title: The epidemiology of specific phobia and subthreshold fear subtypes in a community-based sample of older adults.
abstract: BACKGROUND
  Specific phobias have received little attention among older adults. This study is aimed at determining the 12-month prevalence rates of fear subtypes in older adults with a full or subthreshold DSM diagnosis of specific phobia as well as to examine differences among these conditions according to health and health behavior characteristics potentially associated with the severity of anxious symptoms.
  
  
  METHODS
  Data came from a representative sample of community-dwelling older adults aged 65 years and older (N = 2784). Diagnoses were established by in-home semi-structured interviews. DSM-IV criteria for specific phobia were slightly modified in line with recommendations for DSM-V.
  
  
  RESULTS
  The 12-month prevalence rates of specific phobias and subthreshold fears were, respectively, 2.0 and 8.7%. More than half of the respondents with a specific phobia did not recognize the "excessiveness" of their fears. Situational and natural environment fears were the most frequent subtypes. Compared to respondents with no symptoms of anxiety, older adults with a full- or subthreshold-specific phobia reported more chronic physical health problems, more comorbid depressive disorders and a higher use of benzodiazepines. However, older adults with specific phobia reported more comorbid anxiety disorders than respondents with subthreshold fears.
  
  
  CONCLUSIONS
  The present study provides evidence for the fact that subthreshold fears have a high prevalence among older adults. Since several older people with specific phobia do not recognize the "excessiveness" of their fears, it is recommended that DSM-V criteria allow clinicians to rely on their own judgment to assess whether the perceived danger is out of proportion.
authors.affiliation: Centre de recherche de l'Hôpital Charles LeMoyne, Greenfield Park, Québec, Canada. grenier.sebastien@uqam.ca
authors.forename: Sébastien
authors.initials: S
authors.lastname: Grenier
authors.forename: Josien
authors.initials: J
authors.lastname: Schuurmans
authors.forename: Maria
authors.initials: M
authors.lastname: Goldfarb
authors.forename: Michel
authors.initials: M
authors.lastname: Préville
authors.forename: Richard
authors.initials: R
authors.lastname: Boyer
authors.forename: Kieron
authors.initials: K
authors.lastname: O'Connor
authors.forename: Olivier
authors.initials: O
authors.lastname: Potvin
authors.forename: Carol
authors.initials: C
authors.lastname: Hudon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005239:Fear; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011792:Quebec