290 CHAPTER 7
Animal Type
Theanimal type of specifi c phobia pertains to an extreme fear or avoidance of any
variety of animal; commonly feared animals include snakes and spiders. Symptoms
of the animal type of specifi c phobia usually emerge in childhood. People with a
phobia for one kind of animal often also have a phobia for another kind of animal.
Hughes’s grandmother and mother had this type of phobia, although his mother’s
fainting in response to seeing an animal is unusual.Natural Environment Type
Thenatural environment type of specifi c phobia typically focuses on heights, water,
or storms. Kevin, in Case 7.5, had a fear of water. Phobias about the natural envi-
ronment typically emerge during childhood.Blood-Injection-Injury Type
Theblood-injection-injury type of specifi c phobia produces a strong response to see-
ing blood, having injections, sustaining bodily injuries, or watching surgery. This
type of phobia runs in families and emerges in early childhood. A unique response of
this specifi c phobia involves fi rst an increased arousal, then a rapid decrease in heartTable 7.10 • DSM-IV-TR Diagnostic Criteria for Specifi c Phobia
A. Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation
of a specifi c object or situation (e.g., fl ying, heights, animals, receiving an injection, seeing blood).B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response,
which may take the form of a situationally bound or situationally predisposed Panic Attack.
Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.C. The person recognizes that the fear is excessive or unreasonable.
Note: In children, this feature may be absent.D. The phobic situation(s) is avoided or else is endured with intense anxiety or distress.E. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes sig-
nifi cantly with the person’s normal routine, occupational (or academic) functioning, or social
activities or relationships, or there is marked distress about having the phobia.F. In individuals under age 18 years, the duration is at least 6 months.G. The anxiety, Panic Attacks, or phobic avoidance associated with the specifi c object or situation
are not better accounted for by another mental disorder, such as Obsessive-Compulsive Disorder
(e.g., fear of dirt in someone with an obsession about contamination [discussed later in this chap-
ter]), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor
[discussed later in this chapter] ), Separation Anxiety Disorder (e.g., avoidance of school [Chapter
14]), Social Phobia (e.g., avoidance of social situations because of fear of embarrassment), Panic
Disorder with Agoraphobia, or Agoraphobia Without History of Panic Disorder.
Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision,
Fourth Edition, (Copyright 2000) American Psychiatric Association.CASE 7.5 • FROM THE OUTSIDE:A Specifi c Phobia (Hydrophobia)
Kevin described an experience in which he almost drowned when he was 11. He and his par-
ents were swimming in the Gulf of Mexico, in a place where there were underwater canyons
with currents that would often pull a swimmer out to sea. He remembered the experience very
distinctly. He was standing in water up to his neck, trying to see where his parents were. Sud-
denly, a large wave hit him and dragged him into one of the underwater canyons. Fortunately,
someone on shore saw what had happened and rescued him. After the experience, he became
very much afraid of the ocean, and the fear generalized to lakes, rivers, and large swimming
pools. He avoided them all.
(McMullin, 1986, p. 165)