|NCS-R Specific Phobia notes to all users:|
The specific phobia section was revised from the earlier CIDI with the collaboration of Uli Wittchen in consultation with Abby Fyer and Randy Nesse. Many of the changes in this section from the original version of CIDI were made by Gavin Andrews in CIDI 2.1.
SC27a-f. A major change was that we replaced the phrase "unreasonably strong fear," which was used in earlier versions of CIDI, with the softer phrase "a lot more afraid than most people". This was done based on the results of pilot research, which suggested that some respondents object to the first phrase even though they meet criteria for specific phobia. We asked about six different types of specific fears in the screener section as well as in the subsequent specific phobia section. This was an innovation introduced by Gavin Andrews.
SC27.1-27.4. This second tier of screening, which assesses the clinical significance of the phobia fears, is included in the diagnostic sections rather than in the SC section for other disorders. These questions were included in the SC section for specific phobia because the repetition of the stems (i.e., the endorsements in the SC27a-f series) is very time-consuming and because we discovered in pilot studies that a substantial proportion of respondents who endorse these stems screen out when they are administered the SC27.2-27.4 questions. It consequently ends up saving time to administer these questions in the SC section.
SP3-3c. This series is repeated up to six times to assess severity of each type of specific fear. Note that separate ages of onset are documented for onset of fear and onset of avoidance.
SP7f. Some of the six series include additional questions. This one, which was suggested by Bill Eaton, was added to study a sub-typing distinction in blood-injury phobia.
SP9f-k. The additional questions in this series were introduced to help distinguish between specific fear of closed spaces and agoraphobia.
SP11f-k. This series was added to help distinguish specific fear or high places from agoraphobia.
SP13f-l. This series was added in recognition of the very high prevalence of fear of flying in order to distinguish potentially interesting subtypes and to help distinguish these subtypes of specific phobia from agoraphobia.
SP16-end. The specific phobia section is one of the longest sections in the CIDI due to the high proportion of the population that endorses one or more specific fears. In order to reduce the length of the section somewhat, beginning with question SP16 all remaining questions were asked in the aggregate rather than separately for each of the six types of specific fears.
SP18. The two-part approach used here - to ask respondents who can read a single yes-no question based on their visual review of the psycho-physiological symptom list, but to read individual symptoms if the respondent cannot read - was developed by Uli Wittchen and first used in his Munich version of the CIDI.
SP21. This question was used as a "second chance" assessment of recency based on the finding in pilot work that many respondents with current specific phobia reported in response to SP19 that they most recently had a strong fear years ago. The confusion seems to be that these respondents interpret the phrase "strongly feared" to mean having a particular instance when they were exposed to the feared object and had a panic attack. Consistent with the pilot results, we discovered in production interviewing that a substantial number of respondents who reported "more than a year ago" at SP19 told us at SP21 that they would be very fearful if they were exposed to the feared stimulus today.
SP22. This is the functional equivalent of SP21 with respect to avoidance.
SP23-41.1. These questions are identical to those included at the end of each diagnostic section. See commentary on the Depression section for a discussion of these questions.
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