Symptoms
When you see the
situation or the object causing the phobia, the individual
may show some
characteristics or symptoms that are useful for
diagnosis, and
points the manual DSM-IV-TR, and teachers Garcia-Sanchez (2002), Horse and
Simon (2005), Nathan Gorman, and Sal kind (2005). We summarize below some of
them:
- Automatic
Reaction severe anxiety voluntary exposure to the phobic stimulus. This can
cause a panic attack about situational linked to a given situation. In children,
the anxiety may be expressed: hugs, tantrums, freezing and crying.
- Understanding
the fear experienced as completely irrational and disproportionate to a
possible threat to their well-being or safety. In children, this irrational and
excessive fear may be missing.
- Triggering
psycho physiological reactions and emotional levels, the most common being the
following: exhaustion, anxiety, exhaustion, anxiety, menstrual disorders, hopelessness,
diarrhea, impaired breathing, headache, difficulty falling or staying asleep, discomfort,
restlessness, impatience, irritability, easy fatigability, malaise, Frequent or
urgent urination, fear, gastrointestinal upset, need to shun away from the
situation or object, nausea, throat, nervousness, chest pain or discomfort, palpitations,
loss of appetite, digestive problems, anger, shortness of breath, dizziness, dry
mouth, flushing or blushing, sweating, trembling in the hands, knees trembling,
muscle tension, sadness, vomiting, etc..
- Avoidance
of the situation or the object causing the phobia. If it supports will
experience intense discomfort or anxiety, and exhaustion.
- Expression
level cognitive thoughts, mental images, reviews, performances, erroneous and
negative related to the phobic situation.
Characteristics
associated
After detailed
psychological research has shown that specific phobia coexists with other
mental disorders, growing to 65% co morbidity (Strategic and Bogojevic, 1997, Stein,
2005). It appears that sex and ethnicity influence patterns of co morbidity.
Of all the
disorders that may coexist with higher probability or frequency are: alcoholism,
drug addiction, anxiety disorders (especially social phobia and PTSD), psychosomatic
manifestations, depression, and obsessive-compulsive disorder (OCD) . The latter
can sometimes be a risk factor for suicide.
All of these
disorders can occur in adolescence causing clinically significant distress
impaired school, family and society. But among all co morbid depression is seen
as the most serious in carrying implicit suicide attempts.
An example of
this coexistence of disorders could be: a student who has a situational
specific phobia (fear of being injured in playground games), together with an
obsessive-compulsive disorder (washing hands frequently, lest we sully the
dress), and social phobia (fear of being ridiculed publicly).
Epidemiology
According to
prevalence studies, specific phobia is one of the most common mental disorders,
with rates ranging between 4.7% and 11.3%, (Who et al., 1989, Kessler et al., 1994
and Stein , 2005).
Also confirmed
after numerous studies specific phobia is more common in women than in men. The
reason for this is because in women is more common role modeling, which allows
the transmission of social phobias and fears (Fredrik son et al, 1996; Stein, 2005).
Furthermore, research
has shown that the annual prevalence of specific phobia in adolescents reached 3.5%,
showing that more girls than boys who meet the diagnostic criteria or reach. (Esau
et al., 2000; Stein, 2005).
In research with
children (4 to 12 years) the prevalence of specific phobia was 17, 6% (Maris
and Merckelbach, 2000; Stein, 2005). And between 1 and 1.5% of children for
school phobia (Echeburúa, 1998; Horse and Simon, 2005).
Furthermore, Escalon
and Tobol (1992) found through their research
that between 15 and 20% of students have high levels of test anxiety.
Evaluation
The assessment of
children and adolescents with type specific situational phobia will be
developed taking into account the stages of pretreatment and post treatment, within
which used a combination of various tools or techniques previously designed as:
- The
interview: through which student information is obtained, the family (mother, father,
siblings), the school psychologist, classroom teachers, classmates, the tutor, etc..
- Inventories
of fear: these psychometric tools will be released in a quantitative way the
intensity of symptoms student. Allow also perceive and evaluate the changes
that are generated through the psychotherapeutic action. Top Rated for its
usefulness and scientific recognition are:
- Test
Anxiety Inventory (TAI), Spiel Berger, 1980.
- The
inventory of fears (FI, Fear Inventory), Stealth and Eosins, 1983.
- The
inventory of fears for Children-Revised (FSSC-R, Revised Fear Survey Schedule
for Children) of Ollendick, 1983.
- Inventory
of school fears (IME), Mendez, 1988.
- Questionnaire
fears exams and classes (CTEC) of
Conseco, 1989.
- Questionnaire
test anxiety (ASAC) of Bas, 1991.
- Inventory
of Situations and Responses of Anxiety (ISRA) of Vandal Tobol & Cano, 1994.
- Test
anxiety questionnaire (CAEX), Valero Ague, 1999.
- The observation
of behavior: is based on the contemplation of student behavior in their natural
environment, facilitating analysis of their behavior (eg absences to school, etc.).
- The self-reports:
through structured information they collect from the anxiety response in the
natural environment of the student, and the possible factors that keep it
active. All data are collected this information for the student.
- The rating
scales: to quantify the degree of fear that has the student. They have the
ability to be quick and easy to apply, and have the advantage of being used in
combination with other assessment instruments (eg interview, fear inventories, etc..).
Also, allow a continuous analysis of the intensity of the fear of the critical
situations that cause it.
- The psycho
physiological recordings: are evaluation techniques specific phobias are
usually reserved for the field of research, based on feasibility and economics.
It is easier and more comfortable to hold still while children and adolescents
are shown the phobic stimulus in the laboratory space, which will analyze and
record their psycho physiological constant through precision scientific
instruments.
After specific
phobia depression is the second most common primary diagnosis (Rudd et al., 1993,
Stein, 2005).
Patients with
this type of phobic disorder should be evaluated psychologically and
psychiatrically, not only to determine their symptoms but also to specify how
they influence the functional level. Also consider carefully whether other co
morbidities, ie matching (eg heart problems or social phobia).
Also explore
whether the patient has other phobias classified in the DSM-IV-TR.
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