CHAPTER 9: BIOPSYCHOSOCIAL APPROACH TO EXPLAIN SPECIFIC PHOBIA Flashcards
biopsychosocial approach
a holistic, interdisciplinary framework for understanding the human experience in terms of the influence of biological, psychological, and social factors
biological factors & treatment options
- gamma-amino butyric acid (GABA) dysfunction
- treatment option: benzodiazepines (GABA agonist)
- long term potentiation
- treatment option: breathing retraining
gamma-amino butyric acid (GABA) dysfunction
- GABA is an inhibitory neurotransmitter that calms the stress response.
- if an individual has low levels of GABA, or it cannot be transmitted or received normally across the synapse, their stress response can be activated more easily and they may find it harder to calm down
- a failure to produce, release or receive the correct amount of GABA needed results in the inability to regulate neuronal transmission in the brain
long-term potentiation
- repeated stimulation of two neurons can strengthen a response.
- therefore, if an individual keeps stimulating this neural pathway and synaptic connections, it enables more transmission along neural pathways associated with a fear response = the phobia will strengthen over time.
relaxation techniques
a commonly used relaxation technique that promote relaxation and help deal with phobic anxiety and other symptoms involves breathing retraining
breathing retraining
helps people to maintain correct breathing or correct abnormal breathing patterns when anticipating or exposed to a phobic stimulus, so it may also help to reduce anxiety or alleviate some of its symptoms
benzodiazepines
- a group of drugs (’agents’) that work on the CNS, acting selectively on GABA receptors in the brain to increase GABA’s inhibitory effects and make postsynaptic neurons resistant to excitation
- stimulates a neurotransmitter’s activity: GABA agonists
- limitations: effective short term, potential negative consequences associated with long-term uses & only treats the symptoms and not the cause (specific phobia) of anxiety
psychological factors & treatment options
- behavioural models (classical and operant conditioning)
- systematic desensitisation
- cognitive models (memory bias and catastrophic thinking)
- cognitive behavioural therapy (CBT)
perpetuation by operant conditioning
- if albert continued to avoid white furry objects as he grew older → this avoidance results in the reproduction or removal of the unpleasant feelings of fear and anxiety that he feels in its presence, and therefore makes him likely to continue to avoid such objects
- negative reinforcement
- negative — something is being taken away (fear/anxiety)
- reinforcement — increases likelihood of the avoidant behaviour in future
precipitation by classical conditioning
- a phobia can be developed when a NS becomes paired with a fearful UCS to become a CS
- eg. little albert developed a CR (fear) to a CS (the white rat) that had been associated with the fear-inducing unpleasant event of the iron bar strike (UCS), then generalised to a similar stimuli — other furry white objects
systematic desensitisation
+ three step process
- applies classical conditioning principles in a process that involves unlearning the connection between anxiety and a specific object or situation and reassociating feelings of relaxation & safety with that particular object or situation
1. teaching the individual a relaxation technique that they can use to decrease the physiological symptoms of anxiety when confronted by the phobic stimulus. e.g breath retraining, progressive muscle relaxation
2. breaking down the anxiety-arousing object or situation into a sequence arranged from least to most anxiety-producing → called fear hierarchy
3. systematic, gradual pairing of items in the hieracrchy with relaxation by working upwards through items in the hierarchy, one ‘step’ at a time. can be achieved either in vivo (real life), using visual imagery (’imagination’) and, more recently, using virtual reality technology
cognitive models
- memory bias
- catastrophic thinking
cognitive behavioural therapy (CBT)
a type of psychotherapy that combines cognitive and behavioural therapies to treat phobias and other mental health problems and disorders
- avoiding objects, activities and situations, or using safety behaviours to cope with them, may prevent a feared outcome and reduce anxiety, but the individual tends to become reliant on them and they perpetuate the phobia → considered maladaptive and are targeted for treatment
memory bias
where present knowledge, beliefs and feelings distorts the recollection of previous experiences
1. consistency bias: current fears of specific objects or situations influence memory reconstruction of those objects or situations in ways that incorporate those fears
2. change bias: whenever we recall a past experience we exaggerate the difference between what we know or felt then and what we currently know or feel, which can lead our phobic fears to grow over time, disproportionately from what they are in reality
catastrophic thinking
- involves overestimating, exaggerating or magnifying the threat of an object or situation and predicting the worst possible outcome
- e.g a person with a specific phobia may assume that they will lose control or die if exposed to a relevant phobic stimulus. in the case of someone with a dog phobia, they may think that any dog they encounter will attack them and leave them with permanent facial disfigurement
