202 Anxiety Disorders
Panic disorder. Individuals with specific phobia may experience panic attacks when con-
fronted with their feared situation or object. A diagnosis of specific phobia would be given if
the panic attacks only occurred in response to the specific obje ct or situation, whereas a di-
agnosis of panic disorder woul d be given if the individual also experienced panic attacks
that were unexpected (i.e., not in response to  the specific phobia object or situation).
Obsessive-compulsive disorder. If an individual’s primary fear or anxiety is of an ob-
ject or situation as a result of  obsessions (e.g., fear of bloo d due to obsessive thoughts about
contamination from blood-borne pathogens [i.e., HIV]; fear of  driving due to obsessive im-
ages of harming others), and if other diagnostic criteria for obsess ive-compulsive disorder
are met, then obsessive-compulsive disorder should be diagnosed. 
Trauma- and stressor-related disorders. If the phobia develops following a traumatic
event, posttraumatic stress disorder (PTSD) should be considered as a diagnosis. How-
ever, traumatic events ca n precede the onset of PTSD and sp ecific phobia. In this case, a di-
agnosis of specific phobia would be assigned only if all of the criteria for PTSD are not met. 
Eating disorders. A diagnosis of specific phobia is not given if the avoidance behavior is
exclusively limited to avoidance of food and food-related cues, in which case a diagnosis
of anorexia nervosa or bulimia nervosa should be considered.
Schizophrenia spectrum and other psychotic disorders. When the fear and avoidance
are due to delusional thinking (as in schizo phrenia or other schizophrenia spectrum and
other psychotic disorders), a diagnosis of specific phobia is not warranted. 
Comorbidity