Lecture Phobia

Phobia

marked by anxious apprehension (the thought of encountering something they perceive as dangerous)

dervied from god of war phobos

apphrension something bad is going to happen or will

Agorophobia

apphrensive worrying about not being able to escape situation or place or help will be unavaliable

afraid of multiple situations

they avoid the situation completely or enteronly with a safe person or endure if not present

commonly avoided situations for agorophobia

staning in line ups

enclosed spaces and open spaces

public transportation

agorophobia prevelane

1.7%

heritability percentage

61% slighter higher compared to other disorders

agorophobia impairment

stuck in safe zone home, clingy and dependent

course of agorophobia

life long condition chronic course in absence of treatment

Controversey agorophobia diagnosis

does it always follow a panic attack?
community surveys show half of cases who dont report panic symptoms so it can be independent from PD, happens automatically

Treatment for agorophobia

CBT first in line

education on how avoidance is bad

relaxation breathing

in vivo exposure : set up situation in IRL and have them face it

safety behaviour fading: reduce reliance on safety behaviours (leaving with a person)

Treatment research on agorophobia

difficult to treat since they have to face fears to seek treatment so reluctant to receive treatment

complete remisson is rare

Specific phobias

persistent fear of object or situation. fear is excessive or unreasonable

happens when in the presence of their feared object situation

types:

Animal: tend to have incorrect beliefs about the animals

Natural environment

Blood injury injection

Situational (claustrophobia, flying)

Other

Prevelance of specifc phobias

general population have specifc fears sure

but only 6% of pop meants criteria

they learn. to aovid object/situation

Culture and age need to be considered with specifc phobia

children grow out of a lot of fears, some fears are specifc to culture, (ex. clock)

2 factor leaning theory Mowrer (theory for cause of phobia)

1. classical conditioning bad experience/must have panic attack

2. operant conditioning: negative reinforcement avoiding object that gives you anxiety, reduces anxiety (rewarding)

Rachmans 3 pathways (phobias)

Direct conditioning: first hand experience

Vicarious Conditoning: through another person

Informational transmission: from info sourse

problem with 2 stelp learnign theory

people with phobia never had panic attack trigger it (conditioning absent)

some people are more susceptible to conditoning than others: more

stimuli specificity: why cant we dev fear of everything becuase cognitive interpretations influence fear. if people understand know it changes their interpretations of object/situation

Biological preparedness

evolutionary reasons for phobia

ex. snake can bite you, enclosed spaces can collapse, rats carry diease, water you can drown

early exposure will reduce conditioning (no later fear)

Integrative model for phobias: etiology

innate vulnerability + learning experiences

leads to amplified threat perceptions

leads to avoidance and other safety behaviours

Safety behaviours

deliberate actions the person takes on to protect them selves avoid the neg outcome but they are unnecessary and perpetuate the fear

avoiding snake, only going out with mom, maintains your sense of danger of snake, world

Treatments: hypotheszied mechanisms

Reconsolidation: reactivate the feared memory in safe environemnt and when it is stored there is less fear attached

extinction learning: develop a new memory with feared stimulis that has safety association

cognitive change: reduce safety behaviour, or buildup safe experience you change perceptions attention to threat

all explain some aspect of improvement

Social anxiety disorder

or social phobia, fear or one or more social or performance situations

fears humilation or offending, negative evaluation (rejection)

Performance only is a subtype of SAD

SAD Prev

4th most common disorder

high in North America 8.1%of canada

lower elsewhere

prev is same in children, ado, and adults

SAD age of onset

typically 15 but can begin earlier, signs earlier

shyness or timid

SAD gender prev

more in women, men less liekly to seek treatment

SAD Culture

low prev in china

japan : nervous temperment

taijin social phobia

Social impairment

less likely to marry

avoidant personality

hikikimori

education

more like to drop out of school

occupational

underemployed dont assert themselves

SAD commorbidity

substance abuse (cannabis)

leads to depression

SAD Bio contribution

nospecific vuln: some infant toddlers senstive to change in environment and strong emotion in response to it

higher reaction to angry disgusted faces

Cog-behavioural contributoin to SAD

Negative life events: criticzed, bullied

negative self beliefs as a result, blame themselves not good enough

negative predictions going into socializing

selective attention: looknig for signs people are being negative to them

judgemental bis: only atten to neg cues, draw conlusion, only neg conclusion

thus safety behavours engaged in

2 main types of safety behaviours

subtle avoidance: stay on outside, don’t talk, self disclosure

false friendliness: in effort to not offend other person: cuts off dev of close relationships not authentic

SAD teatment

SSRI

start with

CBT

education

behavioural experiments

interpersonal processes: teach how to get close to people

Treatment outcomes:

thenssri work quickly go of it more lieky to relapse,

cbt takes long time but less liekly to relapse