PHOBIAS + AGORAPHOBIA Chp.4.2 (Exam 1; PSYC168)

What are Phobias?

A persistent and unreasonable fear of a particular object, activity, or situation.

What are the main symptoms? (hint:4)

Usually lasting at least 6 months...

1. Avoidance of situation or object due to fear

2. Fear out of proportion to danger posed

3. Object/situation produced immediate fear

4. Disrupts lives: significant distress or impairment

Lifetime prevalence of phobias?

12%

What do we know about demographics? Ie. typical age of onset and gender, racial and SES differences in prevalence?

More common in women (as of many anxiety disorders)

What is a specific phobia?

DSM-5-TR's label for a severe, intense, and persistent fear of a specific object or situation. When exposed to the feared object/situation, they typically experience immediate fear. Common specific phobias include specific animals or insects, heights, enclosed spaces, thunderstorms, and blood.

What is agoraphobia?

A fear of venturing into public places or situations in which escape might be difficult or help unavailable if one were to become panicky or incapacitated (or have "embarrassing" symptoms).

Lifetime prevalence of agoraphobia?

1.3%

Agorophobia is more common in ____

women

Agoraphobia is pronounced, disproportionate or repeated fear of being in AT LEAST 2 of the following situations...(Hint:4)

1. Public transportation (e.g., auto or plane travel)

2. Parking lots, bridges, or other open places

3. Lines or crowds

4. Away from home unaccompanied

Which disorders often precedes agoraphobia?

Panic disorder; panic attacks may occur when they enter public places and set the stage for the development of agoraphobia.

What us Mowrer's Two factor Theory?

Suggests phobias are developed in two steps...

1. Classical conditioning: develops the phobia

2. Operant conditioning: maintains the phobia

How does classical conditioning develop a phobia? Outline the basic process.

Two events that occur close together in time become strongly associated with each other in a person's mind, and the person reacts similarly to both of them. Fearful events cause them to be afraid of stimuli associated with the event.

Ex. Dogs in general (NS) → Bit by dog (US) → Pain/fear (UR) → Generalized to all dogs (CT) → Phobia of dogs (CR)

What does research suggest about how often phobias develop from classical conditioning?

It implies that phobias can be acquired by CC or modeling, but researchers have not established that the disorder is ordinarily or exclusively acquired in this way. Support is mixed; some support but several lab experiments have failed. Furthermore, not all case studies trace phobias back to CC or modeling.

Briefly explain the "Little Albert Experiment" and why it relates to classical conditioning of phobias.

The "Little Albert Experiment" by John B. Watson & Rosalie Rayner (1920) involved teaching a baby called Little Albert to fear white rats. The rat was associated with a loud noise that scared Albert; he learned to fear and avoid the rat. He generalized it to all white fluffy things, resulting in a phobia.

What are the two ways phobias can be developed?

1. Direct experience (classical conditioning)

2. Modeling or Vicarious conditioning (watching others how fear)

How does operant conditioning maintain a phobia?

Avoidance of feared objects negatively reinforced by decreased fear, prevents extinction

Phobias require the ______. (Ex. for it to be a phobia, a boy has to be afraid of ALL dogs, not just one specific dog)

Generalization Ex. Getting bit by a dog → fear generalizes to all dogs

What is preparedness theory?

An evolutionary theory that explains why some objects are more commonly feared than others. Suggests only certain objects/situations are more likely to become a source of acquired fear because they had evolutionary significance to survival for our ancestors. We are "prepared" to develop certain phobias and not others.

Ex. Snakes, heights, and spiders

What is exposure therapy?

Therapy in which clients are exposed to the objects or situations they dread. Around 70% see significant improvement.

What are the three kinds of exposure therapy?

1. Systematic desensitization

2. Flooding

3. Modeling

What is systematic desensitization?

An exposure therapy treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations they dread.

What are the three steps of systematic desensitization?

1. Patient creates a fear hierarchy: Bottom= little fear vs. Top=Terrifies them

Ex. Fear of dogs → Bottom= watching dogs on TV vs. Top= petting a dog

2. Graduated exposure to situations that cause greater fear: Going from top to bottom of hierarchy.

3. If remain in situation, fear will extinguish

Often paired w/ relaxation training

What happens if the client leaves the situation during systematic desensitization?

Reinforced avoidance and the phobia

What is relaxation training and why is it often paired with systematic desensitization?

Progressive muscle relaxation & deep breathing produce relaxation; relaxation and fear are incompatible, it substitutes the fear response.

What is flooding?

An exposure treatment for phobias that doesn't use relaxation training or gradual buildup; repeatedly and intensively exposed into their most feared situation until their fear declines. Not common for moral reasons.

What is modeling as an exposure technique?

Therapist confronts the feared object or situation while the fearful person observes; therapist demonstrates that the person's fears are groundless. After several sessions, many clients are able to approach the object or situation calmly.

What is in vivo exposure?

The exposure therapy happens in real life; direct interaction with the feared object.

Ex. Fear of heights → climb a ladder

What is covert exposure?

The therapist describes it while clients imagine themselves interacting with the feared object.

Is in vivo or covert exposure more successful?

In vivo exposure.The key to greater success in all forms of exposure appears to be the actual contact.

Which model's approach to treating phobias is the most used and successful?

Cognitive-behavioral approach.

What supplementary features does exposure therapy for agoraphobia often include?

1. support groups

2. Home-based self help programs

Explain how support groups are used in treating agoraphobia.

Small number of people with agoraphobia do group exposure sessions for several hours and eventually coax each other to venture out on their own.

Explain how home-based self-help programs are used in treating agoraphobia.

Clinicians give clients and their families detailed instructions for carrying out exposure treatments.

What is Excerptive Exposure Therapy? What does it target?

Targets agoraphobia. Exposes them to the feared situations that tend to evoke panic attacks (doesn't target panic attacks)

What is Introceptive Exposure Therapy? What does it target?

Targets panic attacks; because panic disorder may lead to the development of agoraphobia, it can be involved in treating patients with agoraphobia. Corrects interpretations of bodily sensations. Educated on panic attack, different causes of sensations, and distraction (relaxation training)