PHOBIA
INTRODUCTION
Phobia is a type of anxiety disorder it is a strong
irrational fear of something that causes little or actual
no danger.
DEFINITION
Phobia is defined as an irrational fear of specific object
activity and situation. That often leads to persistent
avoidance of the object activity or situation.
INCIDENCE
More common in woman
Onset is late second decade and early third decade
The course is usually chronic with gradual increasing
restriction of daily activities.
TYPES OF PHOBIA
1. SIMPLE OR SPECIFIC PHOBIA
2. SOCIAL PHOBIA
3. AGORAPHOBIA
SIPMLE PHOBIA
It is characterized by irrational fear of specific object.
Acrophobia (fear of high places)
Zoophobia: fear of animals
Xenthophobia: fear of stranger
Ergophobia: fear of pain
Claustrophobia: fear of closed places
Aqua phobia: fear of water
Nyctophobia: fear of darkness
Pyriphobia: fear of fire
Social phobia
This is an irrational fear of the activities of social
interaction.
It is characterized by fear of performing activities in the
presence of other people or interacting with others.
Ex :- public speaking, public performance on the stage,
participating in groups, writing in public, speaking to
strangers.
AGORA PHOBIA
This is an example of irrational fear of a situation. It is
commonest type of phobia seen in the clinical practices.
It is characterized by irrational fear of being in place
away from familiar setting of home
It includes fear of open places, public places crowd places, an
any other places where is no is escape to a safe place.
It will occur full blown panic attack ( agoraphobic with panic
disorder) or only with symptoms like dizziness and
tachycardia ( without panic attack)
ETIOLOGY
PSYCHODYNAMIC THEORY
In the phobia secondary defense mechanism “ displacement” is
activated and by this anxiety is transferred from really dangerous
or frightening object to neutral object.
PSYCHOBIOLOGICAL THEORY
A traumatic experience of childhood may affect
the child’s developing brain. In such manner that child
becomes susceptible to fear in childhood.
LEARNING THEORY
Classical conditioning says “ a stressful stimulus
produces an unconditional response- fear . When the
stressful stimuli is repeatedly paired with harmless
object , eventually harmless object alone can produce
the fear. If person avoid harmless object to avoid fear,
the fear becomes phobia.
COGNITIVE THEORY
Anxiety is a product of faulty cognition. This theory
says that some individual engage in negative and
irrational thinking that produce anxiety. The individual
being seek avoidance behavior to prevent anxiety , that
eventually leads phobia
SYMPTOMS OF PHOBIA
1. physical symptoms
a) Motor symptoms
Tremors
Restlessness
muscle twitches
Fearful facial expression
B) AUTONOMIC AND VISCERAL SYMPTOMS
Palpitation
Tachycardia
Sweating
Dysponea
Hyperventilation
Dry mouth
Diarrhea
Psychic symptoms
Poor concentration
Distractibility
depersonalization
derealization
Unpleasant
fearful
inability to relax
irritability , insomnia
DIAGNOSTIC EVALUATION
Careful observation of the symptoms.
The fear in unreasonable and excessive.
TREATMENT
Treatment approach is multimodal.
PHARMACOTHERAPY
Benzodiazepines
Ex :- Alprazolam
Lorazapam
ANTI DIPRESSANTS
EX:- SSRI’s :- paraxitine, fluoxitine sertraline
TCA’s ;- Imipramine,
MOA’s :-phinilzine
PSYCHOTHERAPY
Supportive psychotherapy
cognitive behavior therapy
BEHAVIOUR THERAPY
the techniques are
Flooding
Systemic desensitization
Exposure and response prevention
Relaxation techniques
SYSTEMIC DESENSITIZATION
NURSING MANANGEMENT
ASSESSMENT
The assessment is to focuses on physical, precipitating
factor, avoidance behavior, normal coping ability, and
supporting social system
NURSING DIAGNOSIS
1. Fear related to specific stimulus evidenced by
behavior directed towards avoidance of the object.
INTERVENTION
2. Reassure the client that he/ she is safe.
3. Explore client perception of the threat to physical
integrity.
3. Discuss reality of the situation.
4. Encourage the client to explore underlying feelings
that may contribute to irrational fear
2) Social isolation related to fears of being in a place in
which ne is unable escape from the situation.
a) convey an accepting attitude.
b) attending group activities with client
c) give recognition and positive reinforcement
d) administer anti anxiety drugs.
e)discuss with patient about symptoms of increasing
anxiety
