Phobias

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  • Phobias
    • Types of Phobia
      • Specific Phobias
        • intense irrational fears about specific objects or situations
        • 12% of the population will develop a specific phobia at some point in their lives
        • Most common in women
        • Examples: Spiders, Snakes, the dark
      • Social Phobia
        • an excessive and persistent fear of particular social situations
        • Examples: eating in public places, using public toilets
        • 12% of the Westernised population will develop a social phobia
        • Starts in late childhood and continues into adulthood
        • Women suffer more than men 3:2 ratio
        • Co-morbidly occurs with depression and substance abuse
      • Agoraphobia
        • anxiety about being in places or situation from which escape might be difficult
        • 2.7% of the population suffer from agoraphobia
        • Onset: early adulthood
        • Women are twice as likely to suffer than men
    • Diagnosis
      • From the ICD-10 criteria
      • Markers and persistent fear that is excessive and unreasonable
      • Always produces an immediate anxiety response
      • person recognises the fear is excessive or unreasonable
      • Phobic situations avoided
      • In individuals under 18 the duration must be longer than 6 months
      • anxiety cannot be explained by any other mental disorder
      • Issues of classification and diagnosis
        • Reliability
          • Inter-rater reliability
            • when two independent assessors give similar scores
            • Skyre:  asked 3 clinicians to assess 54 patient interviews using structured interviews. high agreement was found (72%) showing Structured Clinical Interviews (SCID-1) as reliable
          • Test retest
            • whether test items are consistent
            • Hiller: reported good diagnostic agreement in a test retest study using Munich Diagnostic Checklist
            • COUNTER ARGUMENT: Kendler used face to face and telephone interviews to assess individuals with phobias over a month interval and found agreement 46% due to people exaggerating symptoms and subjective opinions from assessor
        • Validity
          • Concurrent Validity
            • establishing the value of a new measure of phobic symptoms by correlating it with an exisiting one
          • Comorbidity
            • the extent that 2 or more conditions co-occur high levels have been found between different phobias suggesting the conditions are not separate
            • creates issues with treatment as which do you treat first?
          • Construct Validity
            • measures the extent that a test for phobic disorders really does measure a symptoms of phobias
    • Biological Explanations
      • Genetic Inheritance
        • Twin Studies
          • Torgerson: compared MZ and same sex DZ twin pairs where one twin had an anxiety disorder with panic attacks, it was 5X more frequent in MZ twin pairs
          • AO2
            • Fail to control for shared environmental experiences
            • Studies of twins reared apart have not been conducted with phobic disorders
            • Diathesis Stress Model: genetic factors predispose an individual to develop phobias but experience plays a role in triggering the response
      • Evolutionary Approach
        • Prepotency
          • animals have evolved to respond to potential threats as experiencing anxiety after an event would not be an adaptive response
          • Natural selection has shaped our nervous system so that we attend more to certain cues than others, we may respond more anxiously to stimuli that reminds us of certain threats
        • Preparedness
          • an innate readiness to learn about dangerous situations
          • Seligman: animals are biologically prepared to rapidly learn an association between particular stimuli and fear
          • We inherit a predisposition to form certain associations, when an infant sees a stranger they look to mother to gauge a response
          • We evolved to quickly learn what will harm us
          • AO2
            • Bennet-Levy and Marteau: 113 pps spilt into 2 groups and given 1 of 2 questionnaires & asked to fat fear, likeliness to approach/pick up and how fast moving they were. there was a disproportionate fear of the rat, females were less likely to approach or pick up the animals, men rated themselves less fearful than women. suggesting we are not preparedness to fear animals but we are prepared to be cautious when approaching the animal.
              • Social desirability bias
                • Questionnaires
              • Low ecological Validity
              • Mixed sample of males and females 59 females 54 males
                • more women than men
                • explored gender differences
              • Easy to repeat method high reliability
              • independent measures design, pps likely to guess aim
              • same animals given to *** so results can be compared and trends can be made
        • AO2
          • IDA Cultural difference: Brown found phobic disorders were more common among African American than White American pps, even when socio-economic factors were controlled
  • Validity
    • Concurrent Validity
      • establishing the value of a new measure of phobic symptoms by correlating it with an exisiting one
    • Comorbidity
      • the extent that 2 or more conditions co-occur high levels have been found between different phobias suggesting the conditions are not separate
      • creates issues with treatment as which do you treat first?
    • Construct Validity
      • measures the extent that a test for phobic disorders really does measure a symptoms of phobias

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