Lecture 2- specific phobias Flashcards
what is anxiety
Anxiety is “a future-orientated mood state associated with preparation for possible, upcoming negative events” (Craske et al., 2009, p. 1067)
Anxiety can be helpful
o Study harder for an exam
o Stay focused on important tasks
- Anxiety can be disruptive
o When targeted at ‘unfounded’ threat
o When out of proportion to the situation
what is fear
Not to be confused with fear
- Fear is an alarm response to threat
- Anxiety is apprehension towards anticipated problem
Difference between normal and abnormal anxiety
Fear can be adaptive
o Avoid or get out of dangerous situations
- Anxiety can be helpful
o Study harder for an exam
o Stay focused on important tasks
- Anxiety can be disruptive
o When targeted at ‘unfounded’ threat
o When out of proportion to the situation
- When does normal anxiety become a disorder?
o When it interferes with normal functioning
o Quite normal and adaptive to be anxious about something
- But what if it stops you ever leaving the house?
- Or stops you interacting with others?
- Or if it makes you late for work or other important commitments?
- Then it is clearly a disabling disorde
prevelance of anxiety
Kessler, Meron Ruscio, Shear, and Wittchen (2008):
- Most common psychiatric disorders
- Age of onset: early compared to some other disorders – specific phobias and SAD often start in childhood
o Associated with onset of other disorders
o But first treatment for anxiety disorders usually not till adulthood
- Wittchen et al. (2011)
o EU 12-month prevalence: 14% of population (14 years old +)
o 61.5 million
o F/M ratio: 2
describe the cognitive features of anx
Anxiety manifest in thoughts
o From mild worry to panic and terror
- Perception of impending disaster
o End of the world or death
- Morbid preoccupation with uncertainty
- Negative thoughts
- Biased information processing
- Negative schema (mental frameworks that organise beliefs and information about the world, self, other people etc. – the mental filters through which we experience)
describe the somatic features of anx
Anxiety shows in any one or more of following
o Shallow breathing
o Dry mouth
o Diarrhoea
o Frequent and urgent urination
o Faintness
o High blood pressure
o Rapid heartbeat
o Sweating
o Muscle tension
o Shaking
- These symptoms make sense in terms of an automatic physiological ‘fight or flight’ response to perceived threat
what is the dsm for a specific phobia
A. Marked fear and anxiety about a specific object or situation (e.g. flying, heights, animals, receiving an injection, seeing blood)
- B. The phobic object or situation almost always provokes an immediate fear or anxiety
- C. The phobic object or situation is actively avoided or endured with intense anxiety or distress
- D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation, and to the sociocultural context
- E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more (NEW)
- F. The fear, anxiety, or avoidance causes clinically distress or impairment in social, occupational or other important areas of functioning
- G. The disturbance is not better explained by another mental disorder (particularly fear/anxiety related to other anxiety, and related, disorders)
- GONE: The person recognises that the fear is excessive or unreasonable+ Some additional specifiers relate to specific objects or situations
what are the 4 types of SP and desrcribe them
Animal Type
o Spiders (very common)
o Snakes
o Dogs
o Cats
o Bees/wasps
o Rats/mice
- Natural Environment Type
o e.g. heights, storms, water
- Situational Type
o e.g. airplanes/flying, lifts, bridge
prevelance of SP
Wittchen et al. (2011)
o EU 12-month prevalence: 6.4% of population (14 years old +)
o 22.7 million
o F/M ratio: 2.4:1
- Kessler et al. (2005)
o Lifetime prevalence in USA: 12.5%
- Most common form of anxiety disorder
- Phobias of animals, natural environment, & blood/injections/injury often start in childhood
- Most situational phobias start in early adulthood
- Typical childhood fears (the dark) often resolve without treatment
- But phobias tend to be very persistent in adults
physcial syptoms of SP
Increased heart beat
- Increased blood pressure
- Shortness of breath
- Except blood, injection, injury phobia
o Fear targeted towards anything ‘medical’
o Or sight of blood and gore
- Physical symptoms can be the opposite of other phobias
- Decreased blood pressure
- May occasionally cause person to faint
DESCRIBE THE FEatures pf S[
Irrationality
o Sufferer may know the fear is irrational
- But cannot do anything about it
o No matter how they try to face fear
- Reinforced by avoidance behaviour
- Confirms the feeling of safety
- Clinically significant?
o Many specific phobias can be unpleasant or inconvenient for the person
- Change route to avoid driving over bridges
o But only clinically noteworthy if significantly interfere with life
- Most specific phobias probably do not
- Disgust
o Often fear of object is associated with disgust
- Especially with animal phobias- Spiders, snakes
o Fear and disgust in spiders (Olatunji & Deacon, 2008)
- Those with specific phobia report elevated fear and disgust when viewing pictures of spiders- Compared to those without phobia
DESCRIBE 2 PSYCHODYNAMIC THEORIES
Freud: phobias: anxiety is displaced onto ‘neutral’ object
o People do not fear the object itself
o But have displaced anxiety over other issue onto it
o Original conflict resides with Oedipus complex
o Too unbearable, so transferred onto neutral object
o Avoiding neutral object ð avoiding original conflict
- Arieti: interpersonal childhood problem is repressed
o Children originally trust those around them
o Protect from danger
o Then fear that adults/parents cannot be trusted
o To deal with mistrust they displace fear onto other objects
o Enable them to trust people again
2 behavioual models of SP
Eysenck’s incubation theory (1968)
- Phobia started with development of conditioned stimulus (CS)
- Neutral S (bee) + sting (unconditioned S) -> bee = CS (now triggers fear and avoidance)
- Does repeated exposure to bee (CS) without sting ð extinction?
o Not necessarily
- Eysenck argued that incubation may occur instead
o Phobia is maintained even with non-reinforced CS
- May be due high trait anxiety overriding extinction
o Predisposition to attend to fear and aversion
o Overly ruminate on original conditioni
Specific phobias as learned behaviour
o Classical conditioning can account for fear of objects
- Previously neutral stimuli paired with traumatic event
- Becomes feared object
o Someone with claustrophobia
- May have been shut in confined space as child
- Famous study of Little Albert (Watson)
o Albert plays white rat with no fear
o Loud noise sounded above head scares Albert
o Repeated pairing of sound with presence of ratð
- Albert associates rat with distress- Becomes scared of rat
- Mowrer’s two-factor theory (1939)
o Phobias acquired through classical conditioning
o Maintained through operant conditioning
- Avoidance relieves anxiety
- Negatively reinforces phobia
- But a person with a bee phobia is not stung every time they see a bee ð so fear should disappear?
o So why is fear maintained despite no repeat of sting? Eysenck’s incubation theory may offer an explanation …
DESCRIBE eyesnecks incubation theory
Phobia started with development of conditioned stimulus (CS)
- Neutral S (bee) + sting (unconditioned S) -> bee = CS (now triggers fear and avoidance)
- Does repeated exposure to bee (CS) without sting ð extinction?
o Not necessarily
- Eysenck argued that incubation may occur instead
o Phobia is maintained even with non-reinforced CS
- May be due high trait anxiety overriding extinction
o Predisposition to attend to fear and aversion
o Overly ruminate on original conditioning event
- Also referred to as ‘paradoxical enhancement’
describe mowrers 2 factor theory
Phobias acquired through classical conditioning
o Maintained through operant conditioning
- Avoidance relieves anxiety
- Negatively reinforces phobia
- But a person with a bee phobia is not stung every time they see a bee ð so fear should disappear?
o So why is fear maintained despite no repeat of sting? Eysenck’s incubation theory may offer an explanation …
