A feared object can be confronted without a high degree of functional impairment. Fear, on the other hand, is not associated with such an intense reaction. Everyday life can be a minefield of potential horrors. Such ongoing monitoring or vigilance, and the concurrent avoidance, cause phobias to be extremely disabling.
The essence of specific phobia is that whenever people come into contact with the intensely feared object or situation, or even suspect that they might, they must either flee from it or tolerate it with severe anxiety. The object of the phobia can be animate or inanimate objects or specific situations. Specific phobias affect between 5 and 10% of the population. Townsend, in Encyclopedia of the Neurological Sciences, 2003 Specific Phobia Phobias that persist into adulthood rarely remit spontaneously. Developing a specific phobia in adolescence increases the likelihood of persistence of symptoms or the development of additional specific phobias. The child's cognitive capacities for recognizing potential dangers are also likely to influence the development of phobias. For example, the most common childhood fears tend to relate to physical harm and injury, and the fear of heights tends to develop as a child becomes increasingly mobile. Developmental milestones and life experiences appear to influence the content and course of phobias. Many fears that develop during childhood (e.g., strangers, darkness, animals, imaginary creatures) are transitory experiences that remit spontaneously. Age of onset for the situational subtype has a bimodal distribution, with a first peak in childhood and a second peak in the mid-twenties. For example, phobias of animals and objects in the natural environment tend to develop in early childhood and blood-injection-injury phobias also tend to develop relatively early. Specific phobias can develop at any point in the lifespan, but symptoms typically first develop in childhood or early adolescence. Approximately 75–90% of individuals with the animal, natural environment, and situational subtypes are female, and ∼55 – 70% of individuals with the blood-injection-injury subtype are female. The ratio of women to men with specific phobias is ∼2:1 however, the sex ratio varies across phobia subtypes. Phobias of heights, spiders, mice, and insects are most common among individuals in the community, whereas claustrophobia (fear of enclosed places), blood-injection-injury phobias, and small animal phobias are most common among treatment-seeking individuals. The lifetime prevalence estimates for specific phobias range from 6% to 23%, making them the most common anxiety disorder and among the most common psychiatric disorders in the community.
Prevalence rates for specific phobias vary depending on the subtype being assessed and the threshold used to determine distress or impairment in epidemiological studies. Phobias are very common in the general population but do not always result in sufficient distress or impairment to warrant a diagnosis of specific phobia. Rector, in Encyclopedia of Human Behavior (Second Edition), 2012 Phenomenology of Specific Phobias Prevalence
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