ANXIETY DISORDER: CHAPMAN & DELAPP Flashcards
1
A
- The diphasic response refers to when a person experiences an increase in blood pressure and heart rate on seeing or imagining blood. This is then followed by the sudden decrease in blood pressure and heart rate.
- People with BII have a stronger than average disgust response and this is associated with fainting.
2
Q
What was the aim
A
- The aim of the study was to investigate the effectiveness of applied tension and manualised CBT through a 9-week course for a patient with BII phobia
3
Q
Describe the sample
A
- One participant referred to as ‘T’
- Hispanic male
- aged 42 years
- experienced this phobia for 20 years
4
Q
Describe T’s symptoms
A
- T perceived medical procedures as ‘dangerous’
- He had physical symptoms such as racing heart, cold chills and dizziness.
- These led to fainting
5
Q
Describe his background info
A
- T’s child had autism and felt guilty for not being able to attend regular medical appointments with his child
- As a child T’s mother ‘joked’ he might have a heart problem.
- His grandmother suffered anxiety related to medical emmergencies as she would listen to ambulance dispatch calls everyday
- T witnessed the deaths of his grandfather, uncle and aunt from illnesses, including cancer.
- He experienced major depressive episodes in college
6
Q
Describe the qualitative data
A
A diagnostic interview confirmed his BII phobia diagnosis.
7
Q
List the quantitative measures in the study
A
- The Beck Anxiety Inventory
- The Fear Survey Schedule II
- The Blood-Injection Symptom Scale
8
Q
Describe the BAI and T’s scores
A
- 21-items
- All rated from 0-3
- Baseline score: 41(severe)
- Follow up: 7(low)
9
Q
Describe the FSS-II and T’s scores
A
- Assesses fear towards 51 objects/situations
- Rated on a 7-point scale
- Baseline: 6 (terror)
- Follow up: Few items reached ‘terror’
10
Q
Describe the BISS and T’s scores
A
- 17 items
- assesses the sensations experienced during situations involving blood/ injections
- Baseline: ‘Yes’ for all 17 items
- Follow up: 4/17 sensations
11
Q
Describe the methodology
A
- This was a case study
- 19 CBT sessions including applied tension
- T completed homeowork between sessions
12
Q
Describe the first parts of the sessions
A
- T had been taught several things about phobias such as thinking errors, cognitive restructuring and graduated exposure (psychoeducation)
- He then created a 10-item hierarchy
13
Q
Describe the Hierarchy and the scale used
A
- It was 10-items
- each item rated from 0-100
- This was investigated using the SUDS(0-100)
- EXAMPLES OF ITEMS:
> Watching YT videos of people having blood tests
> Taking blood pressure myself
> Wife taking my blood sugar
14
Q
outline the Applied tension procedure
A
- Find a comfortable chair
- Tense the muscles of your arms, torso and legs
- Hold the tension for 10-15 seconds
- Release for 20-30 seconds
- Repeat 5 times
15
Q
What were the follow-up results
A
- 4 months later: Was starting to book doctors appointments
- 10 months later: Still showed improvement
- 12 month later: He completed follow up questionnaires and compared scores between baseline and follow up scores
16
Q
What did they conclude
A
- Psychoeducation, CBT and applied tension are effective in the treatment of a man with severe BII phobia
17
Q
State the 3 methodological strengths
A
- for ethics, therapists ensured they worked with him and made sure that they moved up the hierarchy at his own pace
- They collected both quantitative and qualitative data. For instance, SUDS scores were taken before during and after the exposure therapy. The qualitative data looked at T’s subjective experience of recovery.
- The researchers provided detailed data about T’s history and his symptoms including depression. The detailed case history means readers can draw their own conclusions about whether the findings would relate to their own.
18
Q
State 2 methodological weaknesses
A
- The use of self reported data is in the form of the SUDS which may not have been valid. He was asked to give his answeres orally and may have given the answers he perceived the therapist expected to hear. T also suffered with social anxiety and so may be motivated to give positive answers.
- There was the lack of a control group. For instance, participants may believe they are learning skills to reduce the risk of fainting but that may not be the case. For T, it is difficult to determine whether it was the treatment that was leading to progress or was it his increased motivation and desire to change his behaviour.
19
Q
Application to everyday life
A
- This study states that people with BII can be treated in outpatient community settings with great success. Because BII is harder to treat than other specific phobias it may however require them to have more sessions and thus more financial costs
- Another limiation is that there is a lack of access to specialist clinics, T had to travel 2.5 hrs to his appointments
20
Q
Idiographic v Nomothetic
A
Idiographic:
- Provided detailed records of the way manualised CBT and AT were personalised to the specific needs of T.
- The focus on one person makes it impossible to generalise it to others.
Nomothetic:
- Results from the SUDS before and after can show a comparison and spread of data during the sessions.
