SUMMARY OF PHOBIC DISORDERS

  • Clinical symptoms
  • classification and diagnoses
  • explanations
  • therapies
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Clinical characterisitics. Symptoms

Criteria differe depending on the type of phobia;

  • Specific
  • Social
  • Agoraphobia

But characterisitcs are broadly similiar, in cases of individual emotions experiences, cognitive, physiological, and behavioural anxiety symptoms.

  • marked and persisten fear that is excessive or unreasonable, cued by the presence of anticipation of a specific object/situation
  • exposure to phobic stimiluar almost always provokes an immediate anxiety response. eg. panick attack
  • the persons recongises the fear is excessive but doesnt stop thoughts
  • the phobic situation is avoided or else endured with intense distress
  • avoidance inteferes with every day functioning
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Issues surrounding classification and diagnoses

Factors that affect the reliability and validity of classification and diagnosis:

  • different types of phobic disorders
  • medicalization of a normal state
  • difference in classication of DSM-IV, ICD-10
  • fear of stigmatized
  • different diagnosis
  • problems with reliability
  • dual diagnosis
  • cultural issues
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Psychodynamic

= phobias are displaced fears [freud]

= related to early seperations from primary care giver [bowlby]

the aim is to uncover repressed feelings that have gone in to the unconsious and the real fear has been displaced on to an object or situation

  • difficult to test theory empirically
  • explanation lacks parsimony
  • little evidence of sympton substitiuion
  • loss of a parent in childhood may predispose to later phobic disorder
  • however evidence is inconclusive [ parker]
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Behavioural

= learned behaviour

  • some support for the idea that phobias are acquired through classical conditioning and maintained through operant conditioning. eg. Little albert, and Lift.

Have a panic attack because trapped in a life [ classical]

generalise to all situations [ stimulus generalisation]

reinforced that using the stairs has had no bad consequences like lift [ operant]

  • not everyone with a phobia has had a conditiong or SLT experience. some people who have experience a really traumatic event dont go on to develop a phobia
  • insufficent account taken of cognitive process
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Prepardness

= extention of basic learning theory

  • we are innatley prepared to fear certain stimuli that are potentially dangerous
  • biological predispostion
  • some good supporting evidence [ Mineka, Rheusus monkeys]
  • explained the apparent irrationality of phobias
  • can explain some phobias [ snakes]
  • but not all individual differences [ buttons]
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Cognitive-Behavioural

= faulty thinking pattenrs of negative, irrational thinking as a contributory factor

  • some research evidnece to support the explanation [ Beck]
  • more obsessed with the fear of the fear
  • Explained individual differences in acquiring phobias
  • gives rise to effective therapy
  • difficult to disentangle cause and effect
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Genetic

= inherited predispotion to develop phobias

  • support from family, twin studies
  • adoption studies very little more would be benefical as different enviroment
  • 100% concordance rate not demonstrate
  • difficult to disentable effects of enviroment
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Biochemical

= GABA hypothesis

  • effective anti anxiety medication of BZS which work similar to GABA have been good in regulating GABA levels and reducing arousal therefore decreasing anxiety
  • difficult to distinguish cause and efffect
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Neuroanotomical

= increased blood flow in the amygdala

  • research support from PET scans showing decreased blood flow when using drug treatment
  • blood flow abnormalities not found in all patients
  • difficult to disentable cause and effect
  • not all people with phobias have increased blood flow in the amygdala
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Diathesis-Stress Model

  • Interation between biological and enviromental factors
  • individuals have a genetic vulnerability for phobic disorder
  • but only develop the disorder in the presenve of triggering enviromental factors such as major life events
  • and accumilating daily hassles

kobasa

holmes and Rahye

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Biological Therapies

  • drugs can be used but only for ST
  • variety of anti anxiety drugs available
  • antidepressent medication can be helpful for people with social, agoraphobia
  • drugs can be effective in reducing symptoms
  • do not work for everytone
  • side effect
  • dependency
  • withdrawal symptoms
  • relieve symptoms not underlying cause
  • raised ethical issues
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Cognitive Behavioural Therapy CBT

= to challenge irrational thinking

  • research evidence suggests that CBT effective for phobic disorders
  • empowers the client
  • no side effects
  • dependency on the therapist
  • effectiveness and efficiecy depends on the skill/experience of the therapist
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Psychodynamic

= uncover repressed conflicts believed to cause phobic disorder

  • no convicing evidence to support this as effective for phobic disorders
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Behavioural

eg. SD, flooding, modelling, VD world,based on conditioning and SLT.

  • quick, effective especially for specific
  • support from research studies
  • no side effects
  • overwhelming if In vitro
  • no always effective for agropahobia and social
  • unpredictive outcome
  • ethical issues

COMBINES TREAMENTS

  • some evidenence that treatments are more effective if combined

eg. medication/drug therapy + CBT

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Comments

MrsMacLean

Wonderful resource, very clear and detailed 

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