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Chapter 13: Specific Phobia - Coggle Diagram
Chapter 13: Specific Phobia
Stress
Stress is a normal part of life: Mild amounts can be adaptive and helpful
State of psychological and physiological arousal produced by internal and external events and are perceived by the individual as challenging or exceeding their ability to cope
Represented on a continuum
Potential factor to a mental health disorder, can develop into a mental health disorder if not managed
Accompanied by physiological changes: Fight, flight, freeze
Factors contributing to the development of a specific phobia (biopsychosocial model)
Psychological factors
Classical and operant conditioning
Specific phobias are learnt through classical conditioning and are maintained through operant conditioning.
We develop a fear of a neutral stimulus because we have associated it with fear.
Once a phobia has been established through CC, its maintained and strengthened through OC. We are negatively reinforced by hiding, backing away or avoiding the phobic stimulus therefore strengthening the avoidance behaviour and therefore her phobic response.
Cognitive models
Cognitive models emphasise how and why an individuals with a phobia have an unreasonable and excessive fear of the phobic stimulus
Cognitive bias
A tendency to think in a way that involves errors of judgement and faulity decision making.
People with phobias are more likely to have unrealistic expectations and make unlikely predications about potential danger.
With cognitive bias, people are prone to experiencing fear or anxiety in a response of the phobic stimulus.
Memory bias
Refers to the distorting influences of present knowledge, beliefs and feelings on the recollection of previous experience
In specific phobias, its the tendency for memory recall of the phobic stimulus to focus on the negative and threatening information than the positive information.
Catastrophic thinking
Overestimating the levels of threat and predicting the worst outcome which increases anxiety levels
Individuals experience heightened feelings of helplessness and underestimate their ability to cope with the situation - increase anxiety levels.
Social factors
Environmental triggers:
Developing a specific phobia after a direct negative experience with an object or situation
These specific objects or situation in the 'environment' trigger a extreme fear response at that time. This is why it is called a specific environmental trigger to describe this type of factor contributing to the development of a phobia.
Often, the initial fear response to a specific environmental trigger becomes a conditioned fear response through CC process and is produced where the stimulus is present
Stigma around seeking treatment
Embarrassment or shame about symptoms and concerns about being negatively judged by others may discourage people with a phobia from seeking treatment.
Biological factors
GABA dysfunction:
Some people experience the anxiety associated with phobias because the neurotransmission of GABA becomes dysfunction. For example, there may be a failure to produce, release or receive the correct amount of GABA needed to regulate neuronal transmission.
Without GABA, activation of the post-synaptic neuron may become out of control
GABA can play a role in anxiety because it acts like a calming agent to the excitatory neurotransmitter
Individuals with low level of GABA are more vulnerable to anxiety
Individuals with low levels of GABA will have their fight, flight, freeze response to be easily triggered
Role of the stress response
The physiological reactions for the FFF response are symptoms that are associated with phobic anxiety
A FFF stress response to a phobic stimulus is often triggered in the absence of any real threat and tends to be excessive. This is more likely to occur if there is also GABA dysfunction
Anxiety can be problematic for someone with a specific phobia as their level of anxiety tends to be excessive because their perception of the threat is unreasonable and out of proportion of what it should be. This means the physiological stress responses they experience associated with FFF response will often be very severe and can persist at a high level for as long as the exposure or anticipation exposure to the phobic stimulus is there.
When you see a threat or the impending harm at the sight or thought of a phobic stimulus, the FFF is activated
The role of the stress response interacts with other factors. Eg, GABA dysfunction may contribute to the excessive stress response or make it more likely to occur compared to someone without GABA dysfunction.
Long term potentiation
.The more the connection is activated through each encounter or anticipation encounter with the phobic stimulus, the more the connection gets strengthened, increasing the efficiency in transferring fear information along the pathway and decreasing the likelihood that the fear response of what has been learnt will be forgotten
LTP pays a role in phobia as the neural pathways are strengthened and the amygdala activates multiple brain regions that produce fear and anxiety
LTP can strengthen the association between a phobic stimulus and a fear or anxiety response through its activity in the synapse.
LTP plays an important role in learning and memory of fear by strengthening synaptic connections in the neural pathway formed during the learning process, resulting in enhanced or more effective synaptic transmission within the pathway
Specific phobia
When someone has a specific phobia, exposure to the phobic stimulus typically triggers an acute stress response (high levels of arousal for a short period of time) involving physiological changes (FFF response) In some cases the persons reaction can be very extreme and intense
The fear interferes with their lives
Disorder marked by fear or anxiety about a specific object or situation, often leading to avoidance behaviour
Fear results in the need to avoid any phobic stimulus. usually the individual organise their life around avoiding the phobic stimulus. When it's not possible to avoid the phobic stimulus,it is endured with intense anxiety or distress
The possibility of encountering the phobic stimulus causes a type of phobic anxiety called anticipatory anxiety.
For those with a specific phobia the anxiety may rise to an unpredictable level.
The phobic stimulus triggers fear or anxiety
Excessive, persistent and unreasonable fear of a specific object or situation.
Evidence based interventions in the treatment of specific phobias
Psychological intervention
CBT (Cognitive behaviour therapy)
Uses verbal and behavioural modification techniwues to help change irrational patterns of thinking
If we can modify negative thoughts and replace them with positive ones, this can lead to behaviour changes
Subjects are encouraged to think realistically about their threat their phobic stimulus poses and monitor their thoughts and feelings
CBT aims to assist the individual to develop a new understanding that their feared stimulus are not or unlikely to be dangerous
Systematic desensitation:
Phobias are learned, so they can be unlearned
This can be done through relaxation and careful exposure to increasingly scary things
The idea is to make the behaviour extinct
Learn relaxation techniques. 2. Build a fear hierachy. 3. Work through hierachy whilst practising relaxing techiques
You make a list from least to most scariest thing related to the phobia. The individual will then start from the bottom and face that fear and use relaxation techniques until they have overcome that fear. Then, they continue to go through the list until everything in the list does not cause any stress, fear or anxiety and therefore the behaviour is extinct
Biological interventions
Relaxation techniques
Breathing retraining
Breathing retraining is an anxiety management technique that involves teaching correct breathing habits to people with a specific phobia
Breathing retaining helps people to maintain correct breathing patterns when anticipating or exposed to a phobic stimulus, so it may help reduce anxiety or ease some of its symptoms.
Individuals are taught slow- breathing techniques to reduce anxious feelings
Breathing technique
Square breathing: Has four parts: Inhale, hold, exhale, hold
Useful for helping people breathe deeper and better overall
Powerful stress reliever and is effective way to calm down
Anti - anxiety medication
Drugs that mimic GABA inhibitory action that can work to reduce symptoms of anxiety
Drugs such as Lorazepam are GABA agonists and is apart of the group called Benzodiazepines.
Benzodiazepines treat the symptoms and not the case of anxiety. They have several side effects eg reducing alertness and can be addictive
Exercise:
Vigorous exercise can reduce anxiety by increasing the metabolism of stress hormones
Exercise may be helpful intervention in one or more of the following:
Promoting relaxation: Providing relief from anxiety
Providing distraction
Altering brain chemistry: Promotes release of endorphins, thereby promoting a sense of wellbeing and indirectly providing relief from anxiety
Social interventions
Psychoeducation
Strategies to help deal with the condition are development and families learn to find ways to help cope with the illness
A psychoeducation program for specific phobia may include ;information about: Role of phobic stimulus, dealing with stigma surrounding phobia, role and importance of breathing retraining, exercise, relaxation techniques and a healthy lifestyle
Provides suffers of mental illness and their families with facts that can help them understand and cope with their illness
Two main approaches: Challenging unrealistic or anxious thoughts: Families and friends can pay an important role in recognizing and challenging these thoughts
Not encouraging avoidance behaviours: Recognizing avoidance behaviour and encouraging phobia sufferers not to exhibit them can help
Anxiety
If anxiety is severe, it can reduce our ability to concentrate, learn, remember, think clearly and perform motor skills
For people experiencing severe anxiety that is unwanted and persistent, it can affect the way a person thinks, feels and behaves. If not managed effectively, can cause distress and disruption to the persons life
Anxiety is a normal human response: Mild amounts can be adaptive and helpful
Severe anxiety can indicate presence of anxiety disorder: A mental disorder with chronic feelings of anxiety, distress, fear of the future.
Anxiety disorders can be formed from a phobia
Represented on a continuum
Accompanied by physiological changes: Fight, flight, freeze
Potential factor to a mental health disorder, can develop into a mental health disorder if not managed
Phobia
A fear response by someone with a phobia is way out of proportion to the actual danger posed by the object or situation
There is a compelling desire to avoid the phobic stimulus by using avoidance behaviour
A phobia is a excessive and irrational fear to a certain object or situation
Sometimes the thought of the phobic stimulus is enough to cause a phobic reaction of stress and anxiety
Having a phobia causes significant anxiety and distress, interferes with everyday functioning (day to day functioning) therefore is a mental disorder
Represented on a continuum
Accompanied by physiological changes: Fight, flight, freeze
Stress + anxiety
They can independently or in combination contribute to the development of a mental disorder. But in themselves, they are not mental disorders.
They both are considered normal human responses that are usually adaptive and beneficial unless excessive and chronic.