Saavedra and Silverman Flashcards
Aim
- To understand the causes of button phobia (koumpounophobia) in a child.
- To treat a child’s phobia of buttons using disgust and fear responses.
Research Method, Design
Case study involving 1 participant, data collected using self-report measures, boy and mother interviewed abt onset of his phobia and subsequent behaviour
Sample
9 year old hispanic american boy, opportunity sampling
Background of the boy
started showing symptoms for 4 years prior to start of the study when he knocked over a bowl of buttons in front of his class and teacher
Procedure
An exposure-based treatment programme that tackled cognition and behaviours was used. With the suggestion of the boy, a special disgust and fear hierarchy using a distress rating from 0-8 was devised, with 8 being ‘small clear plastic buttons’ and 0 being ‘large denim buttons’. The boy was asked to rate 11 different scenarios that included buttons. The subjective ratings were used as a Feelings Thermometer.
The boy had 4 sessions of behavioural exposure to the buttons using the hierarchy. Then 7 sessions were planned to look into his disgust imagery and cognitions. He got to know what he found disgusting about buttons and, researchers used self-control and cognitive strategies with him to change these thoughts.
First Intervention used
Positive Reinforcement Therapy ➔ a behavioural therapy based on operant conditioning. Using positive reinforcement principles, contingency management was applied. The boy was rewarded for showing less fear and for handling the buttons. The mother provided positive reinforcement if the boy successfully completed the gradual exposure to buttons. Sessions lasted for about 30 minutes with the boy alone, and 20 minutes with the boy and his mother.
Second Intervention used
Imagery Exposure ➔ Imagery exposure therapy was based on classical conditioning using the Vivo method. An interview with the boy revealed that he found buttons touching his body disgusting and believed that buttons smelled unpleasant. This formed the basis for disgust imagery exercises. The boy was asked to imagine buttons falling on him, and consider how they looked, felt, and smelled. Exposures progressed from images of larger to smaller buttons, in line with the boy’s fear hierarchy.
Result- positive reinforcement therapy
The boy was observed approaching the buttons more positively. His objective ratings of distress increased between sessions 2 and 3. By session 4, the number of items on the hierarchy increased in dislike from the original scores.
Despite his behaviour to the fearful stimuli improving, his feelings of disgust and fear increased by the end of the therapy. Findings were consistent with evaluated learning. Despite the behavioural change, evaluative reactions are unchanged or have increased.
Result- imagery exposure therapy
The therapy was successful in reducing his rating of distress. For example, when he had to imagine buttons falling on him, prior to imagery therapy/cognitive restructuring, he rated the experience as 8 on a scale of 0 to 8. This rating decreased to 5 midways through the session, and was just 3 by the end of the session.
The boy was followed up 6 and 12 months after treatment and at both times he did not meet the DSM-IV criteria for a specific phobia anymore. He could wear clear plastic buttons on his school uniform shirt.
Conclusion
- Emotions and cognitions relating to disgust are important in the development and maintenance of a phobia.
- Imagery exposure has a long-term effect on reducing distress relating to specific phobias as it tackles negative evaluations.
Strengths
- High internal validity
- High reliability
Weakness
- Research bias
- Low generalisability
Application
Shows how therapy based on classical conditioning can be used to treat some phobias. It also shows the long-term improvement from exposure therapies.
