Psychopathology - 03 The Behavioural Approach To Explaining and Treating Phobias Flashcards

1
Q

Who created the 2 process model?

A

Mowrer (1960)

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2
Q

What are the 2 parts of the 2 process model?

A

1-phobias start through classical conditioning (association)
2-phobias are maintained through operant conditioning (negative reinforcement - removal of something unpleasant)

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3
Q

Explain classical conditioning in terms of phobias

A

-humans naturally fear pain and so fear response to pain is unconditioned
-when this unconditioned response is associated with a neutral stimulus through experience, then a person can become conditioned to associate the response (fear with the stimulus.
-this is based on the work of Ivan Pavlov

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4
Q

Behaviourist approach (phobias) key study: little Albert

A

-Watson & Rayner (1920)
-baby given a white rat to play with
-did not have fear response towards rat initially but researchers made loud noise which frightened him
-repeated several times, after Albert demonstrated fear when presented with rat even without loud noise
-created conditioned response to previously neutral object

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5
Q

Explain operant conditioning in terms of phobias

A

-the avoidance of the phobia object reduces fear and is therefore reinforcing
-this is an example of negative reinforcement as the individual avoids the anxiety created by avoiding them completely

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6
Q

evaluation - behavioural explanation of phobias (phobias that do not follow trauma)

A

-not all phobias are the result of a bad experience and negative associations
-so classical conditioning cannot be the only explanation for how we develop phobias
-other explanations need to be investigated

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7
Q

evaluation - behavioural explanation of phobias (alternative explanation - biological preparedness)

A

-not always develop after traumatic incident
-Seligman (1970), we genetically programmed to rapidly learn association between life-threatening stimuli and fear
-ancient fears, dangerous in evolutionary past
adapted to avoid dangerous stimuli
-explains why people are less likely to fear modern objects
-so behavioural explanations alone cannot be used to explain the development of phobias

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8
Q

weakness of behavioural explanations of phobias (ignores cognitive factors)

A

-two process model cannot be the only explanation
-cognitive approach says phobias develop due to irrational thinking which cause anxiety and trigger a phobia
-focusing on the role of conditioning only is too simplistic

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9
Q

evaluation - behavioural explanations of phobias (needs a multi-factorial model)

A

-diathesis stress model
-develop phobia from stressful environment trigger but only if we have the genetic risk for developing a phobia
-this suggests we need to look at biological factors in addition to learning from our environment

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10
Q

What are the two treatments used for treating phobias?

A

-Systematic desensitisation
-Flooding

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11
Q

What is systematic desensitisation?

A

-based on the idea that you cannot be anxious and relaxed at the same time
-form of counter-conditioning, where a person is trained to substitute the fear response with relation in the presence of the phobic stimulus

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12
Q

What are the 3 stages of systematic desensitisation?

A

-hierarchy of fear
-relaxation methods
-graduated exposure

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13
Q

What happens in the first stage of systematic desensitisation?

A

-therapist sits down with client and they make a hierarchy of fearful situations and arranging them in order from least to most fearful

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14
Q

What happens in the second stage of systematic desensitisation?

A

-the client is then trained in methods of relaxation like releasing muscular tension, controlled breathing and visualisation techniques

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15
Q

What happens in the third stage of systematic desensitisation?

A

-graduated exposure
-client brought gradually into contact with phobic stimulus , following hierarchy established
-at each stage they use techniques they have learned to produce a state of relaxation
-only when full relaxation has been achieved does the treatment move onto the next stage pf the hierarchy

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16
Q

When does treatment end in systematic desensitisation?

A

When the client is desensitised and able to work through the entire hierarchy without anxiety

17
Q

Effectiveness of systematic desensitisation

A

-Gilroy et al (2002)
-42 patients with arachnophobia each treated using three 45 minute systematic desensitisation sessions
-3 months and 33 months later the SD group were less fearful than the control group (only taught relaxation techniques)

18
Q

Suitability of systematic desensitisation

A

-not effective with all phobias for example fears of snakes (developed not through classical conditioning) but have an evolutionary survival benefit
-social phobias/agoraphobia do not show much improvement

19
Q

Conflicting evidence of systematic desensitisation

A

-Capafons et al. (1998) 41 aerophobia sufferers
-20 treated with SD given 2, 1 hour sessions a week over a 12-15 week period
-During flight simulation all but 2 of those who had SD reported lower levels of fear and anxiety
-one of control group, signs of improvement
-not 100% effective not cured just helped symptoms

20
Q

Alternative treatments of systematic desensitisation

A

-flooding
-equally as effective but is more cost-effective and less time consuming achieving positive results quicker
-exposes individual to phobic stimulus immediately so unable to negatively reinforce the phobia so extinction occurs quicker

21
Q

Practical issues of systematic desensitisation

A

-can take quite a long time as you would have multiple sessions spaced out over time
-As there are multiple stages it makes it more costly

22
Q

Ethical issues of systematic desensitisation

A

-people subjected to their most feared situations causing very high levels of distress
-people may leave in worse state than they began due to the stress
-BUT more ethical than flooding which exposes straight to phobic stimulus without escape

23
Q

What is flooding?

A

-one long session where the patient experiences their phobia at its worse while practising relaxation
-session continues until patient is fully relaxed
-stops phobic response very quickly
-no option of avoidance behaviour

24
Q

What is the procedure of flooding?

A

-learn relaxation techniques
-applied in one session in presence of most feared situation
-usually lasts 2-3 hours
-fear response has time limit, as adrenaline levels naturally decreases
-new stimulus response link can be learned between feared stimulus and relaxation

25
Q

Effectiveness of flooding

A

-Keane et al (1989
-24 Vietnam veterans with PTSD
-14-16 flooding sessions
-tested before, after and 6 months later for symptoms
-compared to control, flooding group had fewer terrifying flashbacks, anxiety and depression
-supports ideas that flooding can extinguish phobias

26
Q

suitability of flooding

A

-highly effective for simple phobias
-less effective for social phobias/agoraphobia
-complex phobias cannot be treated may be more responsive to CBT for example

27
Q

conflicting evidence of flooding

A

Wolpe (1969) had a client hospitalised because flooding made her so anxious
-This shows that flooding is not completely effective as it cased a client so much trauma and anxiety rather than helping them to reduce it

28
Q

alternative treatments for flooding

A

-CBT
-includes both cognitive and behavioural elements
-aims to identify irrational and negative thoughts and replace them with more positive ones
-so is much more ethical and aims to solve the main problem to stop symptoms all together

29
Q

practical issues of flooding

A

-highly traumatic means many clients do not complete their treatment sue to stress
-so often waste of time and money if a patient does not finish

30
Q

ethical issues of flooding

A

-not very ethical
-causes high levels of anxiety and backfire causing more stress than the start
-although there is informed consent many patients do not complete their treatment due to the stress