Phobias

• Definition of phobias?

  • They are a type of anxiety disorder so their main symptom is of course extreme anxiety.
  • Phobias are irrational fears that produce a conscious avoidance of an object.
• Different types of phobias?

  • Specific phobias (simple phobias): snakes, spiders etc
  • Agoraphobia (agora - a place of assembly or marketplace) - fear of being out in public place with no escape
  • Social phobias - Fear of talking to a group of people and interacting in social situations
• Behavioural characteristics of phobias?

  • The person affected by the phobia will avoid the object of the fear and react with a freeze or faint response to it
  • This was used for making a predator think we were dead.
  • Avoiding the source of fear can lead to disruptions such as being able to go to work, having an active social life.
  • This shows how it is different from everyday fears that do not have an impact on our life.
• Cognitive characteristics of phobias?

  •  The phobic will have an irrational thought process, they will be resistant to rational arguments like fear of flying where it is the safest form of transport statistically.
  • Person recognises their irrationality and this is the difference between delusion and a phobia
• What is a two-process model for the phobias?

  • First stage: Classical conditioning (association)- Initiation
  • Second stage: Operant conditioning (reward) - Maintenance
• What is classical conditioning (association) - initiation? (Watson and Rayner)

  • This can be seen in the case study of Little Albert, who learnt to scared of a white rat which he associated with fear.
  • A white rat was presented to Little Albert who showed no fear and was happy to play with the rat, who was the neutral stimulus, with no response. 
  • The rat was paired with loud noise, which was the unconditioned stimulus, which caused the crying
  • The baby cried at the presence of the rat, it became the conditioned stimulus and Albert cried in its presence, which was the conditioned response. 
• Definition of operant conditioning (reward) - maintenance?

  • This explains why the fear continues and why people avoid the feared object:
  • Rewards reinforce behaviour.
  • Avoiding the fear will reduce fear, which is rewarding, so the person will repeat the behaviour and avoid the object.
  • This is known as negative reinforcement - someone who is nervous of open spaces will avoid going out. 
  • Reducing fear reinforces behaviour so for example, avoidance of going out will reinforce agoraphobia
• Positive evaluation regarding supporting evidence?

  • It is based on scientific lab experiments that have found support for the behaviourist approach.
  • For example, Pavlov and Skinner’s rats.
  • This adds validity that phobias can be learnt.
  • This viewpoint of Little Albert can also support this as he learnt his phobia through classical conditioning. 
• Positive evaluation of treatments for phobias?

  • It has led to effective treatments by unlearning behaviours.
  • For example, systematic desensitisation involves exposure to the phobia to break the association.
  • Systematic desensitisation has a 75% success rate demonstrating an important real life application to his model.
• Negative evaluation for phobias regarding reductionism?


  • It reduces phobias to learnt behaviours
  • There are processes that can explain phobias
  • Modelling can explain why people are scared of spiders
  • Another example is the evolutionary theory which says we make associations between fear and life-ending stimuli
  • This helped our ancestors survive as it would have been adaptive in the EEA against spiders, heights and other things
  • Evolutionary theory explains we don't develop phobias of modern objects
  • Infants aged 8-16 months failed to learn a phobia of building blocks with loud bells, suggesting fear responses are learnt through living animals
• Negative evaluation regarding phobias for determinism?

  • It says that people have no control over their phobias and it is determined by the environment.
  • It says that learnt association WILL cause phobias but it may not always.
• What is the conclusion of phobias?

  • In conclusion, the diathesis-stress model proposes that we have a genetic predisposition for developing mental disorders such as phobias (the diathesis).
  • But a disorder will not only develop if there is an environmental trigger.
  • This explains why not everyone who is bitten by a dog develops a phobia as they must have already had a genetic predisposition to it.
• Behavioural treatments for phobias?

  Treatments allow patients to unlearn negative associations by replacing them through a process of relaxation - counter conditioning.
• What is systematic desensitisation?

  • The individual constructs an anxiety hierarchy consists of situations linked to their phobias.
  • These situations are ordered from least to most anxiety provoking.
  • Relaxation training as the aim with breathing exercises or muscle relaxation
  • The patient is asked to imagine the scene at the bottom of the hierarchy and relax at the same time.
  • When they feel relaxed, they go up hierarchy and this is known as graded pairings with real or imagined stimulus
  • Graded pairing is always effective and longer lasting than the imagined technique 
• Positive evaluation for SD regarding high success rate?

  • 75% for specific phobias and 90% for blood-injection phobias after 5 sessions of graded exposure.
  • This treatment is most successful when real stimuli are used.
  • The SD can be a very effective treatment for phobias
• Positive evaluation of SD regarding no ethical issues?

  • A strength of SD is that the patient does not have to experience intense anxiety as they are in control.
  • They only move up the anxiety hierarchy when they feel relaxed to do so.
  • No ethical problems with this use of the treatment.
• Positive evaluation of SD regarding it's effectiveness to other treatments?

  
  

  • It is fast and requires less effort from the patient relative to other treatments like CBT where patients comprehend their thinking and restructure thoughts to change behaviours.
  • Lack of thinking in SD means it can be successful with children and adults with learning difficulties.
  • It can be used as a treatment for most patients
• Negative evaluation of SD for lack of reality?

  • A weakness of this is that behaviour learnt under one set of conditions does not always generalise to another.
  • It is very different facing fear alone when you have had the safety of a therapist beside you so SD may not be appropriate for all phobias.
• What is flooding?

  • This therapy involves exposure to the stimulus. Flooding experiences one long session with the phobia at its worst.
  • They still do practice relaxation during the session until the anxiety disappears.
  • Fear response has a time limit.
  • As adrenaline decreases, there is a new link between the stimulus and a response where relaxation replaces anxiety.
• Limited use of flooding treatment evaluation?

  • Choy et al (2007) reported both were effective but flooding was more so.
  • However, while flooding may be good for simple phobias, it may not be good for social or agoraphobia.
  • This is due to some of the community thinking that social phobias are not caused by anxious experiences but rather due to irrational thinking.
  • These complex phobias cannot be treated by behaviourist treatments but rather by CBT, treating irrational thinking
• Positive evaluation for speed of flooding?

  • Flooding is a quick treatment relative to CBT and SD.
  • It only takes a single session of about 2-3 hours compared to SD which may take several session due to graduated exposure and multiple sessions to this stimulus
• Ethical issues for flooding?

  • Flooding can cause traumatic experiences for the patient.
  • The patient is exposed to extreme anxiety compared with SD where they have choices to move up to graded exposure of their fears.
• Negative exposure evaluation for flooding?

  • Quitting during the exposure of their stimuli can have consequences for the patient.
  • The patient can have reduced effective treatment or have increased phobia due to quitting at the height of their anxiety.
  • The negative reinforcement not being broken reinforces the fear.
• General evaluation for systematic sensitisation and flooding?

  
  

  • It only treats the symptoms and not the cause.
  • Removing the symptoms means there is still the cause of the phobia, which can make the symptoms re-emerge at a later time.
  • The psychodynamic approach may be a way of explaining it as being based on projection.
  • Sigmund Freud has a case called “Little Hans” where he had a phobia of horses but his main cause was due to his intense envy of his father.
  • This went away when he accepted the feelings, had the therapist not treated the horse, the problem may have resurfaced elsewhere.
• Emotional characteristics?

  • Includes the feeling of excessive and persistent fear as well as anxiety.
  • These are caused by the presence or thought of an object. The feelings of anxiety are out of proportion.