Diagnostic Criteria (DSM-V & ICD-10)
Arachnophobia, like other specific phobias, is characterized by an intense and irrational fear of spiders or spider-like creatures. The diagnosis for specific phobias, including arachnophobia, is detailed in both the DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and the ICD-10 (International Classification of Diseases, Tenth Edition). The diagnostic criteria for each are as follows:
DSM-V Criteria for Specific Phobia
- A: Marked fear or anxiety about a specific object or situation (in this case, spiders).
- B: The phobic object or situation almost always provokes immediate fear or anxiety.
- C: The phobic object or situation is actively avoided or endured with intense fear or anxiety.
- D: The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
- E: The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
- F: The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- G: The disturbance is not better explained by another mental disorder, such as fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
ICD-10 Criteria for Specific (Isolated) Phobias
- A: marked fear that is evoked by the presence or anticipation of a specific object or situation.
- B: Exposure to the phobic stimulus invariably provokes an immediate anxiety response, which may take the form of a panic attack.
- C: The individual recognizes that the fear is excessive or unreasonable.
- D: The phobic situation(s) is avoided or else is endured with marked distress.
- E: The avoidance, anxious anticipation, or distress in the feared situation interferes significantly with the individual’s normal routine, occupational functioning, or social activities or relationships.
Tools and Assessment Methods
Diagnosing Arachnophobia, or any specific phobia, requires a comprehensive assessment, often through structured clinical interviews and standardized questionnaires. Some of the widely-used tools and methods include:
a) Structured Clinical Interviews
These are in-depth interviews that give clinicians a full picture of an individual’s symptoms and their severity. One popular tool is the Structured Clinical Interview for DSM-V Disorders (SCID-V).
b) Behavioral Avoidance Tasks
These are hands-on tests where a person might be asked to approach or interact with a spider, giving the clinician insight into the severity of the phobia.
c) Self-report Questionnaires
Patients are often asked to describe their own feelings and behaviors related to spiders. These self-reports can be beneficial in identifying the presence and intensity of arachnophobia.
Fear of Spiders Questionnaire (FSQ)
a) Original Citation
Szymanski, J., & O’Donohue, W. (1995). Fear of Spiders Questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 26, 31–34.
b) Description
The FSQ is a self-report questionnaire consisting of 18 statements related to fear of spiders. Respondents rate each statement on an eight-point scale from 0 (totally disagree) to 7 (totally agree).
c) Administration and Scoring
It can be completed in about 5 minutes. To calculate the total score, add up the scores from all 18 items. Total scores can range from 0 to 126.
Spider Questionnaire (SPQ)
a) Original Citation
Klorman, R., Hastings, J. E., Weerts, T. C., Melamed, B. G., & Lang, P. J. (1974). Spider Questionnaire. Behavior Therapy, 5, 401–409.
b) Description
The SPQ is a 31-item self-report scale. Each item presents a statement related to spiders, and participants indicate whether it’s true or false.
c) Administration and Scoring
It takes approximately 5 minutes to complete. To score, assign a “1” for each true response and a “0” for each false response. Some items are reverse-scored, and then all scores are added up, resulting in a score ranging from 0 to 31.
Watts and Sharrock Spider Phobia Questionnaire (WS-SPQ)
a) Description
The WS-SPQ is a self-report scale consisting of 43 statements about spiders. Respondents indicate agreement with each statement using “yes” or “no.” It generates three subscales for measuring vigilance, preoccupation, and avoidance of spiders. Additionally, five items assess factual knowledge about spiders, while five other items do not belong to any specific factor.
Note: The WS-SPQ should not be confused with the Spider Questionnaire (SPQ) by Klorman et al. (1974), despite the similar acronym.
Differential Diagnosis
When diagnosing arachnophobia, it is essential to differentiate it from other conditions that might present with similar symptoms. A differential diagnosis ensures that the individual receives appropriate treatment. Some conditions to consider include:
a) Other Specific Phobias
Individuals with arachnophobia may also have other specific phobias, such as fear of insects, snakes, or heights. Clinicians should assess whether the fear of spiders is the primary concern or if other specific phobias coexist.
b) Generalized Anxiety Disorder (GAD)
While individuals with GAD experience excessive anxiety and worry about various topics, events, or activities, it’s more diffuse than the focused fear seen in arachnophobia.
c) Obsessive-Compulsive Disorder (OCD)
While OCD might involve fears or distressing thoughts about contamination or harm, the response is typically compulsive behaviors or mental rituals, which differs from the avoidance behaviors seen in specific phobias.
d) Panic Disorder
While a spider might induce a panic attack in someone with arachnophobia, panic disorder involves recurrent panic attacks that are not consistently tied to specific triggers.
e) Medical Conditions
Certain medical conditions, such as hyperthyroidism or substance use, can mimic anxiety symptoms. A thorough medical evaluation should be conducted to rule out any underlying medical causes of anxiety.
