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Broad introduction to phobias - anxiety disorders.

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  • Systematic desensitization – the person is asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Graded real-life exposure has also been used with success to help people overcome their fears.
  • The amygdala (Latin, corpus amygdaloideum) is an almond-shape set of neurons located deep in the brain's medial temporal lobe. Shown to play a key role in the processsing of emotions, the amygdala forms part of the limbic system. In humans and other animals, this subcortical brain structure is linked to both fear responses and pleasure. Its size is positively correlated with aggressive behavior across species. In humans, it is the most sexually-dimorphic brain structure, and shrinks by more than 30% in males upon castration. Conditions such as anxiety, autism, depression, post-traumatic stress disorder, and phobias are suspected of being linked to abnormal functioning of the amygdala, owing to damage, developmental problems, or neurotransmitter imbalance.The role of amygdala:
  • Phobias

    1. 1. Phobias Anxiety disorders Roman Trnovsky | |
    2. 2. Phobias  The word ‘phobia’ comes from the name of Greek God Phoebus, who fought with the enemy as he gives him a fear  Fear serves to each of us a warning of danger.  A common fear can turn into something that complicated our life - the phobia  7 - 11% of the population has specific phobias (APA, 2000) Psychotherapy  Psychodynamic approach  Behavioural approach  Cognitive model  Cognitive – behavioural model
    3. 3. What is phobia? “Irrational” fear of an “objectively harmless” stimulus. D B A: Accountant at work B: Oil rig worker in North sea Fear C: Bomb disposal worker D: Phobia! A C Reality of Danger
    4. 4. Categorisation (DSM-IV)  Agoraphobia - Public places outside home, e.g. shops trains  Social phobia - Being watched / appraised by other people  Specific phobia - grouped into:  Animals and insects  Blood / injury / medical (e.g. dentist)  Situational (e.g. driving, crowds, enclosure, air travel)  Natural Environment (e.g. heights, water)
    5. 5. Selected list of phobias  Agoraphobia  Social phobias  Specific phobias  Sexual phobias  Animal phobias Funny Phobias (YouTube)  Xenophobia  Arachnophobia  Homophobia  Acrophobia  AIDS phobia  Photophobia  Flying phobia  Nozophobia  Blood phobia  Phobophobia  Death phobia  Nomo phobia Fear of being out of mobile phone contact. Observable unreasoned Irrational or in critical and hostile which is fear of that behaviour Fear as discrimination such of phobia(s), and perceived to be foreign more specifically, of and violence on the the or strange. internal sensations basis of sexual associated that are orientationswith that nonphobia and anxiety. heterosexual
    6. 6. Frequency of specific phobias Animals Height INTENSIVE Water AVERAGE Storm Close space 5% 10% 15% 20%
    7. 7. Cognitive approach  Anxiety Automatic Thoughts  Self-attention  Cognitive mistakes Physical symptoms            Palpitations Chest strains Shortness of breath Feelings of choking Trembling Nausea Dizziness Chills or hot flushes Depersonalisation Fear of dying Losing control
    8. 8. Psychodynamic approach  The importance of unconscious conflicts from childhood.  Use defence mechanisms to cope with anxiety.  Freud theorized that phobia occurs when people converted anxiety instead of unconscious motives or desires for objects symbolize the motives and desires. Behaviourism  Functional approach - treat each phobia as the same.  Phobias are formed through classical conditioning.  Many phobias arises after experiencing traumatic events (e.g. social frustration)  Someone was drowning phobia water
    9. 9. Psychodynamic therapy 1. Identify what the unconscious fear is 2. Help the client bring it to consciousness 3. Help the client understand, accept and then change how they deal with the fear  Free association – the client relaxes and tries not to think about anything. They simply allow thoughts to enter their mind and describe them to the therapist.  Dream analysis - the client keeps a record of the things they dream about. They bring it to their therapy sessions and describe the dreams to the analyst.  Recent literature reviews have concluded that the efficacy of pharmacological treatments for phobic disorders in children is unclear.
    10. 10. Agoraphobia  Fear of situations where one would not have to call for help if something happened.  Fear of leaving the house, visiting shops, fear of crowds, public places, travelling by public transport, visit the theatre or cinema, from the enclosed space etc.  Exorbitance’s victim realizes his fear and is able to admit that there is a real danger, but rather to avoid these situations.  This significantly impairs quality of life. Affected do not drive transport equipment, do not go shopping in stores, sometimes the result that sits in his apartment on the phone, which may in case of problems related to call for help.
    11. 11. Agoraphobia Symptoms  Fear of being alone  Fear of losing control in a public place  Fear of being in places where escape might be difficult  Becoming housebound for prolonged periods of time  Feelings of detachment or estrangement from others  Unusual temper or agitation with trembling or twitching  Feelings of helplessness  Dependence on others  Feeling that the body is unreal  Feeling that the environment is unreal  Anxiety or panic attack
    12. 12. Agoraphobia Treatment  The most effective treatment of agoraphobia is a combination of psychotherapy and drug therapy.  The psychotherapeutic approaches are proven to be highly effective cognitive-behavioral therapy (CBT).  For more severe course, especially with panic attacks is recommended drug therapy. They are used SSRI antidepressants or moclobemide, for quick relief anxiolytics.  The goal is to help the phobic person function effectively.  The success usually depends upon the severity of the phobia.  Systematic desensitization is a technique used to treat phobias.  Antianxiety and antideprresive medications.
    13. 13. Social phobias  ‘A persistent fear of one or more situations in which the person is exposed to possible scrutiny by others and fears that he or she may do something or act in a way that will be embarrassing.’ (The American Psychiatric Association)  3-13% of the population suffer throughout the life. (Kessler et al., 1994)  Phobias become most often between 14 to 20 years.  The slope of phobia can be based on lack education or lack of socialization with the environment of the child. High probability of occurrence  Early childhood during the formation of a personality clash with the world  Puberty and self-realization  Creating your first partner relationships and family formation  The transition to non-productive age
    14. 14. Social phobias Causes  Inborn abnormal function of amygdala  Various diseases and disabilities  Side effects of some medications Effects  Inferiority - you can not take criticism or praise, can not say no, fear of abandonment, change, addiction, emotional closeness, fear their potential  Anxiety - is due to fear of possible threats, the voltage from a known or unknown situations  Automatic Negative Thoughts  Containment - afraid to talk about their pain and excessive expression of joy, or vice versa exaggeration of joy, as a way of masking true feelings  Hypersensitivity - fear of observation conflict, inconsistency, negative facts, weather
    15. 15. Social phobias Psychological self-defence  Avoiding stressful situations  Rationalization  Obsessive-compulsive behaviour  Delusions and distorted self-image  Sovereign behaviour  Aggression  Alcohol and drugs  Work holism and careerism
    16. 16. Social phobias ? Emotion Situation Automatic thoughts Anxiety, fear, anger Eating in front of people. What happens if I will shake. Symptoms Everyone see me! Everyone think, that I am strange! I will lose self control! Tremor, heat, sweat, breathing difficulty, palpitations Behaviour Breath shortness Grip spoon Avoiding of eye contact Avoiding of similar situations
    17. 17. Social phobias Cure methods  CBT - Cognitive Behavioural Therapy  Psychotherapy with relational dynamics orientation  Art therapy, drama therapy  Psychoanalysis  Pharmacotherapy  Social skills training Exposure therapy  Patient is gradually exposed to feared situations from the simplest and less fearsome to the most complex.  Patient should be carried out systematically, under the supervision of the therapist.
    18. 18. Treatment strategies Pharmacotherapy  Benzodiazepines  Nonbenzodiazepine Anxiolytic (sedatives)  Beta-adrenergic blockades  Calcium channel blockers  Antidepressants – tricyclics  SRIs, SSRIs & MAOIs Additional Psychosocial Treatments  Relaxation  Spouse participation  Self-help (group) interventions  CBT & medication Non-traditional techniques  Eye movement desensitization & reprocessing  Virtual Reality Exposure  Thought Field Therapy (the Callahan Technique)  Interpersonal psychotherapy  Group Treatment  Homeopathic treatments (natural herbs & roots)
    19. 19. Bibliography American Psychiatric Association (2000) DSM-IV-TR. [Online] Available at: [Accessed: 08 May 2013]. American Psychiatric Association (2013) DSM-5: The Future of Psychiatric Diagnosis. [Online] Available at: [Accessed: 08 May 2013]. Cocks, R. (2006) Anxiety disorders: phobias: anxiety disorders such as phobias can devastate the lives of sufferers. How do behaviourism and other psychological perspectives explain this pathology? Psychology Review, 12(1), p.10. Curtis, A. (2012) Clasification and diagnosis of mental disorders. Psychology Review, 18(2), pp.10-11. Gross, R. (2010) Psychology: The Science of Mind and Behaviour, 6 edn. London: Hodder Education, an Hachette UK Company. Main, J. (2012) Clasification and diagnosis of mental disorders: The proposed DSM-5. Psychology Review, 18(2), pp.7-9. Plotnik, R., & Kouyoumdjian, H. (2011) Introduction to Psychology, 9th edn. Belmont, USA: Wadsworth, Cengage Learning. Stern, R. (1995) Mastering Phobias: Cases, Causes, Cures. London: Penguin Books Ltd. World Health Organization (2010) International Classification of Diseases (ICD). [Online] Available at: [Accessed: 08 May 2013].