Family Aggregation and Risk Factors in Phobic Disorders over Three-Generations in a Nation-Wide Study
Open accessAbstract
OBJECTIVE: This nation-wide register-based study investigated how often phobic disorders (PHO) and co-morbid disorders occur in affected families compared to control families. Furthermore, the study addressed the impact of sex, year of birth, and degree of urbanization in terms of risk factors. METHOD: A total of N = 746 child and adolescent psychiatric participants born between 1969 and 1986 and registered in the Danish Psychiatric Central Research Register (DPCRR) with a diagnosis of a mental disorder before the age of 18, and developed PHO at some point during their life-time until a maximum age of 40 years were included. In addition, N = 2229 controls without any diagnosis of mental disorders before age 18 and that were matched for age, sex, and residential region were included. Diagnoses of mental disorders were also obtained from the first- degree relatives as a part of the Danish Three Generation Study (3GS). A family load component was obtained by using various mixed regression models. RESULTS: PHO occurred significantly more often in case than in control families, in particular, in mothers and siblings. Substance use disorders (SUD), Depressive disorders (DEP), anxiety disorders (ANX) and personality disorders (PERS) in the family were significantly associated with specific phobia in the case-probands. After controlling for various mental disorders comorbid to PHO it was found that some of the family transmission could be caused by various other mental disorders in family members rather than the PHO itself. Female sex and more recent year of birth were further risk factors while region of residence was not related to the manifestation of PHO. Case-relatives did not develop PHO earlier than control relatives. After adjusting for various additional explanatory variables, the family load explained only 0.0013% of the variance in the manifestation of PHO in the case-probands. DISCUSSION: These findings, based on a very large and representative dataset, provide evidence for the family aggregation and further risk factors in PHO. In contrast to anxiety disorders and other major mental disorders the family load of PHO in this nation-wide study was rather low.
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Specific phobias set early in life, have a chronic course, and predict development of additional mental health concerns later in life.
“Speci fi c phobias set early in life, have a chronic course, and predict development of additional mental health concerns later in life; however, little is currently known about the origins of speci fi c phobias in young children aged 3 -6 years.”
From Specific Phobia in Young Children: Associations between the Origins of Fear and Clinical Expression of Phobia Symptoms. (2025) · cites this paper as Steinhausen et al., 2016
The Introduction says phobic disorders, including specific phobia, are among the disorders with the earliest onset and have substantial comorbidity with other mental disorders. It does not establish a chronic course or show that specific phobias predict the later development of other mental health concerns. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSpecific phobias are among the most commonly occurring disorders across the lifespan and are one of the earliest to onset.
“Speci fi c phobias (SP) are among the most commonly occurring disorders across the lifespan and are one of the earliest to onset (Lieb et al., 2000; Steinhausen et al., 2016)”
From Specific Phobia in Young Children: Associations between the Origins of Fear and Clinical Expression of Phobia Symptoms. (2025) · cites this paper as Steinhausen et al., 2016
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“Obviously, urbanization with potentially underlying stress factors or stronger help-seeking attitudes does not play a significant role in the manifestation of PHO, which is in contrast to our findings with the same approach in SCZ [27], ANX [29] but in line with findings in BP [28], OCD [30], and AN [32].”
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- Authors
- Steinhausen, H.-C., Jakobsen, H., Meyer, A., Jørgensen, P. M., & Lieb, R.
- Affiliations
- University of Basel (CH)
- Aalborg University Hospital (DK)
- Aarhus University Hospital (DK)
- Corresponding author
- Steinhausen, Hans-Christoph
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-01-19
- Volume
- 11
- Issue
- 1
- Pages
- e0146591
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4718671
- OpenAlex
- W2264208386
- Cited by
- 17
- References
- 44
- Citations by year
- 2026: 2 · 2025: 6 · 2023: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc)
- Zurich Open Repository and Archive (University of Zurich)
- 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
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- phobia, specific phobia, familial aggregation, risk factors, comorbidities, substance use disorders, depressive disorders, anxiety disorders, personality disorders, first-degree relatives, sex differences, birth year, urbanization, family transmission, child and adolescent psychiatry
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Denmark, Family, Family Characteristics, Female, Humans, Infant, Infant, Newborn, Male, Phobic Disorders, Risk Factors, Case-Control Studies, Genetic Predisposition to Disease, Young Adult
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