Tests and diagnosis

By Mayo Clinic Staff

There are no lab tests for phobias. Instead, the diagnosis is based on a thorough clinical interview and diagnostic guidelines. Your doctor will ask questions about your symptoms and take a medical, psychiatric and social history.

To be diagnosed with a phobia, you must meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. This manual is used by mental health providers to diagnose conditions and by insurance companies to reimburse for treatment.

Specific phobias

Diagnostic criteria for specific phobias include:

  • An intense fear or anxiety triggered by an object or situation, such as snakes, flying or storms
  • An immediate anxiety response when you confront the source of your fear
  • Fear or anxiety that is irrational or out of proportion to the risk posed by the object or situation
  • Avoidance of the object or situation you fear, or endurance of it with extreme distress
  • Significant distress or problems with social activities, work or other areas of your life due to the fear, anxiety and avoidance
  • Persistent phobia and avoidance, usually lasting six months or longer

Social phobia (social anxiety disorder)

Diagnostic criteria for social phobia include:

  • An intense fear or anxiety in one or more social situations where there is the possibility of scrutiny by others
  • Fear that you'll embarrass or humiliate yourself or be viewed negatively by others with the possibility of rejection or offending others
  • Intense anxiety, which may take the form of a panic attack, that almost always results from exposure to social situations
  • Avoidance of social or performance situations you fear, or endurance of them with extreme distress
  • Fear and anxiety that are out of proportion to any real risk of being viewed negatively in the situation
  • Problems or distress caused by the phobia that severely affect your life, including your job, social activities and relationships
  • Persistent phobia and avoidance, usually lasting six months or longer

Agoraphobia

Diagnostic criteria for agoraphobia include a severe fear or anxiety about two or more of the following situations:

  • Using public transportation, such as a bus, plane or car
  • Being in an open space, such as a parking lot, bridge or large mall
  • Being in an enclosed space, such as a movie theater, meeting room or small store
  • Waiting in a line or being in a crowd
  • Being out of the home alone

These situations cause anxiety because you fear you won't be able to escape or find help if you develop panic-like symptoms or other incapacitating or embarrassing symptoms.

In addition, diagnostic criteria for agoraphobia include:

  • Fear or anxiety that almost always results from exposure to the situation
  • Avoidance of the situations, required assistance of a companion or endurance of situations with extreme distress
  • Fear or anxiety that is out of proportion to the actual danger posed by the situations
  • Significant distress or problems with social situations, work or other areas in your life caused by the fear, anxiety or avoidance
  • Persistent phobia and avoidance, usually lasting six months or longer
Feb. 08, 2014