Lecture 1: The acquisition of phobias C83MLP Mechanisms of Learning and Psychopathology Dr. Mark Haselgrove

Lecture 1:

The acquisition of phobias

C83MLP Mechanisms of Learning and Psychopathology

Dr. Mark Haselgrove

Content of Lecture

(2) Reminder of Conditioning terminology/procedures

(3) The acquisition of Phobias

(1) Introduction and Overview of module

What is a phobia?

What causes a phobia? - Traditional Conditioning account

- Rachman’s challenge

- Contemporary learning theory view

Retrospective studies of Phobia acquisition

How do we treat them

Role Staff Member Room Email

Module ConvenorDr Mark Haselgrove

Psychology C09 [email protected]

Teaching StaffDr Jasper Robinson

Psychology B33 [email protected]

Teaching StaffDr Charlotte Bonardi

Psychology B27 [email protected]

Teaching StaffDr TobiasBast

Psychology C82 [email protected]

C83MLP Introduction and Overview


Syllabus Plus Timetable Week

Teaching Week

Week Commencing Comments

Lecture/Seminar date Teacher Lecture/seminar

1 1 24/09/2012

Autumn teaching START 27/09/12 N/A No Lecture No Lecture

2 2 01/10/2012Autumn Semester 03/10/2012 MH Lecture: Introduction & Phobias

3 3 08/10/2012Autumn Semester 10/10/2012 MH Lecture: Conditioning and Cancer

4 4 15/10/2012Autumn Semester 17/10/2012 CB Lecture: Time & Causality

5 5 22/10/2012Autumn Semester 24/10/2012 CB Lecture: Learning to tell things apart

6 6 29/10/2012Autumn Semester 31/10/2012 (1) MH/(2)CB Seminars: (1) Exam Answers on Phobias (2) Topic by request

7 7 05/11/2012Autumn Semester 07/11/2012 JR Lecture: Higher order learning 1

8 8 12/11/2012Autumn Semester 14/11/2012 JR Lecture: Higher order learning 2

9 9 19/11/2012Autumn Semester 21/11/2012 (1) CB/ (2) JRSeminars: (1) Topic by request (2) Revision on 2nd order conditioning

10 10 26/11/2012Autumn Semester 28/11/2012 TB Lecture: Memory & hippocampus 1

11 11 03/12/2012Autumn Semester 05/12/2012 TB Lecture: Memory & hippocampus 2

12 12 10/12/2012term finishes Friday 14 Dec 12/12/2012 TB Seminar: Revision questions and Q&A on hippocampus

13Vacation 17/12/2012Christmas




17Assessment 14/01/2013Assessment


Autumn Term


Spring Term

19 1 28/01/2013Spring Semester 30/01/2013 MH Lecture: Depressive realism

20 2 04/02/2013Spring Semester 06/02/2013 CB Lecture: Contextual control of learning.

21 3 11/02/2013Spring Semester 13/02/2013 JR Lecture: Neural substrates of attention

22 4 18/02/2013Spring Semester 20/02/2013 (1) JR/(2) MHSeminars: (1) Simulating configural learning with RW model (2) Revision of depresive realism & ITI hypothesis

23 5 25/02/2013Spring Semester 27/02/2013 CB Lecture: Learning about complex representations

24 6 04/03/2013Spring Semester 06/03/2013 (1) CB/ (2) MH Seminars: (1) Topic by request (2) Dissertation Meeting

25 7 11/03/2013Spring Semester 13/03/2013 MH Admin Lecture: Dissertation Groups

26 8 18/03/2013Spring Semester 20/03/2013 MH/TB/CB/JR Dissertation tutorial - Student presentations/ Discussions

27Vacation 25/03/2013Easter






33 11 06/05/2013 (Monday this week is May Bank Holiday) 08/05/2013 JR Seminars: Exam Essay Plans - Sticky board session

34 12 13/05/2013Revision/Assessment N/A No Lecture No Lecture




38- 10/06/2013-

39- 17/06/2013term finishes Friday 21 June

HAND IN DISSERTATIONS BY Tuesday 7th MAY 2013

Brilliant reading

Out Now!

Chapters relevant to lectures on:PhobiasANVDepressive realism

Also chapters on:Schizophrenia Drug addiction Relapse

Potential use for C83CLI??

A reminder of some terminology and facts…

Unconditioned Stimulus (US): Biologically significant event (e.g. food, pain)

Unconditioned Response (UR): The response evoked by the US

Conditioned stimulus (CS): Previously neutral stimulus (e.g. tone) that acquires a response by being paired with a US

Conditioned response (CR): The response evoked by the CS

Shock

(US) → (UR)

Clicker → → Jumping Jumping

(CS) → (CR)

Conditioning and Learning

What is a phobia?

“Irrational” fear of an “objectively harmless” stimulus

Fea

r

Reality of Danger

A

BA: Accountant at work

B: Oil rig worker in North sea

C

D

C: Bomb disposal worker

D: Phobia!

What is a phobia?

DSM-IV categories:

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)

What causes a phobia?

Associative learning (Conditioning) account:

Acquired through experience of phobic stimulus (CS)being paired with a really frightening or painful event (traumatic US)

e.g. Dental phobia

Street....Waiting room….Dentist’s chair….sight of drill/needle PAIN

Potential phobic stimuli

CS(First order)

Aversive USHigher-order CSs

Dentist’s waiting room (e.g.) associated with aversive US (pain)- thus evokes anxiety/avoidance

How do we treat it?

e.g. Dental phobia

Street....Waiting room….Dentist’s chair….sight of drill/needle PAIN

Potential phobic stimuli

e.g. Systematic desensitization

(1) Teach relaxation techniques (e.g. slow breathing)(2) Establish hierarchy of fear (low-high)(3) Work up hierarchy, pairing each level with relaxation Monitor success

with fear ratings

Relaxation


Rachman (1990) – Need to revise conditioning model

(1) Phobics can’t always recall an experience wherephobic stimulus paired with traumatic event

(2) People who experience Stimulus → Trauma don’t always go on to develop a phobia of that stimulus

(3) Incidence of phobias ≠ likelihood of experiencing Stimulus → Trauma

(4) People can have phobias of things never experienced (e.g. snake phobia in town dwellers)

Rachman proposed 3 pathways to fear…

(1) Conditioning (as on previous slide)(2) Vicarious (observing another person expressing fear of a stimulus)(3) Information/Instruction (stories/warnings)

N.B. All pathways propose an associative experience, But not necessarily “real” stimulus or “real” trauma


Contemporary learning theory can address some of Rachman’s problems…

(i) Prevention of associative learning (Davey, 1989)

Despite CS-US pairings, associative learning may not take place…

(A) Latent inhibition(B) Overshadowing, Blocking

Discussion point:What are these?


(ii) Experience after original associative learning (Davey et al. 1993)

Associative learning will only give rise to a fear CR, if the US is evaluated asaversive

Evaluation of US can ↑ or ↓ and alter the CR

e.g. Dentists waiting room → Drill (not painful)

Association formed, but drill is not aversive, thus no fear of waiting room.

- Later a friend reports traumatic experience with drill…person evaluates drill as aversive….waiting room evokes fear



(iii) Selective associations

Some CS-US associations are predisposed to be learned, others not.Biases present in people, monkeys and rats

e.g. Cook & Mineka (1990) – Monkeys readily associate sight of snake, but not flowers, with fear in another monkey.

e.g. Garcia & Koelling (1966) - Flavour → Illness

Light → Shock

Flavour →Shock

Light → Illness

Easy to Learn

Hard to Learn

Might explain why some phobias are very common, despite few opportunities to learn



(iv) S-R associations

- Phobic stimulus may not be associated with a painful/aversive US (S-S learning)

- But with fear of threat (S-R learning)


e.g. Dentists waiting room Drill (not painful)

Belief that drill will cause pain (Anxiety)

S-S

S-R

Some phobic learning (e.g. agoraphobia) may result from “false alarm” experiences - including panic attacks rather than true harm/danger.


All foregoing accounts imply some form of associative experience is important for acquisition of phobia (not necessarily 1st order conditioning though)

Menzies & Clarke (1995) – Suggest experience is not necessary for phobia

- Many fears develop without learning (fear of heights, water, strangers)

- Selective associations taken as evidence for this (unlearned tendency for fear …… not for prepared learning)

- Learning is important for loss of fear not acquisition

Merckelbach, de Jong et al (1996) – Disagree. Evidence for learning origin is convincing.

So, we need research on what experiences people with phobias have had (and ask whether these are different from experiences of non-phobics)….

Retrospective studies

Best if research could be Prospective (i.e. look at what happened before phobia)

- Nearly all research retrospective – Done with people who already have phobia- Reports of experience potentially inaccurate/distorted

Öst (1991) – review of retrospective studies in clinical phobics Used Öst/Hugdah POQ – Phobic Origins Questionnaire

9 Questions (Did you have this type of experience - Yes/No Answers)

Conditioning (2 qs) Experienced phobic stim +real aversive eventVicarious (4 qs) Observed other person showing fear of aversive eventInstruction (3 qs) Given information that phobic stimulus is harmful

Focused on how people believe phobia started – responses classified in above types (or no recall of experience)

80%-90% of people came into one of the categories (conditioning most common)

e.g. animal phobia - 48%, social phobia - 51%, agoraphobia - 81%


McNally & Steketee (1985) 22 severe animal phobics (incl. 10 snake phobics)

Structured interview focussing on experiences round the start of phobia

- 15 (68%) could provide no information re onset of phobia- of 7 who could recall, 5 reported conditioning-like experiences

Also asked what they feared would happen if did encounter phobic animal..41% - feared harm from animal91% feared panic or similar (c.f. S-R model)

Results linked to concept of “anxiety sensitivity”, common in many anxiety disorders. Afraid of being afraid….


Himle et al (1991) reviewed case records of 89 simple phobics. 4 phobia subtypes:

animal/insect blood/injury situational choking/vomit

Raters classified “onset events” into 5 types. 96% agreement between independent raters. Only 5/89 could not be classified

1. Realistic, e.g. attack or bite by animal; car crash (S-S)2. Spontaneous, e.g. uncued anxiety attack while driving (S-R?)3. Vicarious/observational learning, e.g. fearful parent4. Gradual onset, no identifiable event5. Lifelong fear, can never remember not having it.

Phobia Realistic Spontaneous Vicarious Gradual Lifelong

Animal (n=22)

Situational (n=37)

Blood/Injury (n=10)

Choke/Vomit (n =9)

60.9

31.7

50

60

0

43.9

10

10

8.7

2.4

40

20

8.7

9.8

0

0

17.4

2.4

0

0

Mode of Onset (%)


None of the previous studies showed experience is critical for phobia acquisition

- no non-phobic controls. Need to show experiences of 2 groups are different.

Doogan & Thomas (1992) – Fear of dogs in adults and children

Follow-up of study by DiNardo et al (1988), who found no diffs in frequency of aversive (S-S or S-R) experiences in high and low dog fearers.

D &T replicated and looked a children to get around “Memory problem”

100 students & 30 children (8-9 yr olds) classified as high or low on fear of dogs (self report). 9 children dropped because of inconsistent responses

Asked by questionnaire/interview if they had had any of the following experiences:


Doogan & Thomas (1992) continued…

Bitten by dog at least once

Frightened by dog at least once

At least 1 frightening or painful encounter with a dog

of these, % who had no direct contact with dogs

prior to 1st frightening/painful encounter

Mother dislikes dogs

Observed fear in others

Distressed by reports of dog attacks

Warned about dogs as a child

High fear Adults

Low fear Adults

High fear Kids

Low fear Kids

16

48

84

95

60

44

80

28

33

12*

65

31*

45

29

44*

15

9

73

91

90

45

27

82

64

0

30*

70

71

50

40

50*

20*

* = sig diff between high/low group

Discussion points:Evidence for S-R learning?

Why are data in red interesting?

% saying yes

Further reading…

Documents

Lecture 1: The acquisition of phobias C83MLP Mechanisms of Learning and Psychopathology Dr. Mark Haselgrove