Psychopathology: Phobias “The behavioural, emotional and cognitive characteristics of phobias” “The behavioural approach to explaining and treating phobias; the two- process model, including classical and operant conditioning; systematic desensitization, including relaxation and use of hierarchy; flooding”

Psychopathology: Characteristics of Phobias AO1 Describe the characteristics of phobias AO2 Identify types of diagnoses of phobias AO3 Evaluate The exams will measure how students have achieved the following assessment objectives. AO1: Demonstrate knowledge and understanding of scientific ideas, processes, techniques and procedures. AO2: Apply knowledge and understanding of scientific ideas, processes, techniques and procedures: • in a theoretical context • in a practical context • when handling qualitative data • when handling quantitative data. AO3: Analyse, interpret and evaluate scientific information, ideas and evidence, including in relation to issues, to: • make judgements and reach conclusions • develop and refine practical design and procedures.

What are you scared of?

Examples of SPECIFIC phobias Arachnophobia Ophidiophobia Coulrophobia Triskaidekaphobia Mycophobia Clowns Mushroons Thirteen Snakes Spiders

What are phobias? Phobias are a type of anxiety disorder. Anxiety is an emotion all people experience an is a natural response to potentially dangerous stimuli, but phobias are characterised by uncontrollable, extreme, irrational and enduring fears and involve anxiety levels that are out of proportion to any actual risk.

DSM-V categories of phobia All phobias are characterised by excessive fear and anxiety, triggered by an object, place or situation. The extent of the fear of out of proportion to any real danger presented by the phobic stimulus. The latest version of the DSM recognises the following categories or phobia and related anxiety disorder: Specific phobia – phobia of an object, such as an animal or body part, or a situation such as flying or having an injection. Social anxiety (social phobia) – phobia of a social situation such as public speaking or using a public toilet. Agoraphobia – phobia of being outside or in a public place.

Characteristics Behavioural Ways in which people act Cognitive Refers to the process of thinking – knowing, perceiving, believing Emotional Ways in which people feel

Emotional characteristics of phobias High levels of anxiety – phobias produce high levels of anxiety due to the presence of or anticipation of feared objects and situations. Fear from exposure to phobic stimulus – phobias produce an immediate fear response, even panic attacks, due to the presentation of the phobic object or situation.

Behavioural characteristics of phobias i Panic Avoidance/Anxiety Disruption of functioning How might you do these?

Cognitive characteristics Selective attention to the phobic stimulus Irrational beliefs Cognitive distortion

What is meant by a phobia? (Total 2 marks) [AO1 = 2] Up to 2 marks for a description of features of a phobia. Likely points: An extreme fear of an object / situation / activity (1) An irrational fear (1) Fear that is disproportionate (to the actual danger) (1) A fear that leads to avoidance (1) A fear that is disruptive to everyday life / maladaptive (1) For two marks there must be some reference to fear.

Outline characteristics of either phobic disorders or obsessive compulsive disorder.(Total 4 marks) AO1 = 4 The outline might include: • physiological, behavioural, emotional and cognitive signs / symptoms • incidence and prevalence • course and prognosis. Examiners should be mindful that this part of the question is only worth 5 marks and so candidates are not expected to cover all these points to access the top marks. However, top band answers should refer to some diagnostic criteria – in particular there must be some reference to the underlying anxiety that characterizes these anxiety disorders. It is acceptable to refer to different types of phobia but these distinctions on their own are not credit- worthy – they must be accompanied by a description of the characteristics of each type.

Explanations of phobias “The behavioural approach to explaining and treating phobias: the two-process model, including classical and operant conditioning; systematic desensitisation, including relaxation and use of hierarchy; flooding.”

What are the key principles of the behavioural approach? All behaviour is learned. Abnormal behaviour is no different. Behaviour is learned via the processes of classical conditioning, operant conditioning and modelling (SLT). What is learned can be unlearned. The same principles apply to humans and non-human animals Focus is on observable behaviour, not the mind.

The Two-Process Model (Mowrer, 1947) Phobias are learned. Classical conditioning – initiation stage. Operant conditioning – maintenance stage.

‘Little Albert’ – CC and phobias Youtube clip - John Watson – Little Albert (2:35 minutes) https://www.youtube.com/watch?v=Xt0ucxOrPQE

Independent task Read the case study of ‘Little Albert’. Identify the UCS, UCR, NS, CS and CR and draw/label a flowchart Watson and Rayner (1921) carried out a landmark study on conditioning in humans. It is often used where people want to explain phobias from a behaviorist point of view. Watson and Rayner (1921) obtained a 9-month old boy called Albert from the nursery of the university where they worked (they did not ask his Mother). Albert was tested with a number of stimuli to see which ones he reacted to. Amongst those he did not respond to was a white rat. He would play happily with the rat in front of him. Amongst those he responded to negatively was the sound of a metal bar being struck with a hammer, which made him very fearful and cause him to cry. On a series of occasions Albert was taken to the laboratory and the rat was placed in front of him at the same time that the metal bar was struck, causing him to start crying. After a few such occasions he was tested with just the rat on its own. Watson and Rayner found that Albert would now start crying as soon as he saw the rat, regardless of whether they made the sound. Albert also appeared anxious when exposed to other white, furry objects besides the rat.

‘Little Albert’ Watson and Rayner (1920) UCS  UCR Loud noise  Fear response (innate reflex) UCS + NS  UCR Loud noise + white rat  Fear response NS = CS  CR White rat = white rat = Fear response Stimulus generalisation – once somebody has been conditioned, they will also respond to other stimuli that are similar to the CS, in this case anything white and fluffy, e.g. cotton wool and a white rabbit.

Pair task Discuss and make notes on the following: - How would operant conditioning explain the behavioural characteristic in phobias of avoidance? Extension task: how might phobias be learned via SLT?

Operant conditioning to explain the maintenance of phobias The phobic response of fear and anxiety is unpleasant. Avoiding (or escaping from) the phobic item/situation avoids/removes this unpleasant response. This is a positive/desirable outcome and therefore is rewarding. Therefore the behaviour (avoiding the phobic item/situation) is repeated. So this involves…….??? Consequently, the phobia is maintained (continued).

Evaluation (A03) Read and summarise 3 evaluation points the behavioural approach to phobias.

Psychopathology: Phobias “The behavioural, emotional and cognitive characteristics of phobias” “The behavioural approach to treating phobias; systematic desensitization, including relaxation and use of hierarchy; flooding”

Systematic Desensitisation Treatment Based on principles of classical conditioning. Progressive, step-by-step approach. Patients learn in stages to replace fear response with feelings of calm/relaxation, to phobic object/situation. Takes about a month to complete therapy.

Pair task Read the 5 stages of systematic desensitisation on your worksheet. Number these into the correct order. Check with me. Write into books 15 minutes.

Exam practise Mia has a phobia of eating in public. She is about to go to university where she knows that she will have to eat her meals in a dining hall surrounded by other students. Describe how a therapist might use systematic desensitisation to help Mia overcome her phobias of eating in social situations. (4 marks) Independently, bullet point your answer to this exam question.

Evaluation of Systematic Desensitisation (AO3) Effectiveness Does the therapy work? Is it effective in treating phobias? Appropriateness Is the therapy suitable? For everyone? Are there any associated side effects? What about ethical issues?

AO1 or AO3? Why? Good/Bad? Flooding is at least as effective as other treatments for specific phobias. Studies comparing flooding to cognitive therapies (Ougrin, 2011) have found that flooding is highly effective and quicker than alternatives. Flooding stops phobic responses very quickly. This may be because, without the option of avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless. The most serious issue with the use of flooding is the fact that it is a highly traumatic experience.

AO1 or AO3? Why? Good/Bad? Flooding stops phobic responses very quickly. This may be because, without the option of avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless. ELABORATE The most serious issue with the use of flooding is the fact that it is a highly traumatic experience. ELABORATE LESS EFFECTIVE FOR SOCAL PHOBIAS. ELABORATE

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