Phobias Flashcards
1
Q
Anxiety vs Fear
A
- Anxiety: general feeling of apprehension about possible future danger.
- Fear: alarm reaction that occurs in response to immediate danger.
2
Q
Anxiety disorders
A
- 25-29% of people in the US are affected.
- Most common category of disorders for women and second most for men.
- Creates enormous personal, economic and health problems.
- Associated with other medical conditions (asthma, chronic pain, hypertension, arthritis, cardiovascular, bowel syndrome etc)
3
Q
Fear response patterns
A
- Basic emotion that involves the activation of the fight or flight response of the autonomic nervous system.
- instantaneous reaction to any imminent threat.
Three components:
1. Cognitive/subjective components
2. Physiological component
3. Behavioral component
4
Q
Anxiety response patterns
A
- Complex blend of unpleasant emotions and recognitions that is both more oriented to the future and much more diffuse than fear.
- Also has the three components
- No activation of the fight or flight response, instead, it primes a person for the fight or flight response should the anticipated danger occur.
- In mild/moderate degrees it increases learning and performance but it can become maladaptive if severe.
5
Q
Specific phobias
A
- Strong persistent fear that is triggered by the presence of a specific object/situation.
Subtypes:
1. Animals
2. Natural environment
3. Blood-injection-injury
4. Situational
5. Others
6
Q
Specific phobias: prevalence, age, gender
A
- 12%
- 75% have at least one other specific excessive fear
- Gender ratio varies but usually more in women.
- Age: varies
7
Q
Psychological etiology (SP): psychoanalytic
A
- Defense against anxiety that stems from repressed impulses from the ID.
- Long criticized for being far too speculative.
8
Q
Psychological etiology (SP): learned behavior
A
- Wolpe and Rachman in 1960
- Development through classical conditioning.
9
Q
Psychological etiology (SP): vicarious conditioning
A
- Observing and modeling others.
10
Q
Psychological etiology (SP): differences in learning
A
- Life experiences may serve as risk factors, to protect or make them more vulnerable to phobias.
- Experiences before and after has an effect on the strength and maintenance of the phobia.
- Cognition or thoughts help maintain phobias.
11
Q
Psychological etiology (SP): evolution
A
- The way primates lived/live.
- Selective advantage
- Not inborn or innate but easily acquired or especially resistant to extinction.
12
Q
Genetic etiology (SP):
A
- Genetic + temperamental variables = speed and strength of conditioning of fear.
- Serotonin-transport gene (s allele) = superior fear conditioning
- MZ twins share animal + situational phobias more than DZ
13
Q
Treatment of Specific phobias: Exposure therapy
A
- Controlled exposure to stimuli/situations.
- Gradually placed - symbolically or increasingly - under ‘real life’ conditions.
- Long periods of time till fear subside.
14
Q
Treatment of Specific phobias: Modeling
A
- Models ways of interacting with phobic stimulus/situation.
- Mediated by changes in brain activation in the amygdala.
- Highly effective if treatment administered in a single long session (3hours).
15
Q
Treatment of Specific phobias: Virtual reality environments
A
- Virtual reality setting for certain phobias.
16
Q
Treatment of Specific phobias: Cognitive restructuring techniques + medications with exposure based techniques
A
- Cognitive techniques alone = no effect
- Medication alone = ineffective
- Combined = d-cyloserine + some exposure therapy is effective.
17
Q
Social phobias
A
- Disabling fear of one or more specific social situation
- Fear of being exposed to the scrutiny and potential negative evaluation of others.
Subtypes:
1. Performance situations: public speaking
2. Non-performance situations: eating in public
18
Q
Prevalence, age, gender of social phobias
A
- Very common
- 12%
- More common in women (60%) than men.
- Begin during adolescence and early adulthood.
- 2/3rds suffer from anxiety disorder and 50% from a depressive disorder.
- 1/3rd abuse alcohol to reduce anxiety.
- Lower employment rates and socioeconomic status.
- Persistent, only 37% recovered over a 12 year period.
19
Q
Psychological factors (social phobias): learned behavior
A
- Originates from simple instances of direct or vicarious classical conditioning.
- Grew up with emotionally cold, socially isolated and avoidant parents.
20
Q
Psychological factors (social phobias): evolution
A
- Humans = people of own species, animals = predators
- Evolved as byproduct of dominance hierarchies.
- Greater activation in the amygdala in response to negative facial expressions.
21
Q
Psychological factors (social phobias): perceptions of uncontrollability and unpredictability
A
- Submissive and unassertive behavior.
- Diminished sense of personal control.
- Grew up with overprotective parents.
22
Q
Psychological factors (social phobias): cognitive biases
A
- Expecting others to reject them or negatively evaluate them.
- Sense of vulnerability when posed with a threat.
- Tendency to interpret ambiguous social information in a negative manner rather than benign manner.
23
Q
Biological factors (social phobias): genetics + temperamental
A
- Behavioral inhibition = characteristics of both neuroticism and introversion
- Shy and avoidant.
24
Q
Treatments of social phobias: cognitive and behavioral
A
- Involves prolonged and graduated exposure to social situations.
- Cognitive restructuring: helps client identify underlying negative, automatic thoughts.
- Cognitive distortion: helps client change these inner thoughts and beliefs through logical reanalysis.
- Very successful.
25
Treatments of social phobias: medications
- Antidepressants are the most effective: monoamines oxidase inhibitors and SSRIs.
- Long term otherwise relapse occurs.
26
Agoraphobia
- Fear of public places of assembly.
- Develops due to the fear of not being physically able to escape or embarrassing themselves if they escape.
- Also frightened by their own bodily sensations - do not engage in activities that activate such arousal.
27
Prevalence, age of onset, gender: agoraphobia
- 4.7% of adults.
- 23 to 34 years old.
- Tends to be a chronic and disabling course.
- More in women (80%0 than men
28
Biological factors of agoraphobia: Genetics
- Moderately heritable
- Manifested by at a psychological level by the important personality trait - neuroticism.
29
Treatment of agoraphobia: medication
- Anxiolytics = relief of symptoms, acts quickly and intensely (used in acute situations), side effects such as drowsiness/sedation (leads to impaired cognitive and motor performance), physical dependence is at risk + relapse (no longer considered drug)
- Antidepressants = do not creat physiological dependence, can alleviate any comorbid depressive symptoms, takes 4 weeks to be beneficial, large side effects, high relapse if discontinued
- SSRIs are preferred by psychologists.
30
Treatment of agoraphobia: Behavioral and cognitive behavioral
- Prolonged exposure to feared situations, with help of family or therapist.
- Effective in 60-75% of people.
- Effects maitained at 2- to 4-year follow up but left 25-45% with no improvement.
- Do not target panic attacks.
- Interoceptive exposure: deliberate exposure.
- Cognitive restructuring: recognition of automatic thoughts.
- High effectiveness compared to medication.
31
Psychological factors: learning theory
- Learned panic
32
Comprehensive learning theory
- conditioning
33
Agoraphobia: Cognitive theory
- Sensitivity to physical sensation and anxiety sensitivity
