Psychopathology: Phobias (L5-7)

Question 1

What is a phobia?

Answer 1

• a mental disorder characterised by high levels of anxiety in response to a stimulus
• this anxiety interferes with their daily life
• it can cause irrational fear and people may consciously avoid the object of their phobia
• people may show signs such as crying, shaking, sweating + panic attacks when in contact with the phobic object

Question 2

What are the 2 manuals psychologists use that help classify psychological disorders such as phobias?

Answer 2

• DSM-V, diagnostic statistical manual version 5
• ICD-10, international classification of diseases version 10

Question 3

What are the behavioural characteristics of phobias?

Answer 3

• avoidance: avoiding the object/situation
• endurance (freeze/faint): bodily response is usually fight or flight
• disruption of functioning: may interfere with the persons ability to function
• panic: such as crying, screaming, vomiting, running away or freezing

Question 4

What are the emotional characteristics of phobias?

Answer 4

• fear: persistent, excessive and unreasonable fear might be felt in the presence of the stimulus
• panic and anxiety: feeling highly anxious and experiencing unpleasant negative feelings when face with the phobic object

Question 5

What are the cognitive characteristics of phobias?

Answer 5

• irrational: person will think in an irrational manner and will resist rational arguments that counter it
• insight: they will know their is excessive or unreasonable but will still find it difficult or not fear the object
• cognitive distortions: personal will have a distorted perception of the stimulus such as viewing the object in a negative way like being aggressive
• selective attention: when they encounter the phobic stimulus, they may not be able to look away and focus all their attention on it while ignoring everything else around them

Question 6

Who made the Two Process Model?

Answer 6

• Mowrer

Question 7

What is the Two Process Model made up of?

Answer 7

• onset of phobia: can occur directly by classical conditioning or indirectly by social learning
• maintenance of phobia: operant conditioning occurs whereby the feared object is avoided (negative reinforcement) which reduces anxiety and acts as a reward

Question 8

Phobias are learnt via:

Answer 8

• classical conditioning
• operant conditioning

Question 9

The behavioural model suggests that:

Answer 9

• all behaviour can be learnt including phobias
• and that people who have an abnormality can learn negative behaviours

Question 10

What is classical conditioning?

Answer 10

• method of learning
• produces a natural reflex in response to a previously neutral stimulus
• involves building up an association between 2 different stimuli so that learning takes place
• a conditioned stimulus is paired with an unconditioned stimulus to produce the conditioned response

Question 11

A study of Classical Conditioning is:

Answer 11

• Little Albert (1920)
• by Watson and Rayner

Question 12

What is operant conditioning?

Answer 12

• learning through the consequences of your actions
• helps explain how phobias can be maintained
• negative reinforcement: removal of something bad such avoiding the phobic object in order to reduce risk of fear
• positive reinforcement: avoiding the phobic object and not feeling fear, this is rewarding

Question 13

Description of the procedure of Little Albert experiment:

Answer 13

• Albert was 11 months old
• baby was shown a white rat (neutral stimulus) on its own
• then loud banging noise (unconditioned stimulus) was made which caused an emotional response
• the 2 stimulus were then paired together until classical conditioning and learning take place
• the 2 stimuli were repeated 3 times in one go and then repeated again 3 times the week after
• when conditioned stimulus was presented Albert had an emotional response (conditioned response)
• learning took place via classical conditioning and the association was established

Question 14

Findings of Little Albert Experiment?

Answer 14

• Albert was conditioned and learnt to be scared of white rates despite no loud noise
• his fear was generalised to all fluffy, white objects

Question 15

+ve evaluation of classical conditioning:

Answer 15

• King (1998) supports the ideas proposed by classical conditioning
• through reviewing cases he found that children acquire phobias through traumatic experiences with the phobic object
• e.g. children who have got bitten by a dog may develop a phobia of dogs

Question 16

-ve evaluation of classical conditioning:

Answer 16

– study of Little Albert can be criticised as it was only repeated once
- findings have not been repeated making them not very reliable
- could be questioned whether the results would be the same if they study was repeated
- but cannot be repeated due to ethical reasons

– some people do have a traumatic experience but may not go on to develop a phobia
- so classical conditioning does not explain how all phobias develop
- opposite is also true as some are scared of an object they haven’t had a negative experience with or even encountered

– the psychologist Menzies criticises the behavioural model, especially the idea of classical conditioning
- studied that people that had a fear of water (hydrophobia) and found that only 2% had encountered a negative experience with water
- which means 98% had hydrophobia without having a negative experience so no learning via classical conditioning
- also found that 50% of people with a phobia of dogs never had a bad encounter
- suggests that learning cannot be a key factor in the development of the phobia

Question 17

What is the social learning theory?

Answer 17

• suggests that social behaviour is learned by observing and imitating the behaviour of others
• like a child observing a family member have a reaction to a particular situation which the child will then copy when in the same situation
• psychologist Minneka found that when one monkey in a cage showed a fear response to snakes, the other monkeys copied, this can be applied to humans

Question 18

+ve evaluation of the Two Process Model:

Answer 18

• Bandura supports the ides of the social learning theory
• reasearch was carried out where a person acted as if they were in pain when a buzzer sounded and participants had to watch this reaction
• later when participants got to hear the sound of the buzzer they showed the same response and acted as if they were in pain
• involves 2 clear steps that highlight how phobias are learned and maintained
• learnt by classical conditioning or social learning then maintained by operant conditioning
• accurate way in explaining how phobias can be learnt overall

Question 19

-ve evaluation of the Two Process Model:

Answer 19

• limited as it ignores other factors which may cause phobias
• behavioural model focuses on learning and the environment but doesn’t take into account biological or evolutionary factors that could cause phobias
• some may have more of a genetic vulnerability and the behavioural model would ignore this
• social learning theory can successfully explain how learning occurs in animals and children
• not very strong in explaining how adults can learn to have phobias
• behavioural model is therefore limited to only explaining learning in only young children and animals

Question 20

Who developed systematic desensitisation?

Answer 20

• Wolpe (1958)

Question 21

What is systematic desensitisation?

Answer 21

• behavioural therapy to reduce/diminish phobias by using classical conditioning

Question 22

How does systematic desensitisation work?

Answer 22

• person with a phobia experiences fear and anxiety as a behavourial response to an object/situation
• SD uses classical conditioning to replace the irrational fears and anxieties associated with phobic objects with calm and relaxed responses instead

Question 23

What is the central idea of SD?

Answer 23

• it is impossible to experience 2 opposite emotions at the same time such as fear and relaxation
• this is called reciprocal inhibition
• if they patient can learn to remain relaxed in the presence of their phobia, they can be cured
• this is called counter conditioning

Question 24

What are the 3 steps involved in SD?

Answer 24

• 1. The hierarchy of fear
• 2. Relaxation techniques
• 3. Gradual exposure

Question 25

What is the hierarchy of fear?

Answer 25

• this is constructed by the therapist and the patient
• situations involving the phobic object are ranked from least fearful to most fearful
• for example, if a person has a phobia of snakes the therapist might at first get the patient to merely look at a photo of a snake
• then at a snake in a tank
• until eventually they are asked to hold a snake

Question 26

What are relaxation techniques?

Answer 26

• patients are taught deep muscle relaxations techniques such as deep breathing, progressive muscular relaxation (PMR) and the relaxation response
• when doing these techniques patients are told to sit quietly and comfortably and close their eyes
• they start by relaxing the muscles of their feet and work up their body relaxing muscles
• while doing this they are asked to breathe deeply, meditate and imagine relaxing situations

Question 27

What is PMR?

Answer 27

• the idea behind PMR is to tense up a group of muscles so that they are as tightly contracted as possible
• they are held in a state of extreme tension for a few seconds and then muscles are relaxed to the previous state
• finally, muscles are consciously relaxed even further so that the patient is as relaxed as possible

Question 28

What is gradual exposure?

Answer 28

• patient is introduced to their phobic object gradually and they work their way up the fear hierarchy starting with the least frightening stage
• they must use their relaxation technique whilst they are exposed to their phobic object at each stage
• once they feel comfortable with one stage of the hierarchy they move onto the next stage
• patients are instructed to use the relaxation techniques while exposed to scenarios of rising intensity
• eventually through repeated exposure to phobic objects with relaxation and no fear, the phobia is eliminated
• this process will take many therapy sessions

Question 29

Evaluation of SD +ve

Answer 29

• Jones (1924) supports the use of SD to eradicate ‘Little Peter’s’ phobia
• a white rabbit was presented to Little Peter at gradually closer distances and each time his anxiety levels lessened
• eventually, he developed affection for the white rabbit which extended to all white fluffy objects
• this shows how SD can work to eliminate phobias
  = Klosko et al (1990) supports the use of SD
  = he assessed various therapies for the treatment of panic disorders and found that 87% were panic free after recieving SD
  = compared to 50% receiving medication
  = 36% receiving a placebo
  = 33% receiving no treatment at all
  = therefore, SD is an effective therapy compared to others
• SD is a less traumatic therapy for phobias than other behavioural therapies such as flooding, which is when the patient has to confront their phobias directly
• therefore, SD has less ethical implications than other behavioural therapies and it is less upsetting for the patient to endure

Question 30

Evaluation of SD -ve

Answer 30

• it is not always practical for individuals to be desensitised by confronting real life phobic situations
• real life step by step situations can be difficult to arrange and control
• such as someone being scared of sharks, it can be difficult to apply this phobia to real life situations
• therefore, SD may be very difficult to apply to real life situations and this can question the effectiveness of the therapy
  = they address the symptoms of phobias but some critics believe the symptoms are merely the tip of the iceberg and that the underlying causes of the phobia will remain
  = and in the future symptoms will return or symptom substitution will occur
  = this is when other abnormal behaviours replace the ones that have been removed

Question 31

What does flooding involve?

Answer 31

• directly exposing the phobic patient to their feared object in an immediate situation
• beforehand, the patient is taught relaxation techniques such as deep muscle relaxation, deep breathing, and meditation
• there is no gradual build-up using a fear hierarchy, which involves immediate exposure to a very frightening and extreme situation
• can be done ‘in vivo, (irl) or it may be virtual (imagining the situation)

Question 32

How does flooding stop phobic responses?

Answer 32

• stops the responses very quickly
• as the patient does not have the option for any avoidance behaviour; they are not allowed to run away or not face their phobic object
• might quickly learn that the phobic object is harmless, extinction then occurs
• in some cases, they may achieve relaxation in the presence of the phobic object as they are so exhausted by their own fear response

Question 33

Is flooding ethical?

Answer 33

• it is ethical
• although it can cause a great deal of initial psychological harm
• the patient would have to give their fully informed written consent so they are fully prepared for the flooding session

Question 34

Sessions lengths, F+SD:

Answer 34

• flooding therapy sessions usually last 2 to 3 hours, much longer than SD sessions
• but SD requires more sessions

Question 35

Evaluation of flooding +ve:

Answer 35

• cost-effective, especially in comparison to cognitive behavioral therapies which take months or years to work and rid the person of the phobia
• quick therapy for phobias which is useful as patients are free of their symptoms ASAP
• treatment is cost-effective and cheaper
• Ost (1997) stated that flooding is an effective and rapid treatment that delivers immediate improvements for phobic patients
• especially when a patient is encouraged to continue self directed exposure to feared objects and situations outside of the therapy situation
• results can then be applied to everyday life outside of the therapy situation

Question 36

Evaluation of flooding -ve:

Answer 36

• less effective for curing some types of phobias such as social phobia
• may be due to social phobias having more cognitive aspects that flooding cannot address very well
• cognitive therapies may be better
• it is a highly traumatic experience and many patients might be unwilling to continue with the therapy until the end
• time and money may be wasted preparing the patient for flooding experience, and then they decide they do not want to take part or complete the treatment, leaving phobia uncured
• waste of time and money, SD may be better