Paper 1 - Psychopathology - Phobias Flashcards
What is a phobia?
A phobia is an anxiety disorder, which interferes with daily living. It is our instant or irrational fear that produces a conscious avoidance of the feared object or situation
What are the emotional aspect of a phobia?
What does this actual mean?
How do you feel when you are a feared object
Anxiety
Increases in heart rate
Increases in breathing rate
Unreasonable emotional
What are the behavioural aspects of a phobia?
What does this really mean?
How do you behave when you see a feared objects?
Panic, crying, screaming and running away
Avoidance of a phobia - which can effect day to day life
Endurance - if you remain in presence of a stimulus you will be experiencing high anxiety
What are the cognitive aspects of a phobia?
What does this really mean?
What do you think about feared objects?
Selective attention - hard to look away from the stimulus
Irrational believes - social phobias - this makes people act differently
Cognitive distortions - perceptions of the stimulus are distorted
Who proposed the two process model?
When?
Hobart Mowler
1960
What is the two process model?
This states that phobias are acquired through classical conditioning and maintained through operant conditioning
What is the two process model based on and what does it try to explain?
The behaviourist approach
Phobias
What tends to happen to responses due to classical conditioning?
Why is this relevant?
CC suggests that phobias tend to fade over time
However phobias tend to be long lasting
So Mower explained this long lastingness with operant conditioning (maintenance of phobias)
When does operant conditioning tend to happen?
When behaviour is either reinforced or punished
What does reinforcement tend to do?
Increase behaviour
What does negative reinforcement do?
What does this result in?
Makes people avoid situations which are unpleasant
This results in a desirable reward (getting rid of the phobia) which means that the behaviour will be repeated. This maintains the phobia
What are the positive evaluations of the two process model of the behavioural approach?
Good explanatory power
What are the negative evaluations of the two process model of the behavioural approach?
There are alternative explanations for avoidance behaviour
An incomplete explanation of phobias
Phobias that don’t follow a trauma
It doesn’t include the cognitive aspect
What explanation do we look at for phobias?
The two process model
Explain the positive evaluation of the two process model: good explanatory power
It explains how phobias can be maintained over time and this has important implications for therapies
Once a patient is prevented from practising their avoidance behaviour the behaviour ceases to be reinforced and the phobia
Explain the negative evaluation of the two process approach as explaining phobias: there are alternate explanations for avoidance behaviour?
Not all avoidance behaviours associated with phobias seem to be the result of anxiety reduction
There is evidence to suggest that at least some avoidance behaviours appear to be motivated by positive feelings of safety. An example of this is agoraphobia
What is agoraphobia?
The fear of being locked in
Explain the negative evaluation of the two process approach as explaining phobias: it is an incomplete explanation of phobias
In 2007 Bounton suggested that evolutionary factors probably have an important role in phobias
Phobias such as being afraid of the dark could be acquired by a source of danger in the past
It is adaptive to develop fears like this
In 1971 Selingman called this biological preparedness - the innate predisposition to acquire certain fears
(Biological preparedness)
Explain the negative evaluation of the two process approach as explaining phobias: it doesn’t include phobias that don’t follow trauma?
For some people they don’t know why they fear something
A phobia could be a result of conditioning but not always such as biological preparedness
Explain the negative evaluation of the two process approach as explaining phobias: it doesn’t include the cognitive aspect?
The behaviouralist approach doesn’t take into account the cognitive approach
The 2 proses model explains the maintenance of phobias in terms of avoidance
A phobia could be caused by a negative schema
We can process emotions cognitively with - cognitive distortions, irrational believes and selective attention
What is systematic desensitisation?
This is a treatment designed to gradually reduce phobic stimulus so they will be cured because if the sufferer can learn to relax in the presence of a stimulus it is by definition cured. This includes the hierarchy of fear
What is counterconditioning?
If the sufferer can learn to relax in the presence of the stimulus they will,be cured because a new response is learned.
This is the hopeful outcome of systematic desensitisation
What are the positive evaluations for systematic desensitisation?
It is effective
It covers a range of phobias
It is acceptable to patients
What are the negative externalities of systematic desensitisation?
It is expensive
Explain the evaluation of systematic desensitisation: it is effective
Gilray (2003) treated 42 patients in 3 45 minute sessions each, compared to a controlled group who were treated using relaxation without. Exposure to the phobia at 3 months and 33 months after the treatments group, were less fearful than the relaxation group
Explain the evaluation of systematic desensitisation: it covers a range of patients?
Some people withy anxiety disorders also have learning disabilities
Other therapies such as flooding and CBT need to patient to reflect on what they are thinking
As a result systematic desensitisation may be the most appropriate therapy if the person has a learning disability
Explain the evaluation of systematic desensitisation: it is acceptable to patients?
Lots of patients prefer systematic desensitisation as it is not as traumatic as flooding
This is reflected in low refusal rates and low attrition rates
Attrition rate - the rate that people leave
Explain the evaluation of systematic desensitisation: it is expensive?
Some people will never be able to teach themselves to relax or it could take a long time so it could be very expensive
In these cases flooding could be better
Quickly explain flooding?
Flooding is quick
Sometimes the phobia is cured because the patient gets exhausted by their fear response
Flooding involves exposing the person to the stimulus
In part, it works because there is no option of avoidance and patients quickly learn that the phobic stimulus is harmless
What is it called when someone gets over their phobia?
Extinction
What are the evaluations of flooding?
It is coast effective
Ethical safeguards
It is less effective for some phobias
The treatment is traumatic
Symptom substitution
Explain the evaluation of flooding: ethical safeguards?
Flooding is a very uncomfortable thing so it is important to get full consent
Patients should be fully prepared
Explain the evaluation of flooding: it is cost effective
Flooding is at least as effective as other treatments for specific phobias
Ougrin (2011) have found that flooding is highly effective and quicker than alternatives. This also makes it cheaper.
Explain the evaluation of flooding: it is less effective for some phobias
Social phobias and agoraphobia seem to show no improvement under flooding.
This is because it doesn’t consider complex cognitive aspects such as anxiety. Therefore CBT could be more useful to challenge irrational thought processing
Explain the evaluation of flooding: the treatment is traumatic for patients
Flooding can be highly traumatic
Often patients are unwilling to see it though until the end
This leads to a waste of time or money
Explain the evaluation of flooding: symptom substitution
This is a common criticism of flooding and systematic desensitisation
This is when one phobia appears and is replaced by another.
HOWEVER THEW EVIDENCE FOR THIS IS MIXED
Frued said that this occurs when the unconscious impulses and conflict which caused the original symptoms are not dealt with effectively
Explain how a session of systematic desensitisation may work?
They may start off with a picture of a bird and discuss feelings. They they may go to a feather, then a video. If at any point the ppt feels too anxious they may scale it back of talk. This will continue until the participant has been counter conditioned. This is referred to as the hierarchy of fear where ppts are taught to relax when reviewing the images. You can’t feel fear and feel relaxed at the same
