Phobias

Definition

• A phobia is an anxiety disorder characterized by obsessive, irrational, and intense fear of a specific object an activity, or a physical situation.
• The fear, which is out of proportion to reality, usually results from early painful or unpleasant experiences involving a particular object or situation.
• A phobia may arise from displacing an unconscious conflict on an object that is symbolically related.

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Types of Phobias

1. Agoraphobia
   • Fear of being in places or situations from which escape may be difficult or help may not be readily available.
2. Social Phobia
   • Also called Social Anxiety Disorder
   • Characterized by persistent fear of appearing shameful, stupid or inept in the presence of others.
3. Specific Phobia
   • Also called Simple Phobia
   • A persistent fear of a specific object or situation, other than of two phobias mentioned above.
   • Sub-categories:
     1. Injury-blood-injection
     2. Situational
     3. Natural environment
     4. Animals
     5. Other (fear of costumed character, space, etc)

Risk Factors

1. Learning theory
   • The belief that phobias are learned and become conditioned responses when the client needs to escape an uncomfortable situation.
2. Cognitive theory
   • Phobias are produced by anxiety-inducing self-instructions of faulty cognitions.
3. Life experiences
   • Certain life experiences, such as traumatic events, may set the sage for phobias later in life.

Signs and Symptoms

1. Withdrawal
2. High levels of anxiety
3. Inability to function and meet self-care needs
4. Inappropriate behavior used to avoid the feared situation, object or activity
5. Dysfunctional social interactions and relationships

Nursing Diagnoses

1. Anxiety
2. Powerless
3. Ineffective individual coping
4. Impaired verbal communication
5. Altered thought processes
6. Self-esteem disturbance
7. Impaired social interaction
8. Risk for injury

Therapeutic Nursing Management

1. Systematic desensitization
   • This process of gradual exposure to phobic object or situation aimed at decreasing the fear and increasing the ability to function in the presence of phobic stimulus.