A 30-year-old man has had marked fear of enclosed spaces since adolescence. He refuses air travel, avoids lifts, and once climbed eight flights of stairs to escape a crowded elevator. He recognises the fear as excessive. According to DSM-5, this presentation belongs to which subtype of specific phobia?

• A Situational type ✓
• B Natural environment type
• C Animal type
• D Blood-injection-injury type

Explanation

DSM-5 divides specific phobia into animal, natural environment, blood-injection-injury, situational, and other types. Fear of enclosed spaces such as lifts, aeroplanes, tunnels, and closed rooms falls under the situational subtype. Natural environment type covers heights, storms, and water, which kills option B. Animal type covers spiders, snakes, and dogs, and blood-injection-injury type is defined by the characteristic vasovagal fainting response.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

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