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Chapter 24

Chapter 24

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Chapter 24: Fear and Anxiety Reduction Procedures  Defining Fear and Anxiety Problems o operational definitions  fear:  composed of both operant and respondent behaviour  typically a person is afraid of a particular stimulus or stimulus situation  in presence of the stimulus, the person experiences unpleasant bodily responses (autonomic NS arousal) o person then engages in escape or avoidance behaviour  anxiety:  the bodily responses experienced the presence of a stimulus they fear  this autonomic NS arousal involved in anxiety is an EO that makes it more likely the person will engage in escape/avoidance o example: fear of spiders  respondent behaviour  conditioned stimulus = spider  conditioned response = arousal of the autonomic NS aka anxiety (increased HR, sweating, msl tension, upset stomach, light- headedness, flushed face)  operant behaviour  behaviour = screaming for husband to kill spider and running away  reinforcing consequence = escape/removal of spider  therefore behaviour is negatively reinforced by removal/escape from spider and reduction in anxiety o most problems we label as fears/anxiety disorders are characterized by a combination of  respondent behaviour  in which bodily response of anxiety is elicited by a particular CS  and operant behaviour  in which escape/avoidance behaviours are reinforced by the removal of the feared stimulus and reduction in the unpleasant anxiety  b/c both are involved, most treatment approaches involve components that address both the operant and respondent behaviours o although it’s clear that respondent behaviour is a component of a fear, often it is not known how the fear developed through respondent conditioning  recall – a neutral stimulus becomes a CS when it’s paired with an unconditioned stimulus (US) or another CS; as a result of this pairing, the neurtral stimulus becomes a CS and elicits the same response that is elicited by the US  but knowledge of how the fearwas conditioned is not necessary to help the person overcome the fear  what’s important is to identify all the stimuli that currently function as CSs and elicit the fear responses (the CRs) o sometimes a problem that appears to be a fear/anxiety problem is simply an operant behaviour with no respondent behaviour or fear component  ie. child who screams and cries and claims to be afraid to go to school  might be a school phobia  or simply an operant behaviour that is positively reinforced by attention or escape from school  therefore important to conduct a functional assessment to determine what function the behaviour serves for the child  Procedures to Reduce Fear and Anxiety o based on principles of respondent conditioning and/or operant conditioning o Relaxation Training  strategies used to decrease the autonomic arousal they experience as a component of fear/anxiety problems  person engages in specific relaxation behaviour that result in bodily responses opposite to the autonomic arousal  ie. decreased msl tension, HR, breathng, warming of hands (decreased anxiety)  4 common relaxation strategies  progressive msl relaxation o person systematically tenses and relaxes each of the major msl groups in the body o tensing and relaxing leaves them more relaxed than in their initial state o first described by Edmund Jacobson o person must first learn to tense and relax  from a therapist  audiotape  reading a description o person should be in a comfortable position, a quiet room or place with no distraction o person closes his/her eyes and tenses and relaxes the msls o starting with first msl group (dominant arm and hand) client tenses msls for 5 seconds and releases  allows client to feel contrast between tense and relax and focus on the feeling of relaation o then moves to next msl group o client should have an easy understanding of a relaxed state o when learning without help, ppl must first practice tensing and relaxing each msl group then memorize the sequence to do so correctly o once practiced many times, they can begin to relax without tensing  PMR teaches ppl to control their own msl tension, they can decrease msl tension in situations in which they are likely to experience more tension  to facilitate this, ppl often use cue words when practicing PMR then later reciting the cue to help them relax in real situations o cue word develops into a CS that elicits relaxation as a CR o reciting cue word also helps person avoid thoughts that might elicit anxiety  diaphragmatic breathing o aka deep breathing or relaxed breathing o anxiety/autonomic arousal involves shallow rapid breathing so..  person breathes deeply in a slow, rhythmic fashion  at each inhalation, person uses msls of the diaphragm to pull O2 deep into lungs  this decreases anxiety by replacing the anxious breathing pattern with a relaxed pattern o to learn  person should get in a comfortable sitting position and place hand on abs (diaphragm)  on inhalation, feel abdomen move outward as the diaphragm pulls the breath of air deep into the lungs  shoulder should be motionless  upward mvmt of shoulders during inhalation indicates shallow breathing in the upper portion of the lungs rather than deep breathing into the lungs  many ppl believe the abs should be pulled in during inhalation  flase: abs move outward when a person breathes deeply using the msls of the diaphragm  after learning to breathe correctly person is ready to begin exercise o to do  person sits/stands/lies in comfortable position with eyes closed  inhale slowly (3-5) seconds until lungs are comfortably filled with air  the diaphragm msl extends the abdomen as air is inhaled  exhale slowly (3-5) seconds  diaphragm msl pulls in abdomen as air is exhaled  best to do so through nose  person should focus attention on the sensations involved in breathing (in and out of msls, air flow, mvmt of abs)  person will less likely think anxiety-provoking thoughts  once person can produce a decrease in anxiety during sessions, use in real situations o note diaphragmatic breathing is often a component of most other relaxation procedures  ie. PMR – must first learn to breathe correctly to enhance the effectiveness of msl tensing/relaxing  not effective if person is breathing shallow and rapidly  also component of attention-focusing exercises  attention-focusing exercises o produce relaxation by direction attention to a neutral or pleasant stimulus to remove the person’s attn form the anxiety-producing stimulus o a class of attn focusing mechanisms  meditation  person focuses attn on a visual, auditory, or kinesthetic stimulus o ie. object, repetitive mantras/words, or own breathing movements  once focused on stimulu, attn cannot be focused on anxious stimuli  guided imagery (or visualization exercises)  person visualizes/imagines pleasant scenes or images  can listen to audio or therapist who describes a scene/image o describes all 5 senses of the scenario  if many senses are engaged, person is more likely to imagine the scene fully and displace any anxiety-provoking thoughts  person must be comfortable, eyes closed  hypnosis  person focuses attn on the hypnotic suggestions from the therapist or audiotape  in hypnotic trance, attn is simply focused on the therapist’s words so that the person is less aware of eternal stimuli  a person can practice self-hypnosis by reciting hypnotic suggestions from a script to induce a state of relaxation o note – typically used as components of other relaxation procedures  all 3 approaches have many components in common  behavioural relaxa
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