Page "Phobia" Paragraph 1

The terms distress and impairment as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV-TR ) should also take into account the context of the sufferer's environment if attempting a diagnosis.

The DSM-IV-TR states that if a phobic stimulus, whether it be an object or a social situation, is absent entirely in an environment-a diagnosis cannot be made.

An example of this situation would be an individual who has a fear of mice ( Suriphobia ) but lives in an area devoid of mice.

Even though the concept of mice causes marked distress and impairment within the individual, because the individual does not encounter mice in the environment no actual distress or impairment is ever experienced.

Proximity and the degree to which escape from the phobic stimulus should also be considered.

As the sufferer approaches a phobic stimulus, anxiety levels increase ( e. g. as one gets closer to a snake, fear increases in ophidiophobia ), and the degree to which escape of the phobic stimulus is limited and has the effect of varying the intensity of fear in instances such as riding an elevator ( e. g. anxiety increases at the midway point between floors and decreases when the floor is reached and the doors open ).