Clinical features and functional impairment

The hallmark feature of specific phobia, which prior to DSM-IV was called simple phobia, is a 'marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation'. Commonly feared/avoided objects include animals, aspects of nature, or blood. Most individuals may endorse a degree of fear of these stimuli. However, in specific phobia, fear and avoidance cause significant interference with an individual's normal routine, career, academic pursuits, or social/interpersonal activities. Nevertheless, some individuals with specific phobias maintain a relatively normal routine by pursuing a lifestyle that minimizes exposure to the phobic stimulus. Consequently, they may present for treatment only when life changes occur that force them to face the previously avoided situation or object. More frequently, specific phobias accompany a more impairing primary disorder, which is the stimulus for seeking treatment. (97)

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