Simple Phobias

Question 1

Definition

Answer 1

excessive, unreasonable, persistent fear triggered by a SPECIFIC object or situation

specific (simple phobia) - e.g. animals, situations, blood-injury related
generalised phobias - e.g. social phobia, agoraphobia

Question 2

DSM criteria for specific phobias

Answer 2

phobic trigger causes avoidance strategies to minimise chance of contact with trigger
phobic trigger causes intense anxiety or distress
symptoms interfere significantly with person’s normal, occupation, social functioning
not better explained by another diagnosis

Question 3

Thorpe and Salkovskis, 1997

Answer 3

phobic beliefs appear to control the fear and maintain fear and avoidance of stimulus

Question 4

Prevalence of disorder

Answer 4

Shepherd, Cooper, Brown and Kalton, 1996 - anxiety problems are prevalent in about 30-40% of people in Western societies
Chapman, 1997 - clear majority of general population experience unreasonable fears but most of these do not result in impairment of severe distress

Question 5

Types of phobia

Answer 5

arachnophobia

pogonophobia

Question 6

Specific phobias

Answer 6

are common
frequently comorbid
3x more common in women than in men
different types have different mean ages of onset
immediate fear response may resemble a panic attack, except for the presence of a trigger

Question 7

Aetiology: psychoanalytic accounts

Answer 7

phobias are symbolic of other, more deep-rooted psychological difficulties (case of Little Hans)
little objective evidence to support such accounts of phobias

Question 8

Aetiology: classical conditioning (behaviourism)

Answer 8

a CS becomes associated with a UCS (which originally causes distress) so eventually the CS alone causes the distress

Question 9

Support for classical conditioning

Answer 9

Watson and Raynor, 1920 - case of little Albert and the fluffy animals (issue: only fear conditioning is shown, not necessarily phobia)
Wolpe, 1952 - induced neurosis in cats through classical conditioning - developed fear of food through electric shocks

Question 10

Challenge of classical conditioning

Answer 10

Emmelkamp, 1982 - trauma is needed but not all phobias have trauma/aversive conditioning
^ this is particularly true for snake/spider phobias - Davey, 1992
^ also true for height phobias - Menzies and Clarke, 1993a
^ so trauma is a necessary but not sufficient condition
phobias are more likely to occur for some stimuli than others - different weighting of fear despite model treating them the same
doesn’t account for incubation period

Question 11

Aetiology: evolutionary theory

Answer 11

universal characteristics of emotional expression across humans and animals
innate fears as adaptive
Seligman, 1971 - evo selection pressures evolved in us a biological predisposition to associate fear with stimuli that have been dangerous to humans for centuries - biological preparedness
Poulton and Menzies, 2002 - non-associative fear acquisition - biologically relevant stimuli develops naturally after early encounters - repeated exposure leads to fear reaction, habituation and should normally disappear (not development of phobia) - explains why some phobias are not caused by traumatic experiences

Question 12

Support for evolutionary theory

Cook and Mineka, 1989

Answer 12

Cook and Mineka, 1989 - can monkeys acquire fear responses by imitating other monkeys - 22 lab reared monkeys - observed wild monkey with fear of snakes - watched video of same but flowers spliced in - fear assessed (time taken to reach for food in presence of fear stimulus) - time taken to reach for food increased after watching videotape where fear stimulus was dangerous (i.e. snake, not flowers) - predisposition to learn particular objects to be feared

Question 13

Challenge of evolutionary theory

Answer 13

difficult to test empirically and assumptions are necessary about survival of ancestors
high levels of anxiety aren’t necessarily adaptive
not all fears can be explained by survival (e.g. fear of beards)
limited therapeutic value

Question 14

Aetiology: cognitive accounts

Answer 14

information processing biases in:
attention
recall/memory
interpretation of stimuli
future judgements
rehearsal/rumination

Question 15

Attentional bias

Aetiology: cognitive accounts

Answer 15

attention is disproportionately captured by phobia-related stimuli
bias in attention leads to enhanced threat perception/fear
the effects is thought to be robust across many different anxiety groups
appears to be eliminated by effective treatment

Question 16

Support for attentional bias

Answer 16

Thorpe and Salkovskis, 1998
study using real phobic stimuli (zebra tarantula)
compare control participants to those with spider phobia, allocated to one of two conditions
examine reaction times to detect a light when it appears in one of two locations in a room
faster reactions indicate attention allocated to that location
those with spider phobia were faster when stimulus and spider were in same location
those with spider phobia significantly faster when spider and stimulus were both by the door then when by the wall
shows standard attentional bias
suggests attention is divided between safety and danger

Question 17

Challenge to cognitive account

Answer 17

not always clear whether information processing changes are a cause versus a consequence of disorder
doesn’t explain where the biases come from in the first place
purely behavioural treatments are highly effective for phobias
origins may differ by individual and phobia type

Question 18

Aetiology: multiple pathways to phobias

Answer 18

multiple processes important in development of phobias
Merckelbach et al., 1996 - different types of phobias acquired in different ways - some phobias develop from trauma, others do not
Davey, 1994b - some phobias linked to emotions (i.e. disgust)
examples show multiple causes of phobia - depends on nature of phobia, therapists need to be more aware and focused on differing aetiology to construct successful treatments

Question 19

Treatment principles

Answer 19

functional analysis: identify triggers, behaviours, consequences
goal setting: what outcome is to be achieved
monitoring change: look at symptom reports and behaviour tests
treatment: behavioural component, cognitive component

Question 20

The best case: one session treatment (OST)

Answer 20

developed by Lar-Goran Ost from previous exposure treatments
effective when done in groups
has strong exposure based component
includes emphasis on changing beliefs about the phobic object and the response to it

Question 21

Ost, Salkovskis and Hellstrom, 1991

Answer 21

34 clients with spider phobia
one session treatment vs manual-based self-exposure over two weeks
self-exposure had more direct exposure but was less effective in reducing fear

Question 22

Miloff, Lindner, Hamilton and Reuterskoild, 2016

Answer 22

assessed traditional OST versus virtual reality exposure therapy
thought that this may reduce cost, increase acceptability and effectiveness
single-session gamified virtual reality exposure therapy using a smartphone is effective for the treatment of spider phobia
found OST was superior to VRET but that VRET was effective alternative if OST cannot be provided