A phobia is an identifiable and persistent fear that is excessive or unreasonable and is triggered by the presence or anticipation of a specific object or situation. Children and adolescents with one or more phobias consistently experience anxiety when exposed to the specific object or situation. Common phobias include fear of animals, blood, heights, closed spaces, or flying. In children and adolescents, the identified fear must last at least six months to be considered a phobia rather than a transient fear. Types of phobias seen in children and adolescents include the following:
Research suggests that both genetic and environmental factors contribute to the onset of phobias. Specific phobias have been associated with a fearful first encounter with the phobic object or situation. The question still exists, however, whether this conditioning exposure is necessary or if phobias can develop in genetically predisposed individuals.
Anxiety disorders are common in all ages. The occurrence of specific phobias in children and adolescents is estimated to range from 1 percent to as high as 9.2 percent. While specific phobias often begin in childhood, they must be differentiated from normal developmental fears. Social phobias are only estimated to occur in up to 1.4 percent of children and adolescents. Panic disorders can develop at any age, but most often begin in adolescence or young adulthood. The study of panic disorders in children (before puberty) has only recently begun.
The following are the most common symptoms that may occur when a child or adolescent is exposed to, or anticipates exposure to, a specific object or situation that produces intense fear or anxiety. However, each child experiences symptoms differently. Symptoms may include:
In panic attacks, at least four of the above listed symptoms must occur with or without a known and identifiable cause.
The symptoms of a phobia may resemble other medical conditions or psychiatric problems. Always consult your child's physician for a diagnosis.
A child psychiatrist or other qualified mental health professional usually diagnoses anxiety disorders in children or adolescents following a comprehensive psychiatric evaluation. Parents who note signs of severe anxiety in their child or teen can help by seeking an evaluation and treatment early. Early treatment can prevent future problems.
Panic disorder, however, may be difficult to diagnose in children and adolescents and may require multiple evaluations and tests in a variety of settings.
Specific treatment for phobias will be determined by your child's physician based on:
Phobias, like other anxiety disorders, can be effectively treated. Treatment should always be based on a comprehensive evaluation of the child and family. Treatment recommendations may include individual or cognitive behavioral therapy for the child (focused on helping the child learn new ways to control anxiety and panic attacks when/if they do occur), family therapy, and consultation with the child's school. Some children may also benefit from treatment with medication - specifically, medications to stop the occurrence of panic attacks. Parents play a vital supportive role in any treatment process.
Preventive measures to reduce the incidence of phobias in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with anxiety disorders.
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