Phobia

Phobia is a type of anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically, result in a rapid onset of fear and are present for more than six months. Those affected will go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed.

Beneath the lateral fissure in the cerebral cortex, the insula, or insular cortex, of the brain has been identified as part of the limbic system, along with cingulated gyrus, hippocampus, corpus callosum and other nearby cortices. This system has been found to play a role in emotion processing and the insula, in particular, may contribute through its role in maintaining autonomic functions.

Studies by Critchley et al. indicate the insula as being involved in the experience of emotion by detecting and interpreting threatening stimuli. Similar studies involved in monitoring the activity of the insula show a correlation between increased insular activation and anxiety.

In the frontal lobes, other cortices involved with phobia and fear are the anterior cingulate cortex and the medial prefrontal cortex. In the processing of emotional stimuli, studies on phobic reactions to facial expressions have indicated that these areas are involved in processing and responding to negative stimuli.

If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, which are often found in agoraphobia. Around 75% of those with phobias have multiple phobias.

Phobias can be divided into specific phobias, social phobia, and agoraphobia. Specific phobias include those to certain animals, natural environment situations, blood or injury, and specific situations. The most common are fear of spiders, fear of snakes, and fear of heights.

Specific phobias may be caused by a negative experience with the object or situation in early childhood. Social phobia is when a person fears a situation due to worries about others judging them. Agoraphobia is a fear of a situation due to a difficulty or inability to escape.

It is recommended that specific phobias be treated with exposure therapy, in which the person is introduced to the situation or object in question until the fear resolves. Medications are not useful for specific phobias. Social phobia and agoraphobia are often treated with some combination of counselling and medication. Medications used include antidepressants, benzodiazepines, or beta-blockers.

Specific phobias affect about 6–8% of people in the Western world and 2–4% of people in Asia, Africa, and Latin America in a given year. Social phobia affects about 7% of people in the United States and 0.5–2.5% of people in the rest of the world.

Agoraphobia affects about 1.7% of people. Women are affected by phobias about twice as often as men. Typically, the onset of a phobia is around the ages of 10–17, and rates are lower with increasing age. Those with phobias are at a higher risk of suicide.

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