phobia

• what is phobia?

  a phobia is an irrational fear of an object or situation. It is characterised by excessive fear and anxiety, but the extent of the fear is out of proportion to the level of threat/danger it presents.
• how does DSM-5 categorises phobia?

  o Specific phobia: a phobia of an object (e.g. animal, body part) or a situation (e.g. flying, having an injection).

  o Social anxiety (social phobia): a phobia of a social situation (e.g. public speaking, using a public toilet).

  o Agoraphobia: a phobia of being outside or in a public place.
• explain the behavioural characteristics of phobia

  a typical response is to feel high levels of anxiety.

  panic behaviours may include: running away, crying, screaming. Children may react in other ways (e.g. freezing, clinging, tantrums).

  some people may avoid their phobia, which can impact their social lives. Others will have to endure their phobias in certain cases which will be very anxiety-inducing.
• explain the emotional characteristic of phobia

  it involves emotional responses like fear, making it difficult for the sufferer to experience positive emotion. e.g. a person with social anxiety will be more aware of themselves when in public and required to speak publicly the person may experience anxiety attacks or panic attacks

  Emotional responses are beyond what might be considered reasonable
• explain cognitive characteristic of phobia

  People with phobias process the phobic stimulus differently to how they process other objects or situations.

  They often pay selective attention to the stimulus. Paying attention to a threat would increase chance of survival, but not when the threat is irrational.

  People with certain phobias may have irrational beliefs, e.g. someone with a social phobia might think “I must always sound intelligent”. They may experience cognitive distortions meaning they perceive stimulus differently to how others perceive it
• who proposed the 2-process model of phobia?


  Mowrer in 1960
• what did Mowrer say about phobias?


  Phobias are acquired by classical conditioning but continue because of operant conditioning as responses acquired by classical conditioning naturally fade away. however, phobias are long lasting.
• types of operant conditioning


  >Negative reinforcement- the person avoids the situation they find unpleasant, this removes the unpleasant stimulus from their life and results in them being more likely to avoid it again in the future.

  >Positive reinforcement- giving reward for a behaviour that is desirable, therefore increasing the likelihood of that they will repeat it again in the future.

  >Punishment- by forcing the phobia, the person feels panicky and anxious. This is a negative consequence of their decision, which will result in them being less likely to repeat this behaviour.
• describe generalisation in relation to phobia

  Phobia generalises to other similar objects OR when objects similar to the conditioned stimulus also elicit the conditioned response.
• describe how little alberts fear of white rats was generalised to other fur things.


  Little albert was placed in a room and a rat (NS) was released to the room where he was and he had no response to the rat. Then the rat was released again but this time with the bang of a hammer(UCS) this made albert scared (UCR). Every time the rat as released into the room, the bang of a hammer will be heard this made albert associate the rat with the bang (CR). The white was then the conditioned stimulus and every time albert saw the rat (CS) he was scared of it because he associated with the bang (CR).
• Does conditioning explain all phobic behaviours? evaluation


  Conditioning explains all phobic behaviours. Bouton (2007) points out that evolutionary factors pro-Agoraphobia is public anxiety towards leaving the home environment. This can prevent the sufferer going about their normal daily life.
• one weakness of the 2-process model


  The 2-way process model suggests that avoidance is motivated by anxiety reduction, however, in some phobias like agoraphobia (fear of being unsafe in places/ situations) the avoidance may be motivated by a positive feeling of safety, which can explain why some can leave their house with a trusted person and feel relatively little anxiety compared to leaving their house alone (Buck, 2010).
• strength of behavioural approach to explaining phobia


  Good explanatory power- proposed in 1960 and at the time it provided a good explanation and had relevant implications for therapy (e.g. exposure to stimulus helps treat it by preventing reinforcement).
• what is SD as a behavioural approach to treating phobia?


  Systematic desensitisation is a behavioural therapy which aims to reduce anxiety stimulus by working through a hierarchy of anxiety-inducing scenarios and teaching the patient to relax between each scenario. Its work is based on classical conditioning (learning through association).

  it works through counterconditioning where we learn new response to stimulus
• state the 3 critical component to systematic desensitisation


  Fear hierarchy - client and therapist rank phobic situation from least to most terrifying.

  Relaxation training - an individual is taught relaxation techniques, such as breathing techniques, progressive muscle relaxation strategies, or mental imagery techniques.

  Reciprocal inhibition - the person is unable to feel anxious and relaxed at same time so relaxation takes over the fear
• RECIPROCAL INHIBITION THEORY


  The final component of systematic desensitisation involves exposing the patient to their phobic situation, while relaxed. According to systematic desensitisation, two emotional states cannot exist at the same time.
• Is there research evidence for systematic desensitisation?


  research evidence that demonstrates the effectiveness of this treatment for phobias. McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation. This was particularly true when using in vivo techniques in which the patient came into direct contact with the feared stimulus rather than simply imagining (in vitro). This shows that systematic desensitisation is effective when treating specific phobias, especially when using in vivo techniques.
• is there support for SD?


  Further support comes from Gilroy et al. (2002) who examined 42 patients with arachnophobia (fear of spiders). Each patient was treated using three 45‐minute systematic desensitisation sessions. When examined three months and 33 months later, the systematic desensitisation group were less fearful than a control group (who were only taught relaxation techniques). This provides further support for systematic desensitisation as an effective treatment for phobias in the long‐term.
• Is systematic desensitisation(SD) effective in treating phobia?

  Systematic desensitisation is not effective in treating all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning), such as a fear of snakes, are not effectively treated using SD. Some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning. This highlights a limitation of systematic desensitisation, which is ineffective in treating evolutionary phobias which have an innate basis.
• Explain flooding as a behavioural approach to treating phobia

  Flooding is a behavioural therapy which, rather than exposing a person to their phobic stimulus gradually, exposes the individual to the anxiety‐inducing stimulus immediately. Sessions typically last 2-3 hours but sometimes only 1 session is needed to completely cure the phobia
• How does flooding work?

  Flooding works by preventing avoidance behaviours, so the patient quickly learns that the phobic stimulus is harmless. In classical conditioning, this is ‘extinction’ because the learned response in unlearned when the CS is encounters without the UCS.
• Are there any ethical concerns of flooding?


  Flooding is NOT unethical, but it is very important to gain the patient’s full informed consent and they can choose SD as an alternative.
• Is flooding cost-effective?

  it provides a cost‐effective treatment for phobias. Research has suggested that flooding is equally effective to other treatments, including systematic desensitisation and cognition therapies (Ougrin, 2011), but takes much less time in achieving these positive results. This is a strength of the treatment because patients cure their phobias more quickly and it is therefore more cost‐effective for health service providers who do not have to fund longer options.
• Can flooding be traumatic for patients?


  it can be highly traumatic for patients since it purposefully elicits a high level of anxiety. Wolpe (1969) recalled a case with a patient becoming so intensely anxious that she required hospitalisation. Although it is not unethical as patients provide fully informed consent, many do not complete their treatment because the experience is too stressful. Therefore, initiating flooding treatment is sometimes a waste of time and money if patients do not engage in or complete the full course of their treatment.
• Does symptom substitution affect flooding?


  An issue for behavioural therapies such as flooding and systematic desensitisation is symptom substitution. This means that although one phobia may be successfully removed through counterconditioning another may appear in its place. If symptoms are treated and removed, the underlying cause may remain and simply resurface under a new guise. Research in this area is mixed, however, and heavily disputed by behaviourists.