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Psychology Revision: Summer A2

Section A: Psychopathology
Candidates should be familiar with the following:
- Clinical characteristics of the chosen disorder
Definition of a phobia: A persistent, disproportionate and irrational fear of an
object of situation which disrupts everyday life.
- The object/situation can present little or no danger at all, and even though the individual will
recognise the fear as unjustified, they will react to the perceived threat with: hyperventilation,
palpitations, choking sensations, flushes, sweating, feeling faint or uscle tension.
!ey characteristics: "#tree fear which is disproportionate to the danger,
avoidance of the object/situation.
To diagnose: $ear ust be unreasonable relative to the danger posed by the
object/situation, it ust be triggered iediately upon e#pose, and it ust
interfere with everyday functioning.
Specific Social Agoraphobia
%trong fear and
avoidance of a particular
object or situation.
%oeties siply
anticipating e#posure
can bring on a panic
An e#tree fear of
ebarrassent or
huiliation in social
situations. &an be
specific or generalised.
A fear of having a panic
attack in public'
particularly regarding
public transport and
busy places like
shopping centres.
".g. claustrophobia,
%pecific: $ear of public
(eneral: $ear of starting
Agoraphobia as a
coplication of panic attack,
or less coonly,
agoraphobia without panic
attacks, fearing the
environent outside an
individual)s hoe.
- Issues surrounding the classification and diagnosis of their chosen disorder,
including reliability and validity
*eliability of testing for a phobia:
- +nter-rater reliability ,siilar scores between researchers-.
- Three clinicians assessed ./ patients using a structured clinical interview. There was
high inter-rater agreeent, so diagnosis of phobia)s using this ethod is reliable. This
could be because the interview re0uired intensive training on the part of the clinicians,
and the interview itself took hours to coplete.
- Test-retest reliability ,sae results when test is repeated-.
- 1D& 2 1unich Diagnostic &hecklist ,self-adinistered short 0uestions to diagnose a
phobia-. "#aination of the 1D& has shown good test-retest reliability for specific
- !endler ,3444- assessed phobias using face to face and telephone interviews, and
found long ter reliability ,5 years- of using these ethods is low. &ould be due to
participants having poor recall of their fears.
*eliability of diagnosing abnoralities:
- *osenhan study when students attepted to gain adission to hospitals
claiing they could hear voices in their heads. They were diagnosed with
schi6ophrenia and during their stay in hospital none of the staff recognised
that they were not ill, although several of the genuine patients were
7alidity: to what e#tent do classification systes easure what they clai to
- %ocial and anial phobias often are accopanied by other abnoralities
,coorbidity- so the D%1 is not useful when recoending a treatent ,D%1
won)t identify a cause or which abnorality needs treating first-.
9hen looking at the validity of different ethods of diagnosis, one could
Concurrent validity Construct validity
&opares one ethod with a
previously validated ethod, e.g. the
%ocial :hobia %cale has high
concurrent validity copared with
other ethods of diagnosing social
Does the concept atch the specific
easureent8 $oe e#aple, the
%ocial :hobia and An#iety +nventory
correlates well with behavioural
easures of a social phobia ,e.g.
public speaking-.
&ross &ultural 7alidity:
9hat is considered a phobia in one culture ight be considered less serious
in another. $or e#aple, in ;apan there is a social phobia or ebarrassing
other people, but in "ngland we would not diagnose an individual with this
condition as having a phobia. Therefore culture has an effect on the diagnosis
of phobias. %iilarly, a phobia can be diagnosed if it interferes with everyday
functioning and causes an e#tree fear. Different cultures have different
ideas of what akes noral functioning and what constitutes and e#tree
- Biological explanations of their chosen disorder, for example, genetics,
*esearch suggests genetics ay lead to the developent of phobias. <o
specific gene has been identified yet, but patients with phobias share certain
genetic anoalies.
$reyer ,344.- found individuals who had close relatives with specific
phobias were ore likely to have a specific phobia theselves.
<o concordance for social phobias.
+f they share the sae environent they could have learned the behaviours
Torgesen ,345=- investigated twins where at least one twin was
agoraphobic and found there was a higher likelihood of both twins having a
phobia in identical twins than fraternal twins.
$ew twin studies so hard to generalise.
+t is not clear e#actly what is passed on in the genes that causes a phobia
to develop. :erhaps soe people inherit a genetic over-sensitivity of the
nervous syste which leaves the sensitive to a range of stiuli.
+nteractionis ,nature 2 genetic over-sensitivity, nurture 2 environental
+ndividuals who have high levels of physiological arousal are ore vulnerable
to the developent of phobic disorders as they are argued to be particularly
sensitive to their e#ternal environent.
>ader and 1atthews ,34?5- found an association between arousal levels
and patients suffering fro panic disorder with agoraphobia.
&orrelation, not causation.
Does arousal lead to developent of a phobia or does a phobia lead to high levels
of arousal8
Evolutionary heory
:hobias are developed to objects/situations that were potential sources of
danger thousands of years ago. Those who developed these phobias would
have avoided the harful object/situation and therefore would be favoured by
@uans have a Apreparedness) to be sensitive to certain stiuli. 9e aren)t
born with the phobia' instead we a born with an innate tendency to ac0uire the
phobia 0uickly to harful objects/situation.
@uans are ore likely to be conditioned to stiuli like snakes which are
Afear-relevant) than stiuli like flowers which are Afear irrelevant).
"thical iplications of conditioning fears into huans.
1onkeys readily ac0uire fears of toy snakes and crocodiles but could not be
conditioned to fear a toy rabbit. Because the onkeys had never seen a
snake or a crocodile before, their fear cannot be e#plained by prior learning.
&an)t generalise fro anials to huans.
$ears ac0uired under lab conditions can easily be reoved, so they are
unlike the phobias that people ac0uire in the real world.
- Biological therapies for their chosen disorder, including their evaluation in terms of appropriateness and effectiveness
!en"odia"epines #!$s% Antidepressants #&A'(s )
!eta*!loc+ers Psychosurgery
,unction Treat the physical
syptos of a phobia,
e.g. slow activity of
sypathetic nervous
syste to reduce an#iety.
Both increase levels of
serotonin. 1AC+s prevent its
breakdown, %%*+s prevent
serotonin reuptake.
*educe the activity of
adrenalin and
noradrenalin, so heart
beats slower, blood
pressure is lower and
patient feels caler and
less an#ious.
Cperations are perfored
on the libic syste
,region associated with
eotions- to treat an#iety.
Positives - 1ore effective than both
placebos and
antidepressants in treating
- %%*+s shown to reduce
an#iety levels significantly ore
than placebos.
- $ew if any side effects
Negatives - %ide effects include
increased aggression and
long ter eory
- Addictive even in sall
doses. *ecoended for
four weeks ,not treating
phobias in long ter-.
- >ink between %%*+s and
increased suicide risk.
- %%*+s take four weeks to
have an effect so patients stop
taking the.
- 1AC+s have a long list of
related side effects such as
insonia and di66iness.
- 1AC+s re0uire strict dietary
restrictions, otherwise they can
be lethal.
- Appear highly effective
in research, but Turner
,344/- found no
difference between B.B
and placebo groups in
ters of heart rate etc.
- +rreversible
- Any lasting daage ay
leave patients with lower
0uality of life than before
the operation.
- Dnethical, suitable only
as a last resort.
General comments
- Cnly treating the syptos of phobias, so are not recoended as
the priary for of treatent.
- &an be useful when a panic disorder accopanies a phobia ,e.g. with
- &ognitive therapies would be ore effective because they would
directly treat the cause of the phobia, not the syptos.
- "thical issue with drug treatents: ost patients are not infored
about the coparative success of drugs versus placebos, so they
e#pose theselves to unpleasant side effects even though the benefits
of the drugs ay be sli.
- Psychological explanations of their chosen disorder, for example,
behavioural, cognitive, psychodynamic and socio-cultural
A&atastrophic thoughts e#planation) E a person with a phobia thinks that
soething dreadful will happen if they encounter the feared object/stiulation,
e.g. Aif + see a snake, it will bite e and I will die). This negative thought
pattern is often accopanied by others, such as believing other people ust
think badly of the.
1en6ies F &lark ,344.- E people with phobias believe negative events are
uch ore likely to happen than those without phobias.
(ournay ,3454- E phobics are ore likely than noral people to overestiate
risks. This suggests they may be cognitively predisposed to develop phobias.
Dseful because psychologists can find out what types of thoughts people
with phobias have, which has led to the developent of treatents which try
to change how such people think.
:sychodynaic e#planations disagree that the focus should be on thought.
They would argue the true cause lies within the unconscious ind, so focus
should be on unlocking that.
:hobias are learnt fro the environent ,classical conditioning-.
>ittle Albert E case deonstrates it is possible to condition a fear of a
previously neutral stiulus.
&annot generalise fro one case study. >atter research failed to replicate
the findings.
"thical issue E conditioning fear in a young child.
Bagby ,34GG- E A young woan developed a fear of running water after she
was trapped by rocks near a waterfall.
Di(allo ,344H- E <early GIJ of people who have been in bad traffic accidents
develop a fear of travelling ,don)t want to travel in a car, frightened of
travelling at ediu speeds, prefer to stay at hoe instead of travelling to
see friends-.
(eneral coents:
- %oe people have phobias of things they have never encountered
- $alls on nurture side of nature/nurture debate
- Too reductionist. :hobias are cople# and it is too siplistic to e#plain
the in ters of classical conditioning.
- Difficult to test behaviourist e#planations e#perientally because it is
highly unethical to cause e#tree fear in participants.
The source of the fear is repressed into the unconscious and the fear is
displaced onto a harless e#ternal object, which is why the fear is seen as
irrational. +t is less threatening for an individual to have a phobia than it is to
have distressing thoughts and conflicts.
>ittle @ans E fear of his father was repressed and displaced onto a harless
e#ternal object ,horse-.
Dnrepresentative, lacks scientific rigour as it is highly subjective
,e#planation depends on interpretation of sybols-. Both $reud and @ans)
father interpreted the evidence according to their e#pectation about the origins
of the phobia.
- 7ery difficult to investigate psychodynaic approach because it focuses on
the unconscious ind.
- This approach can e#plain agoraphobia as the result of separation an#iety
e#perienced as a child. Dnconsciously the person thinks that separation
an#iety is less likely if the person is at hoe all the tie.
o Bowlby ,34H=- found that agoraphobics often had early e#periences of
faily conflict.
o <o other evidence supports this e#planation.
- Psychological therapies for their chosen disorder, for example, behavioural, psychodynamic and cognitive-behavioural, including
their evaluation in terms of effectiveness and appropriateness.
Systematic desensitisation ,looding Cognitive !ehavioural herapy
&ethod A stepped approach of increasingly
Afrightening) tasks, teaching people
rela#ation techni0ues they can use
when they feel an#ious.
:atient is presented with their phobic
ite/situation in a repeated,
intensive way so they Aunlearn) their
associated negative feelings.
Ais to change distorted thinking
patterns associated with the phobic
ite/situation, coupled with
behavioural therapy.
Research >ang F >a6ovic ,34?=- E (roup 3
had %D for snake phobia, (roup G
no %D. (roup 3 showed less fear of
snakes than G. ? onths later (roup
3 still showed reduced fear of
%tudy found &BT reduced children)s
fear of the dark, and three years later
iproveent had been aintained.
Negatives "ffectiveness of behavioural therapies ay rely on clients following
instructions for techni0ue practice at hoe. Treatent failures ay have
ore to do with lack of coitent than the techni0ue itself.
Don)t know which bit of the therapy
worked' cognitive or behavioural8
- &ould change have been caused
by another factor, e.g. edication8
Ethics :rotection fro psychological har'
forcing soeone to face a phobia
that intensively could cause traua.
@owever, end result ay justify the
*esearch was %D vs no treatent'
any therapy would be ore effective
than no therapy.
:sychodynaic approach argues
that to cure a phobia the true cause
ust be unlocked fro the
unconscious ind.
-*esearch was &BT vs no treatent'
any therapy would be ore effective
than no therapy.
-& vs B 2 little difference in
Comments Behavioural therapy treats the syptos, not the cause.