Phobias

What are phobias

They are a type of anxiety disorder. Anxiety is an emotion all people experience and is a natural response to a potentially dangerous stimulus. But a phobia is an extreme fear of an object/situation/activity which is irrational and disproportionate to the actual danger.

What are the subtypes of phobias

Subtypes of Phobia:

• Specific phobias - Fear of a specific thing eg. spiders, flying

• Social phobias - Being over anxious in social situations eg. public speaking/crowds

• Agoraphobia - Fear of leaving home or a safe place - can be a response to active avoidant behaviour.

Explain in more detail the characteristics of phobias

Characteristics of phobias:

BEHAVIOURAL:

Panic - in the presence of the phobic stimulus, behaviors include crying, screaming, running away.

Children may freeze or cling to an adult.

Avoidance - Not going to places/situations where they might come into contact with it eg. avoiding parks due to wasp phobia.

EMOTIONAL:

Fear - feelings of horror/terror/feeling scared - fearing dying in a plane crash eg.

Anxiety - feelings of worry/stress/distress in presence of phobia stimulus.

COGNITIVE

• Selective attention - in the presence of the phobic stimulus, the person will find it difficult to direct their attention elsewhere and they are fixated on the object they fear due to the irrational beliefs about the danger.

• Irrational beliefs - illogical + erroneous ideas/decisions eg. a person with a spider phobia may believe that all spiders are dangerous + deadly but no spiders in UK are deadly.

What is the way for explaining phobias

1. The behavioral approach to explaining phobias

   THE TWO PROCESS MODEL:

   Mowrer proposed this model that suggested that phobias are learnt and developed through an experience to a negative / traumatic event.

   It says they are acquired through classical conditioning and maintained through operant conditioning.

   How phobias are acquired - classical conditioning:

   Phobias are formed through forming an association between neutral and unconditioned stimulus which creates a fear response and the once neutral stimulus now becomes a conditioned stimulus that creates a conditioned fear response.

   Case study - Little Albert

   NS - white rat - before conditioning - showed no response to white rat

   UCS - loud noise (hit/smash a steel bar) while presented with rat

   UCR - crying / fear

   CS - rat

   CR - Fear

   How phobias are maintained - operant conditioning of negative reinforcement.

   Negative reinforcement = Avoidance of the feared object reduces the negative consequence, fear or anxiety (unpleasant).

   This strengthens the avoidance behavior so phobia is maintained.

Give 3 evaluation of the explanation to phobias

Evaluation of 2-process model.

1. There is supporting evidence for the acquisition of phobias via classical conditioning.

   For example, Watson & Rayner conditioned little Albert to have a fear of white rats by pairing the loud noise (UCS) which scared him (UCR) with the rat (NS) to condition a fear response to rats (CR).

   Also, Sue et al found people with phobia often recount a traumatic incident where the phobia appeared eg bitten by a dog.

   They both tell us that phobias are learnt through association but not about how the phobia is maintained. So the research lacks support of the whole 2-process model.

2. Some people develop have negative experiences without developing a phobia.

   For example, Dinardo found that participants with a phobia of dogs had also experienced a fearful incident with a dog to those with a phobia. This challenges the two-step process model as it suggests not everyone will learn to fear these things through association with a negative experience. This suggests that other factors eg. cognition & individual differences may play a part in phobias not just behavior learning theory.

3. Understanding how phobias are acquired has led to development of behavioral treatment of phobias so it has positive application.

   For example, systematic desensitisation helps people form a new association with the phobia (relaxation not fear) using the principles of classical conditioning while flooding prevents people avoiding phobias (negative reinforcement).

   These are very effective & not only support 2-process model but show its usefulness.

Explain the first behavioural approach to treating phobias

SYSTEMATIC DESENSITISATION:

→ A behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning principles.

A new response to a phobic stimulus is learnt (relaxation instead of fear) - COUNTERCONDITIONING - opposite of classical conditioning

This results in reciprocal inhibition = the relaxation prevents the anxiety as it is impossible to have both.

It can. SD can be...

in vivo = directly exposed to phobia stimuli.

in vitro = where they imagine being exposed to it.

There are 2 main processes:

1. Relaxation - they are techniques taught to the service user

   → focus on breathing and taking slow deep breaths as anxiety causes high rapid breathing so slowing this down reduces anxiety

   → visualize a peaceful scene

   → progressive muscle relaxation - one muscle at a time is relaxed

2. Hierarchy:

   → At beginning of therapy, the therapist and service user will identify fearful situations with phobia & rank them.

   → They then are gradually exposed to the fearful situations, one step at a time, from the bottom to the top of the fear situations. Using relaxation & fearful techniques they learnt and will not move on until anxiety is reduced.

The treatment is successful when they can remain relaxed topay heirary.

Steps:

1. Relaxation technique are taught

2. Heirary is made

3. One step at a time they start the heirary

4. As one step is mastered they progress

5. Treatment succeeded.

Explain how you evaluate treatments

For treatments we must consider appropriateness and effectiveness.

Effectiveness - we consider research studies - success in treated

appropriateness - how long treatment takes?

• side effects?

• suitable for all systems?

Or comparing to another treatment.

Explain the evaluation of systematic desensitisation

1. Effectiveness

• Gilroy et al found that at both 3 and 33 months after a treatment a group with SD compared to just relaxation where less feared of spiders. This demonstrates the gradual exposition is vital to the effectiveness and the 33 months demonstrates it is an effective long term treatment.

2. Appropriateness

• Evidence suggests that SD isn't good at treating all phobias. It's better at treating specific phobias rather than social phobias where CBT is used as a better alternative. This is because rather than changing the reaction to the phobia, CBT identifies and challenges irrational

  Which can have more of an impact on the development of complex phobias in comparison to specific phobias. So we need to consider the type of phobia before treatment.

  3. Appropriateness

  • SD involves the individual confronting their fear which leads to psychological distress however not in comparison to flooding. SD involves gradually exposing them during relaxation.

  • More ethical for vulnerable people e.g. children.

Explain the second behavioural approach to treating phobias

2. Flooding

• It is a behavioral therapy that involves immediate and direct phobia exposure.

  Eg. a person with a phobia of elevators would be placed in an elevator until they reduced distress.

• Here the person is unable to avoid the phobia so the avoidance through operant conditioning of negative reinforcement can't be maintained so the anxiety can't be maintained - eventually the fear will extinguish.

• Flooding sessions last longer than SD - 2-3 hours but only one session may be needed.

Explain the evaluation of flooding

1. Effectiveness

   Kaplan and Tolin found 65% of specific phobia session - after years. This suggests a good long term treatment but not for everyone as not everyone was cured - depends on the person

2) Appropriateness

Effective for specific phobia however its less effective for social phobia / more complex phobias As social phobias have a cognitive element eg. sufferers experience irrational thoughts of social situations. So like so we must be cautious when using Flooding and consider all options like CBT

3) Appropriateness

Despite the informed consent of phobic patients, Flooding is highly traumatic as they experience high levels of anxiety. Because of this it requires high treatment. So it may increase anxiety not reduce it as they didn't finish the treatment. It's also sensitive to children or vulnerable adultsnot suitable for all.