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BIOPSYCHOSOCIAL FRAMEWORK

ANXIETY DISORDER: SPECIFIC PHOBIA

ANXIETY
- A feeling of apprehension, dread or uneasiness in

response to an unclear or ambiguous threat.

- Certain level of stress and anxiety is normal. However,

when anxiety becomes irrational, unrealistic and intrusive, it begins to interfere with day-to-day functioning.

- A mental disorder involving feelings of extreme anxiety,

accompanied by physical and psychological symptoms, inhibiting normal functioning.

ANXIETY
ABS reports 13% of young people experience anxiety Anxiety disorders occur most frequently between 18 and

25 years Teenage girls more likely to experience than boys.

There are several disorders which fall under the major


-

heading of Anxiety Disorders: Generalised Anxiety Disorder Panic Disorder Social Phobias Post-traumaic Stress disorder

SPECIFIC PHOBIA
An intense, irrational fear and avoidance of a

particular object, activity or situation.

A persons phobia interferes with a persons ability to

function normally.

There is no single cause of phobias, but is often a

learnt response or a reaction to a certain experience.

http://www.youtube.com/watch?v=E2pbYxA-MzI

BIOLOGICAL CONTRIBUTING FACTORS

- As specific phobias can be seen as an exaggerated

fear response, similar physiological changes activated by the fight or flight response are activated in response to an individuals specific phobia.
- Learning to recognise the stress response can help

sufferers gain control over it.

BIOLOGICAL CONTRIBUING FACTORS

- When released some neurotransmitters have an

excitatory effect prepare the body for fight or flight - Other neurotransmitters (GABA) have an inhibitory effect- calm the body, returning to homeostasis.

BIOLOGICAL CONTRIBUING FACTORS


Biological and psychological treatment of phobic

disorders often target the enhancement of GABA neurotransmission in order to inhibit the overactivation of the bodies resources by the stress response.

A group of medications known as benzodiazepines

can be used for he short-term treatment of phobic anxiety as they enhance the effect of GABA upon the body - leading to a slowing or calming of the bodied response to the stress or fear.

PSYCHOLOGICAL CONTRIBUTING FACTORS


The psychological factors involved in developing a simple

phobia refer to our thoughts, beliefs and perception about ourselves, our experiences and our environment.

Those who are more sensitive and anxious and feel less

in control are more likely to notice events in their environment and to view them as potentially threatening, even though there may be nothing to fear.

These thoughts and perceptions play a key role in

developing a simple phobia.

PSYCHODYNAMIC MODEL
The psychodynamic model (based on work of Freud)

proposes that the development of phobias is due to unresolved conflicts that arise during the phallic stage of a childs development.

Conflict- the male child feeling hostile towards the parent

of the same sex (the father) because of the childs underlying sexual impulses towards his motherthe Oedipal complex. Female equivalent of this- Electra complex
According to psychodynamic theorists, if a person is

unable to successfully deal with this conflict, their anxiety is displaced to a situation or object that is less relevant.

BEHAVIOURAL MODEL
The behavioural approach focuses on observable

behaviours and examines how an organisms behaviours are influenced by environmental factors. According to the behavioural model, phobias are learnt through classical conditioning and maintained through operant conditioning. The avoidance of an individuals phobia acts as a negative reinforcement. Whereas, the relief which comes from having avoided the phobia, acts as a positive reinforcement.

COGNITIVE MODEL
The cognitive model emphasises the influence of thought

processes on how we feel and behave.

Consequently, psychologists use this model to examine

the distorted thinking processes involved in the development and maintenance of simple phobia and look at ways to change those incorrect thoughts. a propensity to exaggerate perceived threats, making them more likely to interpret some situations, objects or activities as more dangerous than the average person would.

This approach also argues that anxious individuals have

COGNITIVE BEHAVIOURAL THERAPY


Cognitive behavioural therapy (CBT) uses a

combination of verbal and behaviour modification techniques to help people change irrational patterns of thinking involved.
CBT focuses on helping change negative thoughts

(flies can kill me) replacing them with more positive, realistic ones (flies are unpleasant but they wont hurt me).

COGNITIVE BEHAVIOURAL THERAPY


Negative thoughts that spring to mind when confronted

with the feared object or event are known as automatic thoughts.

The cognitive behavioural therapist attempts to modify

these thoughts so that the person no longer experiences the phobic response. avoid the feared stimulus.

In turn, reducing the persons behavioural tendencies to

http://www.youtube.com/watch?v=3Y8VKs3__cA

SYSTEMATIC DESENSITISATION
Systematic desensitisation is based upon the

assumption that most anxiety responses are initially acquired through classical conditioning.
Therefore, eliminating a phobia can be achieved

through counter-conditioning or weakening the association between the conditioned stimulus (for example rat, needle, flying) and the conditioned response of fear or anxiety.

SYSTEMATIC DESENSITISATION
This is done in three steps: - 1 The therapist helps the client build an anxiety/fear

hierarchy. - The client makes a list of anxiety-causing stimuli that are linked to their simple phobia, from least anxiety/fearinducing to most anxiety/fear-inducing.
- 2 The therapist trains the client in deep muscle relaxation. - 3 The client tries to work through the hierarchy, learning to

remain relaxed while imagining each stimulus on their hierarchy. - This is repeated until the person can imagine each situation or object with little or no anxiety/ fear.

SYSTEMATIC DESENSITISATION
Essentially, the objective of systematic desensitisation is

simple: - To recondition people so that the feared object, animal or situation (the conditioned stimulus) elicits relaxation rather than fear or anxiety
Systematic desensitisation is more effective in treating

simple phobia rather than social phobia or agoraphobia.

Systematic desensitisation is less effective in treating

performance fears such as exam anxiety if the person.

http://www.youtube.com/watch?v=Wz-H7nwMXco

FLOODING
Sometimes known as exposure therapy Behavioural psychotherapy based on the premise

that phobias are learnt through classical conditioning


Unlike systematic desensitisation where the person

is gradually exposed to the object of the phobia, patients are actually exposed at once and for prolonged periods to the feared stimulus.

FLOODING
Patients are subjected to high levels of anxiety which they

seek to replace with feelings of relaxation.

Although this method can achieve quicker results and

has been successful in treating simple phobia

It is not suitable for all people as it can increase rather

than decrease their phobia

Has a greater incidence of spontaneous recovery of the

phobia than other methods.

SOCIOCULURAL CONTRIBUTING FACTORS


Social and cultural factors can influence the type and

incidence of simple phobia.

Parental Modeling- Research has found that a child whose parent suffers from a

phobia of moths, for example, is more likely to develop the same or a similar phobia as a result of simply observing their parents fear response and making the cognitive connection that moths are dangerous.

Transmission of Threat Information- Developing a fear of dogs after hearing stories about children,

adults or family pets being attacked by vicious dogs.

SOCIOCULURAL CONTRIBUTING FACTORS


Specific Environmental Triggers Direct exposure to a distressing or traumatic event,

such as being bitten by a dog

Witnessing other people experiencing a traumatic

event, such as seeing another person being mauled by a dog (observational learning)

Reading or hearing about dangerous situations or

events (transmission of threat information).

BIOPSYCHOSOCIAL
BIOLOGICAL - The bodys physiological makeup and how the brain processes

and responds to fear. anxiety disorder.

- The influence of genetics, in terms of inherited vulnerability to

- The potential effect of being born with a highly sensitive and

easily startled personality.

- Influence of key brain systems such as noradrenaline

(overactive), GABA (underactive).

- Physical Health or Illness

BIOPSYCHOSOCIAL
PSYCHOLOGICAL- Factors such as thoughts, beliefs, personal experiences

and perceptions of ourselves can influence whether or not we interpret events around us as a source of danger. experience a stress response

- Overestimating the perceived level of danger and

- Use of avoidance strategies to alleviate the distress - Observational Learning

BIOPSYCHOSOCIAL
SOCIAL - Family and cultural background can lead them to focus

their apprehension on particular objects or situations.


- Modeling- parental observation - Social Support - Exposure to environmental elements

INTERACTION OF BIOPSYCHOSOCIAL FACTORS IN SPECIFIC PHOBIA


Although individuals may have a inherited

vulnerability, a combination with an exposure to an environmental trigger and parent modeling is generally needed.
As the cause of phobias is a combination of factors,

management is most effective if undertaken using a number of strategies.

INTERACTION OF BIOPSYCHOSOCIAL FACTORS IN SPECIFIC PHOBIA


Behavioural therapy using systematic desensitisation

is effective for most cases.

Benzodiazepines are generally only used when the

individual is too overwhelmed to even participate in therapy.

Tolerance can occur if used for extended periods.

http://www.youtube.com/watch?v=WGpfntjwYwc

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