Phobias (Psychopathology)

Question 1

Phobia

Answer 1

anxiety disorders which interferes with daily living. An irrational fear that produces a conscious avoidance of the feared object or situation.

Question 2

Emotional aspects of a phobia

Answer 2

Anxiety from fear of the phobic stimulus. Emotional response that is negative.

Unreasonable emotional response, disproportionate to the danger posed.

Question 3

Behavioural aspects of a phobia

Answer 3

Panic- crying, screaming, running away.

Avoidance- take a lot of effort to avoid stimulus which affects daily life.

Endurance- if you remain in the presence of stimulus experiencing high anxiety.

Question 4

Cognitive aspects of a phobia

Answer 4

Selective attention- hard to look away from the stimulus.

Irrational beliefs- social phobia- ‘if I blush I am weak’ increases pressure on person to perform in social situations.

Cognitive distortions- perceptions of the stimulus are distorted.

Question 5

The Two Process Model

Answer 5

The behavioural approach emphasises the role of learning in the acquisition of behaviour.
-Hobart Mowrer (1960) proposed the two process model based on the behavioural approach to phobias.
-this states that phobias are acquired through classical conditioning and maintained through operant conditioning.

Question 6

Maintenance of a phobia through operant conditioning

Answer 6

Negative reinforcement is avoiding an unpleasant situation, resulting in a desirable consequence which means that the behaviour will be repeated. When we avoid the phobic stimulus, we avoid the fear and anxiety associated with it, reinforcing avoidance and the phobia is maintained.

Question 7

Systematic desensitisation (behavioural therapy)

Answer 7

-designed to gradually reduce phobic anxiety through the principle of classical conditioning
-if the sufferer can learn to relax in the presence of the phobic stimulus they will be cured
-a new response is learnt- this is called counterconditioning
The idea behind this is called reciprocal inhibition: we cannot feel fear and relaxed at the same time.
—Process: the client works out a hierarchy of fear from the least frightening to the most frightening (function analysis) parts of the thing that they fear. The client is exposed to the phobic stimulus while in a relaxed state. They start at the bottom of the hierarchy and work through to the highest.

Question 8

Flooding (behavioural therapy)

Answer 8

A behavioural therapy designed to rapidly stop a phobic response. It invilves immediate exposure to a frightening experience. There is no option of aviodance and the patient quickly learns that the phobic stimulus is harmless. This is called extinction.

Question 9

Good explanatory power (Evaluation of Behavioural Approach to phobias)

Answer 9

The Two process model was influential in the 1960s

Explains how phobias can be maintained over time and this has important implications for therapies

Once a patient is prevented from practicing their avoidance behaviour, the behaviour is no longer reinforced and thus declines.

Question 10

Alternative explanation for avoidance behaviour (Evaluation of Behavioural Approach to phobias)

Answer 10

Not all avoidance behaviour associated with phobias seems to be the result of anxiety reduction

Evidence suggests that at least some avoidance behaviour is more motivated by the positive feeling of safety

Buck 2010; Agoraphobia is more to stick with the safety of being inside

Question 11

An incomplete explanation of phobias (Evaluation of Behavioural Approach to phobias)

Answer 11

Bounton 2007 suggested that evolutionary factors probably have an important role in phobias
It is adaptive to acquire some fears (the dark for example). It is an innate predisposition
Seligman 1971 called this biological preparedness.

Question 12

Phobias that don’t follow trauma (Evaluation of Behavioural Approach to phobias)

Answer 12

Some people do not know why they fear something
A fear might not be the result of conditioning

Question 13

The cognitive aspects of phobias (Evaluation of Behavioural Approach to phobias)

Answer 13

The behavioural approach ignores cognitive factors
There is no mention of how we process emotions
Ignores cognitive distortions, irrational beliefs and selective attention

Question 14

It is effective in reducing phobic behaviour (Evaluation of systematic desensitisation)

Answer 14

Gilroy et al 2003- 42 patients treated for spider phobia in three 45 minute sessions were compared to a control group who were treated by relaxation without exposure
After 3 months and then after 33 months the treatment group were less fearful than the relaxation group

Question 15

It is suitable for a diverse range of phobias (Evaluation of systematic desensitisation)

Answer 15

Some people with anxiety disorders also have learning disabilities
It can be difficult for people to understand other therapies such as flooding or CBT that require the ability to reflect on what you are thinking
Systematic desensitisation is the most appropriate therapy

Question 16

It is acceptable to patients (Evaluation of systematic desensitisation)

Answer 16

Patients tend to prefer systematic desensitisation as it is not as traumatic as flooding. It also includes some pleasant elements (relaxation)
Reflected in low refusal rates and low attrition rates

Question 17

Ethical safeguards (Evaluation of flooding)

Answer 17

It is an unpleasant experience so it is important that patients give fully informed consent They should be fully prepared before the session.

Question 18

It is cost effective (Evaluation of flooding)

Answer 18

It is at least as effective as other treatments, while Ougrin 2011 found it to be quicker

As it is quicker, it is cheaper

Question 19

It is less effective for some phobias (Evaluation of flooding)

Answer 19

Social phobias and agoraphobia don’t seem to show the same improvement.

This is because of complex cognitive aspects and anxiety/unpleasant thoughts.

CBT can be more effective

Question 20

It is traumatic for patients (Evaluation of flooding)

Answer 20

It can be highly traumatic and patients are often unwilling to see it through until the end, meaning that time and money are wasted.

As it is an unpleasant experience, patients need to be able to give fully informed consent and be fully prepared before the session.

Question 21

Symptom substitution (Evaluation of flooding)

Answer 21

It is often the case that one phobia disappears and another replaces it

However, the evidence is mixed

Freud said this happens when unconscious impulses and conflicts responsible for the original symptom are not dealt with effectively