Anxiety Disorders

Anxiety Disorders

1. Characteristics

   • Anxiety disorders refer to fear that is disproportionate to a given situation
     • Panic attacks are a common feature of of anxiety disorders
     • These fears may be shown in different ways, for example they may have a: fear of dying, feel dizzy or light-headed, they may sweat, have an accelerated heart rate, feel sick, have shortness of breath or a feeling of chocking
   • Case study, Kimya- A 39 year old female with a phobia of birds, anything relating to birds makes her feel sick, this had limited her social life
   • Types of phobias- Agoraphobia: fear of public spaces, Haemophobia: fear of blood, animal phobia, button phobia: Saavedra and Silverman, Needle phobia
   • Measures- BIPI, the blood phobia inventory is a way of measuring the severity of blood phobic people, it consists of 18 situations involving blood and injections and asks the participants to rate how they would react which includes cognitive, physiological and behavioural responses (they also have to rate the frequency of each symptom out of 0-3)
     • Strengths- Had good concurrent validity, has been thoroughly tested therefore reliable
     • Weaknesses- relies on a self report which could have some form of bias
   • Measures- GAD-7, this is a questionnaire screening test often used to enable further referral to a psychiatrist, it has a 7 item scale to measure the severity of anxiety (participants also have to rate each situation out of 3) 0 being not at all and 3 being nearly everyday
     • Strengths- Has good concurrent validity, its also very reliable and has been thourgly tested
     • Concurrent validity is a way to judge validity by comparing measures of the same occurrence in different ways
     • Weaknesses- Relies on a self report which can be open to different bias which reduces reliability

2. Explanations

   • Behavioural by Watson & Rayner- This explanation was based on classical conditioning, so when a harmless stimulus is paired with a frightening experience a phobia can occur. The study by Watson & Rayner used a baby called little Albert and created a fear response with a loud unpleasant noise with a neutral stimulus (a rat) in order to create a phobia
     • Strengths- The study conducted a lot of trials using different stimuli to see if Albert was just a fearful boy making it more reliable, There is a lot of evidence to prove classical conditioning for example Pavlovs dog experiment
     • Weaknesses- This is by no mean ethical, babies cry for no reason some times this was a case study so not very generalisable, this is a very reductionist approach as the explanation for his phobia is based entirely on his conditioned experience and therefore doesn't have good ecological validity
   • Psychoanalytic by Freud 1909- This explanation of phobias stems from the impulses of the Id which are denied or repressed to cause a phobia later in life, the boy "little Hans" apparently had an Oedipus complex, a phobia of horses a fear of castration which was confirmed by his notable fantasies about plumbers replacing penises and having children with his mother
     • Strengths- All information was very ecological valid as information was gathered from the boy in his natural environment, this sways on the nurture side of the nature nurture debate and is based of previous evidence.
     • Weaknesses- The father referred the boy and was the primary information giver, this has a huge bias which images the validity and reliability, Hans and freud only met around 2 times so this compromises validity. This was a case study so it lacks generalisability, this study also lacks objectivity due to the bias from Freud and Hans father being friends. It also lacks validity because of the possible research bias. It also wasn't very ethical on Hans as he was only 5
   • Biochemical/Genetic by Öst 1992- This explanation suggest that we are born prepared to fear certain objects, certain things that may pose a threat to our survival could be fixed by being genetically set up to avoid them. This would be transmitted though generation to help with survival. The study by Öst 1992 used need and blood phobic participants to test the genetic link between family history in phobias
     • Strengths- This was in a lab setting which was standardised (they also used standardised tests) making it more reliable and valid.
     • Weaknesses- For a biological study the sample size needs to be very large and this is quite small and therefore not generalisable, there also wasn't an even split between blood phobic and need phobic, not very ethical as they were forced to watch something they were terrified of. every person is very unique and to generalised all phobias wouldn't help an individual person very much
   • Cognitive by Di Nardo 1988- This explanation believes that people with phobias are bias in their reasoning about what is harmful and what is not and the study by Di Nardo 1988 shows how people with dog phobias how more fear and anticipation of harm than non fearful people but the bad encounters with dogs were the same none the less
     • Strengths- This was done with standardised measures like the individual structured interview, this study is quite applicable to everyday life and dog phobias are quite common, Therapies that rely on cognitive treatments have a very good success rate which gives the study some support
     • Weaknesses- Not a huge sample and they were all from the same collage and all females so not very generalisable and the study doesn't actually prove its own point, there isn't the possibility that phobias are based only on conditioning as that doesn't account for all the 66% of people in the non fearful group who don't have phobias despite having a bad encounter.

3. Treatments

   • Systematic desensitisation by Wolpe 1958- This treatment aims to reduce undesirable responses to particular situations, this theory is based on the idea of conditioned response to stimuli in the environment. This treatment believes that conditioned responses can be unlearned. The key to unlearning a phobic response is to put the fearful feelings associated with a phobic stimulus directly in conflict with feelings of deep relaxation.
     • Strengths- There is evidence to back up this theory with other case studies like Kimura
     • Weakness- This treatment is kind of in the past as new forms of expose therapy are more commonly used
   • Applied Tension by Öst 1989- This form of treatment involves applying tension to the muscles in an effort to increase blood flow in certain areas, in the study by Öst 1989 there were 30 patients from the same hospital with blood phobia who under went applied tension, applied relaxation and a combination of the two.
     • Strengths- Treats all patients individually so there is less bias, the results can be applied to both genders as the study used both, using independent measures design meant the groups could be compared
     • Weaknesses- Not a very large or generalisable sample as their all from the same hospital, participant variables are possible with independent measures design, exposing people to their phobias and making them watch anxiety producing videos is unethical
   • CBT by Öst & Westling 1995- This study aims to compare the effectiveness of CBT with applied relaxation in the treatment of those with panic disorder, it used 38 patients with panic disorder and put them in either a CBT group or a applied relaxation group to see which was more effective
     • Strengths- Having no relapses is very good as most drug treatments he a high relapse rate, more ethical than applied tension as this study just go them to note down their panic attacks instead of creating one with anxiety producing videos. The training in the applied relaxation group was standardised and therefor more valid. Its quite ecological valid as they were in their natural setting when the panic attack occurred. This study also used a year follow up rather than the 6 months that Öst 1989 study used.
     • Weaknesses- Might not work for everyone as very particular to the person, some people might not like being told their thoughts are wrong in the CBT group and reset the therapy