Week 2: Specific Phobias Flashcards
According to Choy et al. 2006, what are the 4 subtypes of specific phobias? (4)
Animal (e.g., spiders),
Natural environmental (e.g., heights, water), situational (e.g., flying, closed spaces),
Blood-injection-injury (e.g., blood, dentist),
“other” category
*For phobias that do not fit into the designated subtypes
True or False
Distinct from other anxiety disorders, specific phobia is not particularly comorbid
False
Highly comorbid
When might applied applied muscle tension be helpful in treating a specific phobia?
Most cases of blood injury phobia have a unique characteristic of a biphasic physiological response to blood, wound and injury stimuli
There is an initial sympathetic response with increased blood pressure and heart rate followed shortly by a parasympathetic response with a drop in blood pressure and heart rate.
Subjects first learn to recognize the early signs of decrease blood pressure, and then practice muscle tension alone-tensing and releasing the tension in the body. Then muscle tension is used in combination with in vivo exposure in order to reverse the drop in blood pressure and prevent fainting.
- As effective as applied relaxation
- The second study found muscle tension alone to be as effective as applied muscle tension, both of which were more effective than in vivo exposure alone
Has Cognitive Therapy been identified as efficacious when treating any specific phobia? If so, which?
As a solo treatment, cognitive therapy was as effective as in vivo exposure in two studies of claustrophobia
True or False:
Hypnotherapy is particularly efficacious when treating specific phobia
False
Not particularly efficacious
Why might a treatment be considered efficacious, but not effective?
Efficacious: The results reported in the acute treatment studies were based on that of study completers.
However, the overall ‘effectiveness’ of the treatments must also take into account treatment motivation and adherence.
An efficacious treatment would not be effective if clients refuse it.
Why would one say that in vivo exposure is not effective?
In vivo is very efficacious
However high-dropout rates need to be considered
Define ‘Incubation’
Where fear increases in magnitude over successive non-reinforced presentations of the CS.
Define ‘Latent Inhibition’
When it is hard to pair the CS with the US, due to having previous non-paired experiences of the CS
According to the Cognitive Model of Human Classical Conditioning (Davey), what are the two potential avenues for intervention?
Outcome Expectancy
Evaluation or the US
Define ‘Covariation Bias’
Distorted perception of the co-variation, usually in the direction of the prior expectation
example:
Participants shown fear-relevant and fear irrelevant stimuli, while receiving electric shock at random.
* Participants over-associated shock with fear-relevant stimuli
(Cognitive Model)
List the relevant factors involved in expectancy evaluation (4)
Situational Contingency Information
o Predictive significance of the CS, as measured by the correlation between the CS and US
Verbally and Culturally Transmitted Information about the Contingency
Existing Beliefs about the CS and the Contingency
Emotions Elicited by the CS
o Degree to which the CS already elicits fear or anxiety
(Cognitive Model)
List the relevant factors involved in UCS revaluation processes (5)
Experience the US alone
-Habituation and Inflation
Socially/Verbally Transmitted Information about the UCS
-Easy to produce increases in fear based on verbal information, less easy to produce US devaluation.
Interpretation of Interoceptive Cues
-A strong CR, can therefore influence a subject’s perception of the UCS
–Participants rated US significantly more aversive when exposed to additional auditory input
Cognitive Rehearsal of the UCS
-Cognitive rehearsal correlates with inflation of CR
–Similar to incubation
Coping Strategies which Neutralize the UCS
-Why do many trauma-exposures fail to result in phobia?
–Individual ability to devalue the trauma immediately following the experience
Define ‘Threat Devaluation’
Which clinical group(s) is less likely to use this?
One’s ability to control the meaning of a trauma and reduce it’s impact.
Phobics and PD-participants use more avoidance strategies and less threat devaluation strategies in managing stressors (compared with healthy controls).
According to Davey (1997), which 7 constructs were identified to contribute to trauma/US devaluation? (7)
Downward comparison
-“Others are worse off”
Positive reappraisal
-Silver linings
Cognitive disengagement
-“This isn’t important enough to get upset
about”
Optimism
-“Everything will work out”
Faith in social support
-“I get by with a little help from my
friends”
Denial
-“I refuse to believe this is happening”
Life perspective
-“I can put up with these problems as long
as I have other things in my life working out”
Which of Davey’s (1997) 7 constructs for US devaluation was not positively correlated with measures of psychological health?
Denial
What is the 3 Pathways account?
Rachman (1977) proposed that there are 3 ways one can learn phobic fear
- Traditional classical conditioning
- Vicarious Learning
- Instructional/Information (transmission of..)
What is the nonassociative perspective of fear acquisition?
Fear is independent of experience and can be regarded as:
- Innate
- Requiring only the development of the nervous system to a particular stage
Commonly cited cases which support the non-associative perspective (3)
Sackett (1966): The fear of conspecific threat in infant rhesus monkeys
o Threatening pictures of conspecifics on screen
Conspecifics do not have to be threatening to elicit fear. Just being unknown can elicit anxiety.
o Stranger fear in children 4-9 months
o Origin in evolution: strangers can be dangerous
Separation anxiety in humans from 8-24 months
Define ‘Dishabituation’
Clarke and Jackson (1983) propose that phobias may arise through this process, in which the original fear response is being only subdued.
Periods of stress may lower the threshold for dishabituation
Criticisms of nonassociative perspective (2)
Based on post-hoc claims
Difficult to test, especially with humans
Factors which predict individual tendency to miscalculate the risk likelihood of a terror attack
Sense of control directly influences the feeling about whether one is susceptible to risk.
No or little escape possibilities
Harming large numbers (at once)
Being incredibly dreadful
What are the general criticisms of conditioning models?
Fears can be acquired without direct experience
No individual differences
Assumption that all stimuli can be similarly conditioned
Fear = US expectancy x US evaluation
The Contemporary Cognitive Model
True or False
A significant portion of clients relapse after exposure therapy
True
19-62% of patients relapse after exposure therapy (Craske & Mystkowski, 2006)
What % of phobic patients seek treatment?
15-25%
What is the % of clients who drop out of exposure therapy?
0-45% (Choy et al., 2007)
Define ‘Flooding’
Start with most fearful component in the fear hierarchy
Define ‘Desensitization’ in exposure therapy procedure
Starting with the least fearful component in the fear hierarchy
Define ‘Spontaneous Recovery’
Return of fear, following extinction and a break
Define ‘Reinstatement’
Return of fear, following extinction and re-exposure to US
Fear of circle (CS) extinguished, but returns after experiencing a shock (US)
How does Propanolol work in treating phobia?
Which phobia is this most researched in?
A fear memory is ‘activated’ likely via exposure.
Propanolol blocks the reconsolidation of the memory, making it fuzzier and more difficult to retrieve.
Next time phobia is encountered, fear memory has less strength.
Preliminary success with spider phobias
