phobias

• The DSM-5 criteria for diagnosing phobias says:

  1. Persistent fear that is excessive or unreasonable cued by a specific object or situation
  2. Exposure to the phobic stimulus invariably provokes an immediate anxiety response
  3. The person realises the fear is unreasonable (except in children)
  4. The phobic situation is avoided or endured with intense stress
  5. The avoidance of the phobia interferes with the person’s functioning
  6. If over 18 years - duration > 6 months
• Types of Phobias

  • Specific phobias (animals, events like flying, bodily fluids such as blood, situations)
  • Social phobias (of social situations, public speaking, parties, meeting new people)
  • Agoraphobia (fear of public crowded spaces and leaving one’s home)
• behavioural characteristics of phobias:

  • panic
  • endurance
  • avoidance
• emotional characteristics:

  • intense fear or anxiety
• cognitive characteristics of phobias:

  • selective attention to phobic stimuli
  • irrational beliefs
  • cognitive distortions
• The two process model says that all behaviour is learned. 

  Dual process is based on classical and operant conditioning.
• phobias are the result of a classically conditioned association between an anxiety-provoking unconditioned stimulus (UCS) and a previously neutral stimulus.
• When the individual avoids the phobia, they are avoiding an unpleasant situation (negative reinforcement). This behaviour will result in a desirable consequence as they have avoided the unpleasant feeling (positive reinforcement) and therefore the behaviour will be repeated.
• treating phobias:

  1. systematic desensitisation

  • Reciprocal inhibition - cannot feel fear + relaxation at the same time
  • Therapy aims to swap fear with relaxation
  • therapist and client create an anxiety hierarchy that they work through slowly using relaxation techniques. the client is gradually exposed to the phobic stimuli until the fear response is replaced with relaxation

  This works better for specific phobias and is an effective treatment though can be slow
• treatments of phobias:

  2. flooding

  • Exposes patient to phobic stimulus without relaxation
  • These sessions tend to be longer
  • Sometimes only one session is needed
  • Eliminates avoidance behaviour
  • Realise stimulus is harmless [EXTINCTION]
  • Needs informed consent 
  • Lots of health checks beforehand
• flooding supporting evidence:

  • Solter (2007) case study on 5 month old baby who showed traumatic stress after 3 day hospital stay after surgery
  • Flooding was used and the child was allowed to have a full blown emotional response. Positive outcome as no signs of stress shown after 1 year. This suggests that flooding is an effective technique in removing fears.
  • however this cannot be generalised to the wider population