1. Anxiety disorder: specific phobia

2. Learn what an anxiety disorder is, focusing on Specific Phobia
Understand the biological contributing factors to phobias and the ways to manage phobias
Lesson objectives

3. application of a biopsychosocial framework to understanding ONE of the following four types of mental disorder and its management:
Anxiety disorder: specific phobia
biological contributing factors: role of the stress response; role of the neurotransmitter gamma aminobutyric acid (GABA) in the management of phobic anxiety
Study design dot point

4. A state of physiological arousal associated with feelings of apprehension, worry or uneasiness that something is wrong or that something unpleasant is about to happen.
Anxiety definition

5. Anxiety disorder definition
Describes a group of disorders that are characterised by chronic feelings of anxiety, distress, nervousness and apprehension or fear about the future, with a negative effect.
Anxiety disorder definition

6. DSM-IV-TR anxiety disorders
Agoraphobia without history of panic disorder
Panic disorder with/without agoraphobia
Specific phobia
Social phobia
Obsessive compulsive disorder
Post-traumatic stress disorder
Generalised anxiety disorder
Acute stress disorder
Anxiety disorder due to a general medical condition
Substance-induced anxiety disorder
DSM-IV-TR anxiety disorders

7. An excessive or unreasonable fear directed towards a particular object, situation or event that causes significant distress or interferes with everyday functioning.
Phobia definition

8. Specific phobia definition
A disorder characterised by significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behaviour.
The specific object/situation producing the fear is called the phobic stimulus.
Specific phobia definition

9. Phobia activity Anunptaphobia: fear of staying single
Arachibutyrophobia: fear of peanut butter sticking to the roof of the mouth
Hippopotomonstrosesquipped-aphiliophobia: fear of long words
Keraunophobia: fear of lighting
Ornithophobia: fear of birds
Papaphobia: fear of the Pope
Pentheraphobia: fear of mother-in-laws
Quadrataphobia: fear of quadratic equations
Vuteuthindon: fear of picnics
Phobia activity

10. The fear is in excess of any real danger posed by the phobic stimulus.
People with a specific phobia know that their level of fear is excessive or unreasonable.
The fear is in excess of any real danger posed by the phobic stimulus.

11. Symptoms Elevated heart rate & blood pressure Hand tremors Diarrhoea
Sweating
Shortness of breath
Dizziness
Feel like they have no control over the situation
Exposure to phobic stimulus
Triggers involuntary anxiety response (similar to stress response)
Can lead to panic attacks (unexpected onset of intense anxiety that can last a few mins > an hour)
Symptoms

12. DSM specific phobia categories
Examples
Animal type
Situation type
Blood, injections and injury type
Natural environments type
Other phobias
Choking, vomiting, loud noises, dying, costumed characters
DSM specific phobia categories

13. Psychological factors
Biological factors
Contributing factors:
Role of stress response
Dysfunctional GABA system
Management:
Benzodiazepines
GABA supplement
Relaxation response
Biological factors
Psychological factors
Social factors
Specific phobia
Biopsychosocial framework applied to specific phobia and its management

14. Biological contributing factors
Genetic predisposition – moderate level of heritability of anxiety disorders
Role of the stress response
Role of the brain’s neurochemistry
Biological contributing factors

15. How does the stress response contribute to phobic anxiety?
Fight-fight response activated
Accounts for phobic symptoms such as sweating & palpitations
Dizziness due to increase in ANS arousal then sudden drop in blood pressure
How does the stress response contribute to phobic anxiety?

16. For example, objects/situations that have little potential for harm
Becomes problematic when the anxiety response is triggered when there is no real threat or danger
For example, objects/situations that have little potential for harm
flowers (anthophobia) or clouds (nephophobia)
Anxiety remains until the exposure to the phobic stimulus is gone

17. Role of GABA NOT THAT GABBA… Gamma-amino butyric acid (GABA)
= Primary inhibitory neurotransmitter
Inhibits firing of neurons
Maintains optimal level of neurotransmission
Low levels of GABA leads to higher levels of anxiety
Neurons are not stopped from
firing
Role of GABA
NOT THAT GABBA…

18. Role of glutamate (GABA’s mate)
Glutamate = primary excitatory neurotransmitter
Makes neurons more likely to fire
Both GABA and glutamate have important roles in arousal and therefore anxiety
Role of glutamate (GABA’s mate)

19. Benzodiazepines: a group of drugs which are referred to as minor tranquillisers
ADVANTAGE: Calm down the body by reducing physiological arousal and promoting relaxation
DISADVANTAGE: induce drowsiness and are addictive
Eg: Valium, Temazepam, Xanax etc
Management of phobias

20. How do ‘benzos’ work? Agonists Antagonists
Imitate therefore stimulate a neurotransmitter’s activity
Benzos are GABA agonists
Benzos have inhibitory effects on neurons which reduce the symptoms of anxiety
Inhibit a neurotransmitter’s activity
Reduce GABA function and increase anxiety symptoms
How do ‘benzos’ work?

21. GABA/anxiety connection
Researchers believe that some people develop anxiety because they have a dysfunctional GABA system
The result of failure to produce, release or receive the correct amount of GABA that is needed to regulate neuronal transmission in the brain
GABA/anxiety connection

22. GABA may be affected by: What can you do?
Genetic inheritance
Socio-cultural factors
Exposure to prolonged stress
Exposure to environmental toxins
Nutritional deficiencies (vitamin B6 and citric acid, and high caffeine intake)
Proposals that GABA levels can be increased “naturally” by:
Drinking green tea
Eating foods “high in GABA” (e.g. beans, dairy foods, eggs, seafoods and wholegrains)
GABA supplements (although there is no significant research evidence that this works)

23. Draw a flow chart to describe and explain how the stress response contributes to a phobic reaction
Review!