A topography of 21 phobic fears: network analysis in an epidemiological sample of adult twins

Abstract

Background Few factor analyses and no network analyses have examined the structure of DSM phobic fears or tested the specificity of the relationship between panic disorder and agoraphobic fears. Methods Histories of 21 lifetime phobic fears, coded as four-level ordinal variables (no fear to fear with major interference) were assessed at personal interview in 7514 adults from the Virginia Twin Registry. We estimated Gaussian Graphical Models on individual phobic fears; compared network structures of women and men using the Network Comparison Test; used community detection to determine the number and nature of groups in which phobic fears hang together; and validated the anticipated specific relationship between panic disorder and agoraphobia. Results All networks were densely and positively inter-connected; networks of women and men were structurally similar. Our most frequent and stable solution identified four phobic clusters: (i) blood-injection, (ii) social-agoraphobia, (iii) situational, and (iv) animal-disease. Fear of public restrooms and of diseases clustered with animal and not, respectively, social and blood-injury phobias. When added to the network, the three strongest connections with lifetime panic disorder were all agoraphobic fears: being in crowds, going out of the house alone, and being in open spaces Conclusions Using network analyses applied to a large epidemiologic twin sample, we broadly validated the DSM-IV typography but did not entirely support the distinction of agoraphobic and social phobic fears or the DSM placements for fears of public restrooms and diseases. We found strong support for the specificity of the relationship between panic disorder and agoraphobic fears.

The Mediation Effect of Phobic Anxiety on the Treatment Outcome of Activity and Participation across Age: Comparison between Online and Face-to-Face Rehabilitation Aftercare of an RCT

“…The mechanisms explored in this study, with short-term treatment change in phobic anxiety mediating the treatment effect on activity and participation, are relatively new. This finding is in line with and adds to previous studies, which reported that phobic anxiety interfered with individuals' lives and activities [26]. It provides the insight that when identifying and providing treatment to individuals with activity and participation difficulties, phobic anxiety should also be considered as one of the possible barriers to becoming active.…”

“…There are hundreds of phobias to be found and they can be classified into three subtypes: agoraphobia, social phobia, and simple/specific phobia [24,25]. Individuals with a phobic anxiety disorder, such as agoraphobia, social phobia, or claustrophobia, will reduce normal activity and participation due to the fears of being in open spaces (i.e., with agoraphobia) or going out of the house alone [26]. Moreover, previous studies have found that the comorbidity rates of phobic anxiety disorders and other mental disorders are high [27].…”

Unravelling the web of addictions: A network analysis approach

“…Alternatively, NA conceptualizes symptoms as mutually interacting and being the cause of the disorder (i.e., formative approach; van Borkulo et al, 2015 ). Thus, rather than only evaluating comorbidity between constructs, NA allows the examination of comorbidity of symptoms within and across disorders ( Fried et al, 2017 , Kendler et al, 2020 ). Such information may be particularly useful considering that comorbid symptoms across different disorders, alternatively known as bridge symptoms, can accommodate either the transition from one disorder to the other, or their co-occurrence ( Epskamp et al, 2018 ).…”

Specific Phobia Disorder Symptoms in People over 65 in Madrid: A Network Analysis

“…These authors note that it is possible that these two symptoms are not directly related but that their association is caused by a third symptom of specific phobia (exposure to the phobic situation/object provokes intense fear, as a result of which a patient (1) avoids that situation/object and (2) feels distressed about the whole situation. Also, no difference in networks based on gender in SPD was found in a recent study conducted with adults (Kendler et al, 2020), where networks of women and men were structurally similar.…”

“…To our knowledge, only a few studies have employed network analysis of SPD symptoms (Borsboom & Cramer, 2013;Kendler et al, 2020), and no symptom network analysis studies were found for SPD in the over 65 population.…”