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Psychology U3/4 > U4AOS2B - Phobia > Flashcards

U4AOS2B - Phobia Flashcards

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1
Q

Explain what is meant by a biopsychosocial framework as an approach to understanding mental health

A
  • A framework is a scientific model or approach used to describe and explain how various internal and external factors interact to affect a person’s mental health
  • Biological → Physiologically based factors
    • Genes, hormones, brain function, genetic vulnerability, poor sleep and substance use
  • Psychological → Internal factors
    • How a person thinks, learns, solves problems, perceives, experiences emotions, manages stress and stores information, and self-efficacy
  • Social → External Factors
    • Forming relationships, the support from friends and family, family upbringing, attachment, cultural values, income level, and educational and employment history
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2
Q

Describe biological factors that contribute to specific phobia

A
  • GABA dysfunction
    • ★ GABA → Inhibitory and calms stress response
    • Low levels/ cannot be transmitted or received normally → Stress response activated more easily + Harder to calm down
    • More susceptible
  • Long-term potentiation
    • ★ Repeated stimulation of 2 neurons; strengthen response
    • Continued costimulation (connection for fear + perception of phobic stimulus) = Phobia strengthens over time
    • High activity in amygdala → Fear

For LTP mention high frequency in amygdala

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3
Q

What is a GABA agonist?

Biological Intervention

A
  • Benzodiazepines
    • Medication/ drug that binds to GABA receptor and increases GABA effects
    • Slow down CNS activity
    • Change shape of receptor to make it more receptive to GABA and more resistant to excitation
    • Can be short acting → Cleared from body quickly
    • Long lasting → Accumulate in bloodstream, longer time to clear
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4
Q

How do you determine whether short/long acting benzodiazepines are appropriate?

Biological Intervention

A
  • Short
    • Phobia → Address specific stimulus
    • Immediate
  • Long
    • GABA is incredibly low and affecting a range of functions
    • Long term
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5
Q

What are advantages of benzodiazepines?

Biological Intervention

A
  • Highly effective in minimising symptoms
  • Alleviate symptoms → Root causes of phobia can be more effectively treated

Explicit mention of relationship between benzodiazepines and CBT/ systematic desensitisation (alleviate symptoms so that CBT/ systematic desensitisation can treat cause)

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6
Q

What are limitations of benzodiazepines?

Biological Intervention

A
  • Body can become dependent → Addictive
  • Only treats symptoms, not underlying causes (not long-term solution)
  • Causes reduced alertness, drowsiness & slower reaction times → Dangerous
  • Lower inhibitions → Increase risk-taking
  • Dangerous when mixed with alcohol or other depressants
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7
Q

How can a benzodiazepine agent help manage a phobia?

A
  • Acts as a GABA agonist in the brain by promoting GABA’s inhibitory effect
    • Helps to calm physiological arousal
  • People with a phobia may have dysfunctional levels of GABA
  • Prescribing a benzodiazepine helps reduce the extreme anxiety experienced because of the phobia → Reducing intensity of stress response
    • Less likely to avoid (perpetuate) phobia via neg. reinforcement
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8
Q

What is breathing retraining?

Biological Intervention

A
  • Method that teaches breathing control techniques that may reduce physiological arousal
  • Reduce sympathetic nervous system activity + Increase parasympathetic
  • Slow breathing → Calm stress response
    • Shortness of breath isn’t associated with phobic stimulus
    • Make individuals feel like they have control over their fear
  • Needs to be practiced when not anxious in order to make it habitual
    • Ensure that individual can implement technique even when not thinking clearly
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9
Q

What are abnormal breathing patterns that can be developed by people with specific phobia?

Biological Symptom

A
  • Shallow ‘chest breathing’ → Not taking in sufficient volume of air
  • Rapid breathing → Number of breaths is unnecessarily increased
  • Deep breathing → Deeper, larger breaths = Too much oxygen
    • Upset balance between oxygen and carbon dioxide
    • Low level of carbon dioxide in blood
  • Symptoms
    • Dizziness
    • Light-headedness
    • Blurred vision
    • All associated with panic attack → Heighten fear and anxiety
  • Solution
    • All require breathing retraining to normalise breathing
    • Maintain correct oxygen and carbon dioxide balance in blood
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10
Q

What are potential benefits of breathing retraining?

A
  • When encountering/ anticipating phobic stimulus…
    • Maintain correct breathing
    • Correct abnormal breathing patterns
    • Enhanced ability to remain calm
  • Minimise likelihood of hyperventilation or panic attack
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11
Q

Describe psychological factors that contribute to specific phobia

A
  • Precipitation - Classical
    • Increase susceptibility and contribute to development of phobia
    • Phobia caused by NS + UCS pairing with NS just before UCS
    • Non-extinguished (without intervention)
  • Perpetuation - Operant
    • Inhibit person’s ability to recover → Continue phobia
    • Avoidance of phobic stimulus = Negative reinforcer (calm)
    • Increase likelihood of behaviour
  • Cognitive Bias
    • Tendency to think in a way that involves errors + faulty decision making
    • Are not factual
    • Fixate on negative

PCPOCB - Pineapples Can’t Possibly Obtain Carbonara Beautifully

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12
Q

Describe the two types of cognitive biases

A
  • Memory Bias
    • Distorting influence of present on the recollection of previous experiences → Selective Memory, only remembering negatives thus forgetting positives that challenge
    • Consistency Bias → Distorted to fit in what is presently known/believed
      • Fear something currently, reflect back and conclude that they feared it in the past as well
      • Similar memories to cause are strengthened & more likely to be retrieved
  • Catastrophic Thinking
    • Predicting worst possible outcome
    • Heightened feelings of helplessness
    • Underestimate ability to cope with situation
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13
Q

What is systematic desensitisation?

Psychological Intervention

A
  • Graded experience where patient with phobia is gradually exposed to phobic stimuli using relaxation techniques to calm response
  • Pair CS (phobic stimulus) with pleasant UCS (relaxation technique) → new UCR
  • Replace anxiety response with relaxation
  • Steps
    • Learn relaxation technique
    • Patient establishes fear hierarchy (what is the scariest to least)
    • Patient exposed to fear hierarchy going up
    • Can only continue up the stages when they are willing and relaxed, fear response is eliminated
    • Continues until extinguished

Treats CC and OC
AKA Exposure Therapy

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14
Q

What are the advantages of systematic desensitisation?

Psychological Intervention

A
  • Use same thing that developed phobia to undevelop it
    • More responsive
  • Can be done over time
  • Address root cause
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15
Q

What are disadvantages of systematic desensitisation?

Psychological Intervention

A
  • Take a lot of time
  • Too fast → Can cause stimulus generalisation
    • Intended pleasant UCS becomes feared
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16
Q

What is cognitive behavioural therapy (CBT)?

Psychological Intervention

A
  • Identifying and replacing negative cognitions & behaviours for more positive, helpful ones
    • Change in thinking supports changed feelings THUS changed behaviour → Removal of negative feelings = No more avoidance
    • Thoughts → Feelings → Behaviour
  • New understanding that phobic stimulus is not (or unlikely to be) dangerous

Assume that reason for behaviour is caused by thought processes (Thoughts-Feelings-Behaviour)
Treats cognitive biases

17
Q

What are the goals of a CBT treatment plan?

A
  • Changing thoughts and behaviour that perpetuate the phobia
    • New understanding that their feared stimuli is not/ not likely to be dangerous
    • Introduces the idea that avoidance and safety behaviours are unnecessary and maladaptive in the long-term
  • New understanding (T) = Change in feeling (F) and Behaviour (B)

Must mention change in thoughts, feelings and behaviour

18
Q

Describe social factors that contribute to specific phobia

A
  • Environmental Triggers
    • Stimuli that evoke an extreme stress response
    • Can be generalised (not just initial stimulus)
    • Direct confrontation, observation, learning (parents and peers)
    • Lead to development of phobia
    • Doesn’t need to be repeated if intense
  • Stigma - Maintains
    • Shame/embarrassment about something that makes one different from others
    • Prevent from seeking treatment → Getting a label
    • Worried about perception from others → Makes phobia worse
19
Q

What is psychoeducation?

Social Intervention

A
  • Teaching families and supporters of individuals with mental health disorders how to…
    • Better understand
    • Deal with disorder
    • Treat disorder
  • Components
    • Challenging unrealistic/ anxious thoughts of the individual
    • Not encouraging avoidance behaviours

BDT - Butter Dog Town
Explicitly mention components in responses

20
Q

State examples of how to effectively + ineffectively challenge phobic thoughts

Social Intervention - Psychoeducation

A
  • Effective
    • Calmly acknowledge + Reassure about lack of danger
      • What is making you feel scared?
      • Is there any evidence that contradicts your thoughts?
  • Ineffective
    • No acknowledgement or reassurance - Stigmatising comments
      • Don’t be stupid
      • You’re crazy
21
Q

State examples of how to effectively + ineffectively discourage avoidance

Social Intervention - Psychoeducation

A
  • Effective
    • Encourage not to engage in avoidance behavior
    • Support to not engage
    • Praise/ positive reinforcement
  • Ineffective
    • Forced exposure
    • Ridicule
    • Impatience
    • Sarcasm
    • Belitting
22
Q

Why are families/ supporters advised not to encourage avoidance behaviour (phobia)?

A
  • It perpetuates the phobia
    • Important that the individual has the opportunity to face what is feared → Learn that their phobic stimuli isn’t dangerous
  • Exposure provides opportunity to learn to cope with fears + Experience control
  • Comforting rather than challenging may unintentionally reinforce avoidance behaviour
23
Q

How can attention in observational learning lead to someone developing a phobia?

A
  • Individual actively focuses on model’s responses to the phobic stimulus
  • Proceed to…
    • Storing/ encoding/ retaining the antecedent-behaviour-consequence relationship
    • NOT just imitating fear response
    • For example → Model is relieved when avoiding phobic stimulus so learner learns vicariously that avoidance of it is negatively reinforced
24
Q

Why are evidence-based interventions preferred in the treatment of a phobia?

A
  • Based on peer-reviewed scientific studies → Increase likelihood of treatment to…
    • Be effective/ maximise chance of benefit
    • Tailored to individual’s specific phobia and their specific symptoms
    • Minimise risk of harm (unlikely to be dangerous)
    • Be of an acceptable cost
25
Q

What is the relationship between GABA and the stress response in the development of a phobia?

A
  • Individuals with a phobia have low levels of GABA
  • Results in neurons firing excessively
  • Individual’s FFF response may activate more easily for a prolonged period when exposed to the phobic stimulus
26
Q

Why is it important to challenge unrealistic thoughts about a phobic stimulus?

A
  • People with specific phobias have cognitive biases → Avoidance behaviours
  • Challenging = Assist person in developing a new understanding that the feared stimulus is not dangerous
    • Avoidance not necessary
27
Q

Why is systematic desensitisation more effective than benzodiazepines?

A
  • Benzodiazepines are a short-term solution that only reduce the phobic response
    • Do not change association between PS and fear
  • Systematic desensitisation is more long-term because it works to change the association between the PS and fear

Psychology U3/4 (12 decks)

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