Fears and phobias represent a major segment of the psychological distress experienced by children while growing up. It is important to distinguish between the two.

Fears are a normal part of life and usually are most vivid and ubiquitous during childhood. Fear is the emotional and physiologic response to an external danger. At their best, fears help keep one safe. The fear of being burned, being accosted by strangers, disappointing parents by doing poorly on an examination, or ending up in jail all can lead to a more healthy and productive life. One could speculate that heights and snakes are among the most common fears among adults because those ancestors who avoided snakes and high places were most likely to live long enough to ensconce these tendencies in the gene pool.

The differential diagnosis of fears and phobias is easier during adulthood than it is during childhood. This is because the child's physical and cognitive immaturity can confound reality testing on developmental and psychopathologic bases. The toddler who is so small, helpless, and unable to understand the forces of physical and human nature accurately often has many normal fears. These typically may include strangers, their parents' leaving, monsters, the dark, or going to sleep.

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