Analysis and Proposal of a New Psychopathological Classification of Phobias

Abstract

Introduction: the study reviews the history and criteria in force in the DSM and ICD diagnostic manuals of the fear reaction called phobia. Material: bibliographic review of changes over time of the international classifications of mental illness up to the current ones. Method: psychopathological analysis of fear and phobias according to the definitions of various authors, and critical review of current criteria, emphasizing the differential diagnosis related to other fear and anxiety pathologies. Results: it is argued that the diagnostic criteria of the current manuals are insufficient to differentiate with psychopathological precision agoraphobia, social phobia and most of the so-called specific phobias, in such a way that they force the examiner toward subjectivity. Discussion and conclusions: it is clear that the current criteria on phobias cannot guarantee the adequate differential clinical diagnosis between the various phobias and other pathologies with some similar symptoms; it is emphasized that many emotional pathologies related to fear and classified as phobias are not; it is proposed to classify phobias as phobia 1 and phobia 2; it is suggested that reactions where non-phobic fear predominates should be diagnosed describing the object or situation (e.g. fear of heights, blood or snakes), and also that phobic reactions should be diagnosed portraying the object or situation, such as phobia 1 (red, number 13), and phobia 2 (social gatherings, oceans, blood, heights or the snakes).