Phobias

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Behavioural Characteristics

Behavioural - ways in which people act

We respond to exposure to the phobic stimulus by feeling high levels of anxiety and trying to escape.

Panic: this may involve a range of behaviours including crying, screaming or running away. Children may react slightly differently - for example by freezing, clinging or having a tantrum

Avoidance - unless the sufferer is making a conscious effort to face their fear they tend to try and avoid coming into contact with the phobic stimulus, making it hard to carry on daily life - for example someone with a fear of public toilets will limit the amount of time they spend outside the house, which can interfere with work, school and social life

Endurance - alternative to avoidance - sufferer remains in the presence of the phobic stimulus but continue to experience high levels of anxiety - this may be unavoidable in some situations, such as when a person has a phobia of flying

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Emotional Characteristics

Emotional - Ways in which people feel

Anxiety - phobias are classed as anxiety disorders - anxiety is an unpleasant state of high arousal preventing relaxation and making it hard to experience positive emotion. Anxiety can be long term, while fear is the immediate and extremely unpleasant response experienced when encountering the phobic stimulus

Example - arachnophobia - people who have a phobia of spiders have increased anxiety whenever they enter a place associated with spiders such as the garden shed and experiences a very strong fear response when seeing a spider itself.

the fear repsonse is extremely irrational and disproportionate when compared to the realistic danger posed by the phobic stimuli- for example the fear of a tiny spider that realistically could do no harm is extremely strong.

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Cognitive Characteristics

refers to the way people think - knowing, perceiving, believing

people with phobias process information about the phobic stimulus differently from other objects or situations

Selective Attention to the phobic stimulus - of the sufferer can see the phobic stimulus it is hard for them to look away from it. while keeping our attention on something really dangerous is a good thing as it gives us the best chance to react quickly to a threat - not so useful with an irrational fear. A pogonophobic will struggle to concentrate when a person with a beard is in the room, which can negativlely impact performance.

irrational beleifs can be held in relation to the phobic stimuli - for exmaple people with social phobias can beleive things like 'I must always sound intellegent' or 'if I blush people will think I`m weak'. this kind of belief increases pressure on the sufferer to perform well in social situations

perceptions of the phobic stimulus can also be distorted - for example a person with a phobia of belly buttons would believe they are ugly and or disgusting.

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Examples of specific phobias

Arachnophobia - fear of spiders                              Nomophobia - lack of a phone signal

ophidiophobia - snakes                                           Pogonophobia - beards

Zemmiphobia - giant mole rats                               Alphabutyrophobia - peanut butter

Coulrophobia - Clowns                                           Triskaidekaphobia - thirteen

Kinemortaphobia - zombies

Lutraphobia - otters

Mycophobia - Mushrooms

Omphalophobia - Belly Buttons

Rectaphobia - Bottoms

Xanthophobia - Yellow

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Systematic Desentisation

Systematic Desensitisation - a behavioural therapy designed to reduce an unwanted response, such as anxiety, to a stimulus. this 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. This learning of a different response is known as counterconditioning. It is also impossible to be afraid and relaxed at the same time, so one emotion prevents the other - this is called reciprocal inhibition Three processes:

  • The anxiety hierarchy is put together by the patient and therapist going in order from least to most frightening. An arachnophobic for example may place seeing a picture of a small spider at number 1 and holding a tarantula at number 10
  • Relaxation - therapist teaches relacation techniques such as breathing exercises or mental imagery techniques. Alternatively patients can take Valium to become relaxed
  • Exposure - patient exposed to the phobic stimulus in a relaxed state across several sessions, starting at the bottom of the anxiety hierarchy. when the patient can stay relaxed in the presence of stimuli on the bottom of the hierarchy they move onto the next level - treatment is successful when the patient is relaxed in situations high on the hierarchy
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Systematic Desensitisation Evaluation

It is effective in the treatment of specific phobias - as proved by research. For example Gilroy et al (2003) followed up on 42 patients who had been treated for spider phobia in three 45 minute sessions of SD. Spider phobia was assessed using several measures including the Spider Questionnaire and assessing response to a spider. A control group was treated by relaxation without exposure. at both three months and 33 months after treatment the SD group was less fearful than the relaxation group. Strength because it shows that the treatment is effective and long term.

It is suitable for a range of patients - alternative treatments such as flooding and cognitive therapies are not well suited to some patients - specifically those with learning disabilities. For these patients SD is probably the most suitable treatment

Patients prefer it as it doesn`t produce the same degree of trauma as flooding and it also includes some aspects (such as learning relaxation techniques) that are quite pleasant. This is reflected in low refusal rates and low attrition (number of patients dropping out of treatment) rates for SD.

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Flooding

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 (2-3 hours) An arachnophobic recieving flooding would have a large spider crawl over them for an extended period. Sometimes only one session is needed to cure a phobia

Flooding stops the phobic response very quickly because without the option of avoidance behaviour the patient realises the stimulus is harmless (in terms of classical conditioning, this is known as extinction). In some cases the patient may relax because they are become exhausted by their own fear.

this isn`t unethical but is an unpleasant experience so its important that patients give fully informed consent to this traumatic experience and they are fully prepared for the experience. patients are generally given the choice of flooding or systematic sensitisation

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Flooding Evaluation

its cost effective and at least as effective as other treatments for specific phobias. studies comparing flooding to cognitive therapies has found flooding is highly effective and quicker than alternatives

it is effective for simple / basic phobias, however, it is less so for complex phobias such as social phobias. this may be becuase social phobias have cognitive aspects, meaning they are more suitable for cognitive therapies which tackle irrational thinking

Most serious issue is that flooding is a highly traumatic experience and, as a result of this patients are unlikely to see it through to the end. this is a limitation as time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment.

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Behavioural Approach explaining Phobias

Two Process Model - phobia is aquired through classical conditioning (as shown through the case study of Little Albert in 1920 who was taught to fear a white rat using a white rat and a loud noise generated by banging an iron bar next to his ear) and maintained using operant conditioning (negative reinforcement is used to avoid the negative sensations generated by being exposed to the stimulus - continued avoidance causes the maintenance of the phobia)

However, this explanation has been criticised as people could avoid the phobic stimulus in order to maintain a feeling of safety as opposed to anxiety reduction (which can explain why some people with social anxiety can leave the house with relatively little anxiety when they are with someone but not when they are alone). Similarly, the two-process model fails to consider evolutionary explanations of phobias (we easily acquire phobias of things that were potential sources of danger in our evolutionary past such as snakes or the dark) - Seligman (1971) called this biological preparedness.

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