PROBLEM 1: FEAR AND PHOBIAS
Learning objectives
Case 1:
What is a phobia?
What is the difference between normal anxiety and a phobia?
Which phobias are distinguished in DSM-V? (criteria/clinical views/epidemiology)
What causes a phobia? How is a phobia developed? (etiological models)
Case 2:
How are phobias treated?
What is exposure and how does it work?
What types of therapies are used to treat specific phobias, social phobias and agoraphobias?
Fear
Clear source of danger
- Basic emotion that involves fight-or-flight response
- Instantaneous reaction to any imminent threat
- Adaptive value is primitive alarm response
- Autonomic nervous system
Fear and panic have 3 distinct components:
1. Cognitive/subjective components (I feel afraid)I am going to die)
2. Physiological components (increased heartrate, heavy breathing)
3. Behavioural components (strong urge to escape or flee)
Loosely coupled: someone might show some indications of fear or panic but not all of them
Anxiety
Frequently cannot specify clearly what the danger is
Complex blend of unpleasant emotions and cognitions
- More oriented to the future
Cognitive/subjective:
- Involves negative mood, worry about possible future threats or danger, self-preoccupation
and the sense of being unable to predict the future threat or to control it
Physiological level:
- Creates a state of tension and chronic over arousal which reflect risk assessment and
readiness for dealing with danger
, - No activation of fight-or-flight
- May create a strong tendency to avoid situations where danger might be encountered
(behavioural) adaptive value:
- Wouldn’t even get into the situation. Helps to plan and prepare for possible threat
- In mind-moderate degrees: enhances learning and performance
Anxiety disorders
Specific phobia : anxiety symptoms about the possibility of encountering their phobic situation and
when actually encountering their phobic situation
Social anxiety disorder (social phobia) : anxiety symptoms about the possibility of encountering their
phobic situation and when actually encountering their phobic situation
Agoraphobia : go to greater lengths to avoid a variety of feared situations
Brain structures involved in disorders
- Limbic system
- Parts of the cortex
- Neurotransmitter substances: aminobutyric acid (GABA), norepinephrine and serotonin
Factors influencing vulnerability:
• People who have perceptions of a lack of control over their environment/ emotions are more
vulnerable
• Classical conditioning
• Perception depends on social environment (parenting styles)
• Faulty or distorted patterns of cognition may play a role
• Sociocultural environment in which people are raised effects on the kinds of objects and
experiences people become anxious about or come to fear
Treatment:
- Graduated exposure to feared cues, objects, situations
- Cognitive restructuring technique
o Help the individual understand their distorted patterns of thinking about anxiety-
related situations and how these patterns can be changed
- Medication
o Useful for treating all disorders (except phobias)
o Antianxiety medication (anxiolytics) and antidepressant medication
Learning objectives
Case 1:
What is a phobia?
What is the difference between normal anxiety and a phobia?
Which phobias are distinguished in DSM-V? (criteria/clinical views/epidemiology)
What causes a phobia? How is a phobia developed? (etiological models)
Case 2:
How are phobias treated?
What is exposure and how does it work?
What types of therapies are used to treat specific phobias, social phobias and agoraphobias?
Fear
Clear source of danger
- Basic emotion that involves fight-or-flight response
- Instantaneous reaction to any imminent threat
- Adaptive value is primitive alarm response
- Autonomic nervous system
Fear and panic have 3 distinct components:
1. Cognitive/subjective components (I feel afraid)I am going to die)
2. Physiological components (increased heartrate, heavy breathing)
3. Behavioural components (strong urge to escape or flee)
Loosely coupled: someone might show some indications of fear or panic but not all of them
Anxiety
Frequently cannot specify clearly what the danger is
Complex blend of unpleasant emotions and cognitions
- More oriented to the future
Cognitive/subjective:
- Involves negative mood, worry about possible future threats or danger, self-preoccupation
and the sense of being unable to predict the future threat or to control it
Physiological level:
- Creates a state of tension and chronic over arousal which reflect risk assessment and
readiness for dealing with danger
, - No activation of fight-or-flight
- May create a strong tendency to avoid situations where danger might be encountered
(behavioural) adaptive value:
- Wouldn’t even get into the situation. Helps to plan and prepare for possible threat
- In mind-moderate degrees: enhances learning and performance
Anxiety disorders
Specific phobia : anxiety symptoms about the possibility of encountering their phobic situation and
when actually encountering their phobic situation
Social anxiety disorder (social phobia) : anxiety symptoms about the possibility of encountering their
phobic situation and when actually encountering their phobic situation
Agoraphobia : go to greater lengths to avoid a variety of feared situations
Brain structures involved in disorders
- Limbic system
- Parts of the cortex
- Neurotransmitter substances: aminobutyric acid (GABA), norepinephrine and serotonin
Factors influencing vulnerability:
• People who have perceptions of a lack of control over their environment/ emotions are more
vulnerable
• Classical conditioning
• Perception depends on social environment (parenting styles)
• Faulty or distorted patterns of cognition may play a role
• Sociocultural environment in which people are raised effects on the kinds of objects and
experiences people become anxious about or come to fear
Treatment:
- Graduated exposure to feared cues, objects, situations
- Cognitive restructuring technique
o Help the individual understand their distorted patterns of thinking about anxiety-
related situations and how these patterns can be changed
- Medication
o Useful for treating all disorders (except phobias)
o Antianxiety medication (anxiolytics) and antidepressant medication
