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Clinical Psychology > Phobias > Flashcards

Phobias Flashcards

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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.
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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)
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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
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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.
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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
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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
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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.
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8
Q

Psychological etiology (SP): learned behavior

A
  • Wolpe and Rachman in 1960
  • Development through classical conditioning.
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9
Q

Psychological etiology (SP): vicarious conditioning

A
  • Observing and modeling others.
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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.
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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.
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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
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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.
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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).
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15
Q

Treatment of Specific phobias: Virtual reality environments

A
  • Virtual reality setting for certain phobias.
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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
Q

Treatments of social phobias: medications

A
  • Antidepressants are the most effective: monoamines oxidase inhibitors and SSRIs.
  • Long term otherwise relapse occurs.
26
Q

Agoraphobia

A
  • 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
Q

Prevalence, age of onset, gender: agoraphobia

A
  • 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
Q

Biological factors of agoraphobia: Genetics

A
  • Moderately heritable
  • Manifested by at a psychological level by the important personality trait - neuroticism.
29
Q

Treatment of agoraphobia: medication

A
  • 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
Q

Treatment of agoraphobia: Behavioral and cognitive behavioral

A
  • 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
Q

Psychological factors: learning theory

A
  • Learned panic
32
Q

Comprehensive learning theory

A
  • conditioning
33
Q

Agoraphobia: Cognitive theory

A
  • Sensitivity to physical sensation and anxiety sensitivity

Clinical Psychology (7 decks)

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