Talk:Specific phobia

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 15 September 2020 and 17 November 2020. Further details are available on the course page. Student editor(s): Lizzymckenzie. Peer reviewers: Npodstawska.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 09:58, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 5 April 2021 and 11 June 2021. Further details are available on the course page. Student editor(s): Miaarosee. Peer reviewers: KMayberry, Aiyuri.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 09:58, 17 January 2022 (UTC)

Clean-up suggested
Perhaps this is a good time to read up on the reference books. I believe NIMH has some materials on specific phobia. --MegaHasher 17:47, 7 February 2006 (UTC)

original research tag
the section on evolution has only one reference and it doesn't even back up the veracity of the major claims made. I'm adding the original research template.

Word swap?
I think you meant "Treatment for Specific Phobia", not "Social".

CarlFink 20:07, 28 September 2006 (UTC)

Re: Word swap?

Agreed -- this section seems to be incorrectly combining references to "socal phobia" and "specific phobia." All references should probably be changed to "specific phobia." I was going to edit it, but I am hesitant to do so, as the original author cites a text. Note that many treatments/interventions for specific phobias can indeed be used for social phobia as well. However, fears of objects (like snakes) have nothing to do with social phobia.

In addition, the suggestion in the section that a client in treatment for snake phobia will eventually "put the snake around the his/her neck and watch TV" sounds quite strange. :) Further, references to "physicians" conducting exposure therapy discounts the fact that many psychotherapists who conduct exposure therapy with clients are not physicians. 4.227.247.71 07:33, 16 November 2006 (UTC)

On second thought, I am going to go ahead and make these edits. 4.227.247.71 07:37, 16 November 2006 (UTC)

Just a question
I know Wikipedia talk pages aren't for this kind of question, but can somebody explain the word choice in the excerpt from the psychology textbook: why does it say "client" and not "patient"?

adding a new change to treatments section
The treatment section of this wiki space should be called treatments and medication. There are treatments out there to help someone who is struggling with this problem. A form of medication is called benzodiazephines because it is used reduce anxiety in a person who suffers from a phobia. In some cases treatment is not always helpful so medication can be the alternative route to this problem. People need to know that there are other options out there for treatment it is important.

source and information:

Medication - For situational phobias/ specific that produce intense, temporary anxiety (for example, a fear of flying), short-acting sedative-hypnotics (benzodiazepines)[2]

Jump up ^ Goldberg, MD, Joseph (2014). "Anxiety & Panic Disorders Health Center". National Institute of Mental Health. http://www.webmd.com/anxiety-panic/specific-phobias?page=3 source and information:

Myriamj123 (talk) 02:51, 8 December 2014 (UTC)Myriamj123

Anatidaephobia redirect
Anatidaephobia redirects here, but there is no mention of that word anywhere in this article. Assuming that redirect is to remain (and the Anatidaephobia page isn't deleted completely) should there be some sourced mention here of why such a page might exist in Wikipedia to begin with? 89.100.100.74 (talk) 21:51, 15 June 2015 (UTC)

2020 Queens University Student Editing Initiative
Hello, we are a group of medical student’s from Queen’s University. We are working to improve this article over the next month and will posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit. Thank you. - Saavhispurkinjefiber — Preceding unsigned comment added by Saavhispurkinjefiber (talk • contribs) 20:19, 23 November 2020 (UTC)

Introduction
(1) We propose to replace the introductory paragraph definition of specific phobia. This updated definition cites a recent and peer-reviewed secondary resource, which integrates DSM-5 and WHO definitions of specific phobia. Updated introductory paragraph is as follows:

"Specific phobia is an anxiety disorder, characterized by an unreasonable fear associated with a specific object or situation, avoidance of the object or situation, persistence of the fear, and significant distress or functional impairment associated with the fear. "

Tannhauser Gate 42 (talk) 01:06, 4 December 2020 (UTC)

The cause of specific phobias can vary based on the phobia itself, but can include genetics, environmental influences, psychological conditioning, and other indirect pathways. Causes can be both experiential and non-experiential; for example, there appears to be a stronger genetic component to blood-injury-injection phobias compared to animal phobias, which are more likely to stem from an experience. --Colinraybrian (talk) 17:18, 4 December 2020 (UTC)
 * Hi, thanks for sharing this here. If this is going into the Lead (Wikipedia's name for the introduction/article summary), I think that it could be dubbed down a little bit more to lay language. For example, words like etiology, even "functional impairment" could be changed to "problems functioning", for example. JenOttawa (talk) 02:49, 5 December 2020 (UTC)
 * Also, this is a picky Wikipedia thing, but the citation goes after the punctuation (rather than before), just to keep the article formatting consistent. It should look like this with no space after the punctuation.

Signs and Symptoms
(2) After consulting with MEDMOS we propose to update the structure of the article by adding a section called Signs and Symptoms. Our proposed paragraph is as follows:

"A person who encounters that of which they are phobic will often show signs of fear or express discomfort. In some cases, it can result in a panic attack. The fear or anxiety associated with specific phobia can manifest in physical symptoms such as an increased heart rate, shortness of breath, muscle tension, or fatigue. " --CactusBanana (talk) 16:19, 3 December 2020 (UTC)
 * Nice use of wikilinks!

Pharmacotherapeutics
(5) We propose to add a pharmacological treatment subsection to the treatment section and insert the following: "As of late 2020, there is limited evidence for the use of pharmacotherapy in the treatment of specific phobia. The selective serotonin re-uptake inhibitors (SSRIs), paroxetine and escitalopram, have shown preliminary efficacy in small randomized controlled clinical trials. However, these trials were too small to show any definitive benefits of anxiolytic medication alone in treating phobia. . Benzodiazepines are occasionally used for acute symptom relief, but have not been shown to be effective for long term treatment. There are some findings suggesting that adjuvant use of the NMDA receptor partial agonist, d-cycloserine, with virtual reality exposure therapy may improve specific phobia symptoms more than virtual reality exposure therapy alone. As of 2020, studies on the use of adjunct d-cycloserine are inconclusive. " Brieeeeloren (talk) 21:15, 2 December 2020 (UTC)
 * Thanks for sharing this. When re-adding the same citation while editing in the actual article, please click "re-use" and then find the reference (i.e., ref 6 and 7) rather than re-inserting it using the tool. This will mean that it is not repeated twice in the article reference list. Also, you may be able to add wiki links to some terms and medications, if they are not already linked earlier in the article. E.g., paroxetine. Thanks again!JenOttawa (talk) 17:16, 3 December 2020 (UTC)

Diagnosis
(6) We propose to remove the four bulleted points under the sentence "Main features of diagnostic criteria for specific phobia in the DSM-IV-TR."Saavhispurkinjefiber (talk) 17:09, 3 December 2020 (UTC)saavhispurkinjefiber

(7) We propose to change the word "fourth" to "fifth" in the sentence "according to the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders, phobias can be classified under the following general categories." under the subheading "Types" Saavhispurkinjefiber (talk) 17:09, 3 December 2020 (UTC)saavhispurkinjefiber

(8) We propose to change "fear of dogs, cats, rats and/or mice, pigs, cows, birds, spiders, or snakes" to "fear of spiders, insects, dogs" Under the subheading "Types" Saavhispurkinjefiber (talk) 17:09, 3 December 2020 (UTC)saavhispurkinjefiber

(9) Under the subheading "Types" we propose to capitalize the first letter of each word following the dash that precedes the general category of specific phobia type. Saavhispurkinjefiber (talk) 17:09, 3 December 2020 (UTC)saavhispurkinjefiber
 * Thanks for posting these here Do you mean caps on each word, or the first word in each type? Wikipedia usually only puts a capital on the first word in a heading (not all the words). See manual of style guideline: MOS:HEADCAPS. I think that makes linking easier via Wikipedia and prehaps to standardize all articles they set it like this. I.e., "Natural environment type" is correct per Wikipedia and not "Natural Environment Type". Thanks! JenOttawa (talk) 17:22, 3 December 2020 (UTC)
 * Hello, thank you for your reply. I was referring to just the first word in each type, however if this change is not consistent with Wikipedia standards, I am happy to omit it. Warm regards Saavhispurkinjefiber (talk) 20:41, 4 December 2020 (UTC)Saavhispurkinjefiber
 * Thanks for the reply Yes, it is just a picky Wikipedia thing to only cap the first word. Thanks for noting this!JenOttawa (talk) 02:45, 5 December 2020 (UTC)

Epidemiology
We propose replace the following sentence: “Specific phobias have a one-year prevalence of 8.7% in the USA with 21.9% of the cases being severe, 30.0% moderate and 48.1% mild.” with the following statement: “Specific phobias have a lifetime prevalence rate of 7.4% and a one-year prevalence of 5.5% according to data collected from 22 different countries. In the USA, the lifetime prevalence rate is 12.5% and a one-year prevalence rate of 9.1%.” --CamQmed (talk) 17:18, 4 December 2020 (UTC)

Queen's University Student Editing Initiative (2021)
Hello, we are a group of medical student’s from Queen’s University (Class of 2025). We are working to improve this article over the next month and will posting our planned changes on this talk page. We look forward to working with the existing Wikipedia medical editing community to improve this article and share evidence. We welcome feedback and suggestions as we learn to edit. Thank you Mxnz1 (talk) 20:07, 15 November 2021 (UTC)

Treatment section (Specific phobia)
Improvement # 1: We propose to insert the following content into the treatment section: "Flooding: A therapy that exposes the person with a specific phobia to the most fearful stimulus first (i.e. the most intense part of the phobia).

Systematic desensitization: A therapy that exposes the person to increasing levels of vivid stimuli gradually and frequently while instructed to relax. " Thank you Chewy11 (talk)

Improvement # 2: I propose to insert the following content into the Treatment section after the sentence on exposure therapy as an effective form of CBT for specific phobia. “In addition, a third of people who have completed exposure therapy as a treatment for specific phobia did not respond, regardless of the type of exposure therapy.” Wallaev  (talk | contribs)
 * Thank you for sharing this suggestion. I have a very minor tweak. I think that you could frame this proof of efficacy in a slightly different way: e.g., "a third of people who complete exposure therapy as a treatment for specific phobia may not respond, regardless of the type of exposure therapy."JenOttawa (talk) 18:27, 16 November 2021 (UTC)

Improvement # 3: I propose to add the following sentence after the list of different exposure therapies: “Treatment is more successful in people with low trait anxiety, high motivation and high self-efficacy entering exposure therapy, high cortisol levels, high heart rate variation, evoking disgust. Thank you! Ashleythecat (talk) 17:32, 16 November 2021 (UTC)
 * This looks like a good improvement. I think that it could be re-worded slightly for clarify and to ensure someone without a medical background can understand the sentence. It would be good to define what you mean by "more successful"- is this a reduction in symptoms, are they "cured" etc. Splitting this into two sentences may also help with clarity. Finally, given lack of strong evidence found in this systematic review, I suggesting using "may" rather than "is". "Treatment may be more successful" (for example). Hope this helps! Thanks for all your hard work here. JenOttawa (talk) 18:27, 16 November 2021 (UTC)

Improvement #4: I propose adding a sentence explaining the current pharmacological regimens.: “Different treatments are better suited for certain types of specific phobia. For instance, beta blockers are useful in those with performance anxiety, and monoamine oxidase inhibitors improve social phobia.” Thank you! Sgrantham99 (talk) 13:51, 18 November 2021 (UTC)
 * Thanks for this suggestion  These improvements look good. Could any of the treatments be wikilinked or are they already linked earlier in the article?JenOttawa (talk) 12:28, 28 November 2021 (UTC)

Improvement #5: I propose adding a sentence explaining prefacing how pharmacological treatments are meant to be used in interventions.: “Pharmacological treatments are typically used in conjunction with behaviourally-focused psychotherapy, as implementing pharmacological interventions independently may lead to high relapse rates.” Kangawiki (talk) 15:30, 19 November 2021 (UTC)
 * Feedback {{{Ping|Kangawiki}}: The edit looks good. Can you try to re-word slighty for a more genera audience? For example, words like conjunction and implementing and even high replase rates could be re-worded so more people can understand it. One very small edit as well: be sure to place your citation immediately after your punctuation (no spaces) like this.

Epidemiology section
Proposed change # 1: We propose to add the following sentence to address the age of the natural onset of specific phobia subtypes: The development of phobias varies with subtypes, with animal and blood injection phobias typically beginning in childhood (ages 5-12), whereas development of situational specific phobias (i.e., fear of flying) usually occurs in late adolescence and early adulthood (Katzman et al., 2014). --Calanco (talk) 14:26, 15 November 2021 (UTC)
 * This looks great. Just to confirm, I am assuming that you put the quotations in order to share exactly what you want to edit here on the talk page. No need for quotations on the article (assuming it is paraphrased and not quoted from the source).JenOttawa (talk) 18:39, 16 November 2021 (UTC)

Proposed change # 2: Our group will be including a new sentence and including a WikiLink: "There may be significant underreporting of specific phobias as many people do not seek treatment, with some surveys conducted in the US finding that 70% of the population reports having one or more unreasonable fears." Thank you! Ptk1987 (talk) 22:09, 17 November 2021 (UTC)
 * Feedback: Thanks for sharing this. You did a nice job preparing the edit. I have one small picky wikipedia style thing: please include your citation immediately after the punctuation so it looks like this.  JenOttawa (talk) 12:37, 28 November 2021 (UTC)

Proposed change # 3:  We propose to change the sentence, “Women are twice as likely to experience specific phobias compared with men.” We will change it to the following sentences. “During childhood and adolescence, the incidence of new specific phobias is much higher in females than males. The peak incidence for specific phobias amongst females occurs during reproduction and childrearing, possibly reflecting an evolutionary advantage. There is an additional peak in incidence, reaching nearly 1% per year, during old age in both men and women, possibly reflective of newly occurring physical conditions or adverse life events.” Thank you! Ashwin.rao98 (talk) 22:13, 17 November 2021 (UTC)
 * Feedback: This looks great. I have one small picky wikipedia style thing: please include your citation immediately after the punctuation so it looks like this. . You will also have to re-use the same citation from the other person in your group (i.e.- not add the same citation twice from scratch). To do this, you click "cite" (as we practiced in class), however, rather than paste in your PMID/DOI and autogenerate your citation, you will clikc "reuse" and then search for the Eaton citation from the list.{{{Ping|Ashwin.rao98}} I found an image on Wikipedia Commons demonstrating this and I will show it in class on Monday as well. Thanks!JenOttawa (talk) 12:43, 28 November 2021 (UTC)

Proposed change # 4:  Our group will also add the sentence: "“An estimated 12.5% of U.S. adults experience specific phobia at some time in their lives and the prevalence is approximately double in females compared to males. An estimated 19.3% of adolescents experience specific phobia, but the difference between males and females is not as pronounced. ” Thank you! Kirsten.allen (talk) 22:16, 17 November 2021 (UTC)
 * Feedback: This looks good. When you are adding the website reference with the statistics, please fill out all fields (title of webite site, authors, etc).JenOttawa (talk) 12:54, 28 November 2021 (UTC)

Treatment
Proposed edit # 1 We propose to insert the following content: “Exposure therapy is a particularly effective form of CBT for many specific phobias, however, treatment acceptance and high drop-out rates have been noted as concerns. Other interventions have also been successful for particular types of specific phobia, such as virtual reality exposure therapy (VRET) for spider, dental, and height phobias, applied muscle tension (AMT) for needle phobia, and psychoeducation with relaxation exercises for fear of childbirth. "
 * Feedback: These edits looks great. Thanks for sharing them here. JenOttawa (talk) 14:24, 28 November 2021 (UTC)

Proposed edit # 2 We noticed that reference #9 is a case study that is not supported by a stronger source. We propose to remove this reference along with the information about cognitive drill theory from this page.Cmockler (talk) 00:51, 3 December 2020 (UTC)
 * Thanks for sharing this. If no other replacement citation that meets MP:MEDRS can be found this makes sense.JenOttawa (talk) 14:24, 28 November 2021 (UTC)

Proposed edit # 3 We additionally propose to insert the following content into the Specific Phobia - Treatment section:

“With exposure therapy, a cognitive-behavioural therapy, clinically significant improvement was experienced by up to 90% of patients. While very long-term outcomes remain unknown, many of the benefits of exposure therapy persisted after one year”. This looks good. Is the "a" in "a cognitive-behavioural therapy" necessary? Also, be sure to expand the information in your citation from the BMJ Best practice citation. Article title, author, date published, date accessed, etc need to be included in the template. Sometimes these need to be included manually if the "autogenerate" is not pulled these from the cite tool. I just re-added it here to test and I think using the cite tool should work. See the difference in the below ref list. Please review and make sure you know how to do this before adding to the actual article. Thanks for sharing this here. JenOttawa (talk) 14:24, 28 November 2021 (UTC)

Proposed edit # 4 “Computer-assisted treatment programs, self-help manuals, and delivery by a trained practitioner are all methods of accessing CBT. A single session of CBT in one of these modalities can be effective for individuals suffering from specific phobia.”


 * Feedback: see comment above for # 3 regarding adding more information about your reference in the citation fields! JenOttawa (talk) 14:24, 28 November 2021 (UTC)

Proposed edit # 5 Specifically for acrophobia, in-vivo exposure (exposure to real-world height-scenarios while maintaining anxiety at controlled levels) has been shown to significantly improve measures of anxiety in the short-term, but this effect decreased over a longer term. Likewise, virtual reality exposure was statistically significant in some measures of anxiety reduction, but not others. Thanks for reading. We appreciate your time and feedback. Tncmgee (talk) 17:45, 17 November 2021 (UTC)
 * Thanks these edits looks good. Please note the information provided for Proposed edit #3 related to adding all the information about your citation. Your citation should have more than the doi in the final version. example (see the differences in the reflist below this comment). JenOttawa (talk) 14:24, 28 November 2021 (UTC)

Causes
We propose the addition of a subheading for Causes which will be inclusive of information regarding etiology and risk factors.

We propose the following changes:

1. Relocation and reformatting of the following sentence, with addition of wikilink for "etiology": "The exact etiology of specific phobias is not known, and may vary based on the phobia itself. Potential causes include genetics, environmental influences, conditioning, and other indirect pathways. Causes of specific phobia can be both experiential and non-experiential; for example, there appears to be a stronger genetic component to blood-injection-injury phobias compared to animal phobias, which are more likely to stem from an experience.[6]"
 * Thanks for sharing this. I would consider the use of etiology as people who are not in medical fields may not understand (even though you wikilinked correctly!). Are you using the existing citation in the article for this?JenOttawa (talk) 14:35, 28 November 2021 (UTC)

I am using the existing narrative and citation from the article, but I will consider changing etiology to something more accessible.20SPD5 (talk) 16:33, 29 November 2021 (UTC)

2. Insert the following, with addition of wikilinks: "The most common classical conditioning model suggests that a phobia will develop when an event that causes a fear or anxiety reaction is paired with a neutral event. An example of this model is when being near a dog (neutral event) is paired with the emotional experience of being bitten by a dog, resulting in a chronic fear which is described as a specific phobia to dogs." For consideration. Thank you. 20SPD5 (talk) 19:05, 17 November 2021 (UTC)
 * Feedback- this looks good, thanks for sharing here. I would re-use the same citation at the end of the second sentence. I have added it above to your edit. Also, I think that citation did not populate all the fields (journal/book name?). When I paste in your PMID I get the following (see in reflist below the difference). Please verify when you are editing live. JenOttawa (talk) 14:35, 28 November 2021 (UTC)

Thank you for the feedback. I will confirm that it reads properly with the final edit. 20SPD5 (talk) 16:33, 29 November 2021 (UTC)

3. The following information can be considered for addition, with the appropriate wikilinks. The same reference will be applied for this section as the one above, due to relevant information from the article required for this section. " An alternative proposed mechanism of association is through observational learning. A person may internalize another person’s fears about a specific object or situation through observation of their reactions."

Hrijal (talk) 19:20, 17 November 2021 (UTC)
 * Feedback: This looks good. be sure to practice "re-using" your reference so that it is not re-added as a separate reference. I posted more information on how to do this for the epidemiology section comment#3 (above)JenOttawa (talk) 14:35, 28 November 2021 (UTC)

4. Please consider the following sentences with the addition of relevant wikilinks: "In non-experiential phobia, the typical activation of the amygdala in response to stimuli may be exaggerated due to pathological changes in the excitability threshold in fear circuits. A deficiency in amygdala habituation may also contribute to the persistence of non-experiential phobia." Thank you! --Angelaluan12 (talk) 19:59, 17 November 2021 (UTC)
 * Feedback: This looks good. Is non-experiential phobia defined earlier in the article? When you are adding your citation, be sure that it comes directly after the punctuation (no spaces) like this. JenOttawa (talk) 14:35, 28 November 2021 (UTC)

5. The following sentence has been proposed to be added under a new subheading, causes. Certain phobias that are less lethal (e.g. dogs) seem to be more frequently observed and easily acquired in comparison to potentially lethal fears which are more relevant to our current society (e.g. cars and guns). This may be due to biological adaptation being passed through evolution which makes recent threats less prone to easy acquisition. Inaram1999 (talk) 20:34, 17 November 2021 (UTC)
 * Feedback: Thanks for sharing this here. A capital is not necessary on the A in acquisition. Your reference looks great.JenOttawa (talk) 14:35, 28 November 2021 (UTC)

Proposed Modifications to Treatment
we suggest the following changes to add clarity and more detail to the 'treatment' section of the article

Proposed Changes: Shrey.58 (talk) 04:06, 19 November 2021 (UTC)

Change 1: There are a variety of treatment options available for specific phobias, primarily focusing on psychosocial intervention
 * Feedback: This looks good. Please be sure to add your citation using the tool when editing Wikipedia live. I know it is different editing here on the talk page as the visual editor option is not available. Here is what it looks like when I pasted in your website and autopopulated the fields. JenOttawa (talk) 14:49, 28 November 2021 (UTC)

Change 2: Studies suggest that different psychological treatments have varying levels of effect depending on the specific phobia being addressed
 * See comment to change 1, above. Also please not if you are re-using the same citations we cannot add them in twice (as two references in the list), they need to be "re-used. Please see comment to proposed change #3 in the epidemiology section above. If you have questions we can go through this in the class.JenOttawa (talk) 14:49, 28 November 2021 (UTC)

Change 3: CBT represents the gold standard and first line of therapy in Specific phobias. CBT is effective in treating specific phobias, this is done by focusing on the factors that impact an individual's anxiety
 * Feedback: Thanks. You could consider changing "individual" to a "person's". Please be sure to add your citation using the cite tool as we practiced in the sandboxes in class. Reach out if you need help with this on Monday.JenOttawa (talk) 14:49, 28 November 2021 (UTC)

Prognosis
Copied over from the main phobia page information regarding prognosis of specific phobia: Phobia Joeception (talk) 20:07, 17 March 2022 (UTC)

Cleanup comments
I've just changed a fair bit of content, so I'll explain the main reasons why.

In the diagnosis section: based on the discussion here, we are not allowed to verbatim copy criteria from the DSM so I paraphrased it. The remaining content in the section seemed to be examples of specific phobia, which I looked through the DSM and the examples were not there. As far as the scope of WP:MEDMOS it isn't appropriate to list examples, especially unsourced ones, in the article. There was also a claim that phobias manifest differently in children/adolescents, and I can't verify that so I've removed it.

In the signs and symptoms section, I found that panic attacks is not a symptom of specific phobia and this was even mentioned in a source, I've mentioned this in the differential diagnosis section.

In the causes section, I found the writing to seem to gloss over the fact that the causes aren't well understood, so I have made that very clear and distinguished different views on the topic and where empirical evidence currently stands. (I couldn't find many studies on it aside from the NIH one.)

This sentence in the lead section Females are twice as likely to be diagnosed than males with a specific phobia (although this can depend on the stimulus). seems to of been previously criticised in the Queen's University Student Editing Initiative comments on this talk page, and I am unable to find any modern gender-related epidemiology statistics so I have added the dubious tag there.

Thanks Darcyisverycute (talk) 16:03, 21 July 2022 (UTC)