Phobias

• What is a Phobia?


  An exaggerated fear of an object or situation
• What is a specific phobia?


  An excessive or irrational fear of a specific object, situation, or activity e.g flying or having an injection
• What is a social phobia?


  Phobia of social situations such as public speaking or using a public toilet
• What is agoraphobia?


  Phobia of being outside or in a public place
• What are the 3 categories of Phobias?

  1. Specific phobias
  2. Social phobias
  3. Agoraphobia
• What are the behavioural characteristics of Phobias?

  • Panic - screaming, crying or running away
  • Avoidance - makes like very difficult e.g may not go to visit friends
  • Endurance - Choosing to remain near the phobic stimulus e.g when there is a spider you stay in the room to see where it is
• What are the emotional characteristics of Phobias?

  • Anxiety - the emotional response to fear, an unpleasant state of high arousal and can be long term
  • Fear - the immediate and extremely unpleasant response we experience when we encounter the phobic stimulus. More intense but experienced for shorter periods
  • Emotional response is unreasonable - The fear is much greater than the actual threat the phobia actually causes
• What are the cognitive characteristics of Phobias?

  • Selective attention to phobic stimulus - hard to look away from phobic stimulus (innate) but is not so useful when the fear is irrational
  • Irrational beliefs - added pressure increases the pressure to perform in social situations and can increase anxiety
  • Cognitive distortions - perceptions of a person with a phobia may be inaccurate and unrealistic
• What is the two process model?


  Looks at how phobias originally occur through classical conditioning and are maintained through operant conditioning
• How does the maintenance of the phobia occur?


  Operant conditioning maintains our phobia through negative reinforcement where we avoid an unpleasant situation (facing our phobia) and we then repeat this behaviour continuing our fear
• In terms of phobias how can generalisation happen?


  If you have a phobia of something it can broaden to other similar objects. For example, being afraid of ducks you may be scared of other birds such as chickens as well
• Behavioural Approach to phobias AO3: Real World Application

  • Two process model has real world application in systematic desensitisation
  • Phobias are maintained through avoiding the phobic stimulus so once the avoidance behaviour is gone the phobia will also be gone
  • The two process model is helpful in treating phobias
• Behavioural Approach to phobias AO3: Ignores cognitive aspects of phobias

  • Two process focuses on explaining behaviour
  • Phobias are not only avoidance responses but have a cognitive component
  • Irrational beliefs play a big part in phobias
  • Two process model does not completely explain the symptoms of phobias
• Behavioural Approach to phobias AO3: Ignores the evolutionary explanation

  • Some argue we have a biological preparedness so we know to be afraid things that present a danger e.g snakes
  • Two process model cannot solely explain the existence of all phobias
• Behavioural Approach to phobias AO3: Not all phobias need a bad experience

  • Some phobias occur and do not need a bad experience to occur
  • Some people do not even come across their phobia
  • Not all frightening experiences lead to phobias
  • Behavioural theories lack a full explanation for phobias
• What are the 2 ways in which we can treat phobias?

  1. Systematic Desensitisation
  2. Flooding
• What is systematic desensitisation?

  • A behavioural therapy based on classical conditioning
  • Patients are slowly exposed to the phobia
• What are the 3 main processes in Systematic Desensitisation?

  1. The anxiety hierarchy
  2. Relaxation techniques
  3. Exposure
• What is reciprocal inhibition?


  Two opposite emotions cannot exist at the same time. Fear and relaxation cannot happen at the same time
• What is the anxiety hierarchy? 


  Creating a hierarchy with steps the patients must overcome going from the least frightening to the most frightening
• What are relaxation technique?

  1. Breathing exercises
  2. Meditation
  3. Relaxation drugs such as Valium
• What is Exposure?

  • Whilst in a relaxed state the patient overcomes the steps in the hierarchy until they reach the top
  • Patients can overcome their fear in 10-12 sessions
• What is In Vivo?

  When the patient has to relax whilst directly dealing with their phobia e.g if someone is scared of dogs they must be in a room with a dog
• What is In Vitro?


  When patient has to visualise their phobia in their head
• Systematic desensitisation AO3: Research of effectiveness

  • Research involved students with snakes which involved 11 sessions of SD
  • Ratings of fear reduced
  • Effects lasted even after 6 months showing it may be long term
• Systematic desensitisation AO3: Helpful for people with learning disabilities

  • Some people requiring treatment for phobias also have a learning disability
  • The main alternatives to SD are not suitable as people with learning disabilities often struggle with cognitive therapies that require complex rational thought
  • They may also feel confused and distressed by the traumatic experience of flooding so SD is the most appropriate for people with learning disabilities who have phobias
• Systematic desensitisation AO3: Virtual reality

  • Traditional SD involves exposure to the phobic stimulus in a real world setting
  • There are advantages to conducting the exposure part of SD in virtual reality
  • It can be used to avoid dangerous situations (e.g. heights) and is cost effective because the psychologist and client don't need to leave the consulting room
  • There is some evidence to suggest that VR exposure may be less effective than real exposure for social phobias because it lacks realism
• What is flooding?


  Involves the immediate exposure to your phobia
• How does flooding work?


  Phobias tend to occur due to avoiding it so flooding ensures the client cannot avoid the phobia and tries to show the phobia is harmless. Association is broken (extinction).
• How long does flooding take?


  Sessions can last 2-3 hours and some patients can be cured in one session
• Ethical Safeguards involved in Flooding

  • Unpleasant experience for patients
  • Must ensure there is full informed consent
• Flooding AO3: Cost Effective

  • Clinical effectiveness means how effective a therapy is at tackling symptoms.
  • When we provide therapies in health systems we need to think about how much they cost and a therapy is cost effective if it is clinically effective and not expensive
  • Flooding can work in as little as one session compared to ten sessions for SD to achieve the same result
  • More people can be treated at the same cost with flooding than with SD or other therapies.
• Flooding AO3: Traumatic

  • It is a highly unpleasant experience as confronting one’s phobic stimulus in an extreme form provokes tremendous anxiety
  • PPs and therapists rated flooding as significantly more stressful than SD which raises the ethical issue for psychologists of knowingly causing stress to their clients, although this is not a serious issue provided they obtain informed consent
  • The traumatic nature of flooding means that dropout rates are higher than for SD
• Flooding AO3: Does not actually get rid of phobias

  • Flooding only masks symptoms and do not tackle the underlying causes of phobias and instead other symptoms arise (symptom substitution)
  • Case of a woman with a phobia of death who was treated using flooding. Her fear of death declined, but her fear of being criticised got worse
  • The only evidence for symptom substitution comes in the form of case studies so it may only generalise to the phobias in the study (phobia of death may be different from a phobia of heights)