Phobias- Behavioural approach + treatments Flashcards

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1
Q

Two process theory

A

Mowrer (1960)
- proposed two process approach to developing phobias:
1. Phobias are acquired by classical conditioning
2. Phobias are maintained by operant conditioning

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2
Q

Example of classical conditioning in relation to phobias:

A

John Watson and Rosalie Rayner (1920)
- Little Albert study

Watson and Rayner selected a 9-month-old infant named “Albert” and exposed him to a series of stimuli, including a rabbit. Initially, Albert showed no fear of any of these objects. However, when the researchers presented the rabbit (neutral stimulus) to him and simultaneously struck a steel bar with a hammer behind his head (unconditioned stimulus), Albert began to cry and show signs of fear (unconditioned response). After several repetitions of this procedure, Albert began to show a fear response to the rat alone, even when the loud noise was not present, as these concepts had become associated and the rabbit became a conditioned stimulus.

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3
Q

What did Watson determine?

A

Watson determined that phobias can be created through classical conditioning.

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4
Q

AO3: Experimental design

A

The experimental design and process were not carefully constructed. Watson and Rayner did not develop an objective means to evaluate Albert’s reactions, instead of relying on their own subjective interpretations.

(+ obvious ethical issues, especially in relation to desensitisation)

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5
Q

AO3: Validity

A

In 2012, Beck and Alan J. Fridlund reported that Little Albert was perhaps not the healthy, normal child Watson described in his 1920 experiment. They presented convincing evidence that Watson knew about and deliberately concealed the boy’s neurological condition. These findings not only cast a shadow over Watson’s legacy, but they also deepened the ethical and moral issues of this well-known experiment.

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6
Q

Operant conditioning

A
  • a characteristic of phobias is avoidance behaviour.
  • by avoiding the phobic stimulus, phobic symptoms reduce for an individual.
  • avoidance behaviours negatively reinforce phobic behaviours (make phobic behaviours more likely to occur due to a removal of anxiety)
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7
Q

AO3: Practical application

A

P- good explanatory power, highlighted by application to therapy.
Ev- flooding and systematic desensitisation use principles of behaviourism to ‘unlearn’ phobias.
Ex- application indicates the basic premise of the theory must hold some element of truth and reliability.
L- strengthens theory as it can be applied to help people with phobias in real life instances.

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8
Q

AO3: Alternate theory- avoidance behaviour

A

P- operant conditioning- not only explanation for avoidance behaviour
Ev- Buck (2010)- avoidance behaviour may be motivated by positive feelings of safety, and to saty within safety factor. eg. agoraphobia, may not leave the house. Explains why some patients are able to leave house with trusted person with relatively little anxiety but not alone.
Ex- suggests a flaw within two-process theory- suggests avoidance behaviour is motivated by anxiety reduction, showing more complexity
L- by highlighting this issue as a weakness the two-process theory must be questioned

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9
Q

AO3: alternate theory- development of phobias

A

P- two process theory does not provide only explanation for the development of phobias
Ev- Bounton (2007) points out evolutionary factors probably have a role but two process theory does not mention this. we easily acquire phobias which have been a source of danger in evolutionary past, such as snakes or the dark.
Seligmann (1971)- ‘biological preparedness’
Ex- sometimes we do not develop phobias of much more current dangers such as cars or guns, which could be explained by the fact that we are not biologically prepared to learn fear responses towards them
L- the phenomenon of preparedness proposes a serious problem as it shows this is due to more than simple conditioning

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10
Q

AO3: Counter-evidence

A

P- people can develop a phobia without being aware of having a related bad experience.
Ev- eg. a fear of snakes can develop without having ever met one/ encountered one.
Ex- presents evidence that phobias can form with no prior conditioning experience or trauma
L- weakness, presents that classical conditioning cannot be sole explanation for the development of phobias

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11
Q

AO3: Cognitive aspects

A

P- behavioural explanations are not oriented to cognition, and focus on behaviour, such as avoidance
Ev- however, cognitive elements are also present within phobias, such as cognitive distortion, where a persons worldview distorts to align with irrational fear
Ex- shows that phobias cannot be explained through the behavioural approach in isolation, as cognitive processes also play a role in the maintenance of phobias.

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12
Q

AO3: Reductionist view

A

Stimulus leading to response could be said to be a reductionist view as there would be vastly more involved, such as cognitive processes.
(environmental reductionism)

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13
Q

Behavioural treatment for phobias: Systematic desensitisation

A
  • Uses a series of sessions (4-6)
  • based on principles of classical conditioning
  • if fear is associated with a stimulus to create a phobia, then the association can be ‘unlearnt’ (counter-conditioning)
  • 3 main processes; anxiety hierarchy, relaxation, exposure (utilising hierarchy)
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14
Q

Behavioural treatment for phobias: Systematic desensitisation- Anxiety hierarchy

A
  • patient ranks phobic stimuli from least (10) to most (1) anxiety provoking
  • eg. fear of pitbulls
    10- interacting with adult pitbull
    1- photo of puppy pitbull
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15
Q

Behavioural treatment for phobias: Systematic desensitisation- Relaxation

A
  • Patient is taught to relax; controlled breathing techniques, mental imagery (‘happy place’), valium
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16
Q

Behavioural treatment for phobias: Systematic desensitisation- Exposure

A
  • patient is exposed to the phobic stimuli gradually, using their hierarchy as a guide
  • once the patient remains relaxed at each stage, they move on
17
Q

Behavioural treatment for phobias: Flooding

A
  • can be achieved in one session
    -involves sudden exposure to the phobic stimulus, with no gradual build up
  • not appropriate for young children/ people with learning impairments- cannot gain fully informed consent
18
Q

Why does flooding work?

A
  • patient cannot exercise avoidance behaviour so they are forced to realise the phobic stimulus/ stimuli is not that bad
  • the body can only maintain a fear response for so long due to EXHAUSTION
  • the association between CS and CR is broken- EXTINCTION
19
Q

AO3: length of treatment

A
  • SD can take up to six sessions, more lengthy treatment- less cost-effective as you are paying for many therapy sessions.
  • Flooding can be completed in one session, short treatment time- more cost effective. flooding compared to cognitive therapies (Ougrin 2011)
20
Q

AO3: Virtual reality

A

SD: for phobia of heights- avoids dangerous situations, cost-effective as does not need to leave consulting room.

CP: Lacks realism- (Wechsler et al. 2019)
perhaps using a flooding technique in real life scenario could be more effective.

21
Q

AO3: Efficacy

A

SD: effective treatment: Gilroy et al. (2003) followed up 42 patients treated for spider phobia who had three sessions of SD.
- both 3 months and 33 months the SD group were less fearful than relaxation (long lasting effects)

Flooding: less effective for some types of phobias eg. complex phobias like social phobias (may be due to cognitive aspects)
eg. not just experiencing anxiety response but unpleasant thoughts about the social situation.

22
Q

AO3: Acceptibility of treatment

A

SD: acceptable to patients: preferred when given the choice. does not cause same degree of trauma and includes elements (learning relaxation procedures) that can be pleasant.
Low refusal and attrtion rates of treatment.

Flooding: treatment is traumatic: patients do give consent but are often unwilling to see it through to the end. time and money sometimes wasted preparing patients only to have them refuse to start or complete treatment.

23
Q

AO3: substitution

A

Symptom substitution: when one phobia disappears another may appear in it’s place. eg. phobia of snakes replaced by phobia of trains.
evidence is mixed, however, and behavioral therapists tend not to believe this.

24
Q

AO3: Strength of SD

A

flooding and cognitive therapies are not suited to some patients.
sufferers of anxiety disorders also sometimes have learning difficulties.
- cannot understand what is happening or to engage
- provides appropriate treatment