Psychopatholgy (abnormality)

Question 1

Define cultural relativism (Definitions of abnormality)

Answer 1

• The view that behaviour cannot be judged properly unless it is viewed in the context of the culture in which it originates

Question 2

Define deviation from social norms (Definitions of abnormality)

Answer 2

• Abnormal behaviour is seen as deviation from unstated social rules about how people should behave
• Anything that violates these rules is considered abnorma

Question 3

Define DSM (Definitions of abnormality)

Answer 3

• Diagnostic and statistical manual of mental disorders
• A list of mental disorders that is used to diagnose mental disorders
• For each disorder a list of clinical characteristics is given, i.e. the symptoms that should be looked for

Question 4

Define statistical infrequency (Definitions of abnormality)

Answer 4

• Abnormality is defined as those behaviours that are extremely rare, i.e. any behaviour that is found in very few people is regarded as abnormal

Question 5

Outline statistical infrequency (Definitions of abnormality)

Answer 5

• A way in which abnormality can be defined
• We define normality by referring to typical values
• E.g the average shoe size for 12 year old
• It involves defining what is most common or normal, then we also have an idea of what is not common i.e. abnormal
• This is done by analysing data from different populations and identifying the most common values
• Anything that is far away from these values is statistically infrequent

Question 6

Outline deviation from social norms (Definitions of abnormality)

Answer 6

• In any society there are stands of acceptable behaviour that are set by the social group, and adhered to by those socialised into that group
• Anyone who behaves differently from these social norms is called as abnormal
• An example of social norms is politeness and it helps us with our interpersonal relations
• people who are being rude are considered to be behaving in a socially deviant way as others find it difficult to interact with them
• Some rules about deviation from social norms are implicit and some are enforced by the law
• e.g. laughing at a funeral or disorder in public both deviations from social norms

Question 7

Example of deviation from a social norm (Definitions of abnormality)

Answer 7

• In the past, homosexuality was classified as abnormal and regarded as a mental disorder
• it was also a mental disorder
• This judgement was based on social deviation
• based on what behaviours are considered to be acceptable

Question 8

Evaluation: Definitions of abnormality (Evaluation of statistical infrequency- some abnormal behaviour is desirable)

Answer 8

• An objection to this approach is that there are many abnormal behaviours that are actually quite desirable
• For example few people have an IQ greater than 150 however having a high IQ IS not undesirable
• Alternatively, there are some normal behaviours that are undesirable for example experiencing depression
• Using statistical infrequency means that we cannot distinguish between desirable and undesirable behaviours
• This is necessary for identifying which behaviours need treatment

Question 9

Evaluation: Definitions of abnormality (evaluation of deviations from social norms- varies as times change)

Answer 9

• A limitation of the concept of deviation from social norms is that it varies as times change
• What is socially acceptable now may not have been 50 years ago
• 50 years homosexuality was included under sexual and gender identity disorders but today it is more accepted
• In Russia, 50 years ago, anyone who disagreed with the state was at risk of being regarded as insane and placed in a mental institution
• This shows that deviation from social norms can be defined unfairly
• As suggested by Thomas Szasz, the concept of mental illness may be used as a way to include non-conformists from society

Question 10

Evaluation: Definitions of abnormality (Cultural relativism)- statistical infrequency

Answer 10

A limitation lies with the attempts to define abnormality in terms of social norms which is relative to the group of people around then

• In the case of statistical infrequency, behaviours that are statistically infrequent in one culture may be statistically more frequent in another e.g. symptoms of schizophrenia is claiming to hear voices
• However this experience is common is some cultures
• Therefore the model is culturally relative

Question 11

Evaluation: Definitions of abnormality (Cultural relativism)- deviation from social norms

Answer 11

• Attempting to define abnormality in terms of social norms is obviously bound by culture because social norms are defined by culture
• Classification systems, such as the DSM are almost entirely based on the social norms of the dominant culture
• Cultural relativism has become acknowledged and the revised DSM makes reference to cultural contexts in many areas of diagnosis
• In the section on panic attaks crying may be a symptom in one culture whereas difficulty breathing may be a primary symptom in others
• No universal standards for labelling a behaviour as normal

Question 12

The behavioural approach to treating phobias: Systematic desensitisation

Answer 12

• One of the reasons that phobias may persist is that phobics avoid the phobic stimulus and therefore
• there is no opportunity to learn that their feared stimulus is not so fearful after all
• Joseph Wolpe (1958) developed a technique were phobics were introduced to the feared stimulus gradually

Question 13

The behavioural approach to treating phobias: (SD) Counterbalancing

Answer 13

• The basis of the therapy is counterbalancing
• The patient is taught a new association that opposes the original association
• Through classical conditioning, the patient is taught to associate the phobic stimulus with anew response, i.e. relaxation instead of fear
• In this way their anxiety is reduced- they are desensitised
• Wolpe also called this ‘reciprocal inhibition’ because this response of relaxation inhibits the response of anxiety

Question 14

The behavioural approach to treating phobias: (SD) Relaxation

Answer 14

• The therapist teaches the patient relaxation techniques
• Relaxation can be achieved by the patient focusing on their breathing and taking slow, deep breaths
• When we are anxious we breathe quickly, so slowing this down help us to relax
• Being mindful of ‘here and now’ can help, as well as focusing on a particular object or visualising a peaceful scene
• Progressive muscle relaxation is also used where one muscle at a time is relaxed

Question 15

The behavioural approach to treating phobias: (SD) Desensitisation hierarchy

Answer 15

• SD works by gradually introducing the person to the feared situation one step at a time so it is not as overwhelming
• At each stage the patient practices relaxation so the situation becomes more familiar, less overwhelming and their anxiety diminishes

Question 16

The behavioural approach to treating phobias: Flooding

Answer 16

• An alternative to the gradual progression through a hierarchy, as used in systematic desensitisation, is to just have one long session where the patient experiences their phobia at its worst while at the same time practising relaxation
• The session continues untill the patient is fully relaxed
• For example a patient who is scared of heights of taken up a tall building

Question 17

The behavioural approach to treating phobias: Flooding in practice

Answer 17

• The procedure can be conducted in vivo (actual exposure) or virtual reality can be used
• As with SD, the first step is to learn relaxation techniques
• Then these techniques are applied in one session in the presence of the most feared situation
• This usually lasts two or three hours
• A persons fear response has a time limit
• As adrenaline levels naturally decrease, a new stimulus-response link can be learned between feared stimulus and relaxation

Question 18

Evaluation: (The behavioural approach to treating phobias) Effectiveness of SD

Answer 18

• Research has found that SD is successful for a range of phobic disorders
• For example, McGrath reported that about 75% of patients with phobias respond of SD
• The key to success appears to lie with actual contact with the feared stimulus,so in vivo techniques are more successful than ones just using pictures or imagining the feared stimulus
• Often a number of different exposure techniques are involved- in vivo and also modelling, where the patient watches someone else who is coping well with the feared stimulus

Question 19

Evaluation: (The behavioural approach to treating phobias) (SD) Strengths of behaviour therapies

Answer 19

• Behavioural therapies for dealing with phobias are generally relatively fast and require less effort on the patients part than other psychotherapies
• For examp,le CBT requires a lot of willpower from the patient in trying to understand their behaviour and apply these insights
• This lack of ‘thinking’ means that the technique is also useful for people who lack insight into their motivations or emotions
• A further strength of SD is that it can be self-administered, a method which has proven to be successful especially with social phobias

Question 20

Evaluation: (The behavioural approach to treating phobias) (Flooding) Individual differences

Answer 20

• Flooding is not for every patient
• It can be a highly traumatic procedure
• Patients are made aware of this before hand, even then, they may quit during the treatment, which reduces the ultimate effectiveness of the therapy for some people

Question 21

Evaluation: (The behavioural approach to treating phobias) (Flooding)Effectiveness

Answer 21

• For those who do choose flooding as a treatment and do stick with it, it appears to be an effective treatment and is relatively quick (compared to CBT)
• For example Choy reported that both SD and flooding were effective but flooding was the more effective of the two at treating phobias
• On the other hand, another review concluded that SD and flooding were equally effective in the treatment of phobias

Question 22

Evaluation: (The behavioural approach to treating phobias) Relaxation may not be necessary

Answer 22

• It may be that the success of both SD and flooding is more to do with exposure to the feared situation than relaxation
• It might also be that the expectation of being able to cope with the feared stimulus is most important
• For example , Klein compared SD with supportive psychotherapy for patients with either social or specific phobias
• They found no difference in effectiveness suggesting that the ‘active agent’ in SD or flooding may simply be the generation of hopeful expectancies that the phobia can be overcome

Question 23

Failure to function adequately: (Definitions of abnormality)

Answer 23

• from an individuals point of view, abnormality can be judged in terms of not being able to cope with everyday tasks i.e. Failure to function adequately
• Not functioning adequately causes distress and suffering for the individual, and/or may cause distress for others
• It is important to include ‘distress to others’ because, in the case of some mental disorders, the individual may not be distressed at all
• People with schizophrenia generally lack awareness that anything is wrong but their behaviour (hallucinations, believing that they are being persecuted) may well be distressing to others
• There may be situations where a person is not coping with everyday life in a ‘normal’ way- for example, a person may be content living in unwashed clothes and not having a regular job
• If this doesn’t cause distress cause distress to self or others then a judgement of abnormality is inappropriate

Question 24

Failure to function adequately: Example

Answer 24

• The DSM includes an assessment of ability to function called WHODAS (world health organisation disability assessment ; which is available online)
• This considered 6 areas: Understanding and communicating, getting along with people, life activities and participation in society
• Individuals rate each item on a scale of 1 to 5 and are given an overall score out of 180
• Therefore an assessment of abnormality using the DSM would include a quantitative measure of functioning

Question 25

Deviation form ideal mental health

Answer 25

• Marie Jahoda pointed out that we define physical illness in part by looking at the absence of signs of physical health
• Physical health indicated by having correct body temperature, normal skin colour, normal blood pressure etc, so the absence of these indicates illness
• Jahoda suggested we should do the same for mental illness
• Jahoda conducted a review of what others had written about good mental health
• These are the characteristics that enable an individual to feel happy (free of distress) and behave competently
• She identified six categories that were commonly referred to:
• Self attitudes: having high self-esteem and a strong sense of identity
• personal growth and self actualisation: the extent to which an individual develops their full capabilities
• Integration: such as being able to cope with stressful situations
• Autonomy: Being independent and self regulating
• Having an accurate perception of reality
• Mastery of the environment: including the ability to love, function at work and interpersonal relationships, adjust to new situations and solve problems
• This deviation from the ideal mental health definition proposes that the absence of these criteria indicates abnormality, and potential mental disorder

Question 26

Define deviation from ideal mental health

Answer 26

• Abnormality is defined in terms of mental health, behaviours that are associated with competence and happiness
• Ideal mental health would include a positive attitude towards the self, resistance to stress and accurate perception of reality

Question 27

Define failure to function adequately

Answer 27

People are judged on their ability to go about daily life
- If they can’t do this and are also experiencing distress (or others are distressed by their behaviour) then it is considered a sign of abnormality

Question 28

Evaluation: (Definitions of abnormality continued- failure to function adequately) who judges?

Answer 28

• in order to determine ‘failure to function adequately’ someone needs to decide if this is actually the case
• It may be that the patient is experiencing personal distress, for example being unable to get to work or eat regular meals
• The patient might recognise that this is undesirable and may feel distressed
• On the other hand, it may be that the individual is quite content with the situation and/or simply unaware that they are not coping
• It is others who are uncomfortable and judge the behaviour as abnormal
• For example, some schizophrenics are potentially dangerous,as in the case of someone like Peter Sutcliffe, the Yorkshire Ripper
• Therefore, the weakness of this approach to defining abnormality is that it depends who is making the judgement

Question 29

Evaluation:(Definitions of abnormality continued- failure to function adequately) The behaviour may be quite functional

Answer 29

• Some apparently dysfunctional behaviour can actually be adaptive and functional for the individual
• For example, some mental disorders, such as eating disorders or depression, may lead to extra attention for the individual
• Such attention is rewarding and thus quite functional rather than dysfunctional for the individual
• Some individuals who cross-dress make a living out of it, yet transvestitism is in the list of mental disorders and is generally regarded as abnormal

Question 30

Evaluation: (Definitions of abnormality continued- failure to function adequately) Strengths of this definition

Answer 30

• On the positive side, hid definition of abnormality does recognise the subjective experience of the patient, allowing us to view mental disorder from the point of view of the person experiencing it
• In addition ‘failure to function’ is also relatively easy to judge objectively because we can list behaviours (can dress self, can prepare meals- as in WHODAS) and thus judge abnormality objectively objectively I.e. When treatment is required

Question 31

Evaluation: (definitions of abnormality- deviation from the ideal mental health) unrealistic criteria

Answer 31

• One of the major criticisms of this definition is that, according to these criteria, most of us are abnormal!
• Jahoda presented them as ideal criterial and they certainly are
• We also have to ask how many need to be lacking before a person would be judged as abnormal
• Furthermore, the criteria are quite difficult to measure. For example, how easy is it to assess capacity for personal growth or environmental mastery?
• This means that this approach may be an interesting concept but not really useful when it comes to identifying abnormality

Question 32

Evaluation: (definitions of abnormality- deviation from the ideal mental health) Suggesting that mental health is the same as physical health

Answer 32

• In general, physical illnesses have physical causes such as virus or bacterial infection,and as a result this makes them relatively easy to detect and diagnose
• It is possible that some mental disorders also have physical causes (e.g. Brain injury or drug abuse) but many do not
• They are the consequence of life experiences
• Therefore it is unlikely that we could diagnose mental abnormality in the same way that we can diagnose physical abnormality

Question 33

Evaluation: (definitions of abnormality- deviation from the ideal mental health) It is a
positive approach

Answer 33

• the deviation from mental health offers an alternative perspective on mental disorder by focusing on the positives rather than negatives and focuses on what is desirable rather than what is desirable
• Even though Jahodas ideas were never really taken up by mental health professionals, the ideas have had some influence and are in accord with the ‘positive psychology’ movement

Question 34

Mental disorders: Phobias

Answer 34

• Phobic disorders are included in diagnostic manuals (DSM and ICD) within the category of ‘anxiety disorders’ a group of mental disorders that share the primary symptom of extreme anxiety
• Phobic disorders, or phobias, are instances of irrational fears that produce a conscious avoidance of the feared object or situation
• this includes agoraphobia (fear of being trapped in a public place where escape is difficult), social phobia (anxiety related to social situations, such as talking to a group of people) and specific phobias (fears of specific phobias, such as spiders or snakes, or specific situations, such as heights or the dark)

Question 35

Phobias: emotional characteristics

Answer 35

• The primary emotional characteristic of a phobia is fear that is marked and persistent, and is likely to be excessive and unreasonable
• Coupled with fear and feelings of anxiety and panic
• These emotions are cure by the presence or anticipation of a specific object or situation (e.g. Spiders, flying, heights, seeing blood) and are out of proportion to the actual danger posed

Question 36

Phobias: behavioural characteristics

Answer 36

• One behavioural characteristic is avoidance
• when a person is faced with the object or situation that creates fear the immediate response is to try to avoid it
• For example, a person with a phobia of spiders avoids being near them; a person with a phobia about social situations avoids being in groups of people
• However, there is also the opposite behavioural response, which is to freeze or even faint
• The stress response is often described as fight or flight but is actually flight or freeze
• ‘freezing’ is an adaptive response because a predator may think the pray is dead
• Avoidance in the feared situation interferes significantly with the persons normal routine, occupation, social activities or relationships, and there is marked distress about having the phobia
• This distinguishes phobias from more everyday fears that do not interfere with normal day-to-day living

Question 37

Phobias: cognitive characteristics

Answer 37

• Cognitive characteristics relates to the thought processes
• In the case of phobias,a defining characteristic is the irrational nature of the persons thinking and the resistance to rational arguments
• For example, a person with a fear of flying is not helped by arguments that flying is actually the safest form of transport
• A further defining characteristic is that the person recognises that their fear is excessive or unreasonable, although this feature may be absent in children
• This characteristic distinguishes between a phobia and a delusional mental illness (such as schizophrenia) where the individual is not aware the unreasonableness of their behaviour

Question 38

What is depression?

Answer 38

Depression is classified as a mood disorder. DSM-V distinguishes between major depressive disorder and persistent depressive disorder which is longer term and or recurring

Question 39

Depression: emotional characteristics

Answer 39

• A formal diagnosis of ‘major depressive disorder’ requires the presence of at least five symptoms and must include either sadness or loss of interest and pleasure in normal activities
• Sadness is the most common description people give of their depressed state, along with feeling empty
• Associated with this, people may feel worthless, hopeless and/or experience low self-esteem all negative emotions
• Loss of interest and pleasure in usual hobbies and activities is associated with depression- anger directed towards others or turned inwards on the self
• Depression may arise from feelings of being hurt and wishing to retaliate

Question 40

Depression: Cognitive characteristics

Answer 40

• The negative emotions related to depression are associated with negative thoughts, such as a negative self-concept (negative self-beliefs) as well as guilt, a sense of worthlessness and so on
• Depressed people often have a negative view of the world and expect things to turn out badly rather than well
• In fact, as you will discover later in this chapter, this is one of the explanations for depression- people have negative expectations about their lives and relationships and the world generally
• Such expectations can be self- fulfilling; for example, if you believe that you are going to fail an
  Exam, that belief may reduce the effort you make and/or increase your anxiety and thus you will fail, confirming your negative self-beliefs
• In general such negative thoughts are irrational; i.e they do not accurately reflect reality

Question 41

Define OCD

Answer 41

• obsessive compulsive disorder is also classed as an anxiety disorder. The disorder typically begins in young adult life and has two main components- obsessions and compulsions are repetitive behaviours

Question 42

OCD: emotional characteristics

Answer 42

• Both the obsessions and compulsions are a source of considerable anxiety and distress
• Sufferers are aware that their behaviour is excessive and this causes feelings of embarrassment and shame
• A common obsession concerns germs which gives rise to feelings of disgust

Question 43

OCD: Cognitive characteristics

Answer 43

• Obsessions are recurrent, intrusive thoughts or impulses that are perceived as inappropriate or forbidden
• They may be frightening and/or embarrassing so that the person doesn’t want to share them with others
• Common obsessional themes include ideas (e.g. That germs are everywhere), doubts (e.g. The worry that something important has been overlooked), impulses (e.g. To shout out obscenities) or images (e.g. Fleeting sexual images)
• these thughts, impulses or images are not simply excessive worries about everyday problems
• They are seen as uncontrollable, which creates anxiety
• The person recognises that the obsessional thoughts or impulses are a product of their own mind (rather than thoughts inserted by someone else as is typical of schizophrenia)
• At some point during the course of the disorder, the person does recognise that the Obsessions or compulsions are excessive or unreasonable

Question 44

OCD: Behavioural characteristics

Answer 44

• Compulsive behaviours are performed to reduce the anxiety created by Obsessions
• They are repetitive and unconcealed, such as hand washing or checking
• They may be mental acts such as praying or counting
• Patients feel they must perform these actions I.e. they are compelled to perform these actions otherwise something dreadful might happen
• This creates anxiety
• The behaviours are not connected in a realistic way with what they are designed to neutralise or prevent and clearly excessive
• Some patients only experience compulsive behaviours with no particular Obsessions, for example, they compulsively avoid certain objects

Question 45

What are phobias?

Answer 45

A group of mental disorders characterised by high levels of anxiety in response to a particular stimulus or group of stimuli. Obsessions are persistent thoughts and compulsions are repetitive behaviours

Question 46

The behavioural approach to explaining phobias: The two process model

Answer 46

• Mowrer proposed the two-process model to explain how phobias are learned
• The first stage is classical conditioning and then, In a second stage, operant conditioning occurs
• Both processes are needed to explain why phobias begin in the first place and then also continue

Question 47

The behavioural approach to explaining phobias: Classical conditioning- initiation

Answer 47

• A phobia is acquired through association- the association between a neutral stimulus such as a white furry hat, and a loud noise results in a new stimulus response being learned, as demonstrated by little Albert

Question 48

Classical conditioning- Little Albert

Answer 48

• In this case the original unconditional stimulus (UCS) was a loud noise, and the original unconditional response (UCR) was fear
• By pairing the loud noise with furry object, the furry object acquired the same properties as the UCS and produced the response of fear, now called a conditioned response (CR) because this is a learned response
• The furry object is now a conditioned stimulus (CS)
• When Albert saw a white furry rat he cried, presumably because the object was now associated with fear

Question 49

Using the process of classical conditioning, explain why someone develops a fear of dogs after being bitten

Answer 49

1) Being bitten (UCS) creates fear (UCR)
2) Dog (NS) associated with being bitten (UCS)
3) Dog (now CS) produces fear response (now CR)

Question 50

The behavioural approach to explaining phobias: Operant conditioning- maintenance

Answer 50

• Through classical conditioning a phobia is acquired
• However, this does not explain why individuals continue to feel fearful, nor does it explain why individuals continue to feel fearful, nor does it explain why individuals avoid the feared object
• The next step involves operant conditioning- the likelihood of a behaviour being repeated is increased if the outcome is rewarding
• In the case of a phobia, the avoidance (or escape From) the phobic stimulus reduces fear and is thus reinforcing
• This is an example of negative reinforcement (escaping from an unpleasant situation)
• The individual avoids the anxiety created by, for example, the dog or avoiding a social situation entirely

Question 51

Social learning

Answer 51

• social learning theory is not part of the two-process model but it is a neo- behaviourist explanation I.e. the fear seems reduced
• Phobias may also be acquired through modelling the behaviour of others
• For example, seeing a parent respond to a spider with extreme fear may lead a child to acquire a similar behaviour because the behaviour appears rewarding, I.e the fearful person gets attention

Question 52

Define two process model

Answer 52

A theory that explains the two processes that lead to the development of phobias- they begin through classical conditioning and are maintained though operant conditioning

Question 53

Classical conditioning:

Operant conditioning:

Answer 53

• Learning through association. A neutral stimulus paired with an unconditioned stimulus so that it eventually takes on the properties of this stimulus and is able to produce a conditioned response
• Learning through reinforcement or punishment. If a behaviour is followed by a desirable consequence then that behaviour is more likely to occur again in the future

Question 54

Evaluation: (The behavioural approach to explaining phobias) the importance of classical conditioning

Answer 54

• People with phobias often do recall a specific incident when their phobia appeared, for example being bitten by a dog or experiencing a panic attack In a social situation
• However, not everyone who has a phobia can recall such an incident
• It is possible that such traumatic incidents did happen, but have been forgotten
• Sue suggested that different phobias may be the result of different processes
• For example, agoraphobics were most likely to explain their disorders in terms of a specific incident, whereas arachnophobics were most likely to cite modelling as the cause

Question 55

Evaluation: (The behavioural approach to explaining phobias) diathesis stress model

Answer 55

• According to the two-process model of phobias, an association between a neutral stimulus and a fearful experience will result in a phobia
• However, research has found, for example, that not everyone who is bitten by a dog develops a phobia of dogs
• This could be explained by the diathesis stress model
• This proposes that we inherit a genetic vulnerability for developing mental disorders
• However, a disorder will only manifest itself if triggered by a life event, such as being bitten by a dog
• So a dog bite would only lead to a phobia in those people with such a vulnerability for developing mental disorders
• However, a disorder will only manifest itself if triggered by a life event such as being bitten by a dog
• So a dog bite would only lead to a phobia in those people with such a vulnerability

Question 56

Evaluation: (The behavioural approach to explaining phobias) support for social learning

Answer 56

• An experiment by Banbura and Rosenthal supported the social learning explanation
• In the experiment a model acted as if he was in pain every time a buzzer sounded
• later on, those participants who had observed this showed an emotional reaction to the buzzer, demonstrating an acquired ‘fear response’

Question 57

Evaluation: (The behavioural approach to explaining phobias) Biological preparedness

Answer 57

• The fact that phobias do not always develop after a traumatic incident may be explained in terms of biological preparedness
• Seligman argued that animals, including humans, are genetically programed to rapidly learn an association between potentially life-threatening stimuli and fear
• These stimuli are referred to as ancient fears- things that would have been dangerous in our evolutionary past (such as snakes, heights, strangers)
• It would have been adaptive to rapidly learn to avoid such stimuli
• This concept of biological preparedness would explain why people are much less likely to develop fears of modern objects such as toasters and cars that are much more of a threat than spiders
• Such items were not a danger in our evolutionary past
• For example, Bregman failed to condition a fear response in infants aged 8 to 16 months by pairing a loud bell with wooden blocks
• It may be that fear responses are only learned with living animals, a link with ancient fears
• This suggests that behavioural explanations alone cannot b en used to explain the development of phobias

Question 58

Evaluation: (The behavioural approach to explaining phobias) the two process model ignores cognitive factors

Answer 58

• There are cognitive aspects to phobias that cannot be explained in a traditionally behaviourist framework
• The cognitive approach proposes that phobias may develop as a consequence of irrational thinking
• For example, a person in a lift may think: ‘I could become trapped in here and suffocate’ (an irrational thought)
• Such thoughts create extreme anxiety and may trigger a phobia
• The value of this alternative explanation is that it leads to cognitive therapies such as CBT that may be more successful than the behaviourist trarnemts