Factors in Phobias 恐惧症中的因素 A relatively extensive treatment of phobic states has been provided recently by Marks (1969, 1970). He notes a number of important elements in phobias which can usefully be taken into account. He notes, for example that certain classes of stimuli have a certain prepotency to involvement in phobic reactions. Thus phobias of going into open spaces or traveling by train or plane are relatively common, whereas phobias of traveling by car are relatively rare, despite the frequency of these situations in everyday experience. Moreover certain classes of stimuli are more likely to trigger phobic responses at particular ages and not at others. Loud noises or sudden movements easily trigger the response of fear in young infants: stranger anxiety is commonly seen in older infants of about 8 months, and animal phobias are common in children of preschool age. Yet the fear of open spaces or of social situations, while rare in childhood, seems to increase in incidence between adolescence and middle age. 马克斯（1969年，1970年）最近对恐惧状态进行了比较广泛的处理。他指出了恐惧症中的一些重要因素，这些因素可以得到有益的考虑。例如，他指出，某些类别的刺激具有一定的参与恐惧症反应的前驱力。因此，进入开放空间或乘火车或飞机旅行的恐惧症相对常见，而乘小车旅行的恐惧症则相对罕见，尽管这些情况在日常经验中很常见。此外，某些类别的刺激在特定年龄段更容易引发恐惧反应，而在其他年龄段则不然。大声的噪音或突然的动作很容易引发小婴儿的恐惧反应：陌生人焦虑症常见于8个月左右的大婴儿，动物恐惧症常见于学龄前儿童。然而，对开放空间或社交场合的恐惧虽然在儿童时期很少见，但在青春期和中年时期的发生率似乎有所增加。 This is partly due to maturational factors, but experiential factors are also an important determinant. These phase-determining incidences, however, are also involved in the emergence of specific dynamic patterns which can underlie the specific fears that are generated. Thus separation anxiety is a more common fear for infants, while animal phobias may be more in evidence in Oedipal age children. The influence of intrinsic and extrinsic factors varies with age. In preschool children, either trivial incidents or none at all can be associated with the origins of animal phobias, while in adults such phobias are usually associated with a definite fright or trauma involving the feared animal. Exposure to the feared situation is also obviously an important factor in school phobias, also in job phobias, and similarly, in later adult life, disease phobias of heart trouble or cancer or even death. 部分原因是由于成熟因素，但经验因素也是一个重要的决定因素。然而，这些阶段性的决定性事件也参与了特定动力学模式的出现，这些模式可能是产生特定恐惧的基础。因此，分离焦虑是婴儿比较常见的恐惧，而动物恐惧症可能在俄狄浦斯年龄的儿童中更为明显。内在和外在因素的影响随年龄的不同而不同。在学龄前儿童中，动物恐惧症的起源可能与一些小事或根本没有发生过的事件有关，而在成人中，这类恐惧症通常与涉及所惧怕动物的明确的惊吓或创伤有关。在学校恐惧症、工作恐惧症中，暴露在恐惧的环境中显然也是一个重要的因素，同样，在成年以后的生活中，心脏病或癌症甚至死亡的疾病恐惧症也是如此。 It is interesting that in general the phobic patients have personalities which are described as timid, shy, dependent, and immature. This obviously does not mean that the development of phobias is restricted to such personalities, although a relatively immature and dependent personality organization seems to form a more appropriate matrix for phobic symptoms to take hold. Similarly phobias can frequently run in families and are quite susceptible to cultural and social influences (Marks, 1970). Phobias may be relatively limited when they follow a simple physical trauma, as for example, fears of dogs after being bitten, or a phobia of heights after a fall, or a fear of driving after a car accident. Fears of horses are relatively common after being thrown by a horse. 有趣的是，一般来说，恐惧症患者的性格被描述为胆小、害羞、依赖和不成熟。这显然并不意味着恐惧症的发展仅限于这种性格，尽管相对不成熟和依赖性强的性格组织似乎形成了一个更适合恐惧症症状的环境。同样，恐惧症也经常会在家庭中流行，并且很容易受到文化和社会的影响（Marks，1970）。恐惧症在简单的身体创伤后可能相对有限，例如，被狗咬伤后对狗的恐惧，或跌倒后的恐高症，或车祸后对开车的恐惧。被马摔下来后怕马的情况比较常见。 Psychological trauma is usually more subtle and involves a phobic result when it touches on or produces severe anxiety, or guilt, or impotent resentment. Phobias may also be triggered by more general life disturbances without specific links between the disturbing situation and the subsequent phobia. Thus agoraphobia may start shortly after traumatic events, like bereavement, marital separation or divorce, accidents, or even severe physical life-threatening illness. The onset of phobic symptoms may not be associated with any major environmental change, and in these instances the change seems to be more within the patient than without. Thus the spontaneous appearance of animal phobias in preschool children may often be related to no specific extrinsic situations or events, but may have internal links to dynamic and instinctual sources of anxiety. Phobias may also serve as a defense against depressive states. 心理创伤通常比较微妙，当它触及或产生严重的焦虑、或内疚、或无力的怨恨时，就会涉及恐惧症的结果。恐惧症也可能是由更普遍的生活干扰引发的，而在干扰情况和随后的恐惧症之间没有具体联系。因此，恐高症可能在创伤性事件后不久就开始了，如丧亲、分居或离婚、意外事故，甚至是严重的危及生命的身体疾病。恐惧症症状的发生可能与任何重大的环境变化无关，在这些情况下，变化似乎更多的是在患者内部而不是外部。因此，学龄前儿童自发出现的动物恐惧症可能常常与任何特定的外在情境或事件无关，而可能与动力学的、本能的焦虑源有内在联系。恐惧症也可能是对抑郁状态的一种防御。