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Specific phobias
Open accessAbstract
Anxiety disorders are among the most prevalent mental disorders, but the subcategory of specific phobias has not been well studied. Phobias involve both fear and avoidance. For people who have specific phobias, avoidance can reduce the constancy and severity of distress and impairment. However, these phobias are important because of their early onset and strong persistence over time. Studies indicate that the lifetime prevalence of specific phobias around the world ranges from 3% to 15%, with fears and phobias concerning heights and animals being the most common. The developmental course of phobias, which progress from fear to avoidance and then to diagnosis, suggests the possibility that interrupting the course of phobias could reduce their prevalence. Although specific phobias often begin in childhood, their incidence peaks during midlife and old age. Phobias persist for several years or even decades in 10-30% of cases, and are strongly predictive of onset of other anxiety, mood, and substance-use disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders. Exposure therapy remains the treatment of choice, although this approach might be less effective in the long term than previously believed. This Review discusses the literature regarding the prevalence, incidence, course, risk factors, and treatment of specific phobias, and presents epidemiological data from several population-based surveys.
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“Arachnophobia is a common source of anxiety within the general population [6].”
From Virtual reality exposure therapy for fear of spiders: an open trial and feasibility study of a new treatment for arachnophobia (2024) · cites this paper as [6]
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“Over time, these mechanisms cause a reduction or avoidance of health care services including preventive measures (9, 29, 31).”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [9]
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“BII phobia is a unique entity featuring intense fear and frequently fainting at the sight or anticipation of blood, physical injury that could lead to blood loss, or injection (9, 28, 29).”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [9]
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“A recent meta-analysis demonstrated a 41% heritability for blood-related fear and 33% for BII phobia, making it the most heritable specific phobia (9, 48).”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [9]
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“However, in the case of phobia relating to blood, injury, and injection (BII), studies identified a distinct pathophysiological mechanism (9, 21–28)”
From Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report (2022) · cites this paper as [9]
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BackgroundInfluentialAugmenting Exposure Therapy: Mobile Augmented Reality for Specific Phobia
Witte, N. A. J. D., Scheveneels, S., Sels, R., Debard, G., Hermans, D., & Daele, T. V. (2020) · Frontiers in Virtual Reality · doi:10.3389/frvir.2020.00008 · Cited by 31
“Specific phobia refers to a persistent unreasonable fear concerning a specific object or situation, which is accompanied by avoidance of the object or situation and results in clinically significant distress or impairment (Eaton et al., 2018).”
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“…prevalence of approximately 5%, occurring somewhat more frequently in women than men [2,4,5] Specific phobias, including AP, often develop quite early in life and their presence is associated with an increased risk of developing other anxiety disorders and depression across the lifespan [6].”
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“But unless a therapist intervenes, we do not forget our phobias, such as a fear of spiders (Eaton et al., 2018; Herry et al., 2010; Kida, 2019; Milton, 2019).”
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“, 2017: Eaton et al., 2018). Females reported a higher incidence of clown fear in our study, and a higher severity of fear compared to male participants. This is consistent with prior research on fear of clowns specifically (e.g. Meiri et al., 2017) and for other specific phobias more generally, e.g., for snakes and s…”
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“The fact that the prevalence and intensity of most phobias tend to decrease with age 56 and that females are at higher risk of developing an SP is well-established 57 .”
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“10 For the fear developed against a situation or object to be defined as a phobia, it must be different and longer lasting than usual and temporary fear.”
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Frequency of and sex distribution in specific phobia subtypes in a treatment-seeking sample
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“14 Female sex and comorbid major depressive disorder were the strongest risk factors for phobia-related worry in one study, as well as traumatic experiences involving significant others, number of chronic diseases and comorbid substance use disorders.”
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“Some of the most common biophobias involve animals (Correia and Mammola 2024 , Zeller et al. 2025 ), with as many as 22% of individuals irra-tionally fearing insects, spiders, and other taxa (Eaton et al. 2018 ).”
Dinh, H. T., Nishimaru, H., Le, Q. V., Matsumoto, J., Setogawa, T., Maior, R. S., Tomaz, C. A. B., Ono, T., & Nishijo, H. (2021) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2021.653250 · Cited by 8
“Specific phobia is a type of anxiety disorder with a lifetime prevalence ranging from 3% to 15% across various countries (Eaton et al., 2018).”
BackgroundRuiz‐García, A., & Aguayo, L. V. (2021) · Clinical Case Studies · doi:10.1177/15346501211007208 · Cited by 6
“Email: aruiz@uco.es the phobic object actually appears or may be imagined to appear (Eaton et al., 2018; Ruiz-García & Valero-Aguayo, 2020a).”
BackgroundThe fear of spiders: perceptual features assessed in augmented reality
Frumento, S., Frumento, P., Laurino, M., Menicucci, D., & Gemignani, A. (2024) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2024.1355879 · Cited by 6
“The imbalance in favor of female participants (representing 28.1 and 71.9% of the sample, respectively) is in line with the higher prevalence of this specific phobia among women (Eaton et al., 2018).”
BackgroundResultInfluentialВладимирович, А. П., Belskaya, G. N., & Никифоров, И. А. (2021) · Meditsinskiy sovet = Medical Council · doi:10.21518/2079-701x-2021-10-66-79 · Cited by 7
Toffolo, M. B. J., Fehribach, J. R., van Klaveren, C., Cornelisz, I., van Straten, A., van Gelder, J., & Donker, T. (2022) · PLoS ONE · doi:10.1371/journal.pone.0271175 · Cited by 6
Cross-cultural adaptation and validation of the Swedish version of the Modified Dental Anxiety Scale
Höglund, M., Göranson, E., Wårdh, I., & Larsson, P. (2024) · Acta Odontologica Scandinavica · doi:10.2340/aos.v83.42436 · Cited by 5
“A patient’s level of dental anxiety varies on a continuous scale from none to extreme, and its most severe form can be considered a specific phobia [3].”
Ramdhan, D., Ardiyanto, E. R., Alexander, P., Putra, E. N., & David (2025) · Software Impacts · doi:10.1016/j.simpa.2025.100770 · Cited by 5
Toward a unified understanding of people’s aversion to nature: biophobia
Jensen, J. K., Persson, A. S., & Soga, M. (2025) · Frontiers in Ecology and the Environment · doi:10.1002/fee.70019 · Cited by 10
Self-reported fears and mental health in elementary school children across Europe
Husky, M. M., Bitfoi, A., Chan‐Chee, C., Carta, M. G., Goelitz, D., Koç, C., Lesinskienė, S., Mihova, Z., Otten, R., Shojaei, T., et al. (2021) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-021-01823-5 · Cited by 5
González-Lozoya, S. M., Meza-Kubo, V., Rodríguez, A. D., Ramírez-Fernández, C., & Morán, A. L. (2022) · TMS Proceedings 2021 · doi:10.1037/tms0000006 · Cited by 5
“Animal Phobia (AP), along with the phobia of heights are among the most common types of phobias in the general population, and it is one of the most common phobias in children, adolescents, and adults (Eaton et al., 2018).”
BackgroundImpact of distance learning on psycho-emotional state in schoolchildren in Krasnodar
Заболотских, Н. В., Vyrodova, E. Y., Dorosheva, A. O., Semerdzhyan, M. A., Simonian, N. E., Shamaeva, M. V., & Artyushkova, A. R. (2020) · Кубанский научный медицинский вестник · doi:10.25207/1608-6228-2020-27-6-109-122 · Cited by 5
von Mücke-Heim, I.-A., Walter, I., Nischwitz, S., & Erhardt, A. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.915058 · Cited by 4
Imprint of ancestral and modern threats in human mind – experience of fear, disgust, and anger
Landová, E., Polák, J., Janovcová, M., Štolhoferová, I., Peterková, Š., Chomik, A., & Frynta, D. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1520224 · Cited by 5
Salehi, M., Amanat, M., Khaleghi, A., Hooshyari, Z., Mostafavi, S., Ahmadi, N., Hojjat, S. K., Safavi, P., & Mohammadi, M. R. (2022) · Clinical Medicine Insights Psychiatry · doi:10.1177/11795573211070537 · Cited by 4
The beneficial effects of a single hypnotherapy session using parts negotiation for specific phobias
Papagianni, V., & Kotera, Y. (2022) · International Journal of Spa and Wellness · doi:10.1080/24721735.2022.2049103 · Cited by 6
Gomes, P. V., Sá, V. J., Donga, J., Marques, A., Gomes, B., de Almeida, R. S., & Pereira, J. (2023) · XoveTIC Conference (XoveTIC) · doi:10.17979/spudc.000024.42 · Cited by 4
Hildebrand, A. S., Breuer, F., Leehr, E. J., Finke, J. B., Bucher, L., Klucken, T., Dannlowski, U., & Roesmann, K. (2023) · PLoS ONE · doi:10.1371/journal.pone.0292471 · Cited by 4
Żuk, P., & Żuk, P. (2024) · Frontiers in Political Science · doi:10.3389/fpos.2024.1288787 · Cited by 4
Specific Phobia, Fear, and the Autism Spectrum in Children and Adolescents: Adapting OST for ASD
Davis, T. E., & Brennan, J. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00475-6 · Cited by 4
Fernández‐Martínez, I., & Muris, P. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01712-3 · Cited by 4
“Meanwhile, research tends to indicate that specific fears (and phobias) are highly prevalent, have an early onset, and may predict the development of later anxiety and other internalizing disorders [49].”
Ardiyanto, E. R., Alexander, P., Putra, E. N., & Ramdhan, D. (2024) · Procedia Computer Science · doi:10.1016/j.procs.2024.10.242 · Cited by 4
An online spider game: Overcome your fear, exposure is near
Dibbets, P., & Schruers, K. R. J. (2022) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2022.100201 · Cited by 4
Animal eMotion, or the emotional evaluation of moving animals
Schmidt, F., Schürmann, L., & Haberkamp, A. (2022) · Cognition & Emotion · doi:10.1080/02699931.2022.2087600 · Cited by 3
PhobeeVR – Design and Development of a Virtual Reality Serious Game for People with Phobias
Ramalhoto, M., Martins, S., & Vairinhos, M. (2024) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah61285.2024.10639582 · Cited by 4
“Specific phobias frequently coexist with comorbidities in 60.5% of cases, and the severity of their impact increases with the cumulative presence of multiple specific phobia sub-types [4], [5].”
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Iannizzotto, A., Frumento, S., Menicucci, D., Callara, A. L., Gemignani, A., Scilingo, E. P., & Greco, A. (2024) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-031-49062-0_81 · Cited by 3
How Maintaining Variables Are Defined and Established in Functional Assessment
Sullivan, W. E., Baxter, E. L., Craig, A. R., DeRosa, N. M., & Roane, H. S. (2021) · Autism and child psychopathology series · doi:10.1007/978-3-030-66270-7_3 · Cited by 3
Areas, M., Babl, A., Fernández‐Álvarez, J., Roussos, A., Botella, C., García‐Palacios, A., Baños, R., Quero, S., Bretón, J., & Penedo, J. M. G. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-022-10343-8 · Cited by 5
Method for Assessing the Influence of Phobic Stimuli in Virtual Simulators
Obukhov, A. D., Krasnyanskiy, M. N., Volkov, A. A., Nazarova, A. O., Teselkin, D. V., Игоревич, П. К., & Zajceva, D. V. (2023) · Journal of Imaging · doi:10.3390/jimaging9100195 · Cited by 3
Ekici, F., Karaoğlan, G., Kandeğer, A., Demir, L. S., & Güler, Ö. (2023) · Genel Tıp Dergisi · doi:10.54005/geneltip.1392240 · Cited by 3
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The Prima Facie View of Perceptual Imagination
Rivadulla-Duró, A. (2025) · Ergo an Open Access Journal of Philosophy · doi:10.3998/ergo.7306 · Cited by 3
“Facilitating this learning is the purpose of exposure therapy, the leading treatment for specific phobias (Eaton et al. 2018).”
Metadata
- Authors
- Eaton, W. W., Bienvenu, O. J., & Miloyan, B.
- Affiliations
- Johns Hopkins University (US)
- Federation University (AU)
- Corresponding author
- Eaton, William W
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 5
- Issue
- 8
- Pages
- 678-686
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7233312
- OpenAlex
- W4245095371
- Cited by
- 203
- References
- 100
- Citations by year
- 2026: 21 · 2025: 33 · 2024: 37 · 2023: 34 · 2022: 31 · 2021: 27 · 2020: 15 · 2019: 5
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (U01AG052445)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- specific phobia, anxiety disorders, prevalence, incidence, developmental course, risk factors, comorbidities, exposure therapy, childhood onset
- MeSH terms
- Age Factors, Avoidance Learning, Humans, Phobic Disorders, Sex Factors, Global Health, Comorbidity, Prevalence, Age of Onset, Substance-Related Disorders
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