Psychology - anxiety fear and phobia Flashcards
How can you manage anxiety, fear & phobia?
Deep breaths
Distractions
What is anxiety?
A hypothetical (not yet proved to be a thing) psychological construct which is (uneasy/concerned):
- anticipatory,
- unpleasant to experience (feel sick, heavy & forboding),
- aversive,
- takes time to dissipate (chronic)
- sometimes associated with a specific event (e.g. Drs & dentists but also sometimes just on general)
What are the possile causes of dental fear?
Cost
Different environement
Alien environment
Pain
Drills
Noise
Needles
Can’t see what is going on
Invasion of personal space
What are the consequences of anxiety of the dentist?
43% avoid visiting the dentist unless in pain
Cancelled appoitments at last minute
Increased level of subjective pain
Ineffective anaesthesia
Fear of specific treatments
Non compliance (not following through on treatment plans -> possibly because struggling to take in the information due to their anxiety e.g. informed consent, diagnosis, treatment & post-operative instruction
What is fear?
Unpleasant emotion caused by impending danger (something that is real)
- 26% scared/afrain of dentist
- Waits until in more pain to go to dentist
- e.g. may make appointments because aware of teeth, keep cancelling them out of fear, thinks about pulling own teeth out with pliers when in pain to avoid going!
What is phobia?
Fear or aversion of specific (limited) criteria
2-7% debilitating fear = daily impact on wellbeing (lower mood), behaviour & daily life generally e.g. not walking down a road because it passes the dentist
What are the 3 components of anxiety?
- Physiological (breathlessness, dry mouth, raised bp & perspiration)
- Cognitive (poor concentration, hypervigilence = very aware of what is going on, imagining worst case scenarios = catastrophise)
- Behavioural (avoidance, escape)
Combine = panic attack = part of fight or flight syndrome (SNS)
Giving patients instructions can help manage any anxiety:
Find car park/how to get there
Tell receptionist you are here
Be clear if you arent doing any treatment that day etc.
What are the common perceptions of fearful patients?
Dentists are efficient and in a hurry
Dentists dont listen, try to trick the patients (e.g. say this wont hurt then it hurts), wont take the patient serously, recommend unnecessary work
Lack of control (can’t see, don’t understand)
Embarrasment (don’t look after teeth well enough or think stupid they are crying/shaking)
What are the two different types of anxiety?
- Somatic
(physical & body based e.g. sweating & cold )
Treatment: biofeedback (moniter & be aware of what is happening), breathing (talk them through), relaxations (radio in background, pictures on cieling, bring own ipod, lavender sprays, motivation & time from dentist)
- Cognitive
(mental/psychological = need to change thoughts)
Treatment: congitive restructuring, thought-stopping, stress inoculation (use tools for good things = start to realise it wasnt so bad), guided imagery & distraction
What is rachmans model of fear aquisition?
Fear develops from:
- Classical conditioning (adverse experience = 33% of children referred)
- Modelling (copy parents = 11% of children referred)
- I_nformation/instruction_ (overheard other people with bad experience with dentist e.g. friends and grandparents = 3 % children referred)
- Disturbed communication between dentist, parent and child (misunderstanding e.g. this wont hurt then it hurts & dentist and mum disagree = 54% children referred)
- Evolutionary prearedness (resisting physical vulnerability = helps us survive but doesn’t actually make sense to avoid)
What is a conditioned fear?
- Acquired in early childhood or later in life
- Mild or intense
- Traumatic experience = conditioning occuring in a single trial
What are the different psychological treatment approaches?
- Psychophysiological = manipulate physiological response (relaxation & biofeedback)
- Systematic desensitisation (take slowly through process of going to the dentist)
- Hyponosis
- Cognitive behavioural therapy/congnitive restructuring (patient behaviour/presence of pain behaviours, goal setting and pacing, expectations and beliefs r.e. pain control and coping, identify and modify maladaptive beliefs)
- Modelling
- Pshycodynamic (pain generated by emotional factors)
What did the cognitions questionarre discover?
That patients feel:
everything goes wrong, something will surely go wrong, i can’t stand this for long, this treatment will hurt, the nerve will be touched, i am helpless, i have no control over what happens, i can’t escape (locked in), the sound of the drill frightens me, ill panic during treatment, i become sick, the dentist will loose control over the drill
What are the two types of hypnosis?
Trance: someone talks you through using guided imagery = common & accessible to most people
Non trance: bypassing critical thinking influence, = manipulates thoughts about being scared (need to watch the words and paralanguage used: language: pain, hurt needle, drill; paralanguage: tone, volume, pacing)
