Phobias

• Phobias

  A phobia is an anxiety disorder, which interferes with daily living. it is an instance of irrational fear that produces a conscious avoidance of the feared object or situation
• DSM-5

  • Diagnostic and statistical manual of mental health
  • published by the American Psychiatric Association
• 3 main categories: Phobias

  1. Specific phobias: Sufferers are anxious in the presence of a particular stimulus-> most common
  2. Social phobias: Sufferers experience inappropriate anxiety in social situations-> can cause avoidance, usually starts in adolescence
  3. Agro-phobia: Sufferers are anxious when outside or in a public space -> avoid situations, most cases begin in early 20s, least common
• Phobias: Behavioural categories

  • Panic (screaming, running, crying)
  • Avoidance (excessive effort to not be near this object)
  • Endurance (stay with it so you can keep an eye on it)
• Phobias: Emotional categories

  • Anxiety-> unpleasant state of high arousal, makes it harder to feel positive emotions
  • Fear-> immediate unpleasant response, intense and short
  • Unreasonable
• Phobias: Cognitive categories

  • Selective attention to phobia stimulus (if you see it you can't look away, impacts concentration)
  • irrational beliefs
  • Cognitive distortions-> inaccurate mental representation of the object
• Behavioural approach to explaining phobias

  • phobia is learnt through reinforcement and punishment (operant)
  • We can also associate a stimulus with a phobia (classical)
• Classical conditioning diagram for fear

  • UCS (shot) -> UCR (fear)
  • UCS + NS (noise) -> UCR
  • CS (noise) -> CR (fear)
• The Little Albert experiment (Watson and Rayner)


  Albert became scared of fluffy animals due to his classical conditioning as he associated them with the loud noise that scared him
• Generalisation


  The extension of fear responses from a specific trigger to similar stimuli or situations due to past traumatic experiences (fear of rabbits maybe extend to all animals)
• Mowrer (1960): Two process model 


  • Once fear has developed through classical conditioning, it is maintained through operant conditioning
  • Escape (avoidance) reduces anxiety -> NEGATIVE REINFORCEMENT
  • Attention from the phobia -> POSITIVE REINFORCEMENT
• Seligman (1970)


  Evolutionary theory of biological preparedness, the two way process is not a universal explanation
• Behavioural approach to treating phobias 


  Technique 1: Systematic Desentization

  Technique 2: Flooding
• Technique 1: Systematic desensitisation

  • Wolpe developed this technique for the treatment of anxiety-related disorders and phobias
  • Based on the principles of classical conditioning
  • GOAL: Become gradually desensitised to the triggers that are causing distress
• Process of Technique 1: Systematic desensitisation

  1. The Anxiety Hierarchy
  2. Relaxation techniques BEFORE the process (mental imagery etc...)
  3. Exposure
• Technique 2: Flooding 


  Overwhelming the individuals senses with the item or situation that causes anxiety so that the person realises no harm will occur. Individual is exposed repeatedly and in an insensitive way with their phobia
• How does Technique 2: Flooding work?


  • Without the option for avoidance behaviour, patient should learn that the phobia is harmless ->process called extinction
  • A learned response is extinguished as the CS is encountered without the UCS
  • Result: CS no longer produces the CR (fear)
  • Flooding stops the phobia very quickly
• Technique 2: Flooding (ETHICS)

  • It is unpleasant experience and the patient has to be properly prepared
  • HOWEVER: Flooding is not unethical per se as the patient gives their informed consent (they know exactly what is involved)
• Evaluation for Systematic Desensitisation

  STRENGTH

  • Lisa Gilroy (2003)
  • Examined 42 patients with arachnophobia
  • Each patient treated using three 45 minute sessions
  • Longitudinal: examined 3 months and 33 months later, group was less fearful
  • REAL WORLD APPLICATION
  • COUNTER: May not be generilisable to all phobias
• Evaluation for Systematic Desensitisation

  STRENGTH

  • People with learning disabilities
  • Some struggle with cognitive therapy
  • Flooding is often too distressing/confusing
  • More accessible
• Evaluation for Systematic Desensitisation

  LIMITATION

  • Not effective in treating all phobias
  • Some people have innate phobias (not developed through personal experience, classical conditioning)
  • Seligman (1970)-> biological preparedness
  • Evoluntionary theory
• Evaluation for flooding

  STRENGTH

  • Cost effective
  • Ourgin (2011) suggested that flooding is comparable to other treatments largely due to the speed of treatment
  • More cost effective for the NHS
  • Counter: High drop out rates, waste to resources
• Evaluation for flooding

  LIMITATION

  • Highly traumatic
  • Shumacher et al (2015) found that participants and patients rated flooding as significantly more stressful that SD
  • Leads to high drop out rates -> waste of money and time
• Evaluation for flooding

  LIMITATION

  • Issues of behaviourists therapies
  • Doesn't tackle the problem, leading to sympton substitution
  • Persons (1986) reported a case where a woman as treated using flooding for her phobia of death
  • This fear declined but the fear of being criticised increased
  • COUNTER: May only be applicable to this specific patient