phobias☑️

phobias

-characterised by excessive fear + anxiety triggered by an object, place or situation. the extent of the fear is out of proportion to any real danger presented by the phobic stimulus; must be considered severe enough to interfere with everyday life

main types of phobias recognised by the DSM-5

-specific phobia: phobia of an object; animals, body parts - or situations; flying or having an injection

-social anxiety (social phobia) - phobia of social situations eg public speaking or using a public toilet

-agoraphobia; phobia of being outside or in an open/public space

behavioural characteristics of phobias

-panic; crying, screaming, running away / freezing

-avoidance; actively trying to avoid phobic stimulus (can interfere with everyday life) - fear of public toilets may prevent people from going out

-endurance; remaining in the presence of the phobic stimulus + keeping a cautious eye on it

emotional characteristics of phobias

-anxiety; unpleasant state of high arousal, preventing person from relaxing

-fear: immediate and extremely unpleasant response when we encounter or think about phobic stimulus; more intense but shorter than anxiety

-unreasonable / irrational response, usually disproportionate to every threat posed (crying over a tiny spider on the other side of the room, dilated pupils, swearing, increased heart rate)

cognitive characteristics of phobias

-selective attention to the phobic stimulus; wont look away due to threats the phobia poses

-irrational beliefs; e.g. social phobia - ‘i must always sound intelligent’ or ‘if i blush, people will think im weak’

-cognitive distortions; perceptions may become inaccurate

the behavioural approach to explaining phobias

the two process model

-orval hobart mowrer (1960) made the two process model that suggests phobias are acquired by classical conditioning and maintained by operant conditioning

classical conditioning sections

• neutral stimulus (NS): a stimulus before conditioning; doesn’t prompt a response

• unconditioned stimulus (UCS): the natural response produced; the provoke

• unconditioned response (UCR): a natural response when the NS is presented

• conditioned stimulus (CS): stimulus which makes an organism react because its associated with something else (the new fear)

• conditioned response (CR): learned response (the effect of the fear)

-the conditioned response must be learned while the UCR is natural

-the conditioned response only occurs post-association between UCS + CS

acquisition by classical conditioning

-learning to associate something that we initially have no fear of (neutral stimulus) with something that already triggers a fear response (unconditioned stimulus)

little albert case study (on behaviourism): watson and rayner (1920) created a phobia in a 9month old baby in a lab study, who prior- didn’t show a negative response to the white rat (NS). when a metal bar was struck everytime albert went to reach for the rat (UCS + UCR) behind his head, he became fearful of the rat and developed a phobia (CS + CR)

he also developed a fear of similar looking objects (eg a santa beard)

maintenance by operant conditioning

behavior is reinforced (rewarded or punished) e.g. fear of dogs will lead to avoidance of public spaces, which ultimately rewards us with minimal fear and anxiety experienced; avoidance strengthens fear

the two process model evaluation

strengths

practical application in exposure therapies: the model explores that phobias are maintained by avoidance of the phobic stimulus, so exposure is beneficial; shows value as it identifies a way of treating phobias

-phobias + traumatic experiences: jongh et al (2006) found 73% of people with a fear of dental treatment had a traumatic experience involving dentistry - confirming association betweena neutral stimulus (dentistry) and an unconditioned response (pain (bad outcome)) does lead to development of phobia -counterpoint

the two process model evaluation

limitations

counterpoint- not all phobias appear following bad experiences (eg snake fears in places where snakes aren’t native) and not all frightening experiences lead to phobias- so association between phobias and frightening experiences might not be strong enough to form a complete explanation

-this behavioural approach doesn’t account to the cognitive aspects of phobias: eg people hold irrational beliefs about the phobia stimulus; the two process model explains avoidance behaviour but doesn’t offer an adequate explanation for phobic cognitions suggesting this model doesn’t completely explain phobia symptoms

-biological preparedness (bouton 2007, seligman 1971) learning theory can’t explain why we seem to be pre-prepared to fear certain stimuli: a reductionist theory

the behavioural approach to treating phobias

• systematic desensitisation (SD)

• flooding

exposure forms

-in vivo - actual, authentic exposure

-in vitro - imagery exposure (through imagination or VR technology)

systematic desensitisation

-uses counter-conditioning to unlearn the negative association to a phobic stimulus, by associating it with calm relaxing feeling

SD: the three critical components

1. fear hierarchy- therapist and client work together to identify least to most frightening phobic scenarios (eg thinking about spiders at 10, holding a spider at 100)

2. relaxation: client attempts to relax as deeply as possible (valium (calming drug), meditation, mental imagery) for reciprocal inhibition (impossible to be simultaneously relaxed and anxious; one process cancels out the other)

3. exposure: client is exposed to phobic stimulus when in a relaxed state; over several sessions, starting at the bottom of the fear hierarchy - treatment is successful when the client can remain relaxed in high hierarchy situations + the old undesirable response is distinguished

SD evaluation

evidence of effectiveness:

gilroy et al (2003) followed 42 arachnophobes using 3 45minute SD sessions. when examined 3 and 33 months later, SD group were less fearful than control group

mcgrath et al (1990) found 75% of patients with phobias were successfully treated using SD, when using in vivo techniques, shows SD is effecting phobia treatment.

(longer lasting effects; relapse rates are lower)

-appropriate for people with learning disabilities as doesn’t require complex rational thought, or cause confusion/distress

-exposure through VR avoids dangerous situations, although may lack effectiveness from lack of realism (wechsler et al 2019).

-more time consuming and expensive

flooding

person with a phobia is exposed to an extreme form of their phobic stimulus (the highest level of their fear hierarchy) to release triggers; a person with a phobia of dogs would immediately be placed in a room with a dog and be asked to stroke it

how flooding works

-a person is unable to avoid (negatively reinforce) their phobia + through continuous exposure, anxiety levels decrease

-the body physiologically can’t cope with high anxiety levels for a prolonged period so the body will naturally eventually return to its resting state

-usually a quick process as without the option of avoidance, client quickly learns that the phobic stimulus is harmless (called extinction) + may achieve relaxation due to exhaustion from fear response

flooding evaluation

-cost and clinically effective (convenient): flooding sometimes only requires one session (significantly quicker than its alternatives - ougrin 2011)

-ethical issues: highly traumatic and unpleasant; rated significantly more stressful than SD (schumacher et al 2015) - controlled by gathering informed consent but attrition (dropout) rates are higher

-only masks symptoms; doesn’t tackle the underlying cause of phobias (symptom substitution)