with early age onset. Children and adolescents who have more than one type of phobic stimulus have been found to have higher rates of psychiatric comorbidity.

Specific phobias that develop during childhood generally attenuate over time but some might persist into adulthood. On the other hand, specific phobias that manifest in adolescents and adults will persist and only about 21% of these cases will resolve without intervention. It is possible to extinguish a fear using natural environmental contingencies. This means that the individual does not undergo any treatment and they manage to eliminate their fear with time. While this is one of the rare cases, there are situations that might force one to face their fear and this might assist to resolve the phobia. An individual with a specific phobia that one is not able to avoid will be forced to seek professional assistance. This is the only way the individual will be able to lead a normal life. Learning to eliminate the irrational thoughts and behavior is vital if one is to lead a normal and fruitful life.

Complex phobias have the same prognosis as specific phobias. However, it has been noted by Samson et al. (2011) that some complex phobias like agoraphobia have a less promising prognosis. The condition is most resistant to behavioral therapy and psychotherapy. This means that a person can undergo treatment and still continue having the same phobia. While the cases are few, the instances where treatment has failed have been noted and one should be prepared for a negative outcome. Patients suffering from a phobia are also at an increased risk of future anxiety disorders. There are some phobias that will get better with age and others will get worse with age. A phobia like the fear of heights will get worse with age. There are numerous reasons that lead to an increase in the phobia like having defendants who would suffer if one is no longer there for them.

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