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The cross-national epidemiology of specific phobia in the World Mental Health Surveys
Open accessAbstract
Background: Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries. Method: Data came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview. Results: The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes. Conclusions: Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.
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“However, most patients with specific phobias, including AP, do not seek treatment for this condition [9], possibly owing to fears about what treatment will involve [10].”
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 [9]
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“Second, though patient characteristics match many of the typical BII phobia demographic criteria (10, 12, 29, 32), severity was very high and combined with probable panic-triggered PNES.”
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 [12]
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“Compared to other specific phobias, FP presents the highest rates of treatment-seeking (Wardenaar et al., 2017), which makes it clear that there is a need for well-established evidence-based treatments for this problem.”
From An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study (2021) · cites this paper as Wardenaar et al., 2017
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“Specific phobias often run a chronic course (9, 10), and significantly impair quality of life and functioning of patients (11, 12).”
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“Studies have shown that they are not only common within the general population but also remain untreated for the majority of people suffering from them (Coelho et al., 2020; Wardenaar et al., 2017; Wright et al., 2018).”
Background‘Coronaphobia’ Among Undergraduate Students: A Pilot Survey Study
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“Since many psychiatric diagnoses have a later onset than specific phobia [20], comparisons of the comorbidity of DP found in this study with studies on other age groups should be made cautiously.”
AZ BİLİNEN BİR ÖZGÜL FOBİ ‘OFIDIYOFOBI’: BİR OLGU SUNUMU
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“Phobias are a frequently observed condition that affected between 7.4% and 5.5% of the adult population in 2017 [1].”
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“One specific subtype of anxiety disorder is specific phobia, with fears related to animals - such as arachnophobia, an intense fear of spiders - being among the most prevalent forms [3].”
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“Specific phobia often precedes the onset of other mental disorders, making it a possible life indicator of psychopathology vulnerability.[29,30] Homoeopathic miasmatic treatment offers not only relief of suffering in phobias but also can prevent possible further transformation into serious disorders.”
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Social Disability and Impairment in Childhood Anxiety
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Brainwide Analysis of Functional Connectivity Patterns in Specific Phobia and Its Treatment
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“Although adults with SP can recognize that the fear is exaggerated or unfounded, even the thought of the feared object or situation triggers severe anxiety symptoms and can lead to impairment in several areas of daily life, such as home management, ability to work, and social life (3).”
Proximisation, metaphor and threat in experiences of insect and bug phobias
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A relação entre fobias específicas com ansiedade, impulsividade e depressão
Vasconcellos, S. J. L., Cas, A. R. D., Ferreira, S. M., Schneider, J. T., Vedoin, C. B., & Barbosa, T. P. (2023) · Psico · doi:10.15448/1980-8623.2023.1.37366 · Cited by 1
Halıcı, Ö. Y., Coşar-Yılmaz, Z. B., Şen, E. T., & Ünsal, P. (2023) · The International Journal of Aerospace Psychology · doi:10.1080/24721840.2023.2260428 · Cited by 1
“…rates of flight anxiety range from approximately 1–2% for flight phobia to 30–40% for low or moderate levels of flight anxiety (Curtis et al., 1998; Depla et al., 2008; Fredrikson et al., 1996; Grimholt et al., 2019; Iancu et al., 2007; van Gerwen & Diekstra, 2000; Wardenaar et al., 2017).”
BackgroundBrennan, J., Jarrett, M. A., & Davis, T. E. (2024) · CBT: science into practice · doi:10.1007/978-3-031-60746-2_5 · Cited by 1
Palau-Batet, M., Bretón-López, J. M., Grimaldos, J., Suso‐Ribera, C., Castilla, D., García‐Palacios, A., & Quero, S. (2024) · Applied Sciences · doi:10.3390/app14209581 · Cited by 2
Snake phobia among the general population of Tamil Nadu, India
Salim, A., Chandrasekharuni, G., Almeida, J. R., Vaiyapuri, R., Williams, H. F., Arumugam, S., Senthilkumaran, S., Patel, K., Williams, T., Zsido, A. N., et al. (2024) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0012284 · Cited by 1
Anxiety and Anxiety Disorders among Mexican Children and Adolescents
Castaños-Cervantes, S., & García, A. O. (2025) · Revista Colombiana de Psicología · doi:10.15446/rcp.v34n1.111641 · Cited by 2
EFFECT OF HYPNOTHERAPY IN REDUCING PHOBIA SYMPTOMS
Auna, M. S. S. (2020) · INTERNATIONAL JOURNAL OF NURSING AND MIDWIFERY SCIENCE (IJNMS) · doi:10.29082/ijnms/2020/vol4/iss1/256 · Cited by 1
“Many as 59.2% of them reported phobia disrupting their daily lives (Wardenaar et al., 2017).”
BackgroundInfluentialYolcularda Uçuş Fobisi ve Başa Çıkmada Kullanılan Psikolojik Müdahaleler
Halıcı, Ö. Y. (2022) · Istanbul University Press eBooks · doi:10.26650/b/ss32.2022.04.24 · Cited by 1
Palau-Batet, M., Bretón-López, J. M., Grimaldos, J., Díaz-Sanahuja, L., & Quero, S. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069026 · Cited by 1
Manuscript Instrument for Fear of Driving (IFD)Preprint
Fischer, C. S., Schröder, A., Taylor, J. E., & Heider, J. (2021) · doi:10.31234/osf.io/rgp2j · Cited by 1
Snakes vs. Guns: A Systematic Review of Comparisons Between Phylogenetic and Ontogenetic ThreatsPreprint
Shapouri, S., & Martin, L. L. (2021) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/6uyfg · Cited by 1
Kiss, B. L., Birkás, B., Zilahi, L., & Zsido, A. N. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4157131 · Cited by 1
Assessing the prevalence of snake phobia among the general population in IndiaPreprint
Salim, A., Chandrasekharuni, G., Almeida, J. R., Vaiyapuri, R., Williams, H. F., Arumugam, S., Senthilkumaran, S., Patel, K., Williams, T., Zsido, A. N., et al. (2024) · medRxiv · doi:10.1101/2024.06.12.24308826 · Cited by 1
Brain Aging in Specific Phobia: An ENIGMA-Anxiety Mega-AnalysisPreprint
Blake, K. V., Hilbert, K., Ipser, J., Han, L. K. M., Bas‐Hoogendam, J. M., Åhs, F., Bauer, J., Beesdo‐Baum, K., Björkstrand, J., Blanco‐Hinojo, L., et al. (2025) · medRxiv · doi:10.1101/2025.03.19.25323474 · Cited by 1
“SPH patients commonly have comorbid psychopathologies, which may become more severe than the phobia (Wardenaar et al. 2017; Sanderson et al. 1990), highlighting the importance of examining whether comorbidities impact the diagnosis- by-age interaction.”
Smith, H. R. (2018) · UC Research Repository (University of Canterbury) · doi:10.26021/9201
Deepening extinction in a virtual reality treatment for fear of heights
McInerney, J. (2019)
Virtual Reality as an Alternative Therapy for Acrophobics
Lionel, E. M., Gozali, I. D., Syakirah, A. N., & Budiharto, W. (2020) · International Conference on Information Management and Technology (ICIMTech) · doi:10.1109/icimtech50083.2020.9211189
“According to research in 2017, the number of people with specific phobias in the world reached 7.4% [2].”
BackgroundInfluentialSpecific Phobias in Children and Adolescents
Picou, P., Adenuga, P., Ellison, K. S., & Davis, T. E. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00041-8
The effectiveness of acupressure therapy on anxiety: a scoping review protocol
Wang, S. Y., & Morse, Z. (2022) · International Journal of Clinical Trials · doi:10.18203/2349-3259.ijct20221873
Lachhwani, P. (2022) · Springer eBooks · doi:10.1007/978-3-031-13195-0_6
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Rakitzi, S. (2023) · Springer eBooks · doi:10.1007/978-3-031-27837-2_5
(2022) · International Journal of Psychiatry · doi:10.33140/ijp.07.03.03
Case report: specific phobia of vaginal penetration in a pregnant patient
Geng, W., Cao, J., Jin, L., & Wei, J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1218900
“A multinational epidemiological survey revealed that the lifetime prevalence of specific phobia was greater in high and upper-middle income nations compared to low and lower-middle income nations (8).”
BackgroundХоміцький, М., & Kondratenko, M. Y. (2023) · Men’s Health Gender and Psychosomatic Medicine · doi:10.37321/ujmh.2023.1-07
Khomitskyi, M. Y., & Kondratenko, M. Y. (2023) · Ukrains kyi Visnyk Psykhonevrolohii · doi:10.36927/2079-0325-v31-is3-2023-20
Amygdala Habituation During Exposure is Associated with Failure to Reduce Phobic SymptomsPreprint
Lor, C. S., Karner, A., Zhang, M., Kostorz, K., Sladky, R., & Scharnowski, F. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.12.29.573600
“Specific phobias are one of the most common anxiety disorders globally and present a substantial challenge for many individuals (Wardenaar et al., 2017).”
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“Spider fear is very common in the general population, especially among women (Arrindell, 2000; Davey, 1994; Stinson et al., 2007; Wardenaar et al., 2017).”
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Dinamika Psikologis Individu Dewasa Awal dengan Gangguan Fobia Spesifik (Ketakutan Terhadap Cacing)
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A Relação de Fobias Específicas e a Intenção de Viagem, segundo os Tipos de Personalidade A e B
Başarangil, İ. (2024) · Revista Rosa dos Ventos - Turismo e Hospitalidade · doi:10.18226/21789061.v16i3p480
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“…prevalence, associated impairment and frequent co-morbidity rates with other disorders (Wardenaar et al., 2017), accurate assessment and diagnosis of SP is critical from both a research and evidence-based treatments perspective (Avasthi et al., 2014; Moses et al., 2020; Wardenaar et al., 2017).”
InfluentialKadınlarda Uçuş Kaygısı ile İlgili Deneyimlerin Tematik Analiz ile İncelenmesi
Halıcı, Ö. Y., Sarı, S., & Arıkan, S. (2025) · Ayna Klinik Psikoloji Dergisi · doi:10.31682/ayna.1569324
Metadata
- Authors
- Wardenaar, K. J., Lim, C. C. W., Al-Hamzawi, A. O., Alonso, J., Andrade, L. H., Benjet, C., Bunting, B., de Girolamo, G., Demyttenaere, K., Florescu, S. E., Gureje, O., Hisateru, T., Hu, C., Huang, Y., Karam, E., Kiejna, A., Lepine, J. P., Navarro-Mateu, F., Oakley Browne, M., Piazza, M., Posada-Villa, J., ten Have, M. L., Torres, Y., Xavier, M., Zarkov, Z., Kessler, R. C., Scott, K. M., & de Jonge, P.
- Affiliations
- University Medical Center Groningen (NL)
- University of Otago (NZ)
- University of Al-Qadisiyah (IQ)
- Hospital Del Mar (ES)
- Universidade de São Paulo (BR)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- University of Ulster (GB)
- Universitair Ziekenhuis Leuven (BE)
- National School of Public Health, Management and Professional Development (RO)
- University of Ibadan (NG)
- National Center of Neurology and Psychiatry (JP)
- Shenzhen KangNing Hospital (CN)
- Peking University (CN)
- University of Balamand (LB)
- Wroclaw Medical University (PL)
- Universidad Peruana Cayetano Heredia (PE)
- Universidad El Bosque (CO)
- Universidad CES (CO)
- Universidade Nova de Lisboa (PT)
- National Center of Public Health and Analyses (BG)
- Harvard University (US)
- Corresponding author
- Wardenaar, K. J.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-02-22
- Volume
- 47
- Issue
- 10
- Pages
- 1744-1760
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC5674525
- OpenAlex
- W2590938221
- Cited by
- 227
- References
- 54
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 30 · 2023: 37 · 2022: 36 · 2021: 31 · 2020: 22 · 2019: 12 · 2018: 9 · 2017: 3
- FWCI
- 17.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion)
- Funders
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01MH061905, R01MH059575, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- National Institute of General Medical Sciences (R01GM061905)
- Fogarty International Center (R03TW006481)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- 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
- Keywords
- specific phobia, prevalence, cross-national comparison, income level, sex differences, age of onset, role impairment, treatment utilization, comorbidities, vulnerability to psychopathology, low- and middle-income countries
- MeSH terms
- Adolescent, Adult, Employment, Female, Health Surveys, Humans, Male, Mental Health, Middle Aged, Phobic Disorders, Sex Factors, Socioeconomic Factors, Global Health, World Health Organization, Comorbidity, Prevalence, Age of Onset, Young Adult
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