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Assessment, Personality and Psychopathology > Specific Phobias > Flashcards

Specific Phobias Flashcards

1
Q

DSM Definition of Specific Phobia

A
  • Marked by fear about a specific object or situation
  • This almost always provokes immediate fear or anxiety
  • It is actively avoided or endured with intense fear
  • Anxiety is out of proportion to the actual danger posed by the specific object
  • The fear is persistent, typically 6 months or more
  • Involves impairment in life or marked distress
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2
Q

The Two Stage Theory of Phobia

A
  1. Acquired by Classical Conditioning
  2. Maintained by Operant Conditioning
    - removing tor avoiding the phobic object increases negative reinforcement
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3
Q

Potential problems with behavioural account of anxiety disorderrs:

A

There doesn’t need to be an initial experience to elicit a fear response

  • For example, just because you were bit by a dog it doesn’t mean you are now afraid of dogs
  • Argument that some stimuli could be conditioned more easily, as a result of evolutionary adaptations
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4
Q

Cognitive View of Phobias

A

→ main component of anxiety is appraisal

appraisal: emotions extracted from the individuals evaluations of their events.

Appraisal Specificity:
- Danger and harm
- Uncontrollability
- Unpredictability

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5
Q

Treatment of Specific Phobias

A

Exposure Therapy
- Graded exposure: incrementally exposing someone to feared stimulus

Cognitive Therapy
- Challenging faulty appraisals and biases

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6
Q

Diagnosis of a Panic Attack

A

→ recurrent unexpected, refers to an abrupt surge of intense fear/discomfort that reaches a peak within minutes, and during which time four of the following occur:
- Palpitations

  • Sweating
  • Trembling
  • Shortness of breath
  • Choking
  • Chest pains
  • Nausea
  • Dizziness
  • De-realisation
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7
Q

Diagnosis for a Panic Disorder

A

→ panic attack does not mean disorder

At least one attack followed by 1+ month of one or both of the following
1. Persistent concern about additional PAs or their consequences

  1. A significant maladaptive change in behaviour related to the attacks
  • Disturbance is not attributable too substance or mental condition
  • Not better explained by another disorder
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8
Q

Diagnosis of Agoraphobia

A

→ marked fear or anxiety about 2+ of the following

  • Public transport
  • Open spaces
  • Enclosed spaces
  • In line or in a crowd
  • Being outside the home
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9
Q

Characteristics of Agoraphobia

A
  • Avoid situations where escape might be difficult
  • Always provokes fear or anxiety
  • Are actively avoided
  • Is out of proportion to the level of threat
  • Is persistent, 6+ months
  • Clinical distress or impairment
  • Excessive
  • Not explained by other disorders
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10
Q

Typical Pattern of Panic Disorder:

A

panic symptoms → having heart attack → seeks medical advice → maladaptive appraisals (must be something wrong with me) → fear of the fear

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11
Q

False Suffocation Alarm Hypothesis (Biological Model of Panic Disorder)

A
  • Automatic system for detecting imbalance of CO2 to O2 evolved to monitor for suffocation
  • Argued that in PD the threshold for setting off alarm is pathologically lowered
  • Patients with history of respiratory disease are at greater risk of PD
  • Most individuals with PD experienced a PA in lab challenge test using CO2 inhalation
  • Physiological response tests similar among other anxiety disorders and only differs with self-reported fear responses
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12
Q

Neural Correlates of Panic Disorder

A

Inputs into the Amygdala

  • cingulate cortex
  • medial prefrontal cortex
  • orbitofrontal cortex
  • insular cortex
  • sensory thalamus
  • sensory cortex
  • hippocampus

Outputs from the Amygdala

  • periaqueductal grey
  • parabrachial nucleus
  • hypothalamus
  • locus caeruleus
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13
Q

A cognitive approach to Panic

A

https://www.google.com/search?sca_esv=0c814c2424608e41&rlz=1C1UEAD_enAU1083AU1083&sxsrf=ADLYWIJwZ4McBbL-JTw_omNpEFN6LsPP6g:1732334752266&q=cognitive+approach+to+panic&udm=2&fbs=AEQNm0Aa4sjWe7Rqy32pFwRj0UkWd8nbOJfsBGGB5IQQO6L3J7pRxUp2pI1mXV9fBsfh39LpAWJ-Nb3mi2m4EiVUszBibUgYBXGmUct3yVHr_9JSnE288fo6RrD78oXAmOKgB50q3R9TnL6GiT-TSc4e50gY12NCMPCqq1khedYIKxEeV2qq9hPSLEOebufY8kQJKNoKafpkMpjAihYoouDfUWxmeoLDTg&sa=X&ved=2ahUKEwj0xqnsyfGJAxXRUGcHHRP3FO4QtKgLegQIFRAB&biw=946&bih=513&dpr=1.35#vhid=nHFfCbVnnbjqpM&vssid=mosaic

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14
Q

Behavioural Approach to Panic

A

→ acute fear following initial PA depends on interoceptive conditioning (or conditioned fear of internal clues)

  • Slight changes (sometimes unconscious) in bodily functions elicit conditioned fear/panic due to previous pairing with terror of panic
  • May contribute to unexpected quality of PAs
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15
Q

Treatment for Panic Disorder

A

→ education about anxiety
→ challenge cognitions
- Correct misinterpretation of sensations

  • Important to understand that it isn’t related to other diseases first

→ exposure to internal feared cues
- Change conditioned reactions to cues

→ exposure to external feared cues
- Reduced avoidance behaviours

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16
Q

Example of Treatment for Panic Disorder

A
  • One hour session for someone that changed her dog walking routine in fear it would elicit a panic attack
  • The test was to go into a cupboard (enclosed space), therapist was on the other side of the door going over some cognitive restructuring
  • Often would elicit a panic attack but as nothing would happen to them and they were forced to stay in the cupboard then they were shown that there is nothing wrong with the situation
17
Q

DSM Definition of Social Phobia

A

→ a persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people to possible scrutiny by others

  • Exposure to the feared event almost invariable provokes anxiety
  • The person recognises that the fear is unreasonable
  • Feared situations are avoided
  • Fear, anxiety, or avoidance is persistent
  • Distress causes functional impairment
  • Not due to substance use
18
Q

Clinical Features of Social Phobia

A
  • Belief that others see them as inept, stupid, foolish
  • Often demonstrates a cycle of anxiety → social deficits → leading to more anxiety
  • Common safety behaviours
  • Avoiding eye contact
  • Talking to safe people
  • Covering face with hair/hands
      Interpretation bias in social phobia
  • Interpreting neutral compliment as a negative comment
19
Q

Cognitive Model of Social Phobia

A

Social Phobia is maintained by:

  • Increased self-focused attention
  • Use of misleading internal information
  • Use of safety behaviours
  • Pre and post event processing
  • Distorted image of public self
  • Increased in self-focussed attention/self-monitoring in social situations → see self from observer perspective
  • It is not actually the real perspective but the negative perception of how it will be
20
Q

Etiology of Social Phobia

A

By testing monozygotic vs dizygotic twins find different results in likelihood of anxiety disorder

  • Found that there is a heritable contribution (0.13 to 0.60) but also a considerably large non-shared contribution (based on their environment) (0.31-0.78)

Gene Factors

  • When young children experience BI (behavioural inhibition - heightened sensitivity to novel perceptual stimuli and avoidance of novel situations) in childhood they are more likely to later exhibit a social anxiety disorder
  • How it has happened remains a question

Gene factors in relation to environmental factors also increase likelihood of social anxiety disorder

  • Example: Parent influences (over controlling) alongside BI increases likelihood

Environmental Influences

  • Fewer friends and less well liked inturn can create negative social influences (peer influence)
21
Q

Cognitive Approach to Treating for Social Phobia

A
  1. Individual formulation
  2. Safety behaviours
  3. Shifting focus of attention
  4. Give video feedback
  5. Behavioural experiments
  6. Identifying problematic anticipatory and post-event processing
  7. Cognitive challenging
22
Q

In Vivo Exposure Hierarchy

A
  • in person
  • Start by saying your worst fear and compare it with something that is easiest
  • Then create steps that eventually build up to the worst fear
23
Q

Group Therapy

A

Beneficial for

  • Vicarious learning
  • See others with the same problem
  • Public commitment to change
  • Multiple people to challenge thoughts
24
Q

DSM Definition of Generalised Anxiety Disorder

A

→ excessive anxiety and worry, occurring more days than not for at least 6 months

  • Difficult to control the worry
  • 3 or more of following symptoms
  • Restlessness
  • Fatigued
  • Difficulty concentrating
  • Irritability
  • Sleep disturbance
25
Q

Comorbidity of GAD with other disorders

A

82% with GAD comorbid disorder

  • 63% with any mood disorder
  • 52% with another anxiety disorder
26
Q

Transdiagnostic Clinical Reality for Anxiety Disorders

A
  • has the potential to better represent the clinical and scientific realty of mental health problems, reflecting the complexity and comorbidity that is the norm in clinical practice

Transdiagnostic Risk factors

  • Sexual and physical abuse especially in childhood
  • Parental psychopathology
  • Harsh parenting

Transdiagnostic mechanisms

  • Intrusive thoughts
  • Recurrent/repetitive negative thinking
    1. Repetitive
    2. Uncontrollable
    3. Negative in content
  • Relevant in depression, PTSD, SAD
  • Emotion regulation difficulties
  • Executive control deficits

Assessment, Personality and Psychopathology (18 decks)

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