SPECIFIC PHOBIAS

anxiety disorder

criteria

• 1. Intense fear of some object or situation

• 2. Avoidance of the phobic stimulus

• 3. Symptoms persist for at least 6 months

• 4. Fear causes significant distress of impairment

subcategories

• 1. Injury or blood – includes injections, fear of dentist

• 2. Situations – riding an elevator, getting on an airplane, driving car on bridges

• 3. Animals – spiders, dogs, bears, cats etc. (most common)

• 4. Natural environment – heights, water (drowning), caves (claustrophobia)

behavioral factors

true alarm (direct experience - avoidance conditioning), false alarm, vicarious learning, information transmission

true alarm (direct experience - avoidance conditioning)

• Little Albert – conditioned to fear all things white and furry

• Mowrer’s two-factor theory:

  • 1. Fear established via classical conditioning

  • 2. Avoidance maintained via operant conditioning

• Problem: Little Albert was hard to replicate

  • 50-70% of phobics did not have a ____ that caused the phobia 

• Preparedness – Mineka research 

  • Certain things should be easy to make someone fear an object, and yet its difficult to condition someone to fear the objects

  • Lack of evolutionary fear

• ____ may not lead to phobia

• Fears acquired more easily via conditioning for some with anxiety

false alarm

• An unexpected panic attack in a specific situation may cause a phobia

• Panic attack may be caused by stressor

• Munjack’s study – people with phobias of driving

  • Half said it was because of a true alarm

  • Others said it was a ____; panic attack while driving

vicarious learning (modeling)

• Phobic response may be learned by watching reactions of others and imitating then

• Ex: kid sees someone else be afraid of the dog, so are they

• Ornithophobia – movie “The Birds” in the 60s made people afraid of birds attacking them

• Selachophobia – movie “Jaws” in the 70s made people afraid of sharks

information transmission

• It's possible that just being warned repeatedly about a potential anger is sufficient 

• Ex: mom who watched “Jaws” and is afraid to go in the water and warns her kids who are now afraid of the water

• Example of woman with snake phobia and wore rubber boots

genetic factors

• Research shows anywhere from 28-31% of the first degree relatives of people with a specific phobia also have a phobia

• Relatives were likely to have very identical phobias

• Ex: someone with a dog phobia had a relative with an animal phobia

• Difficult separating genes from environment; modeling

• Blood-injection phobia highly heritable

  • 3-4% of population

  • Disgust and fear of blood or needles

  • Looked at 25 patients with BIP; found that 64% of them had at least one first degree relative with this same phobia

  • Important of vasovagal response – inheriting response that causes them to have a significant drop in blood pressure

    • Increases chances in fainting; only with blood or needles

systematic desensitization

• Developed by Joseph Wolpe (1958)

• Premise: you cannot be both anxious and relaxed at the same time

• Three steps:

  • 1. Learning relaxation strategies 

    • Progressive muscle relaxation

    • Imagery techniques 

  • 2. Creating an anxiety hierarchy – different levels of fear

    • Order stimuli from least to most anxiety producing

    • Ex: looking up at the Empire State Building (least) vs. looking down from the top of it

  • 3. Exposure to feared stimulus

    • Can be imagined or real (“in vivo”)

    • Virtual reality has made these situations helpful

    • Begin with least anxiety producing stimuli, take SUDS level (subjective unit of discomfort)

    • Bring SUDS level down with relaxation

    • Move to next item on hierarchy

• Procedure is really a form of counterconditioning

  • UCS (elevator) → UCR (fear)

  • CS (elevator) → CR (relation)

  • Extinction = anxiety should become weaker if elevator is paired with relaxation and success getting to desired floor

  • Avoidance prevents extinction 

  • Extinction is not forgetting

modeling

a person is exposed to a video model or live model who interacts with feared object

flooding

expose person to the feared stimulus all at once

drug therapy

• benzodiazepine or SSRIs; generally not that affective