Psychopathology - 03 The Behavioural Approach To Explaining and Treating Phobias Flashcards
Who created the 2 process model?
Mowrer (1960)
What are the 2 parts of the 2 process model?
1-phobias start through classical conditioning (association)
2-phobias are maintained through operant conditioning (negative reinforcement - removal of something unpleasant)
Explain classical conditioning in terms of phobias
-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
Behaviourist approach (phobias) key study: little Albert
-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
Explain operant conditioning in terms of phobias
-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
evaluation - behavioural explanation of phobias (phobias that do not follow trauma)
-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
evaluation - behavioural explanation of phobias (alternative explanation - biological preparedness)
-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
weakness of behavioural explanations of phobias (ignores cognitive factors)
-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
evaluation - behavioural explanations of phobias (needs a multi-factorial model)
-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
What are the two treatments used for treating phobias?
-Systematic desensitisation
-Flooding
What is systematic desensitisation?
-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
What are the 3 stages of systematic desensitisation?
-hierarchy of fear
-relaxation methods
-graduated exposure
What happens in the first stage of systematic desensitisation?
-therapist sits down with client and they make a hierarchy of fearful situations and arranging them in order from least to most fearful
What happens in the second stage of systematic desensitisation?
-the client is then trained in methods of relaxation like releasing muscular tension, controlled breathing and visualisation techniques
What happens in the third stage of systematic desensitisation?
-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
When does treatment end in systematic desensitisation?
When the client is desensitised and able to work through the entire hierarchy without anxiety
Effectiveness of systematic desensitisation
-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)
Suitability of systematic desensitisation
-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
Conflicting evidence of systematic desensitisation
-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
Alternative treatments of systematic desensitisation
-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
Practical issues of systematic desensitisation
-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
Ethical issues of systematic desensitisation
-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
What is flooding?
-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
What is the procedure of flooding?
-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
Effectiveness of flooding
-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
suitability of flooding
-highly effective for simple phobias
-less effective for social phobias/agoraphobia
-complex phobias cannot be treated may be more responsive to CBT for example
conflicting evidence of flooding
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
alternative treatments for flooding
-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
practical issues of flooding
-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
ethical issues of flooding
-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
