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CP: 1.4 Anxiety disorders and fear-related disorders > 1.4.3 Treatment and management of anxiety disorders and fear-related disorders > Flashcards

1.4.3 Treatment and management of anxiety disorders and fear-related disorders Flashcards

1
Q

Treatments

What are the most common behavioural treatments for anxiety/fear-related disorders?

A
  • Systematic desensitisation
  • Applied tension
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2
Q

Treatments

What are the most common biological treatments for anxiety/fear-related disorders?

A

Anti-anxiety drugs, such as beta blockers.

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3
Q

Systematic desensitisation (Wolpe, 1958) - Behavioural therapy

Systematic desensitisation therapy

A

Patient is taught relaxation skills and to identify relaxed muscles, so that they can recreate this when confronted with the source of their phobia.

Patient and therapist then construct a hierachy of fears, starting with the least fear-inducing situation (like seeing an image) and working up to their most fearful.

They then go up the fear hierachy, replacing their fear response with relaxation and calm (classical conditioning).

This is a non-directive therapy which goes at the patient’s pace.

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4
Q

Systematic desensitisation (Wolpe, 1958) - Behavioural therapy

In vitro

A

Instances where exposure to the phobic stimulus is imagined, such as through a visualisation exercise.

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5
Q

Systematic desensitisation (Wolpe, 1958) - Behavioural therapy

In vivo

A

Instances where the individual is directly exposed to the phobic stimulus in real life.

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6
Q

Systematic desensitisation (Wolpe, 1958) - Behavioural therapy

How well does this therapy work?

Do people tend to relapse?

A

Complex and social phobias, such as agoraphobia, do not respond so well and relapse rates are high.

Craske and Barlow (1993) found agoraphobic clients often relapsed completely after 6 months.

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7
Q

Flooding - Behavioural therapy

Flooding

A

When the patient is directly exposed to their strongest fear (they consent to this) and have no option but to face it.

Sometimes ‘implosion’ is used, where the direct exposure is only imagined.

During this, the patient experiences extreme discomfort and fear, however, it dies off as the body cannot sustain such high arousal levels for a long time.

The theory is that fear/anxiety will diminish and the patient will learn there is nothing to be afraid of.

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8
Q

Flooding - Behavioural therapy

‘Implosion’ flooding

A

When the direct exposure is only imagined, so less stressful.

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9
Q

Flooding - Behavioural therapy

Criticism of flooding

A

Can be seen as very unethical.

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10
Q

CHAPMAN AND DELAPP (2014)

Context

A
  • Disgust in response to blood is associated with fainting.
  • CBT is more effective in reducing fear than disgust in people with BII phobias.
  • Applied tension targets fainting, which is less treatable with CBT alone.
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11
Q

CHAPMAN AND DELAPP (2014)

How is CBT effective at treating phobias?

A

It challenges irrational thoughts (fears) and replaces them with more rational ones, leading to behavioural and emotional changes that can be practised.

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12
Q

CHAPMAN AND DELAPP (2014)

Aim

A

To investigate whether BII phobia could be successfully treated using CBT and applied muscle tension.

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13
Q

CHAPMAN AND DELAPP (2014)

Method

A

Case study.

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14
Q

CHAPMAN AND DELAPP (2014)

Participant

A
  • White
  • 42-years-old
  • Male
  • Known as ‘T’
  • Diagnosed with BII phobia
  • Diagnosed with MDD (recurrent in full remission) based on an incident in college
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15
Q

CHAPMAN AND DELAPP (2014)

How was baseline data collected?

A

Using psychometric tests.

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16
Q

CHAPMAN AND DELAPP (2014)

What data was collected using interviews?

A

A detailed life history, including several challenging times in his life, such as witnessing the deaths of family members, living with an anxious Grandmother who would list to emergency dispatch calls on a scanner and witnessing other family members faint during medical procedures.

17
Q

CHAPMAN AND DELAPP (2014)

What questionnaires were used?

A
  • Beck’s anxiety inventory (BAI) = measure of anxiety.
  • Beck’s depression inventory (BDI) = measure of depression.
  • The quality of life questionnaire (Q-LES-Q = measure of general life satisfaction.
  • The blood-injection symptom scale (BISS) = tested if ‘T’ met the diagnosis criteria.
18
Q

CHAPMAN AND DELAPP (2014)

What treatment plan was used?

A

‘T’ underwent 9 sessions of CBT and applied muscle tension.

He was educated about how common phobias are and also made a fear hierarchy to work through.

He was also introduced to the Subjective unit of discomfort scale (SUDS) which gave rating of his anxiety as he moved through the hierarchy.

19
Q

CHAPMAN AND DELAPP (2014)

Subjective unit of discomfort scale (SUDS)

A

Gave rating of anxiety (0-100) throughout different stages of the hierarchy exposure.

20
Q

CHAPMAN AND DELAPP (2014)

How many items did the fear hierarchy include?

A

10 items.

21
Q

CHAPMAN AND DELAPP (2014)

Sample items from fear hierarchy

A
  • Watching blood tests on Youtube
  • Finger-prick blood tests
  • Observing blood donations
  • Booking and having a blood test
22
Q

CHAPMAN AND DELAPP (2014)

At what intervals was data collected after treatment?

A

At 4, 10 and 12 months following treatment.

23
Q

CHAPMAN AND DELAPP (2014)

When were the psychometric tests carried out?

A

Before and after treatment.

24
Q

CHAPMAN AND DELAPP (2014)

What was found after ‘T’s’ treatment?

A

He no longer had BII phobia.

25
Q

CHAPMAN AND DELAPP (2014)

Before treatment, what did T’s assessments show he had?

A

Severe anxiety; minimal depressive symptoms, and overall good health in most life areas.

He showed intense fear/anxiety surrounding blood and injections.

26
Q

CHAPMAN AND DELAPP (2014)

How did his fear hierachy end?

How did his SUDS score change?

A

The treatment ended with him having his blood taken.

His SUDS were 40/100 initially, then dropped to nothing, with only minimal muscle tension used.

27
Q

CHAPMAN AND DELAPP (2014)

What did results of the self-report measures show at the end of the study?

A

His anxiety levels had dropped significantly and he no longer showed fear or terror to medical-related stimuli.

28
Q

CHAPMAN AND DELAPP (2014)

Conclusion

A

CBT with AT is an effective treatment for BII phobias.

29
Q

CHAPMAN AND DELAPP (2014)

Strengths

A
  • Detailed = case study is in-depth with triangulation of data collection methods.
  • RWA = findings can be applied to BII phobia research.
  • Quantitative data = SUDS scores allowed changes to be monitored.
30
Q

CHAPMAN AND DELAPP (2014)

Criticisms

A
  • RWA/generalisability is limited = sample is small and undiverse, so findings cannot be applied to others.
  • Low reliability = case studies cannot be replicated.
  • Self-report = liable to social desirability bias and mis-remembering, lowering validity.
  • No control group = extraneous variables could have impacted results, no proof the treatments made the difference.
31
Q

Issues and debates

What do all these treatments have?

A

RWA.

32
Q

Issues and debates

Is Chapman and DeLapp’s study idiographic or nomothetic?

A

Idiographic, since it provides a detailed insight into one participant because it’s a case study.

CP: 1.4 Anxiety disorders and fear-related disorders (3 decks)

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