Chapter 9: Development of specific phobia

Question 1

what is a specific phobia

Answer 1

It is characterised by marked fear and anxiety towards a specific object, or situation

Question 2

what is the biopsychosocial approach

Answer 2

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.

Question 3

what are the three factors of the biopsychosocial approach

Answer 3

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.

Question 4

Biological contributing factors to phobia

Answer 4

GABA neurotransmitter dysfunction
Long term Potentiation

Question 5

what is GABA dysfunction

Answer 5

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.

Question 5

what is LTP in phobia

Answer 5

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.

Question 6

Psychological contributing factors to phobia

Answer 6

classical conditioning (precipitation)
operant conditioning (perpetuation)
cognitive biases- memory bias; catastrophic thinking

Question 7

Precipitation by classical conditioning

Answer 7

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.

Question 8

perpetuation by operant conditioning

Answer 8

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.

Question 9

cognitive bias

Answer 9

A cognitive bias is “a systematic error of thinking that affects decisions and judgments, usually leading to inaccurate or unreasonable conclusions”

Question 10

memory bias

Answer 10

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.

Question 11

catastrophic thinking

Answer 11

Catastrophic thinking is “a type of cognitive bias in which a stimulus or event is predicted to be far worse than it actually is

Question 12

what are social contributing factors

Answer 12

specific environmental triggers
stigma around seeking treatment

Question 13

what are the three specific environmental triggers

Answer 13

direct confrontation
observation
learning/indirect confrontation

Question 14

what is stigma around seeking treatment

Answer 14

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.

Question 15

what are biological interventions to phobia

Answer 15

use of anti-anxiety benzodiazepine agents
breathing retraining

Question 16

use of benzodiazepine

Answer 16

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.

Question 17

breathing retraining

Answer 17

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

Question 18

what are the psychological interventions

Answer 18

cognitive behavioral therapy (CBT)
Systematic desensitization

Question 19

what is CBT

Answer 19

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.

Question 20

what is systematic desensitisation

Answer 20

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).

Question 21

what are social interventions

Answer 21

education for family and supporters which helps with challenging, unrealistic and anxious thoughts
AND
not encouraging avoidance behaviour

Question 22

what is psychoeducation

Answer 22

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).