SUMMARY OF PHOBIC DISORDERS
- Clinical symptoms
- classification and diagnoses
- explanations
- therapies
- Created by: lucy collier
- Created on: 01-06-10 16:50
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
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
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]
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
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]
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
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
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
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
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
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
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
Psychodynamic
= uncover repressed conflicts believed to cause phobic disorder
- no convicing evidence to support this as effective for phobic disorders
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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