Psychology - Psychopathology: Phobias Overview

Psychology - Psychopathology: Phobias Overview

1. Classification and Diagnosis

   • Clinical Characteristics
     • An anxiety disorder (agoraphobia, social phobias and specific phobias
     • Marked and persistent fear that is excessive, cued by presence or anticipation of specific object or situation
     • Person is aware that fear is excessive
     • The distress and avoidance of feared situation interferes significantly with the person's day to day living
     • The phobic situation is avoided or endured with intense anxiety or distress
     • Panic attacks are associated with phobias
     • Duration of 6 months or more
     • Diagnosis of phobic disorder only made possible if no possible physiological cause or better accounted for by another disorder
   • Validity
     • Extent to which diagnosis represents something real and distinct from other disorders, and measures what it claims to measure
     • Comorbidity with other disorders is high, suggesting that diagnostic category is not useful when deciding on treatments
     • Concurrent validity- compared one method of diagnosis with another.
     • Construct validity - extent to which test measures target construct, eg phobics might underestimate coping in social situations
     • Comorbidity supported - Eysenck (1997) found 66% comorbid and Vasey and Dadds (2001) reported little relationship and treatment success
     • Concurrent validity demonstrated - Mattick and Clarke (1998) - SPS correlated well with other measures
     • Construct validity demonstrated eg SPAI correlates well with behavioural measures of social phobia (Beidel et al. 1989)
     • Validity may be compromised when using computer based diagnosis, because it lacks ability to facilitate disclosure of troubling information (Heimberg et al. 1999)
     • Cultural differences in diagnosis means cultural norms determine what is "normal" functioning (taiijin-kyofusho in Japan)
   • Reliability
     • Refers to consistency of measuring instrument or scale to assess fear ratings.
     • Measured by degree of agreement over symptoms (inter-rater reliability) and consistency scores on different occasions (test-retest reliability)
     • Skyre et al. (1991) - high inter-rater reliability for diagnosis of phobias using SCID-1.
     • Hiller et al (1990) - high test-retest reliability for diagnosis of specific phobias using MDC
     • SCID requires extensive training and this enhances reliability
     • Some studies have found lower levels of test-retest reliability, particularly over longer-term intervals (Kendler et al. 1999)
     • Picon et al. (2005) found high test-retest reliability (more than +.80).
     • Low reliability may be due to poor recall of fears or different criteria used by interviewers
     • Reliability improved using computerised scales reducing opportunity for interviewer effects (Kobak et al., 1992)

2. Therapies for phobic disorders

3. Explanations of Phobic Disorders

   • Biological Explanations