By S. Manning, R. Gillies

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Contact with the phobic stimulus is endured with intense distress or it is avoided entirely. The avoidance, anxious anticipation, or distress must interfere significantly with the person’s normal routine, occupational or academic functioning, or social activities and relationships. Most people who have specific phobias do not present for treatment. Conversely, most anxiety disorders that present in primary care settings are not specific phobias. The DSM-IV-TR requires that the distress and avoidance associated with the phobic stimulus are not better accounted for by another disorder that may have different treatment implications.

A cycle of escalating intrusions, hypervigilance, futile control of inherently uncontrollable thoughts, reactive panic, and powerfully reinforcing relief through neutralizing rituals becomes self-perpetuating [1]. ’’) that are experienced as remarkably intrusive and inappropriate, or (2) compulsions: anxiety-relieving, repetitive behaviors (eg, hand washing, checking, reassurance seeking) or mental acts (eg, praying, covert words or images, counting) that aim to neutralize distress or ‘‘prevent’’ bad outcomes.

A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Compr Psychiatry 1990; 31(5):416–25. [83] Wilens TE, McDermott SP, Biederman J, et al. Cognitive therapy in the treatment of adults with ADHD: a systematic chart review of 26 cases. J Cogn Psychother 1999;13(3):215–26. [84] Torgerson T, Gjervan B, Rasmussen K. ADHD in adults: a study of clinical characteristics, impairment and comorbidity. Nord J Psychiatry 2006;60:38–43. [85] Searight HR, Burke JM.

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