Phobias

• What is a phobia?

  An extreme irrational fear that is disproportionate to the actual danger and leads to avoidance of behaviour. The fear is maladaptive so causes personal distress and may disrupt everyday life.
• Mowrer's two process model; 1. A phobia is first aquired through classical conditioning 2. Once a phobia has been aquired it is maintained through operant conditioning - A behaviour that is reinforced is more likely to be repeated and since a phobic response is unpleasant, escaping the object or situation causes a reduction in fear (negative reinforcement)
• Strengths of Mowrer's two process model; - Has real life applications. It can both explain how a phobia is developed and maintained which means that it can be used to explain how to remove a phobia - Supported by research. Di Nardo suggests that around 50% of people with a fear of dogs relate their fear to a frightening experience with a dog
• Limitations of Mowrer's two-process model; - How do we explain the other 50% of people from Di Nardo's research - Some people have phobias of things that they have never come into contact with (eg. sharks, snakes etc.) - Biological preparedness - We are innately prepared to fear some things more than others. Biological preparedness suggests that the two-process model is reductionist, as it shows that there is more to acquiring phobias than just simple conditioning - Maintenance due to negative reinforcement may be oversimplified as behaviours can change due to positive feelings too (eg. being with someone you trust in a scary situation) - The model does not apply to all phobias (eg. arachnophobia is more likely to be explained by modelling) - Does not consider SLT (modelling and vicarious reinforcement) - Does not consider cognitive aspects. It is generally oriented towards explaining behaviour rather than the cognition (thinking) behind it
• Systematic desensitisation; - Based on classical conditioning - It is based on the idea that two conflicting emotions cannot occur at the same time 1. Relaxation training - Breathing techniques and meditation 2. Anxiety hierarchy - Rank situations from the least to the most frightening 3. Gradual exposure - Gradual using hierarchy. We only move onto the next stage when the subject is completely relaxed
• Study for systematic desensitisation by Lang & Lazovik; Procedure: - A controlled experiment was done to assess the effectiveness of desensitisation as a treatment for people with a phobia of snakes - People with a phobia of snakes were divided into two groups; Group 1 received systematic desensitisation therapy for their phobia. Group 2 received no therapy (control group) Results: - Group 1 showed less fear of snakes after receiving the therapy than the control group - The same people were followed up after 6 months and those in group 1 still showed a reduced fear of snakes in comparison to the control group Conclusion: - Desensitisation therapy has both an immediate and long-term effect in reducing fear associated with specific phobias, such as fear of snakes
• Strengths of systematic desensitisation; - There is supporting evidence. Gilroy used it for arachnophobia and at 3 and 33 months the SD group was less fearful than the control - Suitable for a diverse range of people (flooding is not suitable for those with learning difficulties) - SD is preferred due to the less traumatic experience when compared to flooding - Has pleasant elements therefore it has less refusal and attrition rates - Patients are more active in their treatments
• Limitations of systematic desensitisation; - May not generalise beyond the clinical setting as people may be exposed to the phobia without warning in the real world - SD is most effective for a clear objective or situation (eg. spiders) but is not as effective when a phobia is not specific (eg. social phobia) - The end goal is not clear and therefore is only effective in some circumstances - Not appropriate for all phobias. May not be effective for evolutionary survival components - Deals with the issue and not the cause - Psychodynamic - may displace fear onto something else
• Flooding; - Immediate exposure without the opportunity of avoidance - Patient learns to be relaxed with their phobia after exhaustion 1. Immediate exposure causes anxiety 2. Patient is prevented from avoiding it 3. After a few hours the patient creates a new association of exhaustion with the phobia
• Strengths of flooding: - Effective treatment for phobias if consent is given - Evidence found 80% are effectively "cured"" after one session - It is quick and cost effective"
• Limitations of flooding: - Less effective for some types of phobia (eg. social phobia) and this could be due to cognitive aspects that aren't being treated and therefore it may only be effective for some phobias (eg. arachnophobia) - Highly traumatic experience. It is not unethical as patients have given consent, however, alot of patients do not see the treatment to the end. Therefore it is not effective as time and money is wasted - May not deal with underlying issues - Psychodynamic approach suggests that phobias are when fear is displaced. If the fear is not treated then the phobia could be displaced again
• Characteristics of phobias; Behavioural: 1. Avoidance - Considerable effort to avoid coming into contact with the phobic stimulus 2. Freeze - People may freeze and become stuck to the spot when facing their phobia. It is an adaptive response which makes a predator think they are dead Emotional: 1. Fear - Fear that is persistent, excessive and unreasonable to the "threat"" posed. It is the immediate experience when the sufferer encounters or thinks about the phobic stimulus. Fear leads to anxiety 2. Anxiety & panic - Feeling of anxiety or panic, increased heart rate etc. It could lead to behaviours such as crying, screaming or running away from the phobic stimulus. This response is widely disproportionate to the threat posed Cognitive: 1. Selective attention (hypervigilance) - Hard to look away from the phobic stimulus 2. Irrational beliefs - They are aware that their beliefs are irrational"