Phobias

• What is a Phobia?

  an 'anxiety disorder' characterised by uncontrollable, extreme, irrational and enduring fear and involve anxiety levels that are out of proportion to any actual risk, this anxiety interferes with everyday living.

  DSM's phobia categories:

  • Specific - phobia of specific objects or situation
  • Social anxiety - phobia of a social situation
  • Agoraphobia - phobia of being outside because you don't want to leave a place that you think is safe
• Behavioural, Emotional and Cognitive characteristics of Phobias

  Behavioural - Panic e.g screaming, crying

  - Avoidance, considerable effort to avoid contact with the phobic stimulus

  Emotional - Fear, leads to anxiety

  - Responses are unreasonable, resonse is unproportional to risk posed

  Cognitive - Selective attention, hard to look away from the stimulus

  - Irrational beliefs
• Two Process Model

  1. Acquisition by CC - learn to associate something we have no fear of (Neutral Stimulus) with something that already triggers a fear response (unconditioned stimulus). This fear is then generalised
  2. Maintenance by OC - avoids phobic stimulus so escapes the anxiety they would've experienced. This reduction in fear, negatively reinforces the avoidance and the phobia is maintained.
• Evaluation of Two process model

  + Supporting evdience - Little Albert. Whenever Albert reached for the white rat a metal bar was struck. When the rat (NS) and the loud noise (UCS) were paired, they become associated and now produces a CR. By the third trial Albert showed fear whenever he saw the rat, which was now a CS and his fear was a CR. This study provides evidence that you can acquire a fear through CC

  X Don't all follow a trauma - e.g few snake phobics have encountered venomous snakes. This would suggest that the model can't explain all phobias so is an incomplete explanation
• Treating Phobias - Systematic Desensitisation

  Based on CC and the idea that two conflicting emotions (fear and relaxation) can't occur at once (reciprocal inhibition). 3 key aspects to this technique:

  1. Relaxation
  2. Anxiety Hierarchy - list of situations related to the phobic stimulus that provoke anxiety in order
  3. Gradual exposure to the stimulus

  The patient is gradually exposed to the stimulus under relaxed conditions until anxiety in extinguished. They overcome their anxiety by learning to relax in the presence of the stimuli
• Evaluation of Systematic Desensitisation

  + Effective - Gilroy followed 42 patients who had SD for spider phobia. At noth 3 and 33 months, the SD group were less fearful than a control group. This is a strength because it shows that SD is helpful in reducing anxiety and the effects are long lasting

  X Therapy may not generalise to beyond clinical setting - the stimulus could be exposed without warning and without the support of the therapist, they may quickly regress back to original state. This is a weakness of SD because it suggests that it may not have long-term benefits
• Treating Phobias - Flooding

  Immediate exposure to the stimulus by bombarding. No option for avoidance so patient quickly learns that its harmless throughout the exhaustion of their fear response (extinction), this is based on the assumption that the body only has limited energy. Steps involved are:

  1. Patient exposed to stimuli causing anxiety
  2. Patient is initially fearful but subsides after a while
  3. Recognises anxiety levels have dropped, the SR of fear is replaced with relaxation
• Evaluation of Flooding

  + Cost effective - as effective as other methods and quicker, this is a strength as it means that patients are free if their symptoms quicker and makes treatment cheaper

  X Traumatic - patients give their consent but are often unwilling to see it through to end (low attrition rates). This is a limitation because time and money are wasted if they don't continue