Task 2 Flashcards
Specific phobia
-DSM criteria
A. anxiety about specific object or situation
B. phobic object or situation provokes immediate fear
C. actively avoided
D. out of proportion
E. 6 months or more
F. causes impairment
G. not another mental disorder
Specific phobia
-subtypes
- animal
- situational (flying, enclosed spaces)
- natural environment (heights, dark)
- BII (needles, blood)
- other (clowns, choking, vomit)
Specific phobia
-3 components of process of anxiety (borkovec)
1) motoric escape and avoidance
2) physiologic activation of sympathetic branch ANS
3) cognitive appraisal of threat and harm
Specific phobia
-differential diagnosis
- Social phobia: content of fear network is interpersonal in nature
- PD with agoraphobia: panic response itself distinguished from specific phobia
- PTSD: its occurrence requires a direct experience
- OCD: obsessions are far more chronic and repetitive
Specific phobia vs agoraphobia
- specific phobia, situational type: one situation is feared
- agoraphobia: two or more sitations that are feared
when avoid or fear more than one situation but situations belong to the same cluster than specific phobia
Systematic desentization (wolpe)
- aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning.
- First patients is taught a muscle relaxation technique and breathing excercises
- second patient creates a fear hierarchy
- third the patient works their way up the fear hierarchy
- induction of relaxation not necessary so has fallen out
Exposure in vivo therapy
-3 phases
- instruction phase: given a plausible model and explanation why fear was maintained. role of avoidance explained and mechanisms of change
- direct in vivo exposure: approach feared object and stay in position until the fear is reduced by at least 50%
- maintenance of results: practicing at home using self-exposure techniques
Applied tension
- for exposure in BII
- trained to identify the earliest signs of bradycardia and drop in blood pressure, and then tense the body muscles to increase blood pressure and prevent fainting
- combines muscle tension with in vivo exposure
Two-phase (biphasic) response to BII stimuli
- initial phase: increase in heart rate and blood pressure
- second phase: characterized by bradycardia and hypotension leading to fainting
Classical conditioning
-example elevator
CS (elevator) + UCS (i will die) = UCR (fear response)
CS (elevator) = UCR (fear response)
Classical conditioning
-US representation
- stimulus can activate the mental representation of itself
- CS (barking dog) + US representation (dog attack) = CR (fear response)
Classical conditioning
-extinction
- dog slowly start to stop salvating when he hears the bell (CS) = inhibitory learning: slow decrease of response (CR) after a CS: the CR to the CS is slowly inhibited
- association not broken but new association is learned = CS-noUS association
- CS-US easily triggered by presenting only once the US after the CS = rapid reacquisition
Classical conditioning
-counterconditioning
-train the CS to predict reaction that is the opposite of the CR: relaxation
classical conditioning
-latent inhibition
- lot of experiences with CS-noUS makes it more difficult to develop a CS-US association
- vaak tandarts zonder pijn, 1x wel pijn geeft nog geen CR (pijn) want vaak geen pijn gehad
classical conditioning
-compound conditioning
- series of CS that become associated: CS itself can be predicted by another CS.
- CS1 (inside bus) - CS2 (dog enter bus) - CS3 (barking dog) - US (attack by dog)
