Phobias 1.Symptoms What are the symptoms? 2.Mechanism Why does it happen? 3.Treatment How is it treated?
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1 Phobias 1.Symptoms What are the symptoms? 2.Mechanism Why does it happen? 3.Treatment How is it treated? 1
2 Types of Phobia 1. Phobia about physical space Acrophobia, claustrophobia, agoraphobia 2. Phobia about substances verminophobia misophobia aichmophobia, zoophobia 3. Phobia about interpersonal situations Social phobia Phobias in DSM-Ⅳ Specific Phobia Animals-related (Animals, insects) Natural environment-related (Storm, height, water) Blood-, injection-, lesion-related Situation-related (vehicles, elevator, airplane, closed space) Others (diseases) Social Phobia Agoraphobia 2
3 Duality of Acrophobia Maladaptive aspect fear of heights, unable to work on high floors Adaptive aspect without acrophobia, one cannot live (Acrophobia is necessary) Acrophobia per-se is not abnormal. Uncontrollable acrophobia is a problem. Predispositing Stress Model for Phobia Traumatic contact experience Biological readiness Phobia 3
4 Watson s Learning Theory of Phobia Little Albert experiment 1. Albert plays with a white rabbit. 2. Show him a white rat with a big hammering noise 3. Albert tries to run away when he sees a white rat. 4. Albert tries to run away upon seeing a white rabbit or a white-bearded Santa Claus face (Phobia is a result of inappropriate learning) 4
5 Pavlov s Classical Conditioning Paradigm 1. Eat ume (Japanese apricot) (UCS) => salivation (UCR) 2. Eat ume (UCS) => salivation (UCR) Look at ume (CS) 3. Look at ume (CS) => salivation (CR) UnConditioned Conditioned Stimulus Response Little Albert s Learning of Fear 1. Loud sound (UCS) => Fear response (UCR) 2. Loud sound (UCS) => Fear response (UCR) White rat (CS) 3. White rat (CS) => Fear response (CR) Children s fear of doctor s white coat Loud sound => Injection White rat => Doctor s white coat 5
6 Biological Readiness (Seligman1970) Learning theory Learned fear Biological readiness Close to innate fear (?) 1. Target Arbitrary (Anything could be a target) Limited (No fear of hammer) 2. Presentatio n 3. Resistance to extinction 4. Mechanism Necessary several times Low (easily cured) Classical conditioning Unprepared learning Once High (difficult to cure) Prepared learning 6
7 The Case of Peter (age 2) Jones Phobia about white rats and rabbits 1. Classical conditioning Showed him a rabbit four meters away from him while giving him snacks and hugging him. Once he got used to it, let the rabbit come a meter closer. 2. Operant Conditioning: The Experimenter praised Peter when he approached the rabbit. 3. Observational Learning: Showed him other children playing with the rabbit with no fear. As a result, Peter gradually became able to be close to the rabbit, and eventually to play with it, touching it with his hands. 7
8 Systematic Desensitization Therapy (Wolpe) 1. Creation of Anxiety Hierarchy 2. Muscle relaxation training (Jacobson method) Arms, face, shoulders, abdomen, legs, whole body, and muscle relaxation 3. Systematic Desensitization Relax the whole body Imagine slightly anxious situations -> toward more anxious situations Anxiety decreases over a few weeks or months Anxiety in real situations decreases Virtual Reality Exposure Method (Tokyo Cyber Clinic) 8
9 Anxiety Hierarchy Image of Anxious Situation A. Hear the word injection B. Hear a story from somebody about injection C. Look at a picture of a syringe D. Look at a picture of a person getting an injection E. Watch somebody getting an injection F. Look at a syringe G. A syringe comes close to the patience mouth H, Get an injection Before Early Late After Treatment Stage Stage Treatment
10 Effects of Cognitive Behavioral Therapy for Anxiety Disorder % Clinical Improvement Time required for treatment 15 GAD 10 Panic attack Hypochondria PTSD Obsessive-compulsive disord Social phobia Specific phobia 5 0 Social phobia GAD Panic attack Specific phobias Hypochondria PTSD Obsessive-compulsive disord Time required for the Cognitive Behavioral Therapy for Anxiety Disorder 10
11 Method-Symptom Interaction (Shapiro & Shapiro (1982) Effectiveness 行動療法 0 不安 抑うつ 恐怖症 認知療法 11
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