Specific phobias Chapter 9

Question 1

The biopsychosocial approach to specific phobia

Answer 1

a holistic and interdisciplinary framework for understanding the human experience in terms of the influence of biological and psychological and social factors

Question 2

biological factors of specific phobias

Answer 2

1. GABA dysfunction
2. Long term potentiation

Question 3

GABA Dysfunction

Answer 3

*GABA is the main inhibitory neurotransmitter that calms the stress response
*if an individual has low levels of GABA, or it can not be transmitted or received normally across the synapse, their stress response can be activated more easily and they may find it harder to calm down

Question 4

Long term potentiation in relation to specific phobia

Answer 4

*The long-lasting and experience dependent strengthening of synaptic connections that are regularly coactivated
*This contributes to the development of phobias by strengthening the association between neural signals involved in perceiving a stimulus and neural signals involved in activating the fear response

Question 5

Psychological factors contributing to specific phobias

Answer 5

1. precipitation by classical conditioning
2. perpetuation by operant conditioning
3. the role of cognitive biases, including memory bias and catastrophic thinking

Question 6

precipitation factors (in relation to specific phobias)

Answer 6

factors that increase the susceptibility to and contribute to the occurrence of developing a specific phobia

Question 7

precipitation by classical conditioning

Answer 7

Classical conditioning can contribute to the development of phobias by increasing susceptibility to and contributing to their occurrence.
Classical conditioning can precipitate specific phobia as phobias can be learned, and therefore developed, through classical conditioning
* Phobic stimulus would initially be neutral stimulus

Question 8

perpetuating factors

Answer 8

factors that inhibit a person’s ability to recover from a specific phobia

Question 9

perpetuation by operant conditioning

Answer 9

antecedent: Phobic stimulus
Behaviour: individuals avoid phobic stimulus
consequence: individual avoids fear response
Negative reinforcement: behaviour is negatively reinforced due to the avoidance of an aversive stimulus

Question 10

Cognitive biases

Answer 10

a predisposition to think about and process information in a certain way

This may cause errors in people’s judgements and thoughts. Cognitive biases contribute to
phobias because some people consider certain stimuli as particularly harmful, dangerous or scary

Question 11

Types of cognitive bias

Answer 11

1.memory bias
2.catastrophic thinking

Question 12

memory bias

Answer 12

a type of cognitive bias caused by inaccurate or exaggerated memory

Question 13

catastrophic thinking

Answer 13

a type of cognitive bias in which a stimulus or event is predicted to be far worse than it actually is

Question 14

social factors that contribute to specific phobias

Answer 14

• specific environmental triggers
• stigma around seeking treatment.

Question 15

specific environmental triggers

Answer 15

stimuli or experiences in a person’s environment that evoke an extreme stress
response, leading to the development of a phobia

• direct confrontation with a traumatic stimulus or event, e.g. being bitten by a snake.
• observation: observing another person having a direct confrontation with a traumatic stimulus or event,
  e.g. watching someone be threatened with a weapon.
• learning/indirect confrontation: learning about a potentially dangerous or traumatic stimulus or event indirectly, e.g. by
  watching a movie about threatening motorcycle gangs or reading about the danger of snakes.

Question 16

stigma around seeking treatment

Answer 16

the feeling of shame or disgrace experienced by an individual for a characteristic that differentiates them from others

Question 17

evidence based interventions for specific phobia

Answer 17

Biological interventions
psychological interventions
social interventions

Question 18

biological interventions

Answer 18

1. GABA agonist
2. Breathing retraining

Question 19

psychological interventions

Answer 19

1. Cognitive behavioural therapy (CBT)
2. Systematic desensitisation

Question 20

social interventions

Answer 20

1. psychoeducation

Question 21

GABA agonist

Answer 21

1. Benzodiazepines bind to a GABA receptor site on a postsynaptic neuron.
2. The benzodiazepines increase the effectiveness of GABA when it later binds to
   the same receptor sites and mimics its effects.
3. GABA is able to then have its inhibitory effect, reducing the likelihood that the neuron will
   fire. This acts temporarily to reduce neural communication, in turn reducing anxiety

Question 22

benzodiazepines

Answer 22

a type of medication that depresses central nervous system activity and is often used as a short-acting anti-anxiety medication

Question 23

agonists

Answer 23

a type of drug that imitates neurotransmitters and works to initiate a neural response (excitatory or inhibitory) when it binds to the receptor sites of a neuron

Question 24

breathing retraining

Answer 24

A psychologist or doctor will teach a person with a specific phobia how to consciously control their breathing. This will include:
* slow and deep inhalations, followed by slow and controlled exhalations
* counting slowly when breathing in, and when breathing out
* breathing slowly in through the nose, and focusing on breathing out slowly from the
diaphragm.

The learner applies the breathing techniques learnt in step 1 when in the presence
of a phobic stimulus. This restores the amount of oxygen in the body to an optimal level to help the parasympathetic nervous system become dominant, in turn decreasing the dominance
of the sympathetic nervous system and reducing anxiety

Question 25

Psychotherapeutic treatments 

Answer 25

treatments that address dysfunctional emotions, thoughts, and behaviours
through therapeutic communication

Question 26

Cognitive behavioural therapy (CBT)

Answer 26

a form of psychotherapy that encourages individuals to substitute dysfunctional cognitions and behaviours with more adaptive ones.

Question 27

steps in CBT

Answer 27

• The cognitive component involves:
  – identifying negative thoughts and feelings (cognitions) about the issue.
  – replacing these negative thoughts and feelings with more positive ones.
• The behavioural component involves:
  – identifying negative behaviours relating to the issue.
  – developing and maintaining more positive behaviours relating to the issue.

Question 28

Systematic desensitisation 

Answer 28

a therapeutic technique used to overcome phobias that involves a patient being exposed
incrementally to increasingly anxiety inducing stimuli, combined with the use of relaxation
techniques

Question 29

steps involved in Systematic desensitisation 

Answer 29

1. The learning of relaxation techniques.
   A therapist might teach a patient a
   technique they can apply to reduce
   the physiological arousal and anxiety
   involved in the fear response
2. The development of a fear hierarchy.
   This involves creating a list of anxiety inducing experiences relating to the
   patient’s phobia, listed in order of
   easiest to confront, to the most difficult
   to confront.
3. The gradual step-by-step exposure.
   The gradual step-by-step exposure
   to each item of the fear hierarchy,
   beginning with the least anxiety inducing stimulus, paired with practice
   of the learnt relaxation techniques with
   each new exposure.
4. The continuation of this systematic
   exposure. The continuation of this
   exposure to items on the fear hierarchy
   until the most fear-inducing stimulus
   can be faced without producing the
   phobic response.

Question 30

psychoeducation

Answer 30

teaching families and supporters of individuals with mental health disorders how to better understand, deal with, and treat their disorder

• challenging unrealistic or anxious thoughts of the individual
• not encouraging avoidance behaviours.

Question 31

challenging unrealistic or anxious thoughts of the individual

Answer 31

Family and supporters are
encouraged to actively challenge these thoughts
in order to help a person with a specific phobia
to understand that some cognitive components
of their fears are potentially unfounded and
irrational.

Question 32

not encouraging avoidance behaviours.

Answer 32

families and supporters are taught that they
should not encourage avoidance behaviours,
as they do not solve and only perpetuate the
phobic anxiety.