Anxiety disorders Flashcards
What are the symptoms of a phobia?
Intense fear and anxiety which may cause a panic attack
Avoidance behaviour, person may engage in complicated behaviours to avoid their fear
What is agoraphobia?
Fear of open spaces
What is a social phobia?
Fear of social or performance situations which embarrassment may occur
What is a specific phobia?
A fear against almost any object
Which two manuals are used by psychologists to diagnose phobias?
DSM-IV : 17 categories (6th section, anxiety)
ICD-10: 11 categories
What does classical conditioning say about phobias?
Phobias are learned through association between the thing that naturally produces the fear (UCS) and the new thing that the person has learnt to become afraid of is the neutral stimulus
Is the phobia maintained through operant conditioning?
Yes
Describe Watson and Rayner’s study
Little albert a 11 month year old boy had no fear of white rats and started to play with it. Each time he went to hold or touch the rat, a metal bar was struck in his ear which produced an UCR of fear. Gradually, little albert associated the fear to the rat and white objects in general
What is positive reinforcement in phobias?
Person achieves attention and comfort so is likely to repeat it again
What is negative reinforcement in phobias?
going out of the way to avoid it
Evaluation of behaviourists explanation of phobias
People often have unpleasant experiences but don’t develop a phobic reaction
Studies lack EV
Nomothetic and creates laws for everyone so doesn’t take into account personal differences
Its unlikely two things would be put together to create a phobia
What is systematic desensitisation?
People practise relaxation techniques when feelings of tension and anxiety arise
A stepped approach to get the person to face the object or situation of their phobia through the hierarchy of fears
What is the hierarchy of fears?
Series of steps in which the person would be introduced to the real situation progressively at their own pace
Evaluation of systematic desensitisation
It can be used only when a particular phobic object or situation has been identified so only really suitable for specific phobias not social.
Quick and cost effective
Patient is in control so no worrying ethical issues
Describe Jones’ study
Two year old boy was afraid of various things including rabbits. Jones put a rabbit in a age infront of the boy when he as eating his lunch. Over 17 steps, the rabbit was brought closer to the boy and was set free. The boy was no longer feared rabbits.
Describe Flooding
Overwhelming the individual with the item of situation that causes anxiety but exposing it to them. The person will eventually realise that no harm will occur and there is no basis for it.
Evaluation of flooding
Causes high levels of anxiety and can be traumatic causing ethical problems
Flooding is unlikely to work on its own for OCD as its rare that a person is completely cured
What is the psychodynamic explanation for phobias?
Seen as conflict between the id and the ego.
The id has unacceptable impulses. The fear these impulses are expressed in cause anxiety and are therefore repressed by the ego.
What does the fear of snakes represent in psychodyanmic view?
Male genitals
What does Freud explain agoraphobia as?
Resulting from separation anxiety experienced by a young child at an unconscious level.
The child has irrational thoughts that they will be separated from their mum/dad/guardian.
Unconsciously, the person thinks that it is less likely to occur if the person is at home all the time
What is a phobia?
Persistent and irrational fear of a particular object, activity or situation
Evidence for phobias, psychodynamic?
Little hans
Evaluation of the psychodynamic explanation of phobias
Theory is unscientific; unfalsifiable Middle class women can't be generalised Only evidence was little hans Theory is ideographic so focuses on the childhood Ignores role of free will
What is the aim of the psychodynamic treatment for phobias?
Provide insight into what is unconsciously causing the symptoms of the phobia and requires the person to confront their fears.
Once this conflict is released, the patient can work through it
What is free association?
The patient relaxes and says everything that comes to mind. The conflict will be brought into the conscious. Once verbalised, the cause can be explained.
The therapist looks for a pattern in the thoughts and is interpreted in terms of unconscious thoughts
What is dream analysis?
Repressed ideas which are likely to cause anxiety are more likely to appear in dreams
Two contents; manifest content (plot, action, images etc)
Latent content; real “meaning” of the dream
Therapist identifies what in the unconscious is causing the mental illness
Manifest: snake
Latent: penis
Describe alstorm’s study
Assigned 42 social phobics to one of 3 therapies:
Psychotherapy; form of free association where fears are spoken about openly
Relaxation techniques
Drug medication
Most significant changes were in psychotherapy rather than the rest
Follow up are needed for the effects to be prolonged
Examples of freudian symbolism
Long things that ‘jut out’: penis (mountains, sticks, poles, umbrellas, snakes, trees, baguettes)
Entrances: vagina (doors, gates, castle)
Curvy objects: breasts (footballs, apples, peaches)
Playing: masturbation
Rhythmical activities: sex (dancing, climbing, riding)
Authority figures: oedipus/electra complex (police, teachers, doctors)
Things which go up: erection (aeroplane, helicopters, rockets)
Small and round things: nipples (buttons, coins)
Penetration(knives, weapons, guns, cannons)
Evaluation of psychodynamic treatment of phobias
Tries to find the root of the phobia and is the only therapy that does this
Expensive and time consuming and usually takes years to complete
Unscientific
Could be traumatic for the person as ego defences are broken down and anxiety comes to conscious
What is OCD?
A disorder in which a person has recurrent and unwanted thoughts, a need to perform repetitive and rigid actions, or both
What is an obsession?
A persistent thought, idea, impulse or image that is experienced repeatedly, feels intrusive and causes anxiety
What is a compulsive?
A repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent or reduce anxiety
What are the main symptoms of OCD?
Recurrent obsessions and compulsions
Recognition by the individual that the obsessions and compulsions are excessive or unreasonable
Persons daily life is disrupted and is distressed
Genetic explanation for OCD
Evidence for twin and family studies suggest that there might be genetic components to OCD
Explain McKeon and Murray’s study into genetics of OCD
Studied the relationship between OCD and family members. They compared families who had a family member with OCD against families who didn’t for the number of others who had it.
They found that the person with a family member affected by OCD are twice as likely to have other members in the family with the disorder
Providing that genes could be a reason why people suffer from OCD
Evaluation of McKeon and Murray’s study
Only a small amount of families studied
The results could be down to socialisation instead of genes
Explain the serotonin hypothesis
Lack of serotonin is seen as causing OCD
Brain deactivates neurotransmitter substances, once they have passed on messages to the next one through producing a chemical called monoamine oxidase.
Monoamine oxidase breaks down the chemical ready for it to pass on the next message.
Reuptake: the neurotransmitter is reabsorbed by the firing neuron once the chemical has been passed onto the next
How is OCD caused by serotonin hypothesis?
Uptake being too good so not enough neurotransmitters are passed across to the next neuron
Too much monoamine oxidase is produced
2 types of antidepressant drugs?
SSRI: Prozac
MAOI: Nardi
Evaluation of the role of serotonin
Some people don’t respond to the drug treatment
Evidence that dopamine plays a part
Research that involves the role of serotonin is conducted in labs so is objective and scientific but lacks ev
What is the role of the orbital frontal cortex?
PET scans have shown that people with high levels of activity on a part of the left frontal cortex (orbital frontal cortex)
High levels of glucose metabolism and blood flow are found here
Area of the brain is involved in converting information from the senses into thoughts
Evaluation of the orbital frontal cortex explanation for OCD
Difficult to determine whether these high levels of activity in the brain are the cause of this disorder
Scientific evidence
May explain obsessional thinking but no reasons behind the compulsions
Cognitive explanation of OCD; characteristics?
More likely to suffer from depression
High levels of moral standards
Believe that thoughts are harmful to others
Believe they should have complete control over their thoughts
What are neutralising thoughts?
A persons attempt to eliminate unwanted thoughts by thinking or behaving in was that puts matters right internally making up for unacceptable thoughts
What does the neutralising effect do?
Makes the person feel better and settles the compulsion
What are catastrophic misinterpretations?
Think something irrational which is severe and excessively negative which causes anxeity
What are Rachman’s four steps?
Step 1; presence of obsessional thoughts or images (harming another person)
Step 2; catastrophic misinterpretation of the thought (i am a bad person and may end up murdering someone)
Step 3; fear and high level of anxiety
Step 4; attempts to resist and avoid the thoughts
What is hypervigilence?
People with OCD have a “cognitive bias” when attending to environmental stimuli. (extra aware)
Explain Rachman’s case study
Female participant had a severe fear of diseases, particularly blood.
She had catastrophic misinterpretations that she will get aids
She scans the environment if in public for evidence of blood, cut and bandages and misperceives red sports for blood.
Her hypervigilant scanning meant that she could recall in great detail the blood related items she had encountered
Evaluation of cognitive explanation for OCD
4 step model helps to explain how OCD is maintained but doesn’t explain why they got the thoughts in the first place
Lack of evidence to support the study as it all occurs in the mind its hard to test scientifically
Nomothetic, ignores the role of individual differences
What is the aim of cognitive therapy?
Replace irrational thoughts with rational ones
Teaches the patient to identify, challenge and replace thoughts with more constructive ones
What are the two steps to change conscious thought processes?
Helping people to understand they are misinterpreting their thoughts
Making people aware that they need to neutralise their obsessive thoughts by attempting to make amends for having them
What are the four steps for conquering OCD urges?
Schwatrz
Relabel ; recongise the thoughts
Reattribute; realise the thought is caused by OCD
Refocus; work around the thought by focusing on something else
Revalue; don’t take OCD thought at value
What is habituation training?
Clients repeatedly think about their obsessive thoughts.
the idea that by deliberately thinking about obsessions will become less anxiety-raising with the consequence that compulsive behaviour is not needed to stop the anxiety
Describe Rufer’s study
Followed 30 inpatients with severe OCD for 6 to 8 years.
patients were on various medication and therapies over the years
rufer interviewed patients and doctors about symptoms and improvements
found that cognitive therapy was found to reduce the frequency and duration of obsessional thoughtd
Evaluation of cognitive treatments
The strategies can be practiced any time, outside of the therapy room
helping the person maintain their ability to cope
Cognitive therapy has been found through follow up studies to be maintained several years after therapy has stopped
Cognitive therapy is not suitable for all people because you need to be prepared to be challenged
The patient has to be willing to do homework tasks that the therapists set them
Lots of studies
What is drug therapy?
Neurotransmitters dopamine and serotonin have all been associated with OCD
Drugs change the levels of these in the brain
SSRI drugs such as Prozac are prescribed to increase the level of serotonin in the brain and MAOI’s are sometimes used if there is no benefit from SSRI’s
What happens if drug therapy doesn’t work?
Neurosurgery. Probes in the brain
Describe Riddle’s study
Wanted to determine the safety and efficiency of SSRI for the treatment of children and adolescents with OCD compares to a placebo.
Given either of these each day for up to 10 weeks.
Found that there was a 42% reduction of OCD symptoms with the SSRI and 26% for the placebo
Evaluation of biological treatments for OCD
SSRIS are easily tolerated and safe, are not addictive
Drug treatments are quick and cheap
Side effects; nausea, headaches if they come off
Take 4 to 12 weeks to feel the benefit
If person stops taking the drugs the symptoms can return
