whether it is typical for the child’s  particular developmental stage. 
Although the prevalence of specific phobia is lower in older populations, it remains
one of the more commonly experienced disorders in late life. Several issues should be con-
sidered when diagnosing specific phobia in  older populations. Fi rst, older individuals
may be more likely to endorse natural envi ronment specific phobias, as well as phobias of
falling. Second, specific phobia (like all anxiet y disorders) tends to co-occur with  medical
concerns in older individuals, including co ronary heart disease and chronic obstructive
pulmonary disease. Third, older individuals may be more likely to attribute the symptoms
of anxiety to medical conditions. Fourth, olde r individuals may be more likely to manifest
anxiety in an atypical manner (e.g., involvin g symptoms of both anxiety and depression)
and thus be more likely to warrant a diagnosis of unspecified anxiety disorder. Addition-
ally, the presence of specific phobia in olde r adults is associated with decreased quality of
life and may serve as a risk factor for major neurocognitive disorder. 
Although most specific phobias develop in ch ildhood and adolescence, it is possible for a
specific phobia to develop at any age, often as the result of expe riences that are traumatic. For
example, phobias of choking almost always follow a near-choking event at any age. 
Risk and Prognostic Factors 
Temperamental. Temperamental risk factors for specif ic phobia, such as negative affec-
tivity (neuroticism) or behavioral inhibition, are risk factors for ot her anxiety disorders as
well. 
Environmental. Environmental risk factors for specif ic phobias, such as parental over-