Specific and Social Phobias

1. Specific phobia 2. Social phobia

1. Intense fear of some object or situation that is out of proportion to the actual threat. 2. Avoidance of the phobic stimulus. Importance of impairment and severity of the fear is important in the diagnosis.

Refers to fear caused by the presence of a specific object or situation.

Prevalence: fairly common. LP is 12% 2x as common in women than men, also more common in minorities

1. Blood and injections 2. Situations (plane, elevator) 3. Animals **MOST COMMON 4. Natural environment (fear of heights, water) 5. Other (clowns, vomiting, fear of contracting an illness)

Excessive use of defense mechanisms: repression and displacement Research support: slim to none

1. Direct experience (true alarm) 2. False alarm 3. Modeling or vicarious learning 4. Info transmission

a. Also known as avoidance conditioning or true alarm b. Mowrer's 2-factor theory: i. Fear established via classical conditioning ii. Avoidance maintained via operant conditioning c. Research support: very little. It's very hard to condition a phobia, so true alarms may not lead to phobias.

a. An unexpected panic attack in a specific situation may cause a phobia b. Panic attack may be caused by a stressor

a. Phobic response may be learned by watching the reaction of others and imitating them b. Selachophobia (JAWS) and ornithophobia (Hitchcock's BIRDS)

It's possible that just being warned repeatedly about a potential danger is sufficient

a. Research findings: 28-31% of the relatives of a person who has a phobia are also likely to have a phobia, compared to 11% in the control group. b. The subtype of phobia tended to breed true: i. animal phobias ran in families, blood/injection phobia in particular is highly heritable. 64% have a relative who also has a blood phobia. ii. Reason why it is more heritable? They probably also inherit a strong vasovagal response, which makes them susceptible to blood pressure drops and fainting. c. Difficulty separating genes from the environment. It may not be genetics, it may be a learned behavior, or modeling.

a. Persistent, irrational fear linked to the presence of other people; fear of embarrassment or humiliation. High degree of impairment b. Can be either specific or generalized: only one fear vs. fear of more than one behavior. c. Vicious cycle: they're so nervous that they do mess up, which makes them even more nervous for next time.

Prevalence is 8%, LP is 12% 60% are women Onset: : late adolescence to early adulthood

Normal: More normal, widely shared fears like meeting S.O's parents, giving a speech, etc. Phobia: a. Much higher degree of self- consciousness. b. Higher estimation of social catastrophe c. Higher level of discomfort d. Constant avoidance of the situation

a. Speaking in public b. Eating in public c. Using public restrooms

a. Behavioral: conditioning may occur, similar to specific phobia. b. Classical conditioning leads to avoidance, which leads to operant conditioning.

a. Preparedness: based on evolution we are more prepared to fear some things more than others, e.g. angry, critical, or rejecting people. b. Greater activation of the amygdala in socially phobic people c. Infant temperament may be a trait of inhibition i. Some infants are born with traits like shyness that is apparent by 4 months old. ii. These infants are more at risk for developing a social phobia.

a. Higher standards. b. Irrationally negative beliefs about consequences. c. More self-focused, more concerned about being evaluated in a negative way.

1. Psychoanalytic i. Need to uncover the repressed conflicts ii. Free association, dream analysis iii. Efficacy research? NO 2. Systematic desensitization. Example of counter-conditioning. Three steps: i. Replace anxiety with relaxation. ii. Create an anxiety hierarchy iii. Exposure to feared stimuli based on hierarchy, one step at a time. Take a SUDs level, which stands for subjective unit of discomfort 3. Modeling 4. Flooding 5. Drug therapy: SSRI's or benzodiazepenes