Specific fears and phobias

Specific fears are a common and normal experience in the life of children and adolescents. In a substantial minority of youths, the fear for a particular stimulus or situation becomes so intense and severe that it starts to interfere with daily functioning, and in these cases the diagnosis of a specific phobia is warranted. In this chapter, we will first describe the phenomena of specific fears and specific phobias in young people. Then, the occurrence of specific fears and their normal developmental course will be addressed, followed by a discussion of the prevalence of specific phobias as well as some epidemiological facts regarding their severity, continuity, and comorbidity. Following this, we will provide an overview of factors that are involved in the etiology of specific phobias. Consecutively, we will discuss the role of genetics (i.e., hypersensitive fear network in the brain and fearful-inhibited temperament), environmental factors (i.e., specific learning experiences—conditioning, modeling, negative information transmission—or fear-promoting parenting), avoidance, and cognitive biases (i.e., attention bias and covariation bias). Finally, treatment options for children and adolescents with specific phobias will be described. Exposure in vivo appears to be the gold standard for treating this condition, whereas virtual reality exposure might provide a viable alternative.