Abnormal psychology
Chapter 5 Trauma, anxiety, OCD and related disorders
Specific Phobias and agoraphobia
• Phobias Are unreasonable or irrational fears of specific objects or situations.
• People with specific phobias experience immediate, intense anxiety when they encounter the
feared object.
• Can produce a panic attack.
• Anxious about encountering the specific object or situation.
• Go to great lengths to avoid.
• Most phobias develop during childhood.
• Adults realize their anxieties are unreasonable, children may not.
• Phobias: most common mental disorder.
Specific phobias 5 types (subdivided in DSM 5)
• Animal type phobias:
- Specific animals or insects e.g snakes, spiders.
- Live in fear/terror encountering the animals and organize their lives around avoiding them.
• Natural environment type phobias:
- Events or situations in the natural environment e.g heights, water.
- Reorganize their lives to avoid situation or have severe anxiety attacks when confronted
with them.
• Situational type phobias:
- Involve fears of public transportation, tunnels, bridges, elevators, flying, driving. Common:
claustrophobia (fear of enclosed spaces).
• Blood-injection-injury:
- Fear of seeing blood or an injury
Treatments CBT: systematic desensitization
• Identify anxiety provoking thoughts and situations.
• Ranked list from least to most feared objects/situations.
• After learning relaxation techniques to manage/ease the anxiety patients can start to expose
themselves to items on their hierarchy of fears beginning with least feared.
• Use imagination.
• Therapist identifies unhelpful thinking e.g survivor guilt and helps patient challenge those
thoughts.
Phobias: specific phobias and agoraphobia
• Phobias = irrational fears of many objects and situations
• DSM divides phobias into
1. Specific phobias - unreasonable or irrational fears of particular objects/animals/places.
2. Agoraphobia - generalized fears of situations in which the person fears they might not be
able to escape.
Specific phobias sometime develop when:
• Experiencing a traumatic event.
• Observation of others going through a traumatic event.
• An unexpected panic attack e.g while using public transport.
• Informational transmission e.g extensive media coverage of a plane crash.
• However some people are unable to recall the specific reason for the onset of their phobia.
, DSM 5 criteria for specific phobia
A. Marked fear or anxiety about a specific object or situation.
B. the phobia object or situation almost always provokes immediate fear or anxiety.
C. the phobia object or situation is actively avoided or endured with intense fear of anxiety.
D. The fear of anxiety is out of proportion to the actual danger posed by the specific object/situation
& to the sociocultural context.
E. The fear, anxiety or avoidance is persistent, typically lasting 6 months or more.
F. The fear, anxiety or avoidance causes clinically significant distress or impairment in social,
occupational or other important areas of functioning.
G. The disturbance is not better explained by symptoms of another mental disorder
Agoraphobia
• Fear places they might not be able to escape from, or get help if they become anxious.
• E.g using public transportation, being in open spaces(parking lot); being in shops or theatres;
being in crowded places; standing in line; being outside the home in other situations.
• Half of all people with agoraphobia experience panic attacks that preceded the development.
• Others 50% have other anxiety disorder or somatic symptoms.
• Begins in early 20s, more common in women.
Fear these situations because of thoughts that:
• Escape from these situations might be difficult.
• Help might not be available in the event of possible panic symptoms or other incapacitating or
embarrassing symptoms.
• Fear they will embarrass themselves if others notice their symptoms or that they are trying to
escape.
Theories of phobias
• Freud argued that phobias result when unconscious anxieties are displaced onto a neutral object
- thus people become phobic not because they have a real fear of certain objects but because
they have displaced their anxieties of other issues onto that specific object.
• Behaviorists maintain that when people avoid the feared object they avoid what could extinguish
the phobia (negative reinforcement).
• If they experience the object they run away reducing their anxiety thus avoidance of the feared
object is reinforced by the reduction of the anxiety.
• Thereafter they avoid the object.
• Other behaviorists maintain that phobias develop through learning.
• Prepared classical conditioning.
Treatment
! Behavioral therapies uses exposure techniques to extinguish the fear of the object
or situation
! 3 types: systematic desensitization, modeling, flooding
1. Systematic desensitization
! Ranked list from most to least feared objects or situations
! After learning relaxation techniques to manage the anxiety, patients can begin to
expose themselves to items on their hierarchy of fears beginning with the least feared
! Seeing picture of snake, coach patient to use relaxation to replace the anxiety with a
calm reaction, then proceed to look at the picture
! When can look at picture without experiencing anxiety - move on to look at snake
through a window - use relaxation to calm anxiety, gradually move through the list
until patient may be able to touch the snake
Chapter 5 Trauma, anxiety, OCD and related disorders
Specific Phobias and agoraphobia
• Phobias Are unreasonable or irrational fears of specific objects or situations.
• People with specific phobias experience immediate, intense anxiety when they encounter the
feared object.
• Can produce a panic attack.
• Anxious about encountering the specific object or situation.
• Go to great lengths to avoid.
• Most phobias develop during childhood.
• Adults realize their anxieties are unreasonable, children may not.
• Phobias: most common mental disorder.
Specific phobias 5 types (subdivided in DSM 5)
• Animal type phobias:
- Specific animals or insects e.g snakes, spiders.
- Live in fear/terror encountering the animals and organize their lives around avoiding them.
• Natural environment type phobias:
- Events or situations in the natural environment e.g heights, water.
- Reorganize their lives to avoid situation or have severe anxiety attacks when confronted
with them.
• Situational type phobias:
- Involve fears of public transportation, tunnels, bridges, elevators, flying, driving. Common:
claustrophobia (fear of enclosed spaces).
• Blood-injection-injury:
- Fear of seeing blood or an injury
Treatments CBT: systematic desensitization
• Identify anxiety provoking thoughts and situations.
• Ranked list from least to most feared objects/situations.
• After learning relaxation techniques to manage/ease the anxiety patients can start to expose
themselves to items on their hierarchy of fears beginning with least feared.
• Use imagination.
• Therapist identifies unhelpful thinking e.g survivor guilt and helps patient challenge those
thoughts.
Phobias: specific phobias and agoraphobia
• Phobias = irrational fears of many objects and situations
• DSM divides phobias into
1. Specific phobias - unreasonable or irrational fears of particular objects/animals/places.
2. Agoraphobia - generalized fears of situations in which the person fears they might not be
able to escape.
Specific phobias sometime develop when:
• Experiencing a traumatic event.
• Observation of others going through a traumatic event.
• An unexpected panic attack e.g while using public transport.
• Informational transmission e.g extensive media coverage of a plane crash.
• However some people are unable to recall the specific reason for the onset of their phobia.
, DSM 5 criteria for specific phobia
A. Marked fear or anxiety about a specific object or situation.
B. the phobia object or situation almost always provokes immediate fear or anxiety.
C. the phobia object or situation is actively avoided or endured with intense fear of anxiety.
D. The fear of anxiety is out of proportion to the actual danger posed by the specific object/situation
& to the sociocultural context.
E. The fear, anxiety or avoidance is persistent, typically lasting 6 months or more.
F. The fear, anxiety or avoidance causes clinically significant distress or impairment in social,
occupational or other important areas of functioning.
G. The disturbance is not better explained by symptoms of another mental disorder
Agoraphobia
• Fear places they might not be able to escape from, or get help if they become anxious.
• E.g using public transportation, being in open spaces(parking lot); being in shops or theatres;
being in crowded places; standing in line; being outside the home in other situations.
• Half of all people with agoraphobia experience panic attacks that preceded the development.
• Others 50% have other anxiety disorder or somatic symptoms.
• Begins in early 20s, more common in women.
Fear these situations because of thoughts that:
• Escape from these situations might be difficult.
• Help might not be available in the event of possible panic symptoms or other incapacitating or
embarrassing symptoms.
• Fear they will embarrass themselves if others notice their symptoms or that they are trying to
escape.
Theories of phobias
• Freud argued that phobias result when unconscious anxieties are displaced onto a neutral object
- thus people become phobic not because they have a real fear of certain objects but because
they have displaced their anxieties of other issues onto that specific object.
• Behaviorists maintain that when people avoid the feared object they avoid what could extinguish
the phobia (negative reinforcement).
• If they experience the object they run away reducing their anxiety thus avoidance of the feared
object is reinforced by the reduction of the anxiety.
• Thereafter they avoid the object.
• Other behaviorists maintain that phobias develop through learning.
• Prepared classical conditioning.
Treatment
! Behavioral therapies uses exposure techniques to extinguish the fear of the object
or situation
! 3 types: systematic desensitization, modeling, flooding
1. Systematic desensitization
! Ranked list from most to least feared objects or situations
! After learning relaxation techniques to manage the anxiety, patients can begin to
expose themselves to items on their hierarchy of fears beginning with the least feared
! Seeing picture of snake, coach patient to use relaxation to replace the anxiety with a
calm reaction, then proceed to look at the picture
! When can look at picture without experiencing anxiety - move on to look at snake
through a window - use relaxation to calm anxiety, gradually move through the list
until patient may be able to touch the snake
