Chapter 9: Development of specific phobia Flashcards
what is a specific phobia
It is characterised by marked fear and anxiety towards a specific object, or situation
what is the biopsychosocial approach
a way of describing and explaining how biological, psychological and social factors combine and interact to influence a person’s mental health and wellbeing
it promotes a holistic view of mental wellbeing by considering biological, psychological and social factors equally and the interaction of these factors.
what are the three factors of the biopsychosocial approach
Biological factors – internal, genetic and physiologically based factors
Psychological factors – internal factors relating to an individual’s mental processes
Social factors: external factors relating to an individual’s interactions with others and their external environment.
Biological contributing factors to phobia
GABA neurotransmitter dysfunction
Long term Potentiation
what is GABA dysfunction
Research shows that there is a link between low levels of GABA and Specific Phobia.
For example, the release of GABA may be inhibited or its binding at the postsynaptic receptor sites.
As such, this can cause someone’s fight-flight-freeze response to be more easily triggered by certain stimuli.
However, if there are low levels of GABA, this means the excitatory effect of glutamate cannot be counterbalanced. And as such, we’ve got this overexcitation happening.
what is LTP in phobia
In particular, the more the connection between one’s phobic stimulus and their fear is activated, the stronger the connection becomes.
This also applies to anticipated encounters with their phobic stimulus, that this connection is strengthened.
Plus, whenever they are thinking about it, bringing it into consciousness awareness.
In turn, this decreases the likelihood that what has been learned, this association between the phobic stimulus and their fear, is forgotten.
Psychological contributing factors to phobia
classical conditioning (precipitation)
operant conditioning (perpetuation)
cognitive biases- memory bias; catastrophic thinking
Precipitation by classical conditioning
Classical conditioning can precipitate the onset of Specific Phobia.
Precipitate here: cause, make happen.
Though classical conditioning involves repeated pairings of the NS and UCS, one may acquire a Specific Phobia through one pairing alone.
For example, developing a Specific Phobia of dogs after being attacked by a dog.
perpetuation by operant conditioning
Operant conditioning can perpetuate one’s Specific Phobia.
Perpetuate: prolong, keep it going.
One symptom of specific phobia is avoidance of the phobic stimulus.
Whilst avoidance may provide short-term relief, it can negatively reinforce one’s phobia.
By avoiding their phobic stimulus – the removal of the unpleasant stimuli – one is more likely to avoid it again – the behaviour strengthening.
cognitive bias
A cognitive bias is “a systematic error of thinking that affects decisions and judgments, usually leading to inaccurate or unreasonable conclusions”
memory bias
a type of cognitive bias caused by inaccurate or exaggerated memory” (Edrolo, 383).
Often those with specific phobia have developed the disorder after having a negative experience with their phobic stimulus.
Their memory of this encounter – and later encounters - tends to be distorted.
catastrophic thinking
Catastrophic thinking is “a type of cognitive bias in which a stimulus or event is predicted to be far worse than it actually is
what are social contributing factors
specific environmental triggers
stigma around seeking treatment
what are the three specific environmental triggers
direct confrontation
observation
learning/indirect confrontation
what is stigma around seeking treatment
Stigma describes “the feeling of shame or disgrace experienced by an individual for a characteristic that differentiates them from others” (Edrolo, p. 384).
Those with Specific Phobia may experience stigma because of their disorder.
This is along with self-stigma: “when an individual accepts the negative views and reactions of others, internalises them, and applies them to themselves…” (Grivas, 2023, p. 520).
Because of this, they may refuse to seek treatment, perpetuating their phobia.
what are biological interventions to phobia
use of anti-anxiety benzodiazepine agents
breathing retraining
use of benzodiazepine
Benzodiazepines can be used as a treatment for specific phobia.
Benzodiazepines are agonists rather than antagonists.
This is because they stimulate neurotransmitter activity rather than inhibit it.
More specifically, they are GABA agonists
They imitate GABA’s inhibitory effects by facilitating the binding of GABA.
Benzodiazepines can be used as an effective treatment for Specific Phobia when there is GABA dysfunction.
HOWEVER
I. No GABA = no effect.
That is, the effect of benzodiazepines is dependent on there being GABA at the synapse.
II. Benzodiazepines treat the symptoms of Specific Phobia, not the cause.
Usually, their use occurs alongside a psychological treatment.
III. Its side-effects.
In particular, benzodiazepines cause sedation, they induce tolerance and withdrawal symptoms, and they have a potential for abuse as they’re highly addictive.
breathing retraining
is an anxiety management technique that involves teaching correct breathing habits to people with a specific phobia” (Grivas, 2023, p. 525).
When confronting their phobic stimulus, one with specific phobia tends to experience hyperventilation – rapid deep breathing – or tachypnea – rapid shallow breathing.
As a result, this upsets the balance between oxygen and carbon dioxide in the blood, leading to an excess in carbon dioxide.
breathing retraining minimizes this
what are the psychological interventions
cognitive behavioral therapy (CBT)
Systematic desensitization
what is CBT
Cognitive behavioural therapy is “a type of psychotherapy that combines cognitive and behavioural therapies to treat phobias and other mental health problems and disorders” (Grivas, 2023, p. 528).
In terms of the cognitive component, in relation to Specific Phobia, CBT focuses on enabling patients to understand their fear is being perpetuated by their cognitive biases.
In particular, that their phobic stimulus is not as dangerous as it may appear, therefore avoidance behaviours aren’t necessary.
what is systematic desensitisation
Systematic desensitisation is “a therapeutic technique used to overcome phobias that involves a patient being exposed incrementally to increasingly anxiety-inducing stimuli, combined with the use of relaxation techniques” (Edrolo, 2023, p. 392).
Systematic desensitisation involves applying the principles of classical conditioning:
Unlearning the association between their phobic stimulus and fear & anxiety
And reassociating their phobic stimulus with feelings of relaxation (and safety).
what are social interventions
education for family and supporters which helps with challenging, unrealistic and anxious thoughts
AND
not encouraging avoidance behaviour
what is psychoeducation
In terms of psychoeducation for families and supporters, we are referring to ‘teaching families and supporters of individuals with mental health disorders how to better understand, deal with, and treat their disorder” (Edrolo, 2023, p. 393).
