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Phobic Disorder

From the Greek word phobos for “fear”phobia-1

Persistent and unreasonable fears of particular objects, activities, or situations

People with a phobia often avoid the object or thoughts about it

Fear is a normal and common experience:

  • How do common fears differ from phobias?
  • More intense and persistent fear
  • Greater desire to avoid the feared object or situation
  • Distress that interferes with functioning
  • The concepts of fear and anxiety are closely related.
  • Fear is anxiety experienced in response to a particular threat.
  • A phobia is a fear of an object or situation that is disproportionate to the threat it poses.

Most phobias technically are categorized as “specific”

What Causes Specific Phobias?

Specific phobia – A phobia that is specific to a particular object or situation.

  • Such as fear of heights (acrophobia), fear of enclosed spaces (claustrophobia), or fear of small animals such as mice or snakes and various other “creepy-crawlies.”
  • The person experiences high levels of fear and physiological arousal when encountering the phobic object, which prompts strong urges to avoid or escape the situation or avoid the feared stimulus, as in the following case.

Each model offers explanations, but evidence tends to support the behavioral explanations:

Phobias develop through conditioning.  Once fears are acquired, the individuals avoid the dreaded object or situation, permitting the fears to become all the more entrenched.

Also two broader kinds:sad.png

Social Anxiety Disorder:

Marked, disproportionate, and persistent fears about one or more social situations

  • May be narrow – talking, performing, eating, or writing in public
  • May be broad – general fear of functioning poorly  in front of others
  • In both forms, people rate themselves as performing less competently than they actually do

It is not abnormal to experience some degree of fear in social situations such as dating, attending parties or social gatherings, or giving a talk or presentation to a class or group.

Social phobia – Excessive fear of social interactions or situations.

  • The underlying problem is an excessive fear of negative evaluations from others.

What Causes Social Anxiety Disorder?

Cognitive theorists contend that people with this disorder hold a group of social beliefs and expectations that consistently work against them, including:

  • They hold unrealistically high social standards and so believe that they must perform perfectly in social situations.
  • They view themselves as unattractive social beings.
  • They view themselves as socially unskilled and inadequate.
  • They believe they are always in danger of behaving incompetently in social situations.
  • They believe that inept behaviors in social situations will inevitably lead to terrible consequences.
  • They believe that they have no control over feelings of anxiety that emerge during social situations.

Cognitive theorists hold that, because of these beliefs, people with social anxiety disorder keep anticipating that social disasters will occur, and they repeatedly perform “avoidance” and “safety” behaviors to help prevent or reduce such disasters.

Treatments for Social Anxiety Disorder:  Only in the past 15 years have clinicians been able to treat social anxiety disorder successfully.

  • Two components must be addressed:
  • Overwhelming social fear
  • Address fears behaviorally with exposure
  • Lack of social skills
  • Social skills and assertiveness trainings have proved helpful
  • Unlike specific phobias, social anxiety disorders are often reduced through medication (particularly antidepressants)
  • Several types of psychotherapy have proved at least as effective as medication
  • People treated with psychotherapy are less likely to relapse than people treated with drugs alone
  • One psychological approach is exposure therapy, either in an individual or group setting
  • Cognitive therapies have also been widely used
  • Another treatment option is social skills training, a combination of several behavioral techniques to help people improve their social functioning
  • Therapists provide feedback and reinforcement
  • In addition, social skills training groups and assertiveness training groups allow clients to practice their skills with other group members

social phobia 1

agoraphobiaAgoraphobia:

  • The word agoraphobia is derived from Greek words meaning “fear of the marketplace,” which suggests a fear of being out in open, busy areas.
  • People with agoraphobia develop a fear of places and situations from which it might be difficult or embarrassing to escape in the event of panicky symptoms or a full-fledged panic attack, or of situations in which help may be unavailable if such problems should occur.

People with agoraphobia may fear shopping in crowded stores; walking through crowded streets; crossing a bridge; traveling on a bus, train, or car; eating in restaurants; or even leaving the house.

Fear of being in public places or situations where escape might be difficult or help unavailable, should they experience panic or become incapacitated

  • Pervasive and complex
  • Typically develops in 20s or 30s
  • Persistent fears of specific objects or situations
  • When exposed to the object or situation, sufferers experience immediate fear

Often explained in ways similar to specific phobias

  • Many people with agoraphobia experience extreme and sudden explosions of fear, called panic attacks
  • Such individuals may receive two diagnoses—agoraphobia and panic disorder

Treatment for Agoraphobia:

Behaviorists favor a variety of exposure approaches for agoraphobia

  • Exposure therapy
  • Support group
  • Home-based self-help

Most Common Phobias: Specific animals or insects, heights, enclosed spaces, thunderstorms, and blood

dsm-5

  • Each year close to 9% of all people in the U.S. have symptoms of specific phobia
  • Many suffer from more than one phobia at a time
  • Women outnumber men at least 2:1
  • Prevalence differs across racial and ethnic minority groups; the reason is unclear
  • Vast majority of people with a specific phobia do NOT seek treatment

 

References:
Bernstein, D.A. & Nash, P.W. (2008). Essentials of psychology (4th ed.) Boston: Houghton Mifflin Company.
Comer, R.J. (2013). Abnormal Psychology (8th ed).  Worth Publishers
Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
Feldman, R. (2013). Essentials of understanding psychology (11th ed.). New York, NY: McGraw-Hill.
Friedman, H.S. & Schustack, M.W. (2012), Personality: classic theories and modern research (5th ed). Boston: Pearson Allyn & Bacon.
McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
Ryckman, R. M. (2013). Theories of personality (10th ed.). Mason, OH: Cengage Learning.
Sue,Sue, and Sue (2014).  Understanding Abnormal Behavior (10th Ed), Cengage Learning

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