U4AOS2B - Phobia Flashcards
(27 cards)
1
Q
Explain what is meant by a biopsychosocial framework as an approach to understanding mental health
A
- A framework is a scientific model or approach used to describe and explain how various internal and external factors interact to affect a person’s mental health
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Biological → Physiologically based factors
- Genes, hormones, brain function, genetic vulnerability, poor sleep and substance use
-
Psychological → Internal factors
- How a person thinks, learns, solves problems, perceives, experiences emotions, manages stress and stores information, and self-efficacy
-
Social → External Factors
- Forming relationships, the support from friends and family, family upbringing, attachment, cultural values, income level, and educational and employment history
2
Q
Describe biological factors that contribute to specific phobia
A
-
GABA dysfunction
- ★ GABA → Inhibitory and calms stress response
- Low levels/ cannot be transmitted or received normally → Stress response activated more easily + Harder to calm down
- More susceptible
-
Long-term potentiation
- ★ Repeated stimulation of 2 neurons; strengthen response
- Continued costimulation (connection for fear + perception of phobic stimulus) = Phobia strengthens over time
- High activity in amygdala → Fear
For LTP mention high frequency in amygdala
3
Q
What is a GABA agonist?
Biological Intervention
A
-
Benzodiazepines
- Medication/ drug that binds to GABA receptor and increases GABA effects
- Slow down CNS activity
- Change shape of receptor to make it more receptive to GABA and more resistant to excitation
- Can be short acting → Cleared from body quickly
- Long lasting → Accumulate in bloodstream, longer time to clear
4
Q
How do you determine whether short/long acting benzodiazepines are appropriate?
Biological Intervention
A
- Short
- Phobia → Address specific stimulus
- Immediate
- Long
- GABA is incredibly low and affecting a range of functions
- Long term
5
Q
What are advantages of benzodiazepines?
Biological Intervention
A
- Highly effective in minimising symptoms
- Alleviate symptoms → Root causes of phobia can be more effectively treated
Explicit mention of relationship between benzodiazepines and CBT/ systematic desensitisation (alleviate symptoms so that CBT/ systematic desensitisation can treat cause)
6
Q
What are limitations of benzodiazepines?
Biological Intervention
A
- Body can become dependent → Addictive
- Only treats symptoms, not underlying causes (not long-term solution)
- Causes reduced alertness, drowsiness & slower reaction times → Dangerous
- Lower inhibitions → Increase risk-taking
- Dangerous when mixed with alcohol or other depressants
7
Q
How can a benzodiazepine agent help manage a phobia?
A
- Acts as a GABA agonist in the brain by promoting GABA’s inhibitory effect
- Helps to calm physiological arousal
- People with a phobia may have dysfunctional levels of GABA
- Prescribing a benzodiazepine helps reduce the extreme anxiety experienced because of the phobia → Reducing intensity of stress response
- Less likely to avoid (perpetuate) phobia via neg. reinforcement
8
Q
What is breathing retraining?
Biological Intervention
A
- Method that teaches breathing control techniques that may reduce physiological arousal
- Reduce sympathetic nervous system activity + Increase parasympathetic
- Slow breathing → Calm stress response
- Shortness of breath isn’t associated with phobic stimulus
- Make individuals feel like they have control over their fear
- Needs to be practiced when not anxious in order to make it habitual
- Ensure that individual can implement technique even when not thinking clearly
9
Q
What are abnormal breathing patterns that can be developed by people with specific phobia?
Biological Symptom
A
- Shallow ‘chest breathing’ → Not taking in sufficient volume of air
- Rapid breathing → Number of breaths is unnecessarily increased
-
Deep breathing → Deeper, larger breaths = Too much oxygen
- Upset balance between oxygen and carbon dioxide
- Low level of carbon dioxide in blood
- Symptoms
- Dizziness
- Light-headedness
- Blurred vision
- All associated with panic attack → Heighten fear and anxiety
- Solution
- All require breathing retraining to normalise breathing
- Maintain correct oxygen and carbon dioxide balance in blood
10
Q
What are potential benefits of breathing retraining?
A
-
When encountering/ anticipating phobic stimulus…
- Maintain correct breathing
- Correct abnormal breathing patterns
- Enhanced ability to remain calm
- Minimise likelihood of hyperventilation or panic attack
11
Q
Describe psychological factors that contribute to specific phobia
A
-
Precipitation - Classical
- Increase susceptibility and contribute to development of phobia
- Phobia caused by NS + UCS pairing with NS just before UCS
- Non-extinguished (without intervention)
-
Perpetuation - Operant
- Inhibit person’s ability to recover → Continue phobia
- Avoidance of phobic stimulus = Negative reinforcer (calm)
- Increase likelihood of behaviour
-
Cognitive Bias
- Tendency to think in a way that involves errors + faulty decision making
- Are not factual
- Fixate on negative
PCPOCB - Pineapples Can’t Possibly Obtain Carbonara Beautifully
12
Q
Describe the two types of cognitive biases
A
-
Memory Bias
- Distorting influence of present on the recollection of previous experiences → Selective Memory, only remembering negatives thus forgetting positives that challenge
-
Consistency Bias → Distorted to fit in what is presently known/believed
- Fear something currently, reflect back and conclude that they feared it in the past as well
- Similar memories to cause are strengthened & more likely to be retrieved
-
Catastrophic Thinking
- Predicting worst possible outcome
- Heightened feelings of helplessness
- Underestimate ability to cope with situation
13
Q
What is systematic desensitisation?
Psychological Intervention
A
- Graded experience where patient with phobia is gradually exposed to phobic stimuli using relaxation techniques to calm response
- Pair CS (phobic stimulus) with pleasant UCS (relaxation technique) → new UCR
- Replace anxiety response with relaxation
- Steps
- Learn relaxation technique
- Patient establishes fear hierarchy (what is the scariest to least)
- Patient exposed to fear hierarchy going up
- Can only continue up the stages when they are willing and relaxed, fear response is eliminated
- Continues until extinguished
Treats CC and OC
AKA Exposure Therapy
14
Q
What are the advantages of systematic desensitisation?
Psychological Intervention
A
- Use same thing that developed phobia to undevelop it
- More responsive
- Can be done over time
- Address root cause
15
Q
What are disadvantages of systematic desensitisation?
Psychological Intervention
A
- Take a lot of time
-
Too fast → Can cause stimulus generalisation
- Intended pleasant UCS becomes feared
16
Q
What is cognitive behavioural therapy (CBT)?
Psychological Intervention
A
-
Identifying and replacing negative cognitions & behaviours for more positive, helpful ones
- Change in thinking supports changed feelings THUS changed behaviour → Removal of negative feelings = No more avoidance
- Thoughts → Feelings → Behaviour
- New understanding that phobic stimulus is not (or unlikely to be) dangerous
Assume that reason for behaviour is caused by thought processes (Thoughts-Feelings-Behaviour)
Treats cognitive biases
17
Q
What are the goals of a CBT treatment plan?
A
-
Changing thoughts and behaviour that perpetuate the phobia
- New understanding that their feared stimuli is not/ not likely to be dangerous
- Introduces the idea that avoidance and safety behaviours are unnecessary and maladaptive in the long-term
- New understanding (T) = Change in feeling (F) and Behaviour (B)
Must mention change in thoughts, feelings and behaviour
18
Q
Describe social factors that contribute to specific phobia
A
-
Environmental Triggers
- Stimuli that evoke an extreme stress response
- Can be generalised (not just initial stimulus)
- Direct confrontation, observation, learning (parents and peers)
- Lead to development of phobia
- Doesn’t need to be repeated if intense
-
Stigma - Maintains
- Shame/embarrassment about something that makes one different from others
- Prevent from seeking treatment → Getting a label
- Worried about perception from others → Makes phobia worse
19
Q
What is psychoeducation?
Social Intervention
A
-
Teaching families and supporters of individuals with mental health disorders how to…
- Better understand
- Deal with disorder
- Treat disorder
- Components
- Challenging unrealistic/ anxious thoughts of the individual
- Not encouraging avoidance behaviours
BDT - Butter Dog Town
Explicitly mention components in responses
20
Q
State examples of how to effectively + ineffectively challenge phobic thoughts
Social Intervention - Psychoeducation
A
-
Effective
- Calmly acknowledge + Reassure about lack of danger
- What is making you feel scared?
- Is there any evidence that contradicts your thoughts?
- Calmly acknowledge + Reassure about lack of danger
-
Ineffective
- No acknowledgement or reassurance - Stigmatising comments
- Don’t be stupid
- You’re crazy
- No acknowledgement or reassurance - Stigmatising comments
21
Q
State examples of how to effectively + ineffectively discourage avoidance
Social Intervention - Psychoeducation
A
-
Effective
- Encourage not to engage in avoidance behavior
- Support to not engage
- Praise/ positive reinforcement
-
Ineffective
- Forced exposure
- Ridicule
- Impatience
- Sarcasm
- Belitting
22
Q
Why are families/ supporters advised not to encourage avoidance behaviour (phobia)?
A
- It perpetuates the phobia
- Important that the individual has the opportunity to face what is feared → Learn that their phobic stimuli isn’t dangerous
- Exposure provides opportunity to learn to cope with fears + Experience control
- Comforting rather than challenging may unintentionally reinforce avoidance behaviour
23
Q
How can attention in observational learning lead to someone developing a phobia?
A
- Individual actively focuses on model’s responses to the phobic stimulus
- Proceed to…
- Storing/ encoding/ retaining the antecedent-behaviour-consequence relationship
- NOT just imitating fear response
- For example → Model is relieved when avoiding phobic stimulus so learner learns vicariously that avoidance of it is negatively reinforced
24
Q
Why are evidence-based interventions preferred in the treatment of a phobia?
A
- Based on peer-reviewed scientific studies → Increase likelihood of treatment to…
- Be effective/ maximise chance of benefit
- Tailored to individual’s specific phobia and their specific symptoms
- Minimise risk of harm (unlikely to be dangerous)
- Be of an acceptable cost
25
What is the relationship between GABA and the stress response in the development of a phobia?
* Individuals with a phobia have **low levels of GABA**
* Results in **neurons firing excessively**
* Individual's **FFF response may activate more easily** for a **prolonged period** when exposed to the phobic stimulus
26
Why is it important to challenge unrealistic thoughts about a phobic stimulus?
* People with specific phobias have **cognitive biases** → **Avoidance** behaviours
* Challenging = Assist person in developing a **new understanding** that the feared stimulus is **not dangerous**
* **Avoidance not necessary**
27
Why is systematic desensitisation more effective than benzodiazepines?
* Benzodiazepines are a **short-term** solution that only **reduce the phobic response**
* **Do not change association** between PS and fear
* Systematic desensitisation is more **long-term** because it works to **change the association** between the PS and fear
