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Normality
 Generally psychologists agree that normality refers to
patterns of behaviour or personality traits that are
typical.
 Sometimes it is very easy to distinguish what is normal
and what is abnormal. At other times it is harder to
make this decision.
Look at the following behaviours and
decide which are normal and which are
abnormal.
 Being scared of hairy spiders
 Enjoying sky diving
 Wearing black makeup and clothing
 Changing your plans because of a horoscope prediction
 Walking arm in arm down the street with a friend of the same sex
 Having a belly button that sticks out
 Being in love with someone you have never met
 Achieving an extremely high score on an IQ intelligence test
 Preferring to live alone, isolated from others
 Being able to provide help to someone in need of it, but choosing not
to.
Normality and abnormality
 There are six different approaches that have been
proposed for describing normality and abnormality:
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Socio-cultural approach
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Functional approach
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Historical approach
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Situational approach
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Medical approach
-
Statistical approach
Socio-cultural approach
 Thoughts feelings and behaviour that are appropriate
or acceptable in a particular society or culture are
viewed as normal and those that are inappropriate or
unacceptable are considered abnormal.
 The socio-cultural approach considers whether
behaviour is typical according to the cultural values
and beliefs of a particular society- whether the
behaviour fits in with the norms of that society.
 Eg. In some cultures crying and wailing at the funeral
of a stranger is expected and considered normal,
whereas in other cultures that is considered abnormal.
Functional approach
 Thoughts, feelings and behaviour are viewed as normal if
the individual is able to cope with living independently in
society, but considered abnormal if the individual is unable
to function effectively in society.
 The functional approach defines normality by the level of
one’s ability to interact and involve oneself in society.
 Eg. Being able to feed and clothe yourself, find a job, make
friends and so on is normal, but being so unhappy and
lethargic that you cannot get out of bed, cannot eat
properly and cannot find a job is abnormal.
Historical approach
 What is considered normal and abnormal in a
particular society or culture depends on the era, or
period of time, when the judgment is made.
 The historical approach to defining normality depends
on the period of time, century or era in which the
judgment is made.
 Eg. Prior to the 20th century, if a parent severely
smacked their child for misbehaving, few people would
have considered this to be abnormal, but in western
societies and cultures today, such behaviour would be
considered abnormal and perhaps even illegal.
Situational approach
 Within a society or culture, thoughts, feelings and
behaviour that may be considered normal in one
situation may be considered abnormal in another.
 The situational approach refers to the social situation,
behavioural setting or general circumstances in which
the behaviour occurs.
 Eg. If you were to come to school wearing pyjamas
most of your friends would think that was abnormal,
however it is considered normal to wear pyjamas to
bed.
Medical approach
 Abnormal thoughts, feelings or behaviour are viewed
as having an underlying biological cause and can
usually be diagnosed and treated.
 According to the medical approach an individual is
considered normal if they are physically healthy while
abnormality is determined by having an illness that has
an underlying physical cause.
 Eg. Someone who is colour-blind would not be
considered as normal. Neither would someone with a
common cold.
Statistical approach
 The statistical approach is based on the idea that any
behaviour or characteristic in a large group of individuals is
distributed in a particular way; that is, in a normal
distribution.
 The statistical approach defines normality based on the
experiences and behaviours of the statistical majority.
 Generally if a large majority of people, called the ‘statistical
average’, think, feel or act in a certain way, it is considered
normal.
 Eg. It is normal to laugh when tickled because most people
do but to laugh when someone dies would be abnormal
because not many people would do this.
Approaches to defining
normality and abnormality
 Psychologists acknowledge that none of these
approaches is entirely satisfactory on its own.
However, each approach has contributed to the
understanding of normality or abnormality.
 Normality is often defined as a pattern of thoughts,
feelings or behaviour that conform to a usual, typical
or expected standard. These standards, however, may
depend upon many different factors.
 In one form or another, each of the six approaches has
influenced the way normal and abnormal thoughts,
feelings and behaviour are viewed and studied.
Approaches to defining
normality and abnormality
 Identifying the meaning of abnormality in relation to
mental processes and behaviour is of greater concern
to psychologists because of the implications when
diagnosing and treating mental health problems.
 Abnormality may be defined as a pattern of thoughts,
feelings or behaviour that are deviant, distressing and
dysfunctional.
Deviant, distressing and
dysfunctional.
 Thoughts feelings and behaviour are considered:
-
Deviant when they differ or vary so markedly from
social or cultural norms ‘governing’ behaviour that
they can reasonably (or legally) be considered
inappropriate or unacceptable
-
Distressing when they are unpleasant and upsetting to
the person experiencing them and/or others around
them
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Dysfunctional if they are interfere with the person’s
ability to carry out their usual daily activities in an
effective way.
Health and illness
 According to the world health organisation (WHO)
health is a state of complete physical, mental and
social wellbeing and not merely the absence of illness
or disease.
 Physical, mental and social wellbeing are all equally
important to the overall health of any individual.
 Illness refers to a person’s subjective experience of
feeling unwell in relation to one or more aspects of
their health including the way they think about their
physical, mental and social health.
Health and illness
 Physical wellbeing primarily involves the body and such
activities as exercising regularly, eating well, being well
rested, and maintaining a body weight that is biologically
appropriate for the individual.
 Mental wellbeing primarily involves the mind and such
activities as expressing feelings calmly even when angry or
sad and rational thinking.
 Social wellbeing primarily involves personal relationships and
interactions with others and such activities as getting along
with family, friends and acquaintances, giving and receiving
social support when needed and making and keeping friends.
Differentiating physical
health from physical illness
 Physical health refers to the body’s ability to function
efficiently and effectively in work and leisure activities,
to be in good condition, to resist disease and to cope in
threatening or emergency situations. (Temperature,
heart rate, blood pressure, cholesterol, breathing etc)
 Physical illness refers to our subjective experience of a
disease or physical health problem that interferes with
the normal functioning of our body and adversely
impacts on our ability to function effectively in
everyday life.
Differentiating mental
health from mental illness
 Mental health and mental illness primarily involve the
mind whereas physical health and physical illness
primarily involve the body.
 Mental health is the capacity of an individual to
interact with others and the environment in ways that
promote subjective wellbeing, optimal development
throughout the lifespan and effective use of a person’s
cognitive, emotional and social abilities.
 Characteristics of good mental health include being
able to establish and maintain positive social
relationships and to cope effectively with problems and
issues that arise in everyday life.
Differentiating mental
health from mental illness
 Mental health is not something that we either have or
do not have.
 Therefore, mental health is often represented as being
on a continuum, ranging from:
-
mentally healthy, when we are functioning well and
coping with the normal stressors of life
-
through to a mental heath problem
-
through to a mental illness that may be serious or
prolonged.
 Mental illness describes a psychological dysfunction that
usually involves impairment in the ability to cope with everyday
life, distress, and thoughts, feelings and/or behaviour that are
atypical of the person and may also be inappropriate within
their culture.
 Dysfunction means that the person does not think, feel and/or
behave as they normally do and it affects their ability to cope
effectively with everyday life experiences.
 When a person experiences distress they are very upset, anxious
and/or unhappy.
 Impairment in the ability to cope with everyday life is another
characteristic of mental illness. If a person is unable to do the
things they normally do on a daily basis because of their
mental state, they are considered to have impaired functioning.
 Atypical means that the person responds in a way(s) that is not
normal, or ‘typical’ for them.
The biopsychosocial
framework
 The biopsychosocial framework is an approach to
describing and explaining how biological,
psychological and social factors combine and interact
to influence a person’s physical and mental health.
 This framework is based on specific factors from each
domain which combine and interact to influence our
wellbeing.
The biopsychosocial
framework
 Biological factors- involve physiologically based or determined
influences, often not under our control, such as the genes we
inherit and our neurochemistry.
 Psychological factors involve all those influences associated
with mental processes such as how we think; learn; make
decisions; solve problems; perceive our internal and external
environments; manage emotions and deal with stress.
 Social factors are described broadly to include such factors as
our skills in interacting with others, the range and quality of
our interpersonal relationships, the amount and type of
support available when needed as well as socio-cultural
factors.
The biopsychosocial
framework
 This framework represents a holistic view of health meaning
that it looks not only at the internal aspects of the individual
but also the external circumstances.
 It views each of the three domains as equally important for
both physical and mental health.
 Eg. A personality disorder might best be explained by the
combined influence of an individual’s inheritance of certain
genes and impaired functioning of part of the brain that
controls impulsive behaviour (biological) poor self image and
an intense fear of abandonment (psychological) and their strict
upbringing and lack of skills required to develop and
maintain social relationships (social).
Pic pg 555
 Biopsychosocial model
Classifying mental disorders
 Clinical psychologists, psychiatrists and other mental health
professionals classify mental health problems and disorders
in different categories according to characteristic patterns of
thoughts, feelings and behaviour.
 Classification is the organisation of items into groups on the
basis of their common properties.
 Often the groups into which items are organised through
classification are referred to as categories or classes.
 Classification makes it easier to identify and understand
relationships between different groups.
Categorical approaches to
classifying mental disorders
 To help provide guidelines and a standard for classification of
mental illnesses, categorical approaches of defining mental
disorders have been developed.
 Categorical approaches involve grouping psychological
problems into broad categories, or groups, with common
symptoms.
 This is a yes-no approach to classification.
 Categorical approaches classify a person’s symptoms in terms
of which specific category of mental disorder they best fit or
‘belong’ to.
 The focus is on diagnosing whether the person has or does
not have a disorder.
Categorical approaches
 A system of classifying mental conditions and disorders that
uses a categorical approach organises and describes mental
conditions and disorders in terms of different categories and
subcategories, each with symptoms and characteristics that
are typical of specific mental conditions and disorders.
 A key principle of the categorical approach is that a mental
disorder can be diagnosed from specific symptoms reported
and/or presented by a client during a mental health
assessment.
 These symptoms fit into a specific category which then
represent the disorder that the person is suffering from.
Categorical approaches
 This means that there are clear boundaries around each
disorder and that disorders do not overlap.
 Eg. The pattern of thoughts, feelings and behaviour
classified as OCD is clearly different from the pattern for
antisocial personality disorder.
 Another principle of the categorical approach is the ‘all or
nothing’ principle which means that an individual either has
a diagnosable mental disorder or does not have a disorder.
 Categorical approaches therefore view mental illness in the
same way as something like pregnancy; you are either
pregnant or you are not pregnant.
Categorical approaches
 Another underlying principle of this approach is that the
system needs to be both valid and reliable.
 Validity means that the classification system actually
organises mental disorders into discrete and distinct
disorders which enables accurate diagnosis of the disorder.
 Reliability means that the classification system produces the
same diagnosis each time it is used in the same situation.
 Inter-rater reliability indicates the degree to which different
mental health professionals diagnose the same client with
the same mental disorder.
Categorical approaches to
classifying mental disorders
 Two examples of categorical approaches to classifying
mental disorders are those provided by the Diagnostic
and Statistical Manual of Mental Disorders, Edition IV, Text
revision (DSM-1V-TR) and the International Classification
of Diseases, Edition 10 (ICD-10)
DSM-IV-TR
 The DSM-IV-TR is a categorical system for diagnosing and
classifying mental disorders based on symptoms that are
precisely described for each disorder.
 Since it was first published in 1952 it has been revised 5
times.
 There are 365 mental disorders described in the DSM-IV-TR.
They are grouped in 16 major categories and there is one
additional section, ‘Other conditions that may be a focus of
clinical attention’.
 It lists known causes of these disorders; provides statistics in
terms of gender, age of onset and prognosis; and also
provides information about some research concerning
optimal treatment approaches.
DSM-IV-TR
 Each disorder has a diagnostic criteria- this indicates the
symptoms that are characteristic of the disorder and
therefore enable assessment of the presence of the
disorder.
 Inclusion criteria- are used to identify the symptoms that
must be present in order for the disorder to be
diagnosed.
 Exclusion criteria- identify the symptoms, conditions or
circumstances that must not be present in order for the
disorder to be diagnosed.
DSM-IV-TR- separation
anxiety
 Inclusion- the presence of at least 3 of the 8 symptoms,
the symptoms must have been present for the last four
weeks, the symptoms develop before the age of 18
years, and the symptoms cause distress or impairment.
 Exclusion- separation anxiety is not diagnosed if the
symptoms can be explained by the presence of another
mental disorder.
DSM-IV-TR
 The DSM-IV-TR also includes information on:
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The typical course of each disorder
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The age at which the person is most likely to develop the
disorder
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The degree of impairment
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How common the disorder is
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Whether it is likely to affect others in the family
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The relationship of the disorder to gender, age and culture
DSM-IV-TR- nightmare
disorder
 The DSM-IV-TR also includes information on:
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The typical course of each disorder (the child usually grows out of
it)
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The age at which the person is most likely to develop the disorder
(3-6 years old)
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The degree of impairment (sleepless nights and sleep deprivation)
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How common the disorder is (11-50% of children experience this
disorder)
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Whether it is likely to affect others in the family (will affect parents)
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The relationship of the disorder to gender, age and culture (females
report nightmares more often than men)
DSM-IV-TR
 When making a diagnosis using the DSM-IV-TR,
information in relation to five different axes must be
considered in order to completely evaluate an
individual’s mental condition.
 This is why diagnosis in this system is called a
multiaxial system.
 Together the five axes are intended to provide
comprehensive and useful information when planning
treatment.
DSM-IV-TR- axis I
 Axis I describes all the mental disorders in the DSM
(except for those in axis II).
 This axis is used to identify the persons current mental
condition and relevant disorders the person may be
suffering from.
DSM-IV-TR- axis II
 Axis II describes only two categories of mental
disorders: personality disorders and mental retardation.
 A personality disorder involves a pattern of inflexible and
maladaptive ways of thinking, feeling and behaving
that are often socially unacceptable and have been
evident over a long period of time.
 A person with an intellectual disability has a significantly
below average level of intellectual functioning and
usually has difficulty in coping independently with
everyday life activities.
DSM-IV-TR- axis III
 Axis III provides information about medical conditions
that may be related to each of the mental disorders in
axis I or II.
 These conditions may give information that is
potentially relevant to understanding and planning
treatment for the individual.
DSM-IV-TR- axis IV
 Axis IV provides information about potential stressors
in an individual’s life that may be relevant to their
disorder, and is used to identify current and recent
stressors impacting on their thoughts, feelings and
behaviour and which need to be considered when
devising a treatment program.
 Eg. If a person had lost their job this may be a consideration
in diagnosis and treatment.
DSM-IV-TR- axis V
 Axis V is used to assess an individual’s overall level of
psychological, social and occupational functioning.
 This is achieved using the descriptions in the Global
Assessment of Functioning (GAF) scale provided in
the DSM.
 This information is obtained during a ‘clinical
interview’ and provides an overall numerical rating on
a 100-point scale on which ‘1’ indicates severe
impairment and ‘100’ refers to superior functioning.
Global Assessment of
Functioning
 Table 11.4
ICD-10
 The International Classification of Diseases and
Related Health Problems (ICD) is a categorical system
for diagnosing and classifying diseases and mental
disorders based on recognizable symptoms that are
precisely described for each disease and disorder.
 The ICD-10 consists of 21 chapters covering the whole
of medical practice; that is, all physical and mental
conditions and disorders.
ICD-10
 Like the DSM-IV-TR, diagnosis of a mental disorder
consists of identifying the disorder(s) that best matches
or reflects the symptoms presented by an individual.
 Diagnostic guidelines are also provided for each
disorder. Diagnostic guidelines identify the symptoms
that are characteristic of the disorder and therefore
indicate the presence of the disorder.
DSM-IV-TR & ICD-10
 Although the ICD is used in the same way as the DSM
and helps a mental health professional decide whether
or not a person can be diagnosed with a mental
disorder, the ICD is a less detailed categorical system
that the DSM.
 The ICD provides a detailed description and diagnostic
guidelines for each disorder, but it typically does not
provide information about the course, prognosis and
prevalence of each disorder as the DSM does.
Strengths of categorical
approaches
 Both diagnostic tools are based on ongoing scientific
research and regularly revised on the basis of the
research findings.
 They are comprehensive in terms of the number of
disorders included and the detail provided for these
disorders.
 Useful in educating mental health professionals and
the community about mental disorders.
 Assists mental health professionals in the diagnosis of
disorders and devising a treatment plan.
 User-friendly and provides a common language.
Limitations of categorical
approaches
 Low inter-rater reliability as different professionals
often reach different conclusions about the diagnosis.
 70% agree on the diagnosis while 30% disagree.
 At times the overlap in symptoms can lead to ‘fuzzy’
categories and uncertainty about the disorder and
diagnosis leading to misdiagnosis.
 Valuable clinical information can be lost. That is,
whenever we use categories the uniqueness of the
person is overlooked.
Limitations of categorical
approaches
 Classifying in this way often involves labeling which
can lead to many issues one of which is stigma.
-
Stigma is a sign of social unacceptability or
undesirability, often involving shame or disgrace. This
can influence the way the person feels above
themselves and they way they are viewed by others.
Dimensional approaches
 Dimensional approaches are an alternative to the categorical
approach.
 Dimensional approaches assume that normality and
abnormality are end points on the same continuum with no
clear dividing line between them.
 A dimensional approach quantifies a person’s symptoms or
other characteristics of interests and represents them with
numerical values on one or more scales or continuums, rather
than assigning them to a mental disorder category.
 Classification is therefore accomplished by assessing a person
on relevant dimensions and giving them a score on each of
these dimensions.
Dimensional approaches
 This can be done using an inventory or test with closedended questions requiring a yes or no answer or statements
requiring a rating.
 A dimension is most commonly viewed as a cluster of
related psychological and/or behavioural characteristics that
tend to occur together and can be measured.
 A key feature of the dimensional approach is that a mental
disorder is not considered in terms of whether it is present
or absent. Rather, the focus is on grading a person in terms
of the magnitude, degree or severity on particular
dimensions rather than assigning them to a diagnostic
category.
 This also helps to measure changes over time.
Dimensional approaches
Strengths of dimensional
approaches
 Many psychologists believe that the dimensional
approaches overcome the limitations of the categorical
approaches.
 They allow for the communication of a considerable
amount of information through a single diagnostic
label.
 Dimensional approaches usually take into account a
wider range of a person’s symptoms and
characteristics. They avoid slotting people into single
diagnostic categories that fail to recognize the
uniqueness of the individual.
Strengths of dimensional
approaches
 Dimensional approaches are also believed to reduce
the stigma usually associated with the diagnosis of
mental disorders because a person is not labeled in the
same way as they are using the categorical approach.
Limitations of dimensional
approaches
 For most disorders in the DSM and ICD there is no
developed inventory or system to support the
dimensional approach.
 It would be difficult and time-consuming for mental
health professionals to develop their own dimensional
inventories for each disorder.
 There is also disagreement between mental health
professionals about the number of dimensions that
would suitably represent the wide range of mental
disorder symptoms a person could experience.
Stress
 Exposure to stressful situations and events is a
common human experience.
 These events can range from a hassle to a traumatic
and overwhelming experience.
 When we are faced with a stressful situation, this is
usually caused by a stressor.
 A stressor is any person, situation or event that
produces stress.
 Stressors may be:
 Physical (extremes in temperature, loud noise)
 Psychological (changing schools, arguing with a friend)
 Internal (originating within the organism)
 External (originating outside the organism)
Stress
 Stress is an unpleasant state of physiological and
psychological tension produced by internal or external
forces, which is perceived as exceeding a person’s
resources or their ability to cope.
Stress
 Stress can affect different individuals in different
ways, depending on the severity or intensity of the
stress response, its duration and the individual
involved.
 Stress reactions or responses are the
physiological, psychological, and behavioural
responses (nausea, biting nails) that people
experience when they are confronted by a stressor.
Stress
 Mild stress can be stimulating, exhilarating,
motivating, challenging and sometimes even
desirable.
 Acute stress that produces very high arousal levels
suddenly, or chronic stress, which produces high
arousal levels for a long period of time can effect
the body both physiologically and
psychologically.
Pic page 583
Physiological responses to
stress
 Two of the most widely used models for describing
and explaining physiological responses to stress are
called the fight-flight response and the General Adaptation
Syndrome.
 Both models describe a pattern of involuntary minor
and major bodily changes that occur when we first
become aware of a stressor.
 These changes involve the sympathetic nervous system
and are generally the same for all individuals.
Physiological responses to
stress
 Any kind of immediate threat to your wellbeing is
usually a stress producing experience that triggers a
rapidly occurring chain of bodily changes.
 Without our awareness or conscious control our body
responds to a perceived threat by automatically
activating the fight-flight response.
Physiological responses to
stress
 Our awareness of our levels of physiological
arousal varies; sometimes we are very aware of
the changes and other times the changes are
minimal and we are not aware of them.
 We can measure our level of arousal by
measuring the level of activity in certain
physiological systems.
Fight-flight response
 The fight-flight response is a reaction that
occurs automatically, resulting in a state of
physiological arousal that prepares the body to
deal with sudden threats by either confronting
them (fight) or running away to safety (flight).
 This is an adaptive response to a threatening
situation.
 The fight-flight response is triggered by both
physiological threats and psychological threats
(anxiety, fear of failure).
Fight-flight response
 Walter Cannon (1932) found that the fight-flight
response involves both the sympathetic nervous system
and the endocrine (hormone) system.
 Changes associated can occur within seconds allowing
the organism to react to the threat quickly.
 Once the threat has passed the parasympathetic
nervous system will take over and restore normal
functioning.
Fight-flight response
 When threat is perceived, the hypothalamus is activated.
 This lower brain structure stimulates the nearby pituitary gland,
which then secretes a hormone called ACTH
(andrenocorticotropic).
 This travels through the bloodstream and stimulates the adrenal
glands.
 This chain of reactions in the physiological response to stress
involving the hypothalamus, pituitary gland and adrenal glands is
known as the HPA axis.
 When the adrenal glands are stimulated they secrete stress
hormones which include adrenalin, noradrenalin and cortisol.
Fight-flight response
 Activity in the cardiovascular system causes the heart
to beat faster.
 This enables the circulatory system to transport blood
carrying adrenalin around the body more quickly.
 As adrenalin moves around the body other systems of
the body are also activated.
 To provide energy stored fats and sugars are released
into the bloodstream and transported to the skeletal
muscles.
Fight-flight response
 In order for these sugars and fats to be converted into
energy for use by the muscular system, the body
needs more oxygen.
 This means that the organism breathes faster,
enabling the respiratory system to take in more
oxygen.
 The visual system is also alerted as the pupils dilate
to allow more light into the eye increasing the
organisms ability to see.
Fight-flight response
 All of these physiological changes occur within
a fraction of a second.
 The physiological changes that take place
when the SNS is activated are part of our
body’s preparation to act in a threatening
situation.
Fight-flight response
 Changes in arousal levels are usually shortterm particularly when the arousal is intense.
 The autonomic nervous system initiates
decreases in arousal (via the SNS) and returns
physiological functioning to normal (via the
PNS).
 Once the threat is removed, the high level of
bodily arousal subsides gradually, usually
within about 20-60 minutes.
Fight-flight response
 When this arousal persists for a long period of
time it can lead to a range of physiological and
psychological effects.
 Prolonged or intense arousal brought about by
the fight-flight response is often associated with
a state of internal tension, and can lead to a
range of physiological problems.
 This is because the body must use more
resources to deal with the threat.
Fight-flight response
 If hormones such as adrenalin, noradrenalin
and cortisol, which fight the effects of stressors,
remain at high levels for a prolonged period of
time, then the body’s overall functioning will
decline.
 The immune system becomes less effective.
Fight-flight response
 Some experienced effects are:
 Dizziness
 Aches and pains associated with muscle tension
 Heart palpitations
 Skin rashes
 Fatigue
 General feeling of being unwell.
General Adaptation
Syndrome
 Hans Selye- earliest researcher to
investigate stress.
 Exposed rats to a variety of stressors and
observed their responses to these stressors.
 The responses were generally the same;
adrenal glands were enlarged, stomach
ulcers developed, weight loss occurred and
vital glands began to shrink.
General Adaptation
Syndrome
 Selye concluded that stress is a condition that is nonspecific and which can be brought on by either internal
or external stressors.
 The condition of stress is the bodies response to both
physical and psychological demands.
 On the basis of his observations, Selye proposed that
the sequence of responses to stress that occur in an
organism follows a consistent pattern which he called
the general adaptation syndrome (GAS).
General Adaptation
Syndrome
 The general adaptation syndrome is a three stage
physiological stress response that occurs regardless of
the stressor that is encountered.
 The means that the GAS is non-specific as the same
reaction will occur whatever the source of the stressor.
General Adaptation
Syndrome
 The GAS consists of three stages;
- An alarm reaction stage
- A stage of resistance
- A stage of exhaustion.
Alarm reaction
 The first stage of the GAS is the alarm
reaction stage, which is said to occur when
the person first becomes aware of the
stressor.
 Following exposure the body goes into a
state of shock and its ability to deal with the
stressor drops below its normal level.
Alarm reaction
 Physiologically the body reacts as if it
were injured.
 The body then rebounds from this level
with a reaction called countershock when
the sympathetic nervous system is
activated and the body’s resistance to the
stressor increases.
Alarm reaction
 The organisms response is a fight-flight response and it
becomes highly aroused and alert as it prepares to deal
with the stressor.
 Adrenaline is released into the bloodstream and the
effects of the sympathetic nervous system are felt by
the organism.
 This initial stage is a general defence reaction to the
stressor, which results in a state of tension and
alertness, and readiness to respond to the stressor.
Resistance
 If the source of the stress is not dealt with
immediately and the state of stress
continues, the organism will move into a
stage of resistance.
 During the stage of resistance, the body’s
resistance to the particular stressor rises
above normal as it attempts to adapt and
cope with the stressor.
Resistance
 Hormones such as cortisol are released into
the bloodstream which helps to repair any
damage that may have occurred.
 Cortisol also weakens the immune system
and therefore interferes with the body’s
ability to fight disease and to protect itself
against further damage.
Exhaustion
 If the stressor is not dealt with successfully
during the resistance stage the organism
enters a state of exhaustion.
 This means that the effects of the stressor can
no longer be dealt with.
 The body’s resources have been depleted and
it becomes vulnerable to physiological and
psychological illness.
Exhaustion
 This stage is characterised by:
-
Extreme fatigue
-
High levels of anxiety and depression
-
Nightmares
-
Impaired sexual performance.
 Extreme exhaustion can bring on diseases such as the
flu, heart disease, arthritis and high blood pressure.
 In extreme cases the organism may die.
Strengths of the General
Adaptation Syndrome
 There is extensive research evidence that suggests stress
is associated with the initiation and progression of a
wide range of diseases, from cardiac, kidney and
gastrointestinal diseases to AIDS and cancer.
 These findings continue to be confirmed by modern
researchers.
 Most theories on stress and stress responses include the
findings from the GAS and fight-flight response.
 This means that stress can be a factor in diagnosing
and treating related illnesses.
Limitations of the General
Adaptation Syndrome
 This theory assumes that everyone has the same general,
predictable and automatic physiological responses to any
stressor.
 This means that this theory does not take into account
individual differences of responses to a stressor.
 It does not take into account any of the cognitive responses
to stress or the brains psychological perspective of a stressor.
 Not all people respond to exposure to chronic stress in the
same way.
 Most of the research is based on animal studied and
therefore may be of little relevance to the human stress
response.
Eustress and Distress
 Generally when we think about stress, we perceive it as
being a negative thing.
 Not all stress is negative or ‘bad’.
 This lead to Selye’s identification of different types of stressone being negative and one being positive.
 Eustress is a positive psychological response to a stressor, as
indicated by the presence of positive psychological states
such as feeling excited, enthusiastic, active and alert.
 Distress is a negative psychological response to a stressor, as
indicated by the presence of negative psychological states
such as anger, anxiety, nervousness, irritability or tension.
Eustress and Distress
 When stress is beneficial or desirable it can be
described as eustress.
 When stress is objectionable or undesireable, it can be
described as distress.
 This varies from individual to individual depending
upon the cognitive interpretation that they make of the
stressor.
Psychological responses to
stress
 Physiological responses described by the fight-flight
response and the GAS are involuntary and occur
automatically in response to a stressor.
 Psychological responses are not involuntary and most
of the time we have control over them, depending on
the individual.
 Psychological responses are not directly observable but
can either be inferred from observable reactions to
stressors or through self-reports or reflections from the
individual.
Psychological responses to
stress
Behavioural changes
-The way a person
looks
-Strained facial
expressions
-A shaky voice
-Hand tremors
-Muscle spasms
-Jumpiness
-Increase of decrease in
eating
-Change in sleep
patterns
-Aggression
Emotional changes
-Anxiety
-Tension
-Depressed
-Angry
-Irritable
-Short tempered
-Hopelessness
-Helplessness
-Feeling trapped
-Having a negative
attitude about yourself
Cognitive changes
-A person’s perceptions
of their circumstances
and environment may
change
-The way they learn
and think may be
effected
-Perceptions could be
distorted or exaggerated
-Difficulty maintaining
focus, making decisions
and thinking clearly
Psychological responses to
stress
 Many factors can influence the psychological responses to stress:
-
Prior experience with stressors and stress responses
-
Attitudes
-
Motivation
-
Level of self-esteem
-
General outlook on life
-
Personality characteristics
-
Coping skills
-
Perception of control
Psychological responses to
stress
 Stress is a subjective experience that depends on how
we interpret a stressor and also our own perception of
our ability to cope.
 Richard Lazarus and Susan Folkman attempted to
create a framework for evaluating how we cope with
stressful events.
 The transactional model of stress and coping
proposes that stressful experiences are a transaction
between a person and their environment; if demands
exceed resources, stress is the likely result.
Psychological responses to
stress
 In comparison to Selye’s biological explanation as to how we
respond to stress, the transactional model suggests that our stress
responses are mediated by our appraisal of the stressor and also by
the social and cultural resources at our disposal.
 Appraisal refers to the act of estimating or judging the nature or value of
something or someone.
 Lazarus and Folkman suggest that when responding to stress:
-
we initially engage in a primary appraisal, in which we decide if a
situation is threatening or positive, or relevant or irrelevant to our
situation.
-
this then sets in motion a process of secondary appraisal in which
we assess what resources are available to us in terms if coping
with the situation.
Psychological responses to
stress
 This model suggests that stress is seen as a result of
how a person appraises a situation and their abilities to
cope with it.
 Stress is thought to be experienced when the demands
on an individual exceed the necessary resources
present to deal with that stressor.
 Read example page 597.
Psychological responses to
stress
 Because we can’t escape the stressor we have to learn to cope.
 Coping is the process of ‘constantly changing cognitive and
behavioural efforts to manage specific internal and/or external
stressor that are appraised as taxing or exceeding the resources of
the person.
 Problem-focused coping involves efforts to manage or change the
cause or source of the problem; that is the stressor.
 Emotion-focused coping involves strategies to attend to our
emotional responses to the stressor. This involves strategies to
decrease the emotional component of the stressor.
 We may first have to deal with the emotional aspects of the
stressor and then attend to solving the problem.
Strengths of the
transactional model
 This model focuses on psychological determinants of the
stress response over which we have control and emphasises
the personal nature and individuality of the stress response.
 This allows for more variability in an individual’s response
to stress.
 It helps to explain why people respond in different ways to
the same types of stressors.
 Has enhanced the understanding of the importance of stress
management programs and strategies to deal with stressors
effectively.
Limitations of the
transactional model
 The major limitation of this model is that it is difficult to
test through experimental research.
 Because of its subjective nature, variability and complexity,
reliable evidence is difficult to collect.
 There is doubt as to whether we actually need to appraise
something as being stressful in order to experience a stress
response.
 Individuals may not always be conscious of, or be able to
label all of the factors that are causing them to experience a
stress response.
Social, cultural and environmental
factors that influence the stress response
 According to the biopsychosocial framework, stress is
also influence by social factors.
 These social factors include cultural and environmental
factors.
 Each factor has an impact on how the stress response
can be either exacerbated or alleviated.
Social, cultural and
environmental factors
Social
Cultural
Environmental
Social factors
 Social factors that can influence the stress response include:
-
Our relationships and social interactions with others
-
Loneliness
-
Feelings of isolation
-
Breaking up or reconciling a relationship (being in a bad
relationship)
-
Lack of social skills in forming and maintaining relationships
-
Lack of social support
-
Making a new friend or gaining a new family member
-
Experiences during recreational activities
Social factors
 Social readjustment refers to the amount of change, or
‘adjustment’ in lifestyle a person is forced to make
following a specific event in their life.
 Any change that requires an individual to adjust their
lifestyle, will cause stress in varying amounts,
depending on the stressor and the level of social
readjustment required.
 Read example page 602.
Cultural factors
 For immigrants, refugees and asylum seekers, coming
to another country can be both a stress release and a
stressor.
 In some cases the person is escaping famine, poverty,
war, torture, civil unrest etc which as a result of
moving alleviates the stress response.
 However, the demands of adjusting to a new culture
can produce or exacerbate the stress response.
Cultural factors
 People entering new cultures frequently encounter:
-
language difficulties
-
racial prejudice
-
lower socio-economic status
-
separation from family
-
conflicts over preserving their old values and beliefs while still adapting
to the customs of their new culture
-
coming to terms with the torture or murder of loved ones back home
 Research shows that belonging to an ethnic or cultural minority group
significantly increases the risk of developing a stress related physical or
mental health problem.
Environmental factors
 Environmental factors that can influence the stress
response include:
-
Crowding (study page 606)
-
Loud noise
-
Air pollution
-
Extremes in temperature
-
Catastrophes (technological and natural disasters)
Allostasis
 The biopsychosocial framework does not explain how
factors from within each domain actually combine, or come
together, when we are exposed to a stressor.
 Theorists have developed a construct called allostasis to
explain this.
 Allostasis refers to the body’s ability to maintain a stable
physiological environment by adjusting and changing to
meet internal and external demands.
 Allostasis therefore helps the body achieve stability by
changing.
 There are however costs associated with allostasis that can
result in permanent damage to the body.
Allostasis
 Allostasis revises and extends the biological construct of
homeostasis.
 Homeostasis is the body’s ability to maintain a stable physiological
environment by keeping certain bodily conditions constant, such
as:
-
Body temperature
-
Blood oxygen levels
-
Blood glucose levels
-
pH acidity
-
Water content
 While homeostasis helps to keep the body stable, allostasis helps
the body achieve stability through changing.
Allostasis
 When internal and external events cause deviation from ideal
physiological conditions, homeostatic mechanisms take corrective
action and operate to restore the steady state or balance.
 Changes associated with homeostasis occur within a relatively
narrow range with upper and lower limits.
 Eg. Body temperature
-
Outside can change more than 20 degrees in a day
-
Body temperature remains constant
-
When something pushes our body temperature above or below its
normal limits, homeostatic mechanisms trigger responses like
sweating or chills to restore the body’s set temperature
Allostasis
 In contrast to homeostasis, allostasis emphasises that
healthy functioning requires continual physiological
fluctuations and adjustments.
 Allostasis enables our body to adjust beneficially to
internal and external demands in a manner that is
different from that of homeostasis.
 In fact the word translated= allo (different) and stasis
(stability).
Allostasis
 Allostasis is achieved through the brain’s regulation of
the activities of our allostatic systems.
 These include the HPA axis, the autonomic nervous
system, and the immune and cardiovascular systems.
 In contrast to homeostatic systems, large variations in
processes regulated by allostatic systems do not lead
directly to death.
 When an individual perceives a situation as stressful
and experiences a stress response, their brain activates,
or ‘turns on’ their body’s allostatic response.
Allostasis
 When an individual has been successful in coping with
the demands of a stressor, or the stressor has passed,
the brain ‘turns off ’ the allostatic response.
 As long as the brain can turn on the allostatic response
when required and turn off the response when it is no
longer needed, the body is able to adapt to the
demands of a stressor and is not likely to suffer adverse
long-term effects.
Allostatic load
 When the allostatic mechanisms are not ‘turned off ’ after a
stress-producing experience there is overexposure to stress
hormones.
 Cumulative exposure to increased secretion of the stress
hormones can lead to wear and tear on the brain and body
known as allostatic load.
 The concept of allostatic load helps to explain how
prolonged (chronic) stress can influence the onset of
physical disorders such as cardiovascular disease, obesity,
diabetes and mental disorders like depression and anxiety.
Allostatic load
 The allostatic model explains the biopsychosocial
framework by explaining the stress response in terms
of the interaction between biological, psychological
and social factors.
 Example page 614.
Strategies for coping with
stress
 Through studying stress and the impact it can have on
the body and a person’s lifestyle, many programs and
strategies have been developed to deal with prolonged
and intense stress responses.
 Some of these are:
-
Biofeedback
-
Meditation and relaxation
-
Physical exercise
-
Social support
Biofeedback
 Physiological responses to stressors involve the coordinated
interaction of numerous bodily processes, which usually
operate automatically.
 With training, we can learn to control some of these
automatically occurring responses.
 This then minimises the adverse effects of physiological
responses when they are repeatedly turned on and off or
occur at elevated levels for a long period of time.
 This can be achieved through biofeedback training.
Biofeedback
 Biofeedback is a technique that enables an individual to receive
information (feedback) about the state of a bodily process (bio).
 With appropriate training we can learn to control a related
physiological response using thought processes.
 During the process, sensors are attached to the patient that will
give them feedback about the physiological responses to stress.
 This may show tension is a particular muscle, blood pressure or
skin temperature.

These signals are detected and analysed to provide the person
with information about the state of their bodily processes.
 The person is then taught a series of physical and mental exercises
to help them gain control over the stress response they are
experiencing.
Biofeedback
 Biofeedback can be useful in helping people learn how
to recognize and control physiological responses to
stressors in their life.
 It is used most often to relieve stress induced problems
like migraines, hypertension and headaches.
 Example page 618.
 One criticism of biofeedback is that although it can be
successful in a clinical setting, the effects may not last
when the patient leaves the clinic as they no longer
have access to the expensive feedback device.
Physical exercise
 Physical exercise is physical activity that is usually
planned and performed to improve or maintain ones
physical condition.
 A distinction is made between aerobic and anaerobic
exercise.
 Aerobic exercise requires a sustained increase in oxygen
consumption and promotes cardiovascular fitness. Eg.
running, swimming, bike riding.
 Anaerobic exercise involves short bursts of muscular
activity that can strengthen muscles and improve
flexibility. Eg. Weight training.
Physical exercise
 Physical activity and exercise is ranked second only to
tobacco control in being the most important factor in
overall health promotion and disease prevention in
Australia.
 Being physically active can substantially reduce the risk
of serious disease.
 Research evidence suggests that aerobic exercise is best
for physical and mental health although anaerobic
exercise is better than no exercise.
Physical exercise
 When an individual experiences stress the sympathetic nervous system
and HPA axis is activated, releasing the bodies stress hormones.
1. Exercise uses up the stress hormones secreted into the blood stream,
thereby helping the immune system return to normal functioning
sooner.
2. Physical activity increases our stamina for encountering future stressors.
3. Many people experience short term psychological benefits during and
after exercising because of chemical changes in the body.
4. Physical exercise can divert a persons attention away from the stressor
and negative emotional states associated with stress.
5. People who exercise with others increase their social support networks.
Social support
 Social support is help or assistance from other people when
needed.
 Social support can come from a number of interpersonal
relationships:
-
Family
-
Work
-
Teachers
-
Friends
-
Self-help groups
Social support
 Social support can take four main forms:
1.
Appraisal support- help from another person that improves the
individuals understanding of the stressful event and suggests
possible coping strategies.
2.
Tangible assistance- provides materials such as financial assistance
or good to help offset the effects of the stressful event.
3.
Information support- a person with experience can provide
information about how to cope with a stressful event.
4.
Emotional support- targets emotional reactions by reassuring a
person under stress that they are an individual who is cared for
and valued.
Meditation and relaxation
 When used for stress management, meditation is an
intentional attempt to bring out a deeply relaxed state in
order to reduce one or more effects of stress related
symptoms.
 Relaxation is any activity that brings out a state of reduced
psychological and or physiological tension.
 The activity may simply involve resting, going for a walk or
jog, or reading a book.
 When in a relaxed or meditative state people typically report
feeling calm, low level or absence of anxiety, and responses
associated with lower physiological arousal.
Meditation and relaxation
 Research findings indicate that a deep state of
relaxation is essentially the opposite to a typical stress
response.
 It has also been found that using these techniques is
more effective than using no treatment.
 A key feature is that this technique does not involve the
use of chemicals as medication does.
 Physical relaxation will lead to a state of psychological
relaxation.
 Progressive muscle relaxation is a common strategy
used to relax the body.
Anxiety and anxiety
disorders
 Anxiety is a state of physiological arousal associated with
feelings of apprehension, worry or uneasiness that something is
wrong or that something unpleasant is about to happen.
 Feeling anxious in these situations is appropriate, and usually we
feel anxious for only a limited amount of time.
 In everyday life, anxiety is an adaptive response.
 A severe anxiety response can be very useful in the short term to
deal with threatening or dangerous situations.
 Mild to moderate levels of anxiety can also make is more alert
and improve our ability to cope.
Anxiety and anxiety
disorders
 Anxiety should always be brief and temporary, and its intensity
should be related to the significance of the situation.
 If anxiety is severe and does not subside, it can be
counterproductive and disabling.
 It can reduce our ability to concentrate, learn, think clearly and
logically, plan, make accurate judgments and perform motor
tasks.
 Severe anxiety is generally accompanied by intense physiological
sensations and responses like breathlessness, sweating, trembling,
feelings of choking, nausea, dizziness, pins and needles and
feelings of losing control.
Anxiety and anxiety
disorders
 The term anxiety disorder is used to describe a group
of disorders that are characterised by chronic feelings
of anxiety, distress, nervousness and apprehension or
fear about the future, with a negative effect.
 People are likely to be diagnosed with an anxiety
disorder when their level of anxiety is so severe that is
significantly interferes with their daily life and stops
them doing what they want to do.
Phobia
 We all have fears, but they are not necessarily severe enough to interfere
with our daily lives.
 A phobia is an excessive or unreasonable fear directed towards a
particular object, situation or event that causes significant distress or
interferes with everyday functioning.
 People with a phobia often become fearful even when they think about
the object, situation or event that they dread.
 It is estimated that phobias affect approximately 3% of the Australian
population.
 As is the case with other anxiety disorders, more women suffer from
phobias than men.
 Most people who suffer from a phobia are very aware that their fears are
excessive and unreasonable but may not know how they started.
Specific phobia
 Phobias are divided into three categories in the DSM:
-
Agoraphobia
-
Social phobia
-
Specific phobia
 A specific phobia is a disorder characterised by significant
anxiety provoked by exposure to a specific feared object or
situation, often leading to avoidance behaviour.
 The specific object or situation producing the fear associated
with a phobia is commonly referred to as the phobic stimulus.
Specific phobia
 According to the DSM, any specific phobia falls into one of five
categories:
1) Animals (spiders, snakes, dogs, insects)
2) Situations (lifts, bridges, enclosed spaces, flying)
3) Blood, injections and injury
4) Natural environments (heights, darkness, thunder, lightning)
5) Other phobias (choking, vomiting, loud noised, costumed
characters)
 All phobias share common symptoms but primarily differ in that
they occur in response to different objects or situations.
Specific phobia
 When someone has a specific phobia, exposure to the
phobic stimulus triggers an involuntary response that is like
the stress response.
 In some cases the anxiety is so intense that it takes the form
of a panic attack.
 A panic attack is the unexpected onset of intense anxiety
that can last a few minutes up until an hour or so.
 Because of their awareness of their fear and the fact that
they know it is unreasonable, often people with a specific
phobia will be embarrassed or feel ‘stupid’.
Specific phobia
 People with a specific phobia begin to organise their life
around avoiding the phobic stimulus.
 Anticipatory anxiety is the gradual rise in anxiety level as a
person thinks about or anticipates being exposed to a phobic
stimulus in the future.
 A diagnosis of specific phobia is only made if the fear of the
specific object or situation has persisted for at least 6
months.
 This is the most common mental disorder among women
and the second most common among men, second to
substance related disorders.
Biological contributing
factors
 Research suggests that some people may be genetically
predisposed or inherit a tendency to develop an anxiety
disorder.
 One of the biological factors that may contribute to
anxiety disorders is the role of the stress response.
 The other is the involvement of the brain’s
neurochemistry, specifically the neurotransmitter called
GABA.
Role of the stress response
 The physiological component of specific phobia is similar to
the physiological response to stress.
 Because there is a threat or impending harm at the sight of
or thought of a phobic stimulus, the fight-flight response is
activated.
 This means all the typical sympathetic nervous system
responses occur.
 Phobic anxiety becomes a problem when the stress response
is triggered in the absence of any threat or danger like
clouds (nephophobia) or flowers (anthophobia).
 The stress response experienced as a result is often very
severe and can persist at this high level for at least as long as
the exposure to the phobic stimulus.
Role of GABA
 GABA and glutamate are naturally occurring
neurotransmitters that carry messages between neurons in
the brain.
 Gamma-amino butyric acid (GABA) is the primary
inhibitory neurotransmitter in the central nervous system
and works throughout the brain to make post-synaptic
(receiving) neurons less likely to fire.
 This neurotransmitter stops excitory neurotransmitters, like
glutamate, from getting out of control and causing
reactions like a seizure.
 As a result both have important roles in regulating central
nervous system functioning.
 It is also believed to play a role in anxiety.
Role of GABA
 The connection between the level of GABA in the
brain and anxiety symptoms has led researchers to
believe that some people develop anxiety because they
have a dysfunctional GABA system.
 A dysfunctional GABA system can result in low levels
of GABA in the brain.
 Eg. Participants diagnosed with a panic disorder had a
GABA level that was 22% lower than that of the
control group with no history or panic disorders.
Role of GABA
 The level of GABA in a persons brain may be effected by a
range of factors like:
-
Genetic inheritance
-
Exposure to prolonged stress
-
Environmental toxins
-
Nutritional deficiencies such as vitamin B6 and citric acid
-
High caffeine intake
 Some researchers have proposed that GABA levels can be
increased ‘naturally’ by drinking green tea or eating foods
high in GABA like beans, eggs or dairy products.
Role of GABA

Drugs have also been used as substitutes to highlight the effects of GABA in anxiety.

Benzodiazepines are a group of drugs commonly referred to as minor tranquillizers as
they have the effect of ‘calming down’ the body by reducing physiological arousal and
promoting relaxation.

However, they induce drowsiness and are highly addictive.

These are most commonly Valium, Serepax, Temazepam, Rohypnol and Xanax.

Benzodiazepines are GABA agonists so they imitate the role of GABA and stimulate
activity at the site of a postsynaptic neuron where GABA is received from a
presynaptic neuron.

This means that they reduce the symptoms of anxiety by acting as GABA should.

Studies have shown that benzodiazepines are effective in the management of specific
phobias, panic disorders and other anxiety disorders.

Alcohol also has similar effects on the GABA receptors, which is why alcohol is
typically experienced as relaxing.
Psychological contributing
factors to phobia
 Some of the models that have been proposed to
describe how a specific phobia can develop due to
psychological factors are:
-
The psychodynamic model
-
The behavioural model
-
The cognitive model
Psychodynamic model
 First proposed by Sigmund Freud in the late 1800’s.
 The psychodynamic model is based on an assumption
that all mental disorders are caused by unresolved
psychological conflicts that occur in the unconscious
part of the mind, beneath the level of ordinary
conscious awareness.
 These conflicts begin in early childhood during which
our urges and what society views as acceptable
behaviour often clash.
Psychodynamic model
 According to Freud, the unconscious part of our mind is
a storage place for all the information about ourselves
that is not acceptable to the conscious mind.
 He believed the unconscious contains all the memories
of experiences that may be a source of anxiety and
therefore difficult for us to bring to our conscious
mind.
 Although we are not aware of them, our unconscious
thoughts can have a huge effect on our thoughts and
behaviour.
Freud’s theory
 Following birth we progress through a series of five
psychosexual stages:
1. The oral stage (0-2 years)
2. The anal stage (2-3 years)
3. The phallic stage (4-5 years)
4. The latency stage (6 years to puberty)
5. The genital stage (puberty- early adult hood)
Freud’s theory
 Freud used the term sex to refer to something that was
‘physically pleasurable’ rather than something
specifically sexual or involving sexual activity.
 As we progress through the stages, different parts of
the body become the focus of pleasure.
 Each stage also has a crucial developmental conflict
that must be satisfactorily resolved in order to move on
to the next stage.
 When it is not resolved this can be a source of anxiety.
Freud’s theory
 Freud described anxiety as an uncomfortable or unpleasant
psychological feeling that often arises from the fear that our
instincts will make us do something we will be punished for.
 We protect ourselves from this by using defense mechanisms.
 Defence mechanisms describe the unconscious process by which
the conscious part of our mind called the ego defends or protects
itself against anxiety arising from unresolved internal conflicts.
 Defence mechanisms reduce anxiety by distorting reality at an
unconscious level.
 According to this theory we are usually not aware that we are
using defence mechanisms.
Freud’s theory
 According to Freud, a specific phobia, which he called anxiety
hysteria develops as a consequence of an unresolved Oedipal
complex.
 The Oedipal complex is a developmental conflict that emerges
during the phallic stage of psychosexual development and
describes the unconscious powerful, passionate love and desire that
the male child has developed towards his mother.
 The boy then begins to fear that his father will become aware of
this desire and punish him.
 This will take the form of castration (cutting off the male sex
organ).
 As a consequence the boy will experience anxiety.
Freud’s theory
 In order to successfully resolve this conflict the male child uses a defence
mechanism called repression to prevent these unacceptable desires to
reach their conscious awareness.
 This means the boy begins to identify with his father and believe that his
father will be less likely to castrate him.
 If repression does not work, another form of defence mechanism called
displacement will be used to try and resolve the conflict.
 Displacement involves directing feeling away from the person or object
onto a substitute object or person that is less threatening.
 This substitute object then becomes the phobic stimulus.
 The child can deal with their unresolved conflict and the anxiety
associated with it by avoiding the phobic stimulus.
 Read Hans case study page 644.
Behavioural model
 According to the behavioural model phobias are
learned through experience and may be acquired,
maintained or modified by environmental
consequences such as reward and punishment.
 The model assumes that phobias are learnt through
operant and classical conditioning processes.
 Classical conditioning plays a role in acquisition while
operant conditioning plays a role in the maintenance
of a specific phobia.
 Eg. Little Albert (others page 646).
Cognitive model
 A cognitive model focuses on how the individual processes
information about the phobic stimulus and related events.
 This refers to the cognitive or thought processes that accompany a
phobia (perceptions, beliefs, memories and expectations).
 The model emphasised how and why people with a phobia have
an unreasonable and excessive fear of a phobic stimulus.
 A key assumption of these models is that people have developed a
cognitive bias.
 A cognitive bias is a tendency to think in a way that involves
errors of judgment and faulty decision making.
Cognitive model
 Some types of cognitive bias are:
-
Attentional bias
-
Memory bias
-
Interpretive bias
-
Catastrophic thinking
Attentional bias
 Attentional bias is the tendency to selectively attend to
threat-related stimuli rather than to neutral stimuli.
 This means that a person with a phobia pays more
attention to threatening information while ignoring
non-threatening information in the environment.
 Eg. Someone with a spider phobia will see the spider
web in the room whereas the person without the
phobia will not even notice it.
 They also tend to be hypervigilint- always alert and
constantly looking around for something relevant to
their phobia that may be potentially threatening.
Memory bias
 Memory bias (also referred to as selective memory)
occurs when recall or recognition is better for negative
or threatening information than for positive or neutral
information.
 Eg. A person with a phobia of spiders will tend to
reconstruct their memory and describe a spider as
bigger, faster or more frightening than it actually was.
Interpretive bias
 Interpretive bias is the tendency to interpret or judge
ambiguous stimuli and situations in a threatening
manner.
 Eg. A person may interpret a piece of fluff on the
carpet as being a spider.
Catastrophic thinking
 Catastrophic thinking is a type of negative thinking in
which an object or event is perceived as being far more
threatening or dangerous than it actually is and will
result in the worst possible outcome.
 Eg. A person with a fear of driving may think if they
get into a car they will definitely have a crash and die.
 Individual experience heightened feelings of
helplessness and underestimate their ability to cope
with the situation.
Socio-cultural contributing
factors
 Some of the socio-cultural factors that can contribute
to the development of a phobia are:
-
Specific environmental triggers
-
Parental modelling
-
Transmission of threat information
Specific environmental
triggers
 Many people who have developed a specific phobia
often report of having a negative and traumatic
experience in the past that attributes to the cause of
their phobia.
 Eg. Phobia of driving after a serious car accident.
 These specific objects or situations in the environment
produced or triggered an extreme fear response at the
time, which is why the term specific environmental
trigger is used.
Specific environmental
triggers
 The more severe the trauma associated with an
unpleasant or harmful initial fear experience, the more
likely it is that a phobia will develop.
 If the experience is significantly traumatic, one
encounter may produce and maintain the fear
response.
 People who develop a phobia after a single traumatic
encounter with a phobic stimulus are usually able to
identify the event as causing their phobia.
Specific environmental
triggers
 Different people may react to the experience differently
causing one to develop a phobia while not affecting the
other.
 This shows that developing a phobia is not always as a result
of one direct experience, it may also be affected by other
prior experiences.
 Eg. A person who has grown up with dogs may be less
likely to develop a phobia of dogs after being bitten
compared to an individual who is bitten the very first time
they encounter a dog.
 Frequent exposure after the traumatic experience may
reduce the likelihood of a phobia forming.
Parental modelling
 Observational learning or parental modelling can also be
involved in the development of phobias through another
person’s fearful behaviour towards a particular object or
situation.
 Eg. A child who observes a parents reaction to a phobic
stimulus or hears a parent discuss their fear may be more
inclined to develop a similar phobia.
 This is because children do not know whether the fear is
rational or appropriate.
 Fears developed through observational learning can be as
strong as fears developed through direct experience,
although direct experience seems to be the most common
pathway to a phobia.
Transmission of threat
information
 Most people with a fear of flying have never been in a
plane crash yet fear of flying is one of the more
common phobias.
 Transmission of threat information refers to the
delivery of information from parents, other family
members, peers, teachers, media and other secondary
sources about the potential threat or actual danger of a
particular object or situation.
 Eg. A person may develop a flying phobia after watch
graphic television coverage of a plane crash.
Socio-cultural contributing
factors
 Specific environmental triggers involve direct experience
with the phobic stimulus whereas parental modelling
and transmission of threatening information involve
indirect experience.
Psychological management
of specific phobias
 Some of the therapies available include:
-
Cognitive behavioural therapy (CBT)
-
Systematic desensitisation
-
Flooding
Cognitive behavioural
therapy
 This type of therapy involves altering the thoughts and
behaviours that maintain a persons phobia.
 Cognitive behavioural therapy combines cognitive
and behavioural therapies to help people manage
mental health problems and disorders.
 Cognitive therapy is a type of talking therapy that
focuses on the role of cognitions (thoughts, beliefs,
attitudes) in determining emotions and behaviour.
 It helps people to become aware of their maladaptive
thinking that can trigger and fuel a phobic response.
Cognitive behavioural
therapy
 Behavioural therapy is the clinical application of
learning theories such as classical and operant
conditioning.
 This form of therapy deals with maladaptive
behaviours such as avoidance and reduced activity
levels which can maintain or worsen a persons
psychological problems.
 This is not necessarily a talking therapy.
 The therapist exposes their client to a new
environmental condition designed to retrain them into
more adaptive habits.
Cognitive behavioural
therapy
 CBT is based on the assumption that the way people
feel and behave is largely a product of the way they
think.
 Anyone can change the way they feel and behave by
thinking about a situation in a more balanced and
helpful way.
 CBT does not involve talking freely or dwelling on
events in a person’s past to gain an insight into their
psychological state.
CBT for specific phobias
 When using CBT to treat specific phobia, mental
health professionals encourage their client to first
identify their fear and anxiety related thoughts.
 The client is then encouraged to look for evidence that
supports their fear and evidence that does not support
it.
 Sometimes the fear may arise from lack of information
or from incorrect information.
 Therefore they are encouraged to gather accurate
information about their phobic stimulus.
CBT for specific phobias
 Once the person has identified their cognitive distortion and
evaluated the evidence they are more able to evaluate their
maladaptive thoughts.
 This will lead to changes in their feelings and behaviour,
particularly a reduction in fear, anxiety and avoidance.
 The therapist may then ask the patient to engage in a
behavioural experiment.
 This involves planned activities undertaken by the client to
help them to realise that the likelihood of a traumatic event
occurring is unlikely.
Behavioural experiment
 A behavioural experiment may follow the following format:
1. Make a prediction (the client specifies the maladaptive
thought they are testing)
2. Review existing evidence for and against the prediction
3. Devise a specific experiment to test the validity of the
prediction
4. Note the results
5. Draw conclusions
Systematic
desensitisation/graduated
exposure
 Systematic desensitisation is a kind of behaviour
therapy that aims to replace an anxiety response with a
relaxation response when an individual with a specific
phobia confronts a stimulus.
 The process involves unlearning the connection between
the anxiety and the object and replacing feelings of
anxiety with feelings of relaxation.
 The three step process requires the patient to learn to
relax while gradually facing increasingly anxietyproducing phobic stimuli.
Systematic
desensitisation/graduated
exposure
 The first step involves teaching the client a relaxation strategy that they
can use to decrease the physiological symptoms of anxiety when
confronted with the phobic stimulus.
 These strategies may include progressive muscle relaxation, visual
imagery or the slow breathing technique (SBT).
 SBT involves learning to slow down the rate of breathing:
-
Hold your breath for six seconds
-
Breathe in and out on a six-second cycle, saying the word relax as you
breathe out
-
After one minute hold your breathe again then continue to breathe on a
six-second cycle
-
Repeat the sequence until anxiety has diminished.
Systematic
desensitisation/graduated
exposure
 The second step in systematic desensitisation involves
breaking down the anxiety-arousing object or situation into
a sequence arranged from least to most anxiety arousing.
 A fear hierarchy is a list of feared objects or situations,
ranked from least to most anxiety producing.
 Ideally fear hierarchies should consist of 10-15 specific
situations, each of which is rated and then ranked on a 100point scale.
 Each situation should provide detail like time of day,
duration of exposure and involvement of other people.
Systematic
desensitisation/graduated
exposure
 The third step involves the systematic graduated
pairing of items in the hierarchy with relaxation by
working upward through items in the hierarchy one
‘step’ at a time.
 This can be in vivo (real life), visual imagery or virtual
reality.
 At all steps the person is encouraged to relax and no
advancement is made to the next step until relaxation
is achieved.
Flooding
 Unlike systematic desensitisation, flooding does not have a relaxation
component to it.
 Flooding involves bringing the client into direct contact with their most
feared object or situation straight away and keeping them in contact
with it until their fear and associated anxiety disappears.

Unlike systematic desensitisation flooding is used to deliberately
produce a massive amount of fear or anxiety in the client.
 Anxiety will be experienced at a very high level and then gradually
diminish, thereby enabling the client to come to learn that it is actually
quite harmless.
 The client will self-report their anxiety levels until it drops to a low level.
 Flooding can be an effective technique when correctly used.