General knowledge

what are three key features of phobias

• extreme, unreasonable, irrational fears

• interference with daily life

• doing whatever you can to avoid the object/situation of your phobia

what are the DSM categories of phobias and related anxiety disorders

specific phobia, social anxiety/phobia, agoraphobia

what is a specific phobia

phobia of an object or situation

what is social phobia/anxiety

phobia of social situations

what is agoraphobia

phobia of being outside or in a public place

what are the categories of characteristics of phobias

behavioural, emotional, cognitive

what are behavioural characteristics of phobias

how we behave, panic, avoidance and endurance

what is endurance as a behavioural characteristic of a phobia

alternative to avoidance, wanting to be able to keep an eye on the phobia so you feel more in control

what are the emotional characteristic of phobias

how it makes us feel, anxiety, fear, unreasonable emotional response

what is the difference between anxiety and fear

anxiety is an unpleasant state of high arousal preventing someone from relaxing and experiencing much positive emotion-can be long term, fear is the immediate and extremely unpleasant response we experience when we encounter or think about a phobic stimulus- normally more intense but shorter than anxiety

what are the cognitive characteristic of phobias

how it affects thinking patterns and processes, selective attention, irrational beliefs, cognitive distortions

2 explanations of phobias

specific traumatic events, family member has it

treatment techniques for phobias behavioural approach

cognitive behavioural therapy, systematic desensitization, flooding

what is cognitive behavioural therapy

teaches patients to be mindful that their fear is irrational, likelihood of their worst fear become true is very low

what is systematic desensitization

patient is gradually and systematically exposed to phobia, learn to identify the anxiety, coping techniques and how to use the coping techniques to overcome situations

what is the behavioural approach to explaining phobias

two-process model

in the behavioural approach of explaining phobias, what is a phobia acquired by

classical conditioning

in the behavioural approach of explaining phobias, how is a phobia maintained

operant conditioning

what is meant by generalisation in conditioning

conditioned response to conditioned stimulus is passed on to similar objects

classical conditioning process

UCS=UCR, UCS+NS=UCR, repeated pairings, CS=CR

what are the types of operant conditioning

reinforcement, punishment

what does reinforcement do

increase and strengthen frequency of behaviour

how does avoidance maintain a phobia

avoiding phobic stimulus avoids anxiety and fear that might have been experienced, reduction in fear reinforces avoidance behaviour so the phobia is maintained, results in desirable consequences so behaviour is repeated

who proposed the two-process model

Mowrer- behavioural approach

what does the behavioural approach two-process model state

phobias are acquired by classical conditioning and maintained by operant conditioning

what does systematic desensitisation use to reduce phobic anxiety

classical conditioning- learning a new response to the phobic stimulus

what is it called when a patient learns a new response to a phobia e.g. in systematic desensitisation

counterconditioning

what is counterconditioning

learning a new response to a phobia

what are the three processes involved in systematic desensitisation

anxiety hierarchy, relaxation, exposure

what is an anxiety hierarchy

put together by client and therapist, list of situations related to the phobic stimulus that provoke anxiety, arranged from least to most frightening

what is the list of situations from least to most frightening called (created in systematic desensitisation)

anxiety hierarchy

what is the relaxation process in systematic desensitisation

therapist teaches patient to relax, impossible to be relaxed and afraid at the same time- reciprocal inhibition, can be breathing techniques, mental imagery techniques, meditation, drugs such as Valium

what is reciprocal inhibition

the emotion of being relaxed preventing the emotion of being afraid

what is it called when being relaxed prevents being afraid as they can’t be experienced at the same time

reciprocal inhibition

what is the exposure process in systematic desensitisation

client is exposed to phobic stimulus while in a relaxed state, starts at bottom of anxiety hierarchy, takes place over multiple sessions, patient moves up a level when they can stay relaxed in the presence of the level of phobic stimulus, treatment is completed when they can stay relaxed in highest situation on hierarchy

what is flooding

exposing people with a phobia to their phobic stimulus, immediate exposure to very frightening stimulus, longer sessions than systematic desensitisation, often only 1 or 2 sessions

how does flooding work

stops phobic responses very quickly, avoidance behaviour isn’t an option so patient learns phobic stimulus is harmless- extinction, conditioned stimulus is encountered without unconditioned stimulus, conditioned stimulus no longer produces conditioned response, clients can become relaxed in the presence of the phobic stimulus as they become so exhausted by their own fear

what is extinction in flooding

learning a phobic stimulus is actually harmless

what is it called in flooding when a patient learns that a phobic stimulus is actually harmless

extinction

what are the ethical safeguards needed with flooding

clients must give fully informed consent, fully prepared before session, normally given the option between flooding and systematic desensitisation

who did a meta-analysis on effectiveness of systematic desensitisation

Smith and Glass

what did Smith and Glass do

meta-analysis of psychotherapy outcome therapies to show effectiveness of systematic desensitisation

what did Smith and Glass collect as data on systematic desensitisation

average effect size- 0.91
number of effect sizes used- 223
standard error of mean effect size- 0.05
median treated person’s percentile status in control group- 82

what were all the studies in Smith and Glass’ meta analysis on effectiveness of systematic desensitisation

clinical trials

what is effect size

compares means when different studies have used different measurement scales to the original studies

what is the number of effect sizes

number of studies

what is median treated person’s percentile status in control group

where the median score of the treatment condition would be in the scores of the control condition

what are the key features of clinical trials

• random allocation to conditions

• use of control groups: no treatment, placebo or alternative treatment

• blind procedures (single or double)

what is DSM-5

diagnostic and statistical manual of mental illnesses

what does the DSM-5 recognise as categories of depression and depressive disorders

major depressive disorder, persistent depressive disorder, disruptive mood dysregulation disorder, premenstrual dysphoric disorder

what is major depressive disorder

severe but often short-term depression

what is persistent depressive disorder

long-term or recurring depression, including sustained major depression and what used to be call dysthymia

what is disruptive mood dysregulation disorder

childhood temper tantrums

what is premenstrual dysphoric disorder

disruption to mood prior to and/or during menstruation

what are the categories of characteristics of depression

behavioural, emotional and cognitive

what are the general behavioural characteristics of depression

activity levels, disruption to sleep and eating behaviour, aggression and self harm

what is the activity levels changes behaviour in depression

typically people become lethargic- decreased energy levels, withdrawing from work/education, social life, can’t get out of bed in severe cases, neglecting personal hygiene, opposite is psychomotor agitation- struggling to relax

what is psychomotor agitation

struggling to relax e.g. pacing, behavioural characteristic of depression

what is it called when someone struggles to relax

psychomotor agitation

what is the disruption to sleep and eating behaviours characteristic of depression

insomnia- reduced sleep, hypersomnia- increased sleep, appetite may increase or decrease leading to weight gain or loss

what is the aggression and self harm characteristic of depression

people with depression often irritable, can be verbally or physically aggressive, can have knock-on effects e.g. ending a relationship, quitting a job, physical aggression directed against the self including self-harm/suicide

what are the general emotional characteristics of depression

lowered mood, anger, lowered self-esteem

what is the lowered mood characteristic of depression

more than the daily kind of sad feeling, feeling worthless or empty

what is the anger characteristic of depression

directed at self or others, can lead to aggressive or self-harming behaviour

what is the lowered self-esteem characteristic of depression

liking themselves less than usual, self-loathing

what is a cognitive characteristic

how someone thinks about things

what are the general cognitive characteristics of depression

poor concentration, dwelling on the negative, absolutist thinking

what is the poor concentration characteristic of depression

unable to stick to a task they usually would, hard to make normally straightforward decisions, interfere with the individual’s work

what is the dwelling on negative characteristic of depression

pay more attention to negative aspects of a situation, ignore positive, glass half empty, bias towards recalling unhappy events, opposite to when not depressed

what is the absolutist thinking characteristic of depression

seeing situations as all-good or all-bad, black and white thinking, absolute disaster

what are the cognitive approaches to explaining depression

Beck’s negative triad, Ellis’s ABC model

why does Beck think some people are more vulnerable to depression

a person cognition’s and ways of thinking make them more vulnerable

what are Beck’s three parts to cognitive vulnerability to depression

faulty information processing, negative self-schema, negative triad

what does Beck mean by faulty information processing

focusing on negatives not positives of situations, absolutist thinking- black and white thinking

what does Beck mean by negative self-schema

packages of information people have about themselves, they interpret all information about themselves in a negative way

what does Beck say about his negative triad

a person develops a dysfunctional view of themselves due to three types of negative thinking that occur automatically, no matter the reality of what is happening

what are the components of Beck’s negative triad

negative view of the world, the future and of the self

what is the impact of negative views of the world in Beck’s negative triad

creates the impression that there is no hope anywhere

what is the impact of negative views of the future in Beck’s negative triad

reduce any hopefulness and enhance depression

what is the impact of negative views of the self in Beck’s negative triad

enhance any existing depressive feelings, confirm the existence of emotions of low self-esteem

where does Beck suggest negative schemas are acquired

in childhood or adolescence

what are examples of how negative schemas are acquired in childhood or adolescence

loss of a parent, rejection by peers, criticism by parents or teachers, physical or emotional abuse

what is Ellis’s explanation of depression

ABC model, good mental health is due to rational thinking, conditions like anxiety and depression are from irrational thought- thoughts that interfere with us being happy and free from pain

what does Ellis define an irrational thought as

a thought that interferes with us being happy and free from pain

what does Ellis’s ABC model stand for

activating event, beliefs, consequences

what is the activating event in Ellis’s ABC model

a negative life event which trigger irrational beliefs

what are the beliefs in Ellis’s ABC model

irrational beliefs which cause an emotional consequence, trigger depression

what are Ellis’s irrational beliefs he identified

‘musturbation’- belief that we must always succeed/achieve perfection, ‘I-can’t-stand-it-itis’- belief that it is a major disaster whenever something does not go smoothly, ‘utopianism’- belief that life is always meant to be fair

what are the consequences in Ellis’s ABC model

emotional response to the activating event and irrational beliefs that it causes

what does Ellis believe is the actual trigger for depression

the irrational beliefs, not the event itself

what is the name for the cognitive approach’s treatment of depression

cognitive behavioural therapy

what is the cognitive element of CBT

an assessment where the client and cognitive behavioural therapist work together to clarify patient’s problem, identify negative irrational thoughts, identify goals, put a plan together on how to achieve the goals

what is the behavioural element of CBT

working on changing the negative and irrational thoughts, put more effective behaviours in place

what are the examples of CBT

Beck’s cognitive therapy, Ellis’s rational emotional behaviour therapy (REBT), behavioural activation

what is Beck’s cognitive therapy

identify negative automatic thoughts (negative triad)- thought catching, challenge these thoughts, patient set homework to test whether the thoughts have a basis in reality- patient as scientist, can then be used as evidence against the irrational thoughts

what is Ellis’s rational emotional behaviour therapy (REBT)

extends ABC model to ACBDE, D- dispute: challenge irrational thoughts, E-effect: outcome of therapy

what types of disputing are there in REBT

empirical argument, logical argument

what is an empirical argument in REBT

showing client is factually mistaken- no evidence to support the belief

what is a logical argument in REBT

showing the client has drawn an unjustified conclusion

what is behavioural activation CBT treatment

to work with depressed individuals to decrease their avoidance and isolation, increase engagement in activities that have been shown to improve mood e.g. exercise, therapist aims to reinforce such activity