Social and personal resources and the prevalence of phobic disorder in a community population

Background. Phobic disorder is one of the most prevalent psychiatric disorders in community populations and much attention has focused on the association of sociodemographic factors and social resources with the disorder. There has been little investigation of the more personal resources such as self-confidence, religiosity, social support and self-perceived health that may increase vulnerability.Methods. We used a sample of 2914 community residents aged 18 or older who participated in the Duke University Epidemiologic Catchment Area Study to explore the relationship between both social and personal resources and the prevalence of DIS/DSM-III phobic disorder.Results. The 1-month prevalence of any phobic disorder was 7·6%. In bivariate analyses, we found both race/ethnicity and gender differences in prevalence, with a higher prevalence of phobic disorder in African-Americans and females. Lower socio-economic status, rural residence and unmarried status were also associated with current prevalence. No association was found for social network and social interaction. Impaired subjective social support, low self-confidence, perceived poorer physical health and co-morbid psychiatric disorder were significantly associated with current prevalence in uncontrolled analyses, while associations between lack of a confidant as well as religiosity and phobic disorder were not. Female gender (OR = 1·7), perceived low self- confidence (OR = 2·0), and two interaction terms, age × co-morbid psychiatric disorder and race/ethnicity × perceived physical health were associated with phobic disorder in controlled analyses using logistic regression.Conclusions. We conclude that both social and personal resources, particularly self-confidence, co-morbidity and perceived physical health are important correlates of phobic disorder.

Phobic Disorders are Associated with Temperament in Alcoholic Men

Objective: To investigate whether in a sample of men with alcohol dependence those with comorbid phobic disorders had higher persistence scores than those without. Method: Ninety-nine men with moderate–severe alcohol dependence recruited from an alcohol treatment programme were interviewed using the Structured Clinical Interview (SCID) and completed a Tridimensional Personality Questionnaire (TPQ). Results: Subjects with a comorbid phobic disorder had significantly higher persistence scores compared to those without. Conclusions: The temperament dimension, persistence, is associated with phobic disorder.

Preparedness, phobias, and the Panglossian paradigm

In his critique of preparedness theory, Davey does not address the limitations of adaptationism. The purpose of this commentary is to outline problems that arise when one assumes that mental illness (e.g., phobic disorder) must have had adaptive significance for it to have survived the vicissitudes of natural selection.