Phobias

What is a phobia? AO1

An anxiety disorder that causes irrational fear & a conscious avoidance of the feared object/situation

What are the behavioural characteristics? AO1

• Panic eg crying, screaming, heavy breathing

• Avoidance of phobic situation

• Endurance eg in the presence of phobia but experiences high anxiety like flying

What are the emotional characteristics? AO1

• Anxiety

• Persistent fear that goes beyond what’s reasonable

What are the cognitive characteristics? AO1

• Selective attention - focusing on phobic stimulus even though it causes anxiety

• Irrational beliefs

• Cognitive distortions - inaccurate perception of phobic stimulus

What is the behavioural approach’s explanation? AO1

Two process model - acquired via classical conditioning and maintained via operant conditioning

Phobia acquisition AO1

• Classical conditioning

• Watson & Rayner conditioned Little Albert to fear white rats

• NS (rat) —> no response

• UCS (loud noise) —> UCR (fear)

• UCS (loud noise) + NS (rat) —> UCR (fear)

• CS (rat) —> CR (fear)

• Phobia can be generalised to similar objects eg cotton balls

Phobia maintenance AO1

• Operant conditioning

• Avoiding phobic situations causes anxiety levels to drop

• By avoiding unpleasant consequence, the avoidance behaviour is negatively reinforced and likely to be repeated again

Explanation strengths AO3

• P - effective treatments eg SD & flooding

• E - SD uses principles of CC to help people unlearn their conditioned fear responses & flooding uses principles of OC to stop negative reinforcement of phobic avoidance

• T - very successful in treating phobias & social & economic benefits

Explanation limitations AO3

• P - ignores evolutionary explanations

• E - Seligman argues that humans have an innate disposition to fear stimuli that proposed a threat to survival in evolutionary past eg snakes/heights. Phobias aid survival & reproduction, evolutionary advantage.

• T - may be reductionist as ignores these factors & focuses on classical/operant conditioning. Limited explanation

• P - overemphasis on learning

• E - believes that phobia are acquired via classical conditioning where a fear response is learned. However, doesn’t explain phobias that have no prior experiences/negative experiences Eg a person may have a phobia of snakes although the fact they’ve never encountered - impossible to CC a fear response to a stimulus that hasn’t been encountered

• T - reductionist & not a full explanation of phobia accquistition as must be other factors involved eg biological

• P - Buck suggested that safety is a greater motivator for avoidance behaviour, rather just avoiding phobias

• E - social phobias sufferers can venture out into public but only with a trusted friend, despite still being exposed to hundreds of strangers which would usually trigger their anxiety.

• T - Mowrer’s explanation of phobias may be incomplete and only suited for some.

Systematic desensitisation AO1

• Gradual exposure to phobic stimulus

• Uses principles of CC that what has been learned can be unlearned (counter-conditioning)

• We can’t be afraid & relaxed at the same time - if we stay relaxed in presence of phobia we won’t fear it (reciprocal inhibition)

Systematic desensitisation steps AO1

1. Patient taught how to relax completely eg breathing exercises, mental imagery processes or relaxation drugs eg Valium

2. Patient & therapist create hierarchy of fear (phobic situations ranked least to worst)

3. Patient works their way up through the hierarchy, only progressing to the next level when they have remained calm in the present level

4. Phobia is cured when the patient can remain calm at the highest anxiety level

SD strengths AO3

• P - research to support

• E - Bronson & Thorpe (2006) used a 1 hour SD programme on technophobes. After a 10 month follow up, their anxiety levels were significantly lower than control group who had no SD

• T - SD is effective & can produce long lasting improvements, even with short sessions, making it accessible & cost effective.

• P - suitable for many patients

• E - less overwhelming & traumatic for patients as it’s a gradual process compared to flooding. Has low attrition rates due to less stressful nature as patients more encouraged to continue & suitable for children. Also, anxiety disorders are often accompanied with learning disabilities so patients may not be able to make the full cognitive commitment associated with CBT or have the ability to evaluate their own thoughts

• T - method is accessible for many patients, increasing real world applicability & effectiveness.

• HOWEVER time consuming as. requires several sessions over several weeks which can be inconvenient for patients with busy schedules - can increase attrition rates. Some patients may prefer a single, intensive session of flooding

SD limitations AO3

• P - not effective for all phobias

• E - works best for simple, specific phobias (eg spiders/heights) as fears involved a clear stimulus that can be gradually overcame. More complex phobias like social phobias involved cognitive aspects which SD doesn’t account for - CBT seen more effective as it focuses on cognition causes rather than behavioural responses

• T - limits generalisability as not a universal treatment for all phobias

• P - treats symptoms but not underlying cause

• E - focuses on reducing behavioural symptoms (eg panic & avoidance) by gradually exposing patient to phobic stimuluses. Doesn’t treat underlying causes eg irrational beliefs or traumatic experiences, causing symptoms to quickly return

• T - not a permanent solution & more of a band aid. May need to be combined with other treatments eg CBT for long term effectiveness

Flooding AO1

• Direct exposure to phobic stimulus/situation

• Exposure is repeated to show client that there’s no basis for their fear

• No gradual build up like SD & patient must sign consent form

• Successful when extinction of the fear (no longer a conditioned response)

Flooding strengths AO3

• P - cost effective treatment

• E - phobias extinction can occur with one session as it’s a direct exposure, making it very cost effective for both patient & health care services. Very convenient for patients with busy schedules who can’t undergo the several weekly sessions or SD

• T - cost & time effective treatment & economic benefits as people don't have to take loads off time off work

Flooding limitations AO3

• P - doesn’t work for all phobias eg social phobias

• E - social phobias may have cognitive aspects which flooding doesn’t acknowledge

• T - reductionist as ignores cognitive aspects & may be less effective than CBT

• P - extremely traumatic

• E - involves an immediate, direct exposure to stimulus - not gradual like SD. Can provoke extreme anxiety & be very overwhelming, leading to high attrition rates which reduces overall effectiveness. Not suitable for all patients eg elderly, children & patients with health conditions. Therapists must gain fully informed consent & screen patients to check they can tolerate the process

• T - practical applicability is limited as not suitable for everyone - SD may be more suited