Week 2: Specific Phobia Flashcards
DSM Criteria (summary)
- fear or anxiety about a specific object or situation
- the object or situation provokes immediate fear or anxiety
- the object or situation is actively avoided or endured with intense fear
- the fear or anxiety is out of proportion to the actual danger
- persistent (important that its persistent) : months and more
- clinically significant distress or impairment in social, occupational, or other areas
- not explained by another mental disorder
Fear is universal, phobias are not. But why? (answer in lecture)
What is the Contemporary Conditioning Model and how is it different from traditional?
- Inclusion of processes that cannot be directly observed ( contains both associative and non-associative element)
Associations between CS and US are learned during classical conditioning. This learned association mediates CR. - Many factors other than pairings of CS and US affect the strength of the association between them.
- verbally and culturally transmitted information
- existing beliefs and expectancies about the possible consequences
- emotional reactions currently associated with the CS. - Strength of CR can be radically influenced by the way the individual evaluates the US through a variety of processes.
Explain using the contemporary conditioning model what factors influence to strengthen or weaken CS + US = CR association.
Expectancy evaluation
1. Situational Contingency Information: if an individual has trauma-free experiences w the CS.
- Latent Inhibition: CS presented many times alone and subsequently paired with the US, it is much harder to associate this CS with the new US than if there were no prior experiences of the CS alone
2. Culturally or verbally transmitted information about the contingency: being told what the relationship between CS and US is, essentially vicarious learning. If one has seen a traumatic experience through the association of someone else it can be learned that way and also strengthens the association between CS and US.
3. Existing beliefs about the CS and Contingency
- prior outcome expectancy can influence the speed with which the CS-US association is learned
- fear-relevant stimulus is learned faster because individuals believe fear-relevant stimuli speed up the CS-US association, making it more resistant to extinction
- judgment of how dangerous CS is
- Semiotic Similarity: greater similarity = increased US expectancy (on valence, arousal, anxiety)
4. Emotions elicited by the CS
- the degree to which CS already elicits prior to fear or anxiety, prior fear will hasten assocition and slow down extinction
Contemporary Conditioning model overview/summary
- Changes in the strength of phobic responding are not only dependent on changes in the CS-US association. Expectancy valuations of CS and, especially (re)evaluation of US can cause dramatic and immediate changes in the strength of phobic responding
- Associations between a neutral CS and aversive US can often be formed in the in the absence of a direct conditioning episode.
- Vicarious experiences the subject being told about CS-US relationship, or through observing another person experiencing that relationship
- Experiences can inflate the aversive evaluation of US and a phobic reaction to the CS may evolve over time.
The overestimation of Fear ( why phobias happen to some people and not others)
- phobics have a significant bias toward expecting fearful or traumatic consequences following encounters with the phobic stimulus
- over-prediction of dangerous elements of the CS and underprediction of available safety resources
- phobias are maintained by conscious cognitions that relate the potential aversive outcomes w the associated contact w phobic stimulus ( information on potential external dangers associated with CS and individual concern of the aversiveness of their own reaction to the CS)
Criticism on Classical Model (conditioning model) Menzies and Clark reading
- phobias do not extinguish under conventional procedures, while in the lab these phobias do extinguish
- many phobics stay fearful even without avoidance behavior
- phobic fear does not reduce when it’s clear that a UCS will not occur but conditioned fear does ( experimentally induced fear can be eliminated by informing subjects that UCS will no longer follow CS, but this is not the case for natural phobias)
- selective nature of phobias: fear stimuli is usually representative of danger that is technical rather than modern man
Preparedness : conditioning reformulation and criticism
Idea: the rate of acquisition of contigencies repeadly faced by generations of a species may become influenced by natrual selection
- quick learning of dangerous sitation/objects leads to survival causing more quick learners overtime
Criticism
- little support for preparedness in clinical cases ( no relationship with aquistion or treatment)
biggest problem: claim that at least one CS-USC trial or a higher-order conditioning trial is required for the acquisitin of any phobia is not true - 40-50% never encountered their fear object or situation
Three pathways account
fear can be learned through vicarious learning, the transmission of information/instruction, and conditioning ( not all phobias arise through direct or indirect associative learning
Most members of the species will show fear to a set evolutionary stimuli in their first encounter, why dont we remain phobic?
Habituation: repeated, nontraumatic exposure to the feared object
- failure of habituation can be due to periods of extreme difficulty could raise levels of arousal and lower the threshold for the dishabituation of previously mastered reactions.
Why do individuals have a strong tendency to miscalculate risk likelihood?
- a sense of control directly influences feeling of if one is susceptible to risk
- no or little escape possibilities
- harming large numbers ( at once)
- being incredibly dreadful
- extremely vivid images of death and damage are being reinforced by media attention and frequent conversation which in turn leads us to highly accessible memories of such events
In- vivo exposure for specific phobia
- most robust treatment
- high dropout rate
- sufficient duration length matters of exposure
- great decrease in subjective anxiety and avoidance
- direct exposure is better than observed
- involves exposure to external stimuli, the patient confronts the actual phobic stimulus such as a live snake in the treatment of snake phobia or standing on a rooftop in the treatment of height phobia
- Usually done in a gradual fashion starting from the least anxiety-provoking aspect of the stimulus
- Significantly more effective than systematic desensitization, but not than imaginal exposure
Specific Phobia overall notes
characterized as excessive, irrational fear of specific object or situation, which is avoided at all cost or endured with great distress
- Most common psychiatric disorder in the US
- Twice as common in women
- Childhood onset for most subtypes
- Later age onset in the twenties for the situational subtype
- Chronic illness, considered benign disorder since anxiety is circumscribed and alleviated when the phobic situation is avoided
- Cases where phobia is unpredictable (thunderstorms or fear of vomiting) the phobia can be particularly debilitating
- Specific phobia is highly comorbid with other mental disorders, particularly anxiety
Systematic Desensitization
exposure to the phobic stimulus through imagination but
: the goal is to suppress anxiety with deep muscle relaxation
- Studies reported improved subjective anxiety but effects on avoidance were mixed
- Flying phobia: systematic desensitization also decreased self report anxiety
- results less consistant in improvement in avoidacne behavior
Imaginal exposure therapy:
involved exposure to the phobic stimulus through imagination; active visualization of the phobic stimulus and
: the goal of the treatment is to achieve habituation and eventual extinction of the phobic reaction
