300.29 Specific Phobia (formerly Simple Phobia)
A. Marked and persistent fear that is excessive or
unreasonable, cued by the presence or anticipation of a
specific object or situation (eg, flying, 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
C. The person recognizes that the fear is excessive
or unreasonable. NOTE: In children, this feature may be
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 significantly 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, the duration is at
least 6 months.
Animal Type: if the fear is cued by animals or
insects. This subtype generally has a childhood onset.
Natural Environment Type: if the fear is cued
by objects in the natural environment, such as storms,
heights, or water. This subtype generally has a
Blood-Injection-Injury Type: if the fear is cued
by seeing blood or an injury or by receiving an
injection or other invasive medical procedure. This
subtype is highly familial and is often characterized by
a strong vasovagal response.
Situational Type: if the fear is cued by a
specific situation such as public transportation,
tunnels, bridges, elevators, flying, driving, or
enclosed places. This subtype has a bimodal age-at-onset
distribution, with one peak in childhood and another
peak in the mid-20s. This subtype appears to be similar
to Panic Disorder With Agoraphobia in its characteristic
sex ratios, familial aggregation pattern, and age at
Other type: if the fear is cued by other
stimuli. These might include the fear or avoidance of
situations that might lead to choking, vomiting, or
contracting an illness; "space" phobia (ie, the
individual is afraid of falling down if away from walls
or other means of physical support); and children’s
fears of loud sounds or costumed characters.