Specific Phobia

Question 1

What is a specific phobia?

Answer 1

A specific phobia is a disorder characterised by marked fear or anxiety about a specific object or situation, often leading to avoidance behaviour

Question 2

What is stress?

Answer 2

Stress is a state of physiological and psychological arousal produced by internal or external stressors that are perceived by the individual as challenging or exceeding their ability or resources to cope

Question 3

What is anxiety?

Answer 3

Anxiety is a state of arousal involving feelings of apprehension, worry or uneasiness that something is wrong or something unpleasant is about to happen

Question 4

Anxiety disorder

Answer 4

The term anxiety disorder is used to describe a group of mental disorders that are characterised by chronic feelings of anxiety, distress, nervousness and apprehension or fear about the future, with a negative effect

Question 5

What does anxiety do?

Answer 5

Reduces our ability to concentrate, learn, remember, think clearly, logically plan, make accurate judgments and perform motor tasks

Question 6

What is severe anxiety accompanied by?

Answer 6

Severe anxiety is generally accompanied by intense physiological sensations and responses, such as shortness of breath, sweating, trembling, nausea, stomach cramps, dizziness, feelings of suffocating, feelings of losing control and/or feelings of impending doom, depending on the stimulus and the individual involved

Question 7

What is a phobia?

Answer 7

A phobia is characterised by excessive or unreasonable fear of a particular object or situation

Question 8

Properties of a phobia

Answer 8

• A fear response by someone with a phobia is typically out of proportion to the actual danger posed by the object or situation  compelling desire to avoid the object or situation
• Sometimes, even the thought of the feared stimulus is enough to cause a phobic reaction
• Considered a mental disorder as it causes significant anxiety and distress and interferes with everyday functioning

Question 9

What is a phobic stimulus?

Answer 9

The specific object or situation producing the fear associated with a phobia is commonly referred to as the phobic stimulus

Question 10

Why is stress, anxiety and phobia represented on a continuum?

Answer 10

• Some psychologists represent stress, anxiety and a phobia on continuums to describe how they can vary independently and collectively in relation to one another

• Phobia has a mix of stress and anxiety, stress often causes anxiety and stress may also be considered a type of anxiety response
• All three can vary in amount or degree within and between individuals at any point in time

Question 11

What differentiates stress, anxiety and phobia?

Answer 11

• Stress and anxiety can independently or in combination contribute to the development of a mental disorder, but they are not in themselves considered to be mental disorders
• Any type of phobia is considered as a mental disorder
• Both stress and anxiety are generally considered normal human responses that are usually adaptive and beneficial (unless excessive and chronic)
• Phobias inevitably cause distress and interfere with a person’s day-to-day functioning through avoidance behaviour and other responses associated with fear. Having a phobia is therefore never beneficial.

Question 12

What 5 categories can phobias fall into?

Answer 12

 animal e.g. spiders, snakes, dogs
 situational e.g. aeroplanes, elevators, enclosed spaces
 natural environment e.g. heights, storms, darkness, thunder, lightning
 blood–injection–injury e.g. seeing blood, having blood taken, having an injection, getting a cut
 other phobias e.g. choking, vomiting, loud noises, costumed characters, falling down, becoming ill

Question 13

Things causing a specific phobia

Answer 13

When someone has a specific phobia, exposure to a phobic stimulus typically triggers an acute stress response involving physiological changes like those of the fight–flight–freeze response

Question 14

What is a panic attack?

Answer 14

A panic attack is period of sudden onset of intense fear or terror, often associated with feelings of impending doom

Question 15

What are the physiological or psychological changes when experiencing a panic attack?

Answer 15

• During the attack, there are physiological or psychological changes such as:
o shortness of breath or smothering sensations
o a racing or pounding heart
o sweating, trembling
o tightness in the chest
o feeling dizzy, unsteady, lightheaded or faint
o nausea
o feelings of going crazy, losing control or even dying

Question 16

What happens when a phobic stimulus can’t be avoided?

Answer 16

• When it is not possible to avoid a feared object or situation, it is endured with intense anxiety or distress

Question 17

What is anticipatory anxiety?

Answer 17

• Anticipatory anxiety is the gradual rise in anxiety level as a person thinks about, or ‘anticipates’, being exposed to a phobic stimulus in the future

Question 18

What factors contribute to the development of a specific phobia?

Answer 18

The development of a specific phobia is influenced by a combination of biological, psychological and social factors, and the best treatment interventions are also based on a biopsychosocial approach

Question 19

What biological factors contribute to a specific phobia?

Answer 19

• GABA dysfunction
• Role of stress response
• LTP

Question 20

What is GABA?

Answer 20

• Gamma-amino butyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system.
• Makes postsynaptic (‘receiving’) neurons less likely to be activated (i.e. it inhibits excitation or ‘firing’)

Question 21

Why is GABA important?

Answer 21

• Without the inhibitory effect of GABA, activation of postsynaptic neurons might get out of control
• Their uncontrolled activation could spread throughout the brain, causing seizures like those of epilepsy
• The inhibitory action of GABA counterbalances the excitatory activity of glutamate and vice versa
• GABA and glutamate have important roles in regulating central nervous system arousal

Question 22

What role does GABA play in anxiety?

Answer 22

• GABA also plays a role in anxiety because it acts like a calming agent or ‘brake’ to the excitatory neurotransmitters that contribute to anxiety

Question 23

GABA dysfunction results in…

Answer 23

There may be a failure to produce, release or receive the correct amount of GABA needed to regulate neuronal transmission in the brain. GABA dysfunction can therefore result in low levels of GABA in the brain

Question 24

What happens to individuals with lower amounts of GABA in the brain?

Answer 24

• Individuals with a low level of GABA are more vulnerable to anxiety
• In addition, their flight–flight–freeze response may also be more easily triggered by a variety of stimuli, which in turn may presdispose them to developing a specific phobia

Question 25

What factors effect the level of GABA in a person’s brain?

Answer 25

• The level of GABA in a person’s brain may be affected by a wide range of factors
o genetic inheritance
o CNS damage
o exposure to prolonged stress
o nutritional deficiencies in vitamin B6 and citric acid
o high caffeine intake

Question 26

Why do these factors affect GABA release?

Answer 26

These factors either inhibit GABA release, inhibit its ability to bind (attach) to GABA receptors on post-synaptic neurons, or to stimulate overproduction of glutamate in some way

Question 27

What happens in the stress response?

Answer 27

• The heart rate and strength of heartbeat increase to speed up blood flow, blood is redirected from places where it is not needed, the speed and depth of breathing increase, adrenal hormones surge into the bloodstream, and so on
• These types of reactions account for many of the symptoms associated with phobic anxiety, such as palpitations and sweating

Question 28

What is hyperventilation?

Answer 28

• Hyperventilation (‘over-breathing’) can heighten the anxiety being experienced and also induce a panic attack

Question 29

Why is the stress response bad/how does it contribute to a phobia?

Answer 29

• Phobic anxiety becomes problematic and especially non-adaptive when the stress response is triggered in the absence of any real threat or danger
• A person with a specific phobia response to a stimulus is triggered by exposure, or anticipated exposure, to objects or situations perceived to be dangerous
• Anxiety is therefore also problematic for someone with a specific phobia as their level of anxiety tends to be inflated or excessive because their perception of threat is unreasonable and out of proportion to what it should be  physiological stress response they experience is often very severe

Question 30

Why can GABA dysfunction contribute to a stress response?

Answer 30

• GABA dysfunction may contribute to an excessive stress response or make it more likely to occur than in someone without GABA dysfunction

Question 31

How can a stress response perpetuate a phobia?

Answer 31

• An excessive stress response can become ‘paired’ with phobic stimuli through classical conditioning processes, setting it in place as a learned response that will inevitably occur whenever a phobic stimulus is encountered

Question 32

What is LTP?

Answer 32

• Long-term potentiation is believed to play an important role in the learning and memory of fear by strengthening synaptic connections in the neural pathway formed during the learning process, resulting in enhanced or more effective synaptic transmission within that pathway

Question 33

How does LTP develop/perpetuate a phobia?

Answer 33

• LTP neurologically strengthens the association between a phobic stimulus and a fear or anxiety response through its activity at the synapse
• The more that the connection is activated through each encounter or anticipated encounter with a phobic stimulus, the more the connection is strengthened consequently, the more the relevant neural pathway is strengthened, increasing the efficiency in transferring fear information along the pathway and decreasing the likelihood that what has been learnt will be forgotten

Question 34

What psychological factors contribute to a specific phobia?

Answer 34

Behavioral models 
- classical conditioning 
- operant conditioning 
Cognitive bias 
- memory bias 
- change bias 
- catastrophic thinking

Question 35

What is a behavioral model?

Answer 35

• Behavioural models: phobias are learned through experience and may be acquired, maintained or modified by environmental consequences such as rewards and punishments

Question 36

What is two-factor learning theory?

Answer 36

• A specific phobia may be precipitated through classical conditioning and perpetuated by operant conditioning

Question 37

How does CC and OC contribute to a specific phobia?

Answer 37

• Explanations of phobias by behavioural models propose that classical conditioning processes play a role in the precipitation (or development) of a specific phobia and operant conditioning processes play a role in the perpetuation (or maintenance) of a specific phobia

Question 38

How is a specific phobia developed?

Answer 38

• The development of a specific phobia in this way is essentially the process by which a stimulus with no particular significance (eg: NS or UCS) becomes, by association, a sign of impending threat, danger or some other unpleasant event (eg: CS). The innate, naturally occurring fear response (UCR) eventually becomes a conditioned fear response (CR).
- Stimulus generalisation may occur to other similar objects or situations

Question 39

How does CC develop a specific phobia?

Answer 39

• After conditioning, the new learned fear response that is automatically and involuntarily produced by the CS is called the conditioned response (CR) because it is the result of experiencing the dependent relationship between the CS and UCS
  • The conditioned fear response can last a very long time
  • Considered to involve a very strong association that is unlikely to be forgotten or disappear (eg: extinguished) without intervention

Question 40

What is one trail learning?

Answer 40

• Conditioning can occur in people after only a single pairing if the UCS is sufficiently intense or traumatic – one trail learning

Question 41

How does perpetuation of a phobia occur through operant conditioning?

Answer 41

An individual begins to avoid the fear- and anxiety-producing phobic stimulus (spiders). Avoidance reduces or removes the unpleasant feelings of fear and anxiety, so avoidance is negatively reinforced. In the future, any response that reduces or removes fear or anxiety will also be negatively reinforced. Consequently, any avoidance response to any phobic stimulus will continue to be reinforced through operant conditioning.

Question 42

What is a cognitive model?

Answer 42

• Cognitive models focus on how the individual processes information about the phobic stimulus and related events. People can actually create their own problems (and symptoms) by the way they interpret objects or situations

Question 43

What do cognitive models examine?

Answer 43

• Examine how people with phobias tend to think about a phobic stimulus and its context, and their perceptions, memories, beliefs, attitudes, biases, appraisals, expectations and other cognitive processes that may be relevant
• Cognitive models emphasise how and why people with a phobia have an unreasonable and excessive fear of a phobic stimulus

Question 44

What is a cognitive bias?

Answer 44

• A cognitive bias is a tendency to think in a way that involves errors of judgment and faulty decision-making
- involves mistaken thinking (cognitive distortion)