Phobias

  • Created by: mlmxx
  • Created on: 27-04-18 16:13
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  • Phobias
    • Characteristics
      • Behavioural
        • High levels of anxiety/panic. the phobic person may panic to the presence of the phobic stimulus eg crying, screaming or running away
          • Children may panic in a different way for example. freezing, clinging or having a tantrum.
        • The phobic tends to make a lot of effort to avoid the phobic stimulus making it hard to go about daily life. for example, a man with a phobia of dogs might avoid leaving his house in fear of seeing a dog affecting his education, work and social life.
        • The opposite to avoidance is endurance where a phobic remains in the presence of the phobic stimulus but continues to experience high levels of anxiety,
      • Cognitive
        • People with phobias process information about phobic stimuli differently from other objects or situations.
          • If a sufferer can see the phobic stimulus it is hard for them to look away, they lose concentration
        • irrational beliefs in relation to phobic stimuli. For example, people with social phobias may believe that they have to always sound intelligent and that if they blush people will think theyre weak. This increases pressure on the sufferer to perform well in social situations.
        • Cognitive distortions- the phobic's perception of the phobic stimulus may be distorted for example people with a phobia of snakes will see them as alien or aggressive looking.
      • Emotional
        • Phobias involve an emotional response of anxiety and fear and makes it very difficult to experience positive emotion. Anxiety can be long term however fear is the immediate response when we encounter or think about the phobic stimulus.
          • Matt has arachnophobia and his anxiety levels will increase whenever he enters a place associated w spiders eg a shed or a zoo. The anxiety is a general response to the situation but when he sees the spider he experiences fear. which is directed mostly towards the spider itself.
        • The emotional responses we feel in response to the phobic stimulus are unreasonable because a spider is tiny and harmless and matt is unlikely to meet a very dangerous spider in his shed.
    • Phobias are characterised by excessive fear and anxiety triggered by an object, place or situation.
    • There are three main phobias recognised by DSM-5
      • Specific Phobia (phobia of an object like an animal or body part) and a phobia of  a situation like say getting an injection.)
      • Social Phobia (phobia of a social situation like public speaking or using a public toilet.)
      • Agoraphobia (phobia of being outside or in a public place.)
    • A phobia is an irrational fear of an object or situation
    • Phobias are classified as anxiety disorders.
    • The two-process model (behavioural approach) is used to explain phobias. It basically says that phobias are acquired by classical conditioning and maintained by operant conditioning (negative reinforcement)
      • Hobart Mowrer (1960)
      • Responses acquired by classical conditioning used tend to decline over time. However, phobias are long lasting.
      • Reinforcement tends to increase the frequency of a BHV.
        • A person tends to avoid a situation that is unpleasant resulting in desirable consequences meaning the BHV is likely to be repeated.
    • The behavioural approach to treating phobias.
      • Systematic desensitisation- a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning. The phobic leans to relax in the presence of the phobic stimulus, curing them.
        • A new response to the phobic stimulus is learned, the phobic stimulus is paired w relaxation instead of anxiety. This is called counterconditioning. You cannot be afraid and relaxed at the same time so one emotion prevents the other, this is called reciprocal inhibition .
        • SD involves drawing up a hierarchy of anxiety-provoking situations related to the phobic stimulus, teaching the patient to relax, and then exposing them to phobic situations. The patient works their way through the hierarchy whilst maintaining relaxation.
          • There are three processes involved in SD
            • The Anxiety hierarchy, this is put together by patient and therapist. it is a list of situations related to the phobic stimulus that provoke anxiety arranged from least frightening to most frightening.
            • relaxation, the therapist teaches the patient to relax as much as possible, eg by doing meditation or breathing exercises. Relaxation can also be done using a drug called Valium.
            • Exposure, the patient is finally exposed to the phobic stimulus while in a relaxed state. This takes place across several sessions starting at the bottom of the anxiety hierarchy. Treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy.
      • Flooding- this is a behavioural therapy in which a phobic patient is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus. This takes place across a small number of long therapy sessions.
        • This involves exposure to the phobic stimulus but doesn't involve an anxiety hierarchy. Flooding is immediate exposure to the frightening situation. Sometimes only one session is needed to cure the phobia.
          • There is no option of avoidance BHV so the patient will learn very quickly that the phobic stimulus is harmless 9extinction) Sometimes the patient may achieve relaxation in the presence of the phobic stimulus as they have become exhausted by their own fear response.
            • flooding isn't unethical it is just very unpleasant so it is important that fully informed consent is given.
      • The patient is normally given the choice of SD or flooding.

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