Saavedra & Silverman (2002) - AICE Psych

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What did this study investigate?

What did this study investigate?

• Phobias

  • When people develop some irrational fear of an object/situation

• Operant conditioning

• Classical conditioning: inspired by Pavlov

  • When stimuli are associated together after several pairings happen

Aim 1

• To investigate the cause of a boy’s button phobia to see if disgust is involved

Aim 2

• To treat the button phobia of a boy by targeting fear and disgust and testing the effectiveness of exposure treatment of a button phobic

Sample

9 year old Hispanic boy - symptoms of button-phobia since the age of 5

What did the boy recall started his button phobia?

• There was an art project using buttons (in kindergarten)

• He had run out of buttons (for his project)

• His hand slipped as he reached for the bowl

• All of the buttons fell down on him.

Sampling method

Opportunity

What symptoms of button phobia did the boy have?

The boy struggled to dress himself and pay attention in school because he was preoccupied with not touching his uniform

How was he diagnosed with button phobia?

• The child and parent were interviewed about button phobia

• Using ADIS-C/P as a standardized interview schedule for the phobia

• DSM-IV was used

• He met criteria for button phobia, didn’t meet criteria for OCD

Research method

Case study - 1 participant in-depth

Data collection

1. Interviews: w/boy and his mother

2. Self reports: Feelings Thermometer

3. Observations during therapy sessions

Feelings thermometer/fear hierarchy

• Rated 11 different scenarios involving buttons

• Ranked from 0-8 → 0 was the lowest distress, 8 was the highest distress

Weakness of fear hierarchy

• It’s subjective

• He could’ve lied

• 0-8 are restrictive

What did the boy rank a 2 on the distress rating?

Large denim jean buttons

What did the boy rank a 3 on the distress rating?

Small denim jean buttons + clip on jean buttons

What did the boy rank a 4 on the distress rating?

Large plastic buttons (clear and colored)

What did the boy rank a 5 on the distress rating?

Hugging mom when she wears large plastic buttons and medium plastic buttons (colored)

What did the boy rank a 6 on the distress rating?

Medium plastic buttons (clear)

What did the boy rank a 7 on the distress rating?

Hugging mom when she wears regular medium plastic buttons

What did the boy rank a 8 on the distress rating?

Small plastic buttons (clear + colored)

Positive reinforcement/exposure therapy (behavior procedure):

4 sessions

• Contingency management = positive reinforcement

  • Rewarded for showing less fear and handling buttons & mother provided positive reinforcements

• Sessions lasted 30 minutes for the boy alone

  • 20 minutes for sessions w/boy and mom

• Produced the fear hierarchy/Feelings Thermometer

  • Exposed to these fears

Imagery exposure/cognitive procedures (disgust-related):

• 3 sessions

• Classical conditioning - ‘Vivo method’

• Boy believed that it was disgusting for buttons to touch his body and they emitted an unpleasant smell

  • Asked to imagine buttons falling on him

    • How they looked, felt, smelled, and made him feel

• Exposure progressed from pics of larger to smaller buttons in line w/boy’s fears

Posttreatment follow-up assessment session:

• They re-administered two measures

• One measured his anxiety towards buttons

• He was also assessed against DSM (IV) criteria

• To see if he still had a diagnosed phobia (of buttons)

Positive reinforcement therapy results:

• Boy approached buttons more positively but his ratings of distress increased b/t sessions 2 and 3

• By session 4, the # of items on the hierarchy increased in dislike

Imagery exposure therapy results:

Successful in reducing distress ratings:

• Prior to therapy, he rated buttons on falling him an 8 on the scale

  • Decreased to 5 midway through the session

  • Reduced to 3 by the end of the session

What happened at the 6-12 month follow up:

• Boy reported minimal distress

• He didn’t meet DSM-IV criteria for a phobia anymore

• He was able to wear clear plastic buttons on his uniform

Conclusions:

• Disgust does play a crucial role in the development and maintenance of a (button) phobia

• Imagery exposure can have a positive long-term effect on reducing distress linked to phobias

Psychology being investigated:

• Phobias are an irrational fear of an object

• Investigated evaluative learning

• A person comes to perceive (evaluate) a previously neutral object or an event negatively.

• The person negatively evaluates the object/event without anticipating any threat/danger.

• This negative evaluation elicits a feeling of disgust rather than fear.

• Operant conditioning is when you learn by consequences

• If you are rewarded you are more likely to repeat that behaviour

Why was the study highly valid/strength of a case study?

Focused on one child:

• In-depth data

  • Assessed using DSM

  • Monitored disgust levels in therapy

Strength of quantitative data:

Allowed improvements to be shown as the ratings on the fear hierarchy decreased

Strength of qualitative data:

Allowed researchers to understand the underlying reasons for his phobia

What standardized measures were used?

• Feeling Thermometer

• 20 minute sessions with the boy alone

  • Allows for reliability

Why did the study have high ecological validity?

Therapy sessions were ‘real’ and these activities would happen in real life

Other strength:

The study had a follow up of 12-months. Therefore, the treatment could be tested for effectiveness in the long term.

Ethics:

• Confidentiality = not broken; We don’t know the ppt’s name just their age, gender, and that he was in a program in FL.

• Informed Consent = not broken; Both mother and child gave full consent for the procedures involved in the therapy

• Privacy = broken; Child revealed which buttons he was scared of, may have felt embarrassed while doing this

• Protection from psychological harm = broken; Exposed to buttons he was scared of, which could’ve caused mental distress

Why does this support the nurture side of the debate?

• During an art class he reached for a bowl of buttons and his hand slipped and the bowl fell on him

  • After that stressful experience he developed the fear of buttons/became fearful because of that situation/experience

How does this study support the learning approach?

• Part of this therapy was based on operant conditioning. He was rewarded for being able to handle buttons on the Feeling Thermometer

• He had an experience of the bowl of buttons falling on to him. He never had this phobia before then so the phobia has been learnt

Real-life applications:

• Shows how therapy based on classical conditioning can be used to treat some phobias.

• It also shows the long-term improvement from exposure therapies.

• After four sessions of the mother providing positive reinforcement the boy could cope with his worst button fears. Therefore, for children with phobias having a parent involved in the therapy might bring about faster positive outcomes.

• The boy’s disgust/fear (for buttons) was found out using a Feelings Thermometer. This might be useful for schools to use with students who show fear to help understand what is causing the fear in a child at school.

Weaknesses:

• Results are unable to be generalized:

  • One ppt limits applicability

• Demand characteristics

  • Boy provided informed consent and knew the study’s purpose so he could’ve had social desirability bias.