Saavedra & Silverman (2002) - AICE Psych

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38 Terms

1
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

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Aim 1
* To investigate the cause of a boy’s button phobia to see if disgust is involved
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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
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Sample
9 year old Hispanic boy - symptoms of button-phobia since the age of 5
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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.

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Sampling method
Opportunity
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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
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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

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Research method
Case study - 1 participant in-depth
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Data collection
  1. Interviews: w/boy and his mother

  2. Self reports: Feelings Thermometer

  3. Observations during therapy sessions

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Feelings thermometer/fear hierarchy
  • Rated 11 different scenarios involving buttons

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

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Weakness of fear hierarchy
  • It’s subjective

  • He could’ve lied

  • 0-8 are restrictive

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What did the boy rank a 2 on the distress rating?
Large denim jean buttons
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What did the boy rank a 3 on the distress rating?
Small denim jean buttons + clip on jean buttons
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What did the boy rank a 4 on the distress rating?
Large plastic buttons (clear and colored)
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What did the boy rank a 5 on the distress rating?
Hugging mom when she wears large plastic buttons and medium plastic buttons (colored)
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What did the boy rank a 6 on the distress rating?
Medium plastic buttons (clear)
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What did the boy rank a 7 on the distress rating?
Hugging mom when she wears regular medium plastic buttons
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What did the boy rank a 8 on the distress rating?
Small plastic buttons (clear + colored)
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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

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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

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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)

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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

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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
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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

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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

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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

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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
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Strength of quantitative data:
Allowed improvements to be shown as the ratings on the fear hierarchy decreased
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Strength of qualitative data:
Allowed researchers to understand the underlying reasons for his phobia
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What standardized measures were used?
  • Feeling Thermometer

  • 20 minute sessions with the boy alone

    • Allows for reliability

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Why did the study have high ecological validity?
Therapy sessions were ‘real’ and these activities would happen in real life
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Other strength:
The study had a follow up of 12-months. Therefore, the treatment could be tested for effectiveness in the long term.
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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

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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
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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

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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.

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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.

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