PHOBIA, an irrational and exaggerated fear of an object or situation. The term is derived from the Greek word phobos, which means “fear,” “terror,” “panic,” or “flight.” But a phobia is more than this, since all persons experience fear or terror occasionally. In fact, normal fear and the process of being afraid or terrified serve a protective function. That is, fear alerts a person to real dangers or threats that must be avoided or confronted. One the other hand, a phobic object or situation—such as a small domestic animal, an elevator, or a crowded movie theater—does not post sufficient danger to provoke rational fear or anxiety.  

恐惧（症），一种对物体或情境非理性和夸张的恐惧。该术语源自希腊语phobos，意思是“恐惧”，“惊恐”，“恐慌”或“逃避”。但恐惧症不止于此，因为所有的人都会偶尔经历恐惧或惊恐。事实上，正常的恐惧和害怕或惊恐的过程起到了一种保护作用。换言之，恐惧使人对必须避免或面对的真正危险或风险产生警觉。另一方面，恐惧的物体或情境—例如小型家畜、电梯或拥挤的电影院—不足以引起理性的恐惧和焦虑。

The names of phobic objects or situations also have been taken from the Greek language. Because someone may develop a phobia concerning almost any object or situation, phobias are as numerous as the objects or situations that can cause fear. To cite just two examples, acrophobia refers to fear of heights, while ailurophobia is an irrational fear of harmless domestic cats.

恐惧的物体或情境的名称也来自希腊语。因为某些人可能会对任何物体或情境产生恐惧，恐惧症与可能引起恐惧的物体或情境一样多。举两个例子，恐高症是指对高度的恐惧，而惧猫症是一种对无害家猫的恐惧。

The defining feature of a phobia that may require treatment is that it causes frequent, severe, and intense anxiety. Everyday living is disrupted, since the phobic individual must avoid numerous objects or situations that might lead to this anxiety. Thus, while clinicians seldom see patients with a phobia of snakes—a problem that most people need not confront daily—they commonly treat people with a phobia of flying on airplanes or with the most dreaded and intense fear of all, agoraphobia.

可能需要治疗的恐惧症的定义特征是它会引起频繁、严重和强烈的焦虑。打乱日常生活，因为有恐惧症的个体必须避免许多可能导致这种焦虑的物体或情境。因此，尽管临床医生很少看到患有蛇恐惧症的患者—多数人无需每天面对的一个问题—但他们通常会治疗患有乘坐飞机恐惧症的人，或患有最可怕和最强烈恐惧的陌生环境恐惧症的人。

Types of Phobia—Agoraphobia. Phobia can be divided into THREE general categories. The first and most serious is agoraphobia, which literally means “fear of the marketplace.” Agoraphobics are afraid to leave a safe place (the home) or a safe person (a spouse or close relative), and doing so causes intense anxiety or panic. They frequently remain housebound for many years. More than anything, agoraphobics fear the occurrence of an uncontrollable panic attack, during which they think they are dying or going crazy. Thus it would be more accurate to describe an agoraphobic as one who is afraid of fear. Agoraphobia usually begins in late adolescence or early adulthood and is more common in women than men. The course of agoraphobia is chronic, but it has a tendency to fluctuate and sometimes is marked by periods of spontaneous remissions. Symptoms of generalized anxiety are common.

恐惧症的类型—陌生环境恐惧症。恐惧症可分为三大类。第一类和最严重的是陌生环境恐惧症，按字面意思是“对集市的恐惧”。陌生环境恐惧症者害怕离开安全的场所（家）或安全的人（配偶或亲属），这样会导致严重的焦虑或恐慌。他们常常多年足不出户。更重要的是，陌生环境恐惧症者担心会出现无法控制的恐慌，在此期间他们认为他们快要死了，或者快要疯了。因此，将陌生环境恐惧症者描述为害怕恐惧的人会更为准确。陌生环境恐惧症通常始于青春期后期或成年期早期，而且女性比男性更为常见。常见的是普遍性焦虑症状。

Social phobia. A second common type of phobia is termed social phobia. Social phobia is an irrational fear of any situation where one might be evaluated and therefore embarrassed in public. Usually, social phobics feel that in these situations they would blush, tremble, or otherwise be unable to perform or behave naturally. Typical social phobias include fear of public speaking, eating in public, parties, social gatherings, or business conferences. Much like agoraphobia, social phobias usually begin in late adolescence or early adulthood and are accompanied by heightened levels of generalized anxiety.

社交恐惧症。第二种常见的恐惧症类型被称为社交恐惧症。社交恐惧症是一种对任何可能评估的情境的非理性恐惧，因此，在公共场合会感到尴尬。通常，社交恐惧症患者感觉在这些情境中他们会脸红、颤抖，或无法自然地表现或行为。典型的社交恐惧症包括对公开演讲、在公共场所、派对、社交聚会或商务会议上用餐感到恐惧。很像陌生环境恐惧症，社交恐惧症通常始于青春期后期或成年期早期，并伴有高度的普遍性焦虑。

Simple Phobia. This category includes all other fears of specific objects or situations. The most common is fear of certain modes of transportation such as driving—particularly across bridges—or flying. Other common phobic objects or situations include harmless animals such as dogs or cats, thunderstorms, darkness, or heights. A special type of simple phobia concerns blood and injury. It is notable because, unlike all other phobias, which cause increased heart rate and other physiological signs of arousal, blood and injury phobia produces decreased heart rate, decreased blood pressure, and fainting spells. Unlike agoraphobia, simple phobias usually begin in childhood and follow a chronic course, without much fluctuation and with no spontaneous remission. Usually no signs of generalized, chronic, high levels of anxiety are present. However, childhood fears of the dark, strangers, or dentists almost always are transient and do not develop into adult phobias.

单一恐惧症。这个类别包括对所有其它特定物体和情境的恐惧。最常见的是对某些交通模式的恐惧，例如驾驶—尤其是通过桥梁—或者飞行。其它常见的恐惧物体或情境包括无害的动物，如狗或猫、雷暴、黑暗或高处。单一恐惧症的特定类型与血液和受伤相关。值得注意的，由于与所有其它恐惧症不同，它会导致心率加快和其它唤醒的生理体征，血液和受伤恐惧症会引发心率下降，降低血压，以及昏厥。与陌生环境恐惧症不同，单一恐惧症通常始于童年，并呈现一种慢性的过程，没有太大的波动，也没有自发性的缓解。通常没有普遍、慢性、高度焦虑的体征。然而，儿童时期对黑暗、陌生人，或牙医的恐惧几乎总是短暂的，并且不会发展为成人恐惧症。

Cause. For years, mental-health professionals thought that phobias and other neurotic symptoms were the result of repressed, unconscious conflicts symbolized by the type of phobia. The individual avoided the phobic situations in order to avoid “cuing” these disruptive conflicts, which were believed to be rooted in early childhood. Later research points to a mix of psychological and biological factors as the causes of phobia. Specifically, most phobias seem to be simply extensions of normal fears, in that they are learned during childhood or adolescence people who are nervous by nature are particularly susceptible to developing phobias. In a minority of cases, phobics may be told as children by overzealous relatives that certain inherently harmless objects or situations are dangerous, or children may observe adults behaving in a phobic manner. In this way, phobias can be passed on through generations. Some evidence also exists that the type of intense anxiety or panic seen in agoraphobia may have biological or biochemical origins. In any case, once a phobia is developed, it maintains itself, since most phobics avoid prolonged contact with the object or situation they fear. Thus they never learn that, in fact, no real danger exists.

原因。多年来，心理健康专业人员认为，恐惧症和其它神经过敏症是以恐惧症类型象征的无意识冲突，压抑的结果。个体避免恐惧的情境，以避免“暗示”这些破坏性冲突，这被认为是植根于早期的儿童阶段。后来的研究指出，心理和生物因素的混合是恐惧症的原因。具体来说，大多数恐惧似乎只是正常恐惧的扩展，因为它们是在童年或青春期习得的，那些天生紧张的人尤其容易患上恐惧症。在少数案例中，恐惧症患者可能在儿童时期被过分热心的亲属告知，某些本质上无害的物体或情境是危险的，或者孩子可能观察到成人以恐惧的方式行事。用这种方式，恐惧症可能被代代相传。一些证据也表明，在陌生环境恐惧症中看到的强烈焦虑和恐慌的类型可能具有生物或生物化学的来源。无论如何，一旦患上恐惧症，它会自我维持，因为大多数恐惧症患者会避免长期接触他们恐惧的物体或情境。因此，他们从未了解它，事实上，真正的危险并不存在。

Treatment. Despite conflicting views of the cause of phobia, experts widely agree that effective treatment involves confronting the phobic object or situation in a gradual way, most often with the help of a therapist. Eventually the phobic individual will come to realize, at a very basic emotional level, that no real danger exists. Freud, from a psychoanalytic viewpoint, pointed out the necessity of this course of action very early. However, in the past most psychoanalysts attempted to treat phobias by determining and then explaining to the phobics their view of the specific nature of repressed, unconscious conflicts. During the early 1950’s a South African psychiatrist, Joseph Wolpe, discovered that encouraging direct confrontation with feared objects and situations was more effective in treating phobias. Most of these treatment procedures are classified under the general heading of behavior therapy and include such specific techniques as systematic desensitization and other “exposure-based” treatments. These procedures are now practiced in phobia clinics throughout the world. In the treatment of phobias in which spontaneous panic is a prominent feature, powerful anti-depressants can be helpful, especially when combined with behavior-therapy procedures.

治疗。尽管对恐惧症的原因存在不一致的观点，但专家们普遍赞同，有效的治疗包括用一种渐进的方式对抗恐惧的物体或情境，最常见的是在治疗专家的帮助下。最终，恐惧症患者会意识到，在非常基本的情绪层面并不存在真正的危险。弗洛伊德从精神分析的角度很早就指出了这种行动方案的必要性。然而，在过去，大多数精神分析学家试图通过确定，然后向恐惧症患者解释他们对被压抑、无意识冲突的具体性质的看法来治疗恐惧症。在20世纪50年代早期，一名南非的精神病学家约瑟夫·沃尔佩发现，鼓励直接对抗恐惧的物体和情境，对治疗恐惧症更有效。这些处理规程中的大多数都归类在行为治疗的总标题下，而且包括系统脱敏等特定技术和其它“基于报道”的治疗。这些规程目前在世界各地的恐惧症诊所进行。在对恐惧症的治疗中，其中自发性的恐慌是一个突出特点，强效抗抑郁药可能会有帮助，尤其是当与行为治疗规程结合时。

                                     DAVID H. BARLOW

                               State University of N.Y. at Albany

                                        大卫H. 巴洛

                                  纽约州立大学，奥尔巴尼分校                                    2025年1月25日译

（译者注：该词条位列《大美百科全书》1985年版，第21卷，第944页至945页）