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Chapter 6

ch.6 for PSYB32

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University of Toronto Scarborough
Konstantine Zakzanis

Psychoanalyst focus on the content of the phobia and see the phobic object as a symbol of an important unconscious fear; content of phobia has important symbolic value Behaviourist ignore content of phobia and focus on function, for them the fears are equivalent in the means by which they are acquired and in how they might be reduced and so on Specific Phobias: unwarranted fears caused by the presence or anticipation of a specific object or situation DSM subdivides these phobias according to the course of the fear: blood, injuries and infection; situations; animals; and natural environment fears can be groups into one of the 5 factors: 1) agoraphobia 2) fear of heights or water 3) threat fears 4) fears of being observed 5) speaking fears o these fears are then classified under two higher order categories: specific fears and social fears lifetime prevalence of specific phobias that involves specific objects was estimated at 7% in men and 16% in women specific fear focused on in a phobia can vary cross-culturally o china: Pha-leng (fear of cold) related to yin and yang o Japanese syndrome: taijinkyofusho (fear of other people)- not a social phobia but an extreme fear of embarrassing others- encourages extreme concern for feelings of others yet discourage direct communication of feelings Social Phobias are persistent, irrational fears linked generally to the presence of other people Extremely debilitating Individual try to avoid particular situations in which they might be evaluated fearing that they will reveal signs of anxiousness or behave in an embarrassing way Speaking or performing in public, eating in public, using public lavatories and other activities carried out in the presence of others can elicit extreme anxiety They can be either generalized or specific, depending on the range of situations that are feared and avoided Generalized social phobias involve many different interpersonal situations; these people have an earlier age of onset, more comorbidity with other disorders such as depression and alcohol abuse and more severe impairment Specific social phobias involves intense fear often particular situation (e.g. public speaking) Social phobias are common with life time prevalence in NCR of 11% in men and 15% in women These phobias have high comorbidity rate with other disorders and often occur in conjunction with GAD, specific phobias, panic disorders, avoidant personality disorder and mood disorders Onset generally takes place during adolescence when social awareness and interactions with others become more important in a persons life Students with it have lower self-esteem and distorted body image relative to students who are not phobic Social phobias are associated with marked dissatisfaction and low functioning in terms of quality of life and it was actually linked with dropping out of school Predictors of recovery include being employed, no lifetime depression, fewer than three lifetime psychiatric disorders, less psychopathology, less anxiety sensitivity, fewer daily hassles and better mental health ETIOLOGY OF PHOBIAS Psychoanalytic theories: According to Freud, phobias are defence against the anxiety produced by repressed id impulses; this anxiety is displaced from the feared id impulse and moved to an object or situation that has some symbolic connection to it; these objects or situations become the phobic stimuli and by avoiding them the person is able to avoid dealing with repressed conflicts Phobias are the egos way of warding off a confrontation with the real problem, a repressed childhood conflict Example: lil Hans had not successfully resolved the Oedipal conflict therefore his intense fear so his father was displaced on horses and he became phobic about leaving his home Arieti proposed that repression stems from a particular interpersonal problem of childhood rather than from an id impulse Behavioural Theories: Focus on learning as the way in which phobias are acquired Avoidance conditioning: phobic reactions are learned avoidance responses www.notesolution.com o Avoidance-conditioning formulation is based on two factor theory proposed by Mowrer, hold that phobias develop from two related sets of learning Via classical conditioning- person can learn to fear a neutral stimulus (CS) if it is paired with an intrinsically painful or frightening event (UCS) The person can learn to reduce this conditioned fear by escaping from or avoiding the CSoperant conditioning (response maintained by its reinforcing consequence of reducing fear) Evidence demonstrates that only the possibility that some fears may be acquired in this particular way Pavlovian conditioning and observational learning via imitation can both play a role; by using masked stimuli that observing another persons fear response and not having explicit, conscious awareness of this conditioned stimulus can still contribute to apparent learning of a fear response Fear is extinguished rather quickly when CS presented a few times without the reinforcement of moderate levels of shock A phobia of a specific object or situation has sometimes been reported after a particularly painful experience with that object Some clinical reports suggest that phobias may develop without a prior frightening experience o Modelling can help solve avoidance-conditioning model Some phobias can be acquired by modelling, not thru an unpleasant experience with the object or situation that is feared modeling is learning fear by imitating reactions of others Vicarious learning is the learning of fear by observing others; it can be accomplished thru verbal instructions Anxious-rearing model is based on premise that anxiety disorders in children are due to constant parental warnings that increase anxiety in the child o Prepared Learning: certain neutral stimulus called prepared stimuli, are more likely than others to become classically conditioned stimuli may account for this tendency Some fears may well reflect classical conditioning, but only to stimuli to which an organism is physiologically prepared to be sensitive Conditioning experiments that show quick extinction of fear may have used CSs that the organism was not prepared to associate with USCs Prepared learning is also prevalence to learning fear by modelling Not every stimulus sis capable of becoming a source of acquired fear o Diathesis is Needed: a cognitive diathesis (predisposition)a tendency to believe that similar traumatic experience will occur in the futuremay be important in developing a phobia o History of not being able to control the environment is another possible psychological diathesis o Aversive conditioning experiences, such as severe teasing, have been proposed to play a role in the development of social phobia o Perceptions of teasing and bullying in childhood and social phobia o While some phobias are learned thru avoidance conditioning, avoidance conditioning should not be regarded as a totally validated theory; many people with phobias do not report either direct exposure to traumatic event or exposure to fearful models Social Skills Deficit in Social Phobias Behavioural model of social phobias considers inappropriate behaviour or lack of social skills as the cause of social anxiety; Individual has not learned how to behave so that he or she feels comfy with others or the person repeatedly commits fax pas, is awkward and socially inept and is often criticized by social companions Social skill deficit may have arisen over time because person was fearful of interacting with others for other reasons such as classical conditioning and therefore had little experience doing so Cognitive Theories Focus on how peoples thought processes can serve as a diathesis and on how thoughts can maintain a phobia Socially anxious people are more -concerned about evaluation, are more aware of the image they present to others and are preoccupied with hiding imperfections and not making mistakes in front of other people- than are people who are not socially anxious People with social phobia have a cognitive bias toward being more attentive visually to negative faces than to positive faces, but no such bias is evident among people with OCD or in control participants Socially anxious people also seem to fear having a negative impact on other people; that is, they are worried about causing discomfort in other people www.notesolution.com Cognitive-behavioural models of social phobia link social phobia with certain cognitive characteristics 1) an attentional bias to focus on negative social info 2) perfectionistic standards for accepted social performances 3) higher degree of public self-consciousness Excessive social consciousness and self-focus tend to increase social anxiety Social phobia is linked with high self-criticism; this may underscore general sensitivity to perceived criticism Socially anxious students not only anticipate negative social experiences, they also engage in extensive post-event processing of the negative social experiences, sometimes experiencing intrusive thoughts and images associated typically with OCD Predisposing Biological Factors Those that are adversely affected by stress have a biological malfunction (a diathesis) that somehow predisposes them to develop a phobia following a particular stressful event o Autonomic nervous system: people differ in their reac
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