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, clinging or having a tantrum

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

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

emotional characteristics of phobias

-anxiety; fears involve an emotional response of anxiety, an unpleasant state of high arousal- preventing the person from relaxing + makes it difficult to experience any positive emotion

-fear: immediate and extremely unpleasant response we experience when we encounter or thinly about a phobic stimulus - usually more intense and 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; hard to look away - done to keep an eye out for threats the phobia poses

-irrational beliefs; may hold unfounded thoughts irrelation to phobic stimuli (eg social phobia - ‘i must always sound intelligent’ or ‘if i blush, people will think im weak’)

-cognitive distortions; perceptions may become inaccurate and unrealistic

the behavioural approach to explaining phobias

the two process model

-orval hobart mowrer (1960) made the two process model that suggests phobias are acquired (learned) by classical conditioning and then continued/maintained because of 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

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

little albert case study (on behaviourism)

-john watson and rosalie 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 other white furry objects (eg a santa beard)

maintenance by operant conditioning

-takes place when out behavior is reinforced (rewarded) or punished (fear of dogs will lead to avoidance in public spaces, which ultimately rewards us as minimal fear and anxiety will be experienced; avoidance strengthens fear)

the two process model evaluation

strengths

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

-phobias+ traumatic experiences (research methods) ad de jongh et al (2006) found that 73% of people with a fear of dental treatment had a traumatic experience involving dentistry- confirming an association between stimulus (dentistry) and an unconditioned response (pain) does lead to development of phobia -counterpoint

the two process model evaluation

limitations

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

-this behavioural approach doesn’t account to the cognitive aspects of phobias: eg people hold irrational beliefs about the phobia stimulus so 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 or seligman (1971)), states learning theory can’t explain why we seem to be pre-prepared to fear certain stimuli; so it’s 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 reverse counter-conditioning to unlearn the negative response to a situation or object, by associating it to a calm relaxing feeling

SD: the three critical components

1. fear hierarchy- therapist and client work together to identify lest to most frightening phobic experiences/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) as it’s impossible to be relaxed and anxious simultaneously so one process cancels out the other (reciprocal inhibition)

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

SD evaluation

evidence of effectiveness:

-lisa gilroy et al (2003) followed 42 arachnophobic clients using 3 45minute SD sessions. when examined 3 and 33 months later, the SD group were less fearful than the 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.

-appropriate treatment for people with learning disabilities with phobias; doesn’t retire complex rational thought, and doesn’t cause confusion and distress

-exposure through VR allows to avoid dangerous situations, although because it lacks realism it may be less effective (wechsler et al 2019).

-longer lasting effects; relapse rates are lower

-more time consuming and expensive

flooding

where a person with phobias is exposed to an extreme form of phobic stimulus in order to release triggers; starts with the highest level of the clients fear hierarchy (a person with a phobia of dogs would initially be placed in a room with a dog and immediately 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 of time so the body will naturally return to its resting state eventually

-usually a quick process as without the option of avoidance behaviour, the client quickly learns that the phobic stimulus is harmless (called extinction), + in some cases may achieve relaxation as the person has become exhausted by their fear response

flooding evaluation

-cost effective while being 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 (sarah schumacher et al (2015))- controlled by gathering informed consent but attrition (dropout) rates are higher

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