PSYCHOPATHOLOGY: Phobias Flashcards
Definition of phobia
The irrational fear of an object or situation characterised by excessive fear and anxiety.
This includes
- an extreme, irrational fear of an object, situation or activity
- a fear that is disproportionate to the actual danger
- a fear that is disruptive to everyday life
Behavioural characteristics
These are the ways that people may act
- panic : involving crying, screaming or running away
- avoidance: going to extreme lengths to avoid their phobia or stimulus (e.g going to work)
- endurance / freeze response: when the sufferers remains in the presence of the stimulus but continues to experience high levels of anxiety
—> this may be unavoidable in some situations such as flying
Emotional characteristics
This is the ways that people may feel
- fear: the immediate and extremely unpleasant response when we encourager or think about a phobic stimulus
- anxiety: phobias are classes as anxiety disorders
Cognitive characteristics
The ways in which people think
- selective attention: if the sufferers can see the phobic stimulus, it may be hard to look away or concentrate on anything else
- irrational beliefs (about the phobic stimulus) : eg social phobias can include beliefs like “i must always sound intelligent
- cognitive distortions: the perception of the phobic stimulus may be distorted and stretched
What is the behavioural approach
The emphasis on the role of learning in the acquisition of behaviour
Classical conditioning: learning via association
Operant conditioning: learning via consequences
The two process model
Mowrer (1960)
He proposed the two process model that claims that phobias are:
> learnt by classical conditioning
> then maintained and continue due to operant conditioning
- “Learning phobias via classical conditioning”
- involves learning to associate something of which we initially have no fear (neutral stimulus) with something that already triggers a fear response (a conditioned stimulus)
Little Albert study
This was carried out by Watson and Rayner (1920)
- they created a phobia in a 9-month baby called little Albert
- they showed him a white rat, which he tried to play with.
- then the experimenters started the conditioning
> every time the rat was presented, there was a loud, frightening noise made by banging an iron bar close to Albert’s ear
—-> this noise was an unconditioned stimulus which created a conditioned response of fear.
When the rat and the conditioned stimulus are encountered close together, the neutral stimulus becomes associated with the unconditioned stimulus and both now produce the fear response - Albert became frightened when he saw a rat, the rat now became a conditioned stimulus that produced a conditioned response of fear.
This conditioning then generalised to similar objects.
Albert displayed distressed at the sight of other furry objects like a white rabbit, a fur coat and a beard of cotton balls.
- “Maintaining phobias via operant conditioning”
- Mowrer claims that phobias are maintained through operant conditioning, specifically negative reinforcement
- operant conditioning increases the frequency of behaviour
> in the case of negative reinforcement, an individual would avoid a situation that would cause them anxiety - this reduction in anxiety reinforces the avoidance behavior
So negative reinforcement =avoidance
- “ the generalisation process”
Generalisation of fear to other objects can occur
Eg. You scared of spiders but then you become scared of all bugs or string /wool that is black
Positive Evaluations for the two -process model
It has good explanatory power which = a good application to therapy
- the two process model was a definite step forward when it was proposed in 1960 as it went beyond Watson and Rayner’s concept of classical conditioning.
- it explains how phobias could be maintained overtime and this had important implications for therapies
- it explains why patients need to be exposed to the phobic stimulus.
- once a patient is prevented from practicing their avoidant behaviour, the behaviour ceases to be reinforced therefore it starts to decline
- this affective application to therapy is the strength of this model
Negative evaluations of the two process model
> there are Alternative explanations for avoidant behaviour (negative reinforcement)
- not all behaviour seems to be linked to anxiety reduction
- there is evidence to suggest that some avoidance behaviour is motivated by more positive feeling for safety
- hence the motivating factor in choosing an action like not leaving the house, is not to avoid the phobic stimulus but more to stick with teh safety factor.
- explains why people with acrophobia are able to leave the house with a trusted person with relatively less anxiety but not alone (Buck, 2010)
this is a problem for the two process model which suggested that avoidance is only motivated by anxiety reduction and negative reinforcement.
> **this is an incomplete explanation of phobias **
- Bouton (2007) points out how evolutionary factors probably have an important role in phobias which the two processes model fails to address
- eg we easily acquire phobias of things that have been a source of danger in the evolutionary past, such as snakes or the dark
- hence it is actually ADAPTIVE to acquire these fears
-Seligman (1971) called this biological preparedness- the innate predisposition to acquire certain fears
- this also explains why phobias of cars and guns which are definitely more dangerous to most of us today in contrast to snakes or the dark, are less common, as they have only existed very recently hence we are not biologically evolved or prepared to become biologically prepared to learn a fear response towards them
- this is a serious problem for the two process theory as it shows there is more to acquiring phobias than simple conditioning
> phobias that dont follow trauma
- sometimes phobias following a bad experience can show how they are a result of classical conditioning
- however people can develop a phobia and are not aware of having a related bad experience
- such as people who might have a snake phobia, most likely had not encountered one before.
Behavioural treatments: Systematic Desensitisation
> definition<
= this is a behavioural therapy designed to reduce an unwanted response, such as anxiety, to a stimulus through the principle of classical
conditioning
Behavioural treatments: Systematic desensitisation
> process<
There are 3 processes involved…
1) Create an anxiety hierarchy
- a list of situations related to the phobic stimulus that provoke anxiety, put together by the patient and the therapist
- in an order of least frightening to most
2) teach relaxation
- the therapist will teach the patient to relax
- eg breathing exercises, mindfulness and meditation
3) exposure to phobic stimulus
- while relaxed, the patient is exposed to phobic stimuli, starting at the bottom of the anxiety hierarchy
- when the patient can stay relaxed at the bottom, they can move to the next level
> the treatment is successful when the patient reaches the top of the hierarchy and is able to remain relaxed
Behavioural Treatments: Systematic Desensitisation
> results
-counter conditioning and reciprocal in inhibition
Essentially a new response to the phobic stimulus called COUNTER CONDITIONING
And in addition, it is impossible to be afraid and relaxed at the same time, so one emotional prevents the other this is called RECIPROCAL INHIBITION
Behavioural Treatments: Flooding
> process<
= a behavioural therapy in which a patient is immediately exposed to an extreme from of their phobic stimulus in order to reduce their anxiety
> this takes place across a small number of long therapy sessions
These sessions last longer than Systematic desensitisation
- 2-3 hours
- but the frequency is a lot less, sometimes only one session is enough
Behavioural Treatments: Flooding
> how does it work?<
- immediate/direct/full exposure to the most intensive version of the phobic stimulus called COUNTER
- participants are prevented from engaging in avoidance
- they remain in this state until patient is calm/ anxiety has receded and fear is extinguished
-Flooding stops phobic responses very quickly, because without the option of avoidance behaviour, the patient learns quickly that the phobic stimulus is harmless
This is called EXTINCTION
Behavioural Treatments: Flooding
> ethical safe guards<
- flooding is not unethical but it’s very unpleasant
- it is important that the patient gives informed consent to this traumatic procedure and that they are fully prepared for this session
A patient would normally be given a choice between SD and flooding
Behavioural Treatments: Systematic desensitisation
> positive evaluations AO3<
1) + IT IS EFFECTIVE
- through research it is proven that SD is effective
Gildroy et al (2003) followed up 42 patients who had been treated for arachnophobia in 3 45min sessions of SD:
- a control group was treated by relaxation without exposure
- the level of phobia was assed on several measures including a spider questionnaire
- after 3 months and 33 months, the SD group were less fearful than the relaxation group.
This showed that the SD is helpful in reducing the anxiety and spider phobia that the effects are long lasting
2) +IT IS SUITABLE FOR A DIVERSE RANGE OF PATIENTS
- alternatives to SD like flooding and CBT are not well suited to some patients
-eg patients with learning difficulties can make it very hard to understand what is going on in flooding or to actively engage in cognitive therapies that require the ability to reflect on what you are thinking.
3) +IT IS ACCEPTABLE TO PATIENTS
- patients like SD as it isn’t at traumatic as flooding
- SD also included elements like learning relaxation procedures, which are pleasant
This is reflected in the low refusal rate and low attrition rates
Behavioural Treatments: Systematic Desensitisation
> negative evaluation AO3<
1) - TIME CONSUMING
- when compared to alternatives such as flooding, the person with the phobia needs to be trained in relaxation techniques and gradual exposure which can take many sessions
- it is expensive and not accessible to working class people
2) - PROGRESS IN THERAPY MAY NOT GENERALISE OUTSIDE FO THE CLINICAL SETTING
- when the person with the phobia must face their fear without the support of the therapist
Behavioural Treatments: Flooding
> evaluations AO3<
1) + IT IS COST EFFECTIVE
- flooding is at least as effective of other treatments for specific phobias.
- studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives (Ougrin 2011)
- the efficiency is a major strength as it means that patients are free of their symptoms as soon as possible and will make the treatment cheaper
2) -IT IS LESS EFFECTIVE
- it is a highly traumatic experience
- the problem isn’t that flooding is unethical but patients are often unwilling to see through to the end
- this is a limitation because the time and money wasted in the preparation of flooding just for the patient refuse to start or complete the treatment
3) -THE TREATMENT TRAUMATIC PATIENTS
- perhaps the most serious issues with the use of flooding is the fact that it is a highly traumatic experience.
^^^^
4)- HIGH REFUSAL AND ATTRITION RATE
