A specific phobia is an intense, lasting fear of a particular object or situation, such as heights, animals, flying, needles or blood. The fear is out of proportion to the real danger and leads to avoidance that limits daily life or medical care.
Key symptoms
- Immediate fear or panic when facing the trigger
- Racing heart, sweating, shaking or shortness of breath
- Avoiding the trigger or enduring it with great distress
- Fainting with blood or needle phobia from a sudden drop in heart rate
- Symptoms lasting 6 months or more
What you find on exam
- Ask what triggers the fear and how it affects daily life
- Mental status exam and screening for other anxiety disorders
- Check vital signs; rule out medical causes of panic-like symptoms
- Ask about avoided medical care such as blood tests or dental visits
Tests
- Diagnosis is clinical, based on the history
- Anxiety screening questionnaires such as GAD-7
- Tests only if symptoms suggest thyroid disease or heart rhythm problems
Treatment basics
- Exposure therapy, step by step, the most effective treatment
- Cognitive behavioral therapy
- Applied tension technique for blood and needle phobia
- Short-term medicine such as propranolol or a benzodiazepine only for rare, planned events
Red flags
- Avoiding needed medical care, surgery or vaccines
- Panic attacks spreading to many situations
- Depression, substance use or suicidal thoughts
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Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.