Psychopathology Lessons 5-7 (Phobias)

Question 1

What is a phobia?

Answer 1

A mental disorder characterised by high levels of anxiety in response to a particular stimulus

Question 2

What are 3 behavioural characteristics of phobias? (actions)

Answer 2

Avoidance and Disruption of functioning
Endurance (freeze/faint)
Panic

Question 3

What is Avoidance and Disruption of functioning?

Answer 3

Avoidance is where a person’s response to their phobia is to evade it at all costs. This can often interfere with the person’s ability to function adequately for example at school or in the workplace.

Question 4

What is Endurance?

Answer 4

When a person is stressed, their normal bodily response is fight or flight. However, when faced with their phobia, their bodily response is freeze or faint:
Freeze - so the phobia may think that the person is dead so may leave them alone
Faint - so scared so pass out

Question 5

What is Panic?

Answer 5

In the presence of the phobia, the individual may show behavioural characteristics like crying, sweating, screaming or running away as a result of panicking.

Question 6

What are 3 emotional characteristics of phobias?

Answer 6

Fear
Anxiety
Emotions (general)

Question 7

What is Fear?

Answer 7

This is where an individual will feel persistent and excessive worry and distress towards a stimulus (their phobia).

Question 8

What is Anxiety?

Answer 8

Where an individual feels apprehensive and uncertain about what is going to happen when they encounter their phobia.

Question 9

What are emotions (general)?

Answer 9

The individual would experience strong emotions that are out of proportion to the actual danger that is posed (the phobia) e.g. screaming uncontrollably at a tiny spider far away.

Question 10

What are the 4 cognitive characteristics of phobias?

Answer 10

Irrational
Insight
Cognitive distortions
Selective attention

Question 11

What is Irrationality?

Answer 11

Resisting rational arguments about their phobia. For example, a person with the fear of flying will not listen to the fact that ‘flying is the safest form of transportation’.

Question 12

What is insight?

Answer 12

Knowing and being very aware that their fear is unreasonable but still being terribly frightened of it.

Question 13

What are cognitive distortions?

Answer 13

When an individual has a distorted perception of their phobia and it in an unusually negative way. For example, a person with arachnophobia may believe that spiders are deadly, dangerous and venomous, even when no spiders in the UK are actually deadly.

Question 14

What is Selective Attention?

Answer 14

When an individual cannot look away from their phobia and focus all their attention onto it. They ignore everything else around them and just focus on the phobic situation.

Question 15

What is the behavioural approach with relevance to phobias?

Answer 15

The behavioural approach suggests that ALL behaviour can be learnt (including phobias)

Question 16

Who developed the two process model?

Answer 16

Mowrer

Question 17

What is the two process model?

Answer 17

A theory which suggests that phobias are initiated and learnt through classical conditioning or by social learning and that phobias are maintained through operant conditioning.

A theory which suggests that phobias are:
1 initiated and learnt through classical conditioning or social learning
2 maintained through operant conditioning

Question 18

What is classical conditioning? How does it relate to phobias?

Answer 18

Classical Conditioning is a method of learning through association between two different stimuli.

Perhaps phobias develop because of a stimulus, which a person is afraid of, becomes associated with another stimulus.

Question 19

Who studied classical conditioning on Little Albert and when?

Answer 19

Watson and Rayner (1920)

Question 20

Describe Watson and Rayner’s study on Classical Conditioning:

Answer 20

Watson and Rayner managed to give an 11 month year old boy, known as ‘Little Albert’, a phobia of rats through the use of Classical Conditioning.

• Initially, the presentation of the white rat (neutral stimulus) to Little Albert evoked no specific response where he was actually keen to play with it.
• Then, a loud banging noise (unconditioned stimulus) was presented to Little Albert which evoked an emotional response where he was startled and began to cry.
• Watson and Rayner then paired the white rat and the loud banging noise together 6 times until classical conditioning took place.
• When the white rat (conditioned stimulus) was presented to Little Albert again on its own, an emotional, conditioned response occurred due to an association built up between the white rat and the loud banging noise
• Little Albert developed a phobia for white rats where generalisations occurred too - Little Albert was also afraid of anything white or fluffy.

Question 21

How could Little Albert have been reconditioned?

Answer 21

Pair the white rat with nice sounds or laughter to make him like the rat once again

Question 22

What is the neutral, unconditioned and conditioned stimulus in the experiment and what does that mean?

Answer 22

Neutral - white rat - produces no reflexes or specific response
Unconditioned - loud banging noise - produces the reflex of fear (do not have to learn anything here - born with certain reflexes)
Conditioned - white rat after association - produces fear after learning

Question 23

What are 3 weaknesses of Classical Conditioning?

Answer 23

1 Classical Conditioning can’t explain how ALL phobias are developed:

• not all traumatic experiences result in phobias being developed (someone in a car crash won’t necessarily develop a phobia for driving)
• not all phobias stem from traumatic experiences (might fear snakes or spiders because they look scary)

2 The study on Little Albert is unreliable as the findings have not been repeated as it was only conducted once

3 Learning doesn’t cause phobias to be developed
- The psychologist Menzies discovered that only 2% of people who had the phobia of water (hydrophobia) had encountered a traumatic experience with it (people had not learnt their phobia due to classical conditioning)

Question 24

What is Social Learning?

Answer 24

Social Learning is a method of observational learning where typically young children observe a reaction from their parents in a particular situation and copy their behaviour. For example, if a child sees their parent respond to a spider by screaming, the child may copy their behaviour of screaming and eventually develop a phobia for spiders.

Question 25

What is Operant Conditioning?

Answer 25

Operant Conditioning is a method of learning through reinforcement and the consequences of one’s behaviour.

Question 26

What are the two types of Operant Conditioning?

Answer 26

Negative and Positive Reinforcement

Question 27

What is Negative Reinforcement?

Answer 27

Negative Reinforcement is where a behaviour STOPS something UNPLEASANT

A phobia is reinforced due to the individual displaying a behaviour, for example, avoidance, to STOP feeling something unpleasant, for example, fear.

Question 28

What are 3 advantages of the Two Process model?

Answer 28

1 The Two Process Model has research support - Bandura supports the Social Learning theory:

• Participants watched someone act as if they were in pain whenever they heard the sound of a buzzer
• When the participants later listened to the buzzer they to acted as if they were in pain (Social Learning had taken place)

2 The Two Process Model does not label people with phobias as mentally ill. Labels can be damaging as they are difficult to remove and usually define people in negative ways. Instead, this model is positive and perceives phobias as incorrect responses to stimuli which can be corrected.

3 King (1998) reviewed several case studies and found that children often develop phobias after having traumatic experiences with it. This supports the Two Process Model as it suggests that phobias are initiated and learned through classical conditioning.

Question 29

What is Positive Reinforcement?

Answer 29

Positive Reinforcement is where a behaviour LEADS TO a REWARD.

A phobia is reinforced due to the individual displaying a behaviour, for example, avoidance, to LEAD TO a reward, for example, not feeling fear.

is where a phobia is reinforced further due to the avoidance continuing which becomes rewarding for the individual so that they don’t feel scared.

Question 30

What are 4 weaknesses of the Two Process Model?

Answer 30

1 The Two Process Model does not take into account biological factors such as genetic vulnerability. For example, possessing particular genes may predispose an individual to developing hemophobia, the fear of blood. This proves how not all phobias develop through learning.

2 The Two Process Model can’t explain how ALL phobias are developed:

• not all traumatic experiences result in phobias being developed (someone in a car crash won’t necessarily develop a phobia for driving)
• not all phobias stem from traumatic experiences (might fear snakes or spiders because they look scary)

3 The Two Process Model suggests that ALL phobias are learned. However, this may not be the case:
- Menzies discovered that only 2% of people who had the phobia of water (hydrophobia) had had a traumatic experience with it (people had not learnt their phobia due to classical conditioning / just had a fear of it).

4 A disadvantage of Classical Conditioning, is that the study on Little Albert is unreliable due to the findings not being repeated where it was only conducted once. This undermines the entire two-process model.

Question 31

What are 2 behavioural approaches to treating phobias?

Answer 31

Systematic Desensitisation

Flooding

Question 32

Who developed the Systematic Desensitisation theory and when?

Answer 32

Wolpe (1958)

Question 33

What is Systematic Desensitisation?

Answer 33

• Systematic Desensitisation is a behavioural therapy that reduces and later diminishes a phobia through classical conditioning.
• A person with a phobia experiences fearful and irrational responses to a stimulus.
• SD aims to replace this response with calm and relaxed ones.
• The central idea of SD is how it is impossible to experience two opposite emotions at the same time (reciprocal inhibition) e.g. fear and relaxation.
  Therefore, if a patient can learn to have a relaxed response to their phobia, they can be cured - this is called counter conditioning.

Question 34

What are the 3 processes involved in Systematic Desensitisation?

Answer 34

1 The hierarchy of fear
2 Relaxation techniques
3 Gradual Exposure

Question 35

What is the hierarchy of fear?

Answer 35

A hierarchy of fear is a list of situations, constructed by the therapist AND patient, involving the patients phobia. These scenarios are ranked from least fearful to most fearful which the patient must eventually be a part of.

For example, if someone has arachnophobia, the first task may be to look at a picture of a spider, and the last task would be to hold a spider for 10 seconds.

Question 36

What are relaxation techniques?

Answer 36

Patients are taught deep muscle relaxation techniques like deep breathing and progressive muscle relaxation (PMR) to rid them of having an irrational and fearful response when presented with their phobia and have a relaxed one instead.

The idea behind PMR is to tense up a group or muscles and hold them in a state of extreme tension for a few seconds before relaxing them. After that, the patient should consciously relax the muscles further to relax the patient even further.

Question 37

What is gradual exposure?

Answer 37

Using the hierarchy of fear and relaxation techniques at the same time:

• The patient will gradually be exposed to their phobia, through the hierarchy of fear they themselves along with the therapist have constructed, from the least frightening stage.
• Whilst being exposed to their phobia, the therapist will remind the patient to use the relaxation techniques they have been taught, to try and rid them of their irrational and fearful response and introduce permanently relaxed responses which will rid them of their phobia due to two opposite emotions not being able to occur at the same time which is called reciprocal inhibition.
• When the patient feels comfortable will the stage of the hierarchy they are on, they can move to the next stage until they get to the most frightening one.
• This can take several therapy sessions and could last for several months.

Question 38

What are 3 advantages of Systematic Desensitisation?

Answer 38

1 Jones (1924) used Systematic Desensitisation to rid Little Peter of his phobia of white rabbits by presenting a white rabbit to him at gradually closer distances where his anxiety lessened each time until he actually showed affection for the white rabbit

2 Less traumatic than flooding and therefore there is less psychological harm for patients and it is less upsetting for them

3 Klosko et al. (1990) supports Systematic Desensitisation where he assessed various therapies for panic disorders and found that in 87% of cases using Systematic Desensitisation, patients were panic free compared to only 50% on medication, 36% on placebo and 33% receiving no treatment at all.

Question 39

What are 2 disadvantages of Systematic Desensitisation?

Answer 39

1 Systematic Desensitisation is not always a practical way of confronting unusual phobias in real life step-by-step situations. For example, a therapist cannot bring a shark into their office if that is what the patient is afraid of.

2 Critics believe that Systematic Desensitisation merely deals with the symptoms of phobias but fails to address the underlying causes of phobias. In the future symptoms may return or symptom substitution will occur which is where other abnormal behaviours will occur to replace the other ones that have been removed.

Question 40

What is flooding?

Answer 40

Flooding is a behavioural therapy which involves directly exposing the patient to their phobia in an immediate situation. For example, someone with arachnophobia may be asked to hold onto a spider for a long period of time.

Question 41

What must happen before the flooding behavioural approach to treating phobias takes place? (2)

Answer 41

Patients must be taught relaxation techniques beforehand such as deep muscle relaxation and deep breathing.
The patient must give fully informed written consent.

Question 43

What two ways can flooding be done in? Which one is better and why?

Answer 43

1 For real - “in vivo”
2 Virtual

Real is better than virtual as even though the patient will still be scared, they will know in their mind that what they’re imagining is not real and therefore the flooding will not completely work as they cannot relate it to real life experiences.

Question 44

Why do phobic responses stop very quickly in flooding? (2)

Answer 44

• The patient does not have the option for any avoidance, like they normally would in the real world, which allows them to quickly recognise that their phobia is actually harmless after all - EXTINCTION OCCURS.
• Because the patient might achieve relaxation due to them being so exhausted by their fear response (running screaming sweating etc)

Question 44

Is flooding ethical?

Answer 44

Yes - patients must give fully informed consent

Question 45

What are 3 advantages of flooding?

Answer 45

• Cheap and Fast (not therapy sessions every week like SD as lasts for only 2-3 hours)
• Flooding can easily be applied to real life situations where patients may face their phobia face on
• Wolpe (1960) supports the use of flooding where a patients phobia of cars was eradicated through the use of flooding where the patient was forced into a car and driven around for hours until her fearful and irrational responses disappeared.

Question 46

What are 2 disadvantages of flooding?

Answer 46

• Flooding is a highly traumatic experience and patients may be unwilling to carry on with the therapy until the end and may withdraw which wastes time and money
• Flooding cannot cure all types of phobias such as social phobias for example speaking in public (cognitive therapies would be better for something like this).