Is he mentally ill?

Disrupting fear, avoidance out of proportion to the danger posed by a particular object or situation; generally recognized as groundless by sufferer

Five subtypes: Animal, Natural Environment, Blood-Injection-Injury, Situational, Other

Common ones: claustrophobia, acrophobia (ht), agoraphobia (open, public spaces)

Common in women

Lifetime prevalence—12%

Animal, dental, and blood-injection-injury typically begin in childhood

Agoraphobia and claustrophobia—adolescence and early adulthood

Animal phobias are most common, but tend to diminish with time, even without treatment

Blood-injection-injury—3-4 % of population, but about 15 % of adults have had a blood or injury related fainting spell

• Disgust is as common as fear
• Initial heart acceleration, followed by a drop in rate and pressure
• Leads to nausea, dizziness, and or fainting (don’t find this with other phobias)

Psychodynamic viewpoint—look at content of phobia. Today view phobia as defensive in some way, such as fear in place of something else.

• Psychodynamic viewpoint—look at content of phobia. Today view phobia as defensive in some way, such as fear in place of something else.

• Behaviorist viewpoint

• Classical conditioning and generalization
• Direct traumatic conditioning (think of the dentist)
• Vicarious conditioning—Mineka and Cook

• Cognitive factors maintain fear

• Evolutionary preparedness

• Cognitive viewpoint

• Phobics are attuned to stimuli that elicit fear—shadowing studies—phobics attend to ear that they are supposed to ignore and start saying phobia-related words
• Also—socially anxious—concerned about evaluation

• Genetic and temperamental—

• ANS—more easily aroused
• 1st degree relatives have increased likelihood of all anxiety
• Behaviorally inhibited toddlers (21 mos)

Systematic desensitization—fear hierarchy; in vivo or in session

• Systematic desensitization—fear hierarchy; in vivo or in session

• Exposure

• Modeling

• Anxiolytics—not effective

• Cognitive—dispute irrational beliefs—not effective alone, not much incremental benefit

Fear of one or more specific social situations—fear is really of scrutiny by others and potential embarrassment

• Fear of one or more specific social situations—fear is really of scrutiny by others and potential embarrassment

• About 60% of sufferers are women. Lifetime prevalence rates vary—your book says 12%, I’ve seen as low as 2%

• Onset is typically in adolescence

• Culture—in collectivist cultures—fear of offending others or bringing shame to the family; individualist cultures—guilt or embarrassment

• High comorbidity with GAD, panic, specific, compulsive PD, depression

Learning—

• Learning—

• Direct or vicarious conditioning such as experiencing or witnessing a social defeat
• More likely to have grown up with parents who were socially isolated or avoidant
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