Specific Phobia in Young Children: Associations between the Origins of Fear and Clinical Expression of Phobia Symptoms

Abstract Specific phobias set early in life, have a chronic course, and predict development of additional mental health concerns later in life; however, little is currently known about the origins of specific phobias in young children aged 3–6 years. The current study explores the origins of phobic fear among treatment seeking pre-school aged children diagnosed with a Specific Phobia. Specifically, Rachman’s (1977) theory of fear acquisition and differences in children’s specific phobia presentation and parental characteristics across direct and indirect (information and modelling) pathways. Seventy-four children aged 3–6 years with a specific phobia, and their parents completed an assessment battery of child phobic symptoms and related child and parent factors. Parents completed a child diagnostic telephone interview and online questionnaires assessing child factors (phobia type, phobia severity, child anxiety) and parent factors (fears, anxiety symptoms, psychopathology, parental rearing). Children participated in a standardised behavioural approach task (BAT) within the clinic and rated subjective units of distress for their phobic stimuli. All children who experienced a direct aversive event, regardless of other pathways endorsed, demonstrated more behavioural avoidance and subjective distress relative to those who did not. Animal phobias were associated with greater frequency of direct aversive events. Children experiencing the indirect pathways experienced greater generalised anxiety symptoms than all other pathways. The findings of this study suggest unique clusters of clinical presentations across the different pathways to fear among young children with SP. Future research examining whether treatment outcomes differ based on pathways to fear would enhance treatment planning.