For Specific phobias the average age of onset is around 7 to 9 years. People with specific phobias know that their fear is excessive, but are unable to overcome their emotion. The disorder is diagnosed only when the specific fear interferes with daily activities of school, work, or home life.
There is no known cause, although they seem to run in families and are slightly more prevalent in women. If the object of the fear is easy to avoid, people with phobias may not feel the need to seek treatment. Sometimes, however, they may make important career or personal decisions to avoid a situation that includes the source of the phobia.
Social phobia is a disorder that is often thought of as shyness, the two are not the same. Shy people can be very uneasy around others, but they do not experience the extreme anxiety in anticipating a social situation - and, they do not necessarily avoid circumstances that make them feel self-conscious. In contrast, people with social phobia are not necessarily shy at all, but can be completely at ease with some people most of the time. Most people experiencing social phobia will try to avoid situations that provoke dread or otherwise cause them much distress.
Social phobia is diagnosed when the fear or avoidance significantly interferes with normal, expected routines, or is excessively upsetting. Social phobia disrupts normal life, interfering with career or social relationships. It often runs in families and may be accompanied by depression or alcoholism. The age of onset tends to be around 15 years and is most prevalent in people aged 18 to 29 years.
Most people with agoraphobia develop the disorder after first suffering a series of one or more panic attacks. The attacks occur randomly and without warning, and make it impossible for a person to predict what situations will trigger the reaction. This unpredictability of the panic causes the person to anticipate future panic attacks and, eventually, fear any situation in which an attack may occur. As a result, they avoid going into any place or situation where previous panic attacks have occurred.
People with the disorder often become so disabled that they literally feel they cannot leave their homes. Others who have agoraphobia, do go into potentially "phobic" situations, but only with great distress, or when accompanied by a trusted friend or family member. Persons with agoraphobia may also develop depression, fatigue, tension, alcohol or drug abuse problems, and obsessive disorders, making seeking treatment crucial. Onset of agoraphobia is generally in early adulthood and is common in females.
Although phobics perceive their disorder to be beyond their control and wish to be rid of it, with the exception of agoraphobics, the phobic’s everyday functioning is unimpaired.
- The Biological explanations of the disorder.
In order to investigate potential genetic factors in the predisposition to suffer phobic reactions researchers look at. Firstly, the family history of the sufferer (to see whether patents and grand parents of sufferers were also sufferers). If the condition appears to run in the family it may well have a generic base. Secondly, adoption studies (to see whether adopted children are any less likely to suffer than other family members). If adoptive family members do exhibit phobic reactions we can conclude that the reaction is learned. And finally, twin studies (to see if rates vary between twins). If there is a high concordance rate that the genetic argument is supported. A study by Solyom et al (1974) of 47 phobic patients found a family history of psychiatric disorder in 45 percent of the cases in contrast to only 19 percent in families of a non-phobic control group of patients. This study supports the genetic explanations for phobias.
Neurological theories are based on the functioning of the automatic nervous system. Research indicates that people who develop phobias are those who generally maintain a high level of psychological arousal which makes them particularly sensitive to their external environment. This suggests an interaction between arousal and conditioning, but the question is whether high arousal levels are the cause of the consequence of the phobia. Asso and Beech (1975) favour the former argument suggesting that a high level of physiological arousal make it easier to acquire a conditioned response. However, Lader and Mathews (1968) found that high levels of arousal are more significant in the cases of agoraphobia and social phobia, where as conditioning is more significant in the case of specific phobias.
The principle strands of the behavioural model are classical conditioning, operant conditioning, social learning theory and Rotter’s control of events theory. Classical conditioning refers to certain stimuli eliciting reflexive, involuntary responses. Referring back to Pavlov’s dog study and Watson and Rayner’s (1920) ‘Little Albert study’.
Classical conditioning might explain phobic reactions in the following way. If a stimulus, such as narrowly avoiding a car accident triggers a panic attack response (feeling uneasy and afraid). This may generalise into a phobia of travelling by car. Hans Eysenck (1970) attempted to link anxiety disorders such as phobias to personality dimensions. Dispute considerable research no firm link had been established between the likelihood of suffering from phobias and possessing particular personality characteristics.
Operant conditioning is where behaviour is learned by its consequences. Skinner (1981) claimed that behaviour including inappropriate phobic responses was learned through experiences that had consequences. If being highly aroused and prepared to deal appropriately with a potentially treating situation (like screaming and running away) has desired consequences (like staying alive) then we would learn to exhibit that behaviour in the future.
Bandura’s Social Learning theory (1963) claims that direct experience of the anxiety producing stimulus, such as flying and aircraft, isn’t necessarily for the acquisition of phobic responses. We learn much by observing and imitating other people, especially as children and when the other people are important to us and looked upon as role models.
Rotter’s Theroy (1966) claims that a phobic reaction is more likely to develop when the individual doesn’t feel that he or she is in control of the situation. Some people, Rotter claims, feel the need to be in control and know they can control the situation by keeping their heads, thinking, reasoning and behaving appropriately. Others have a lowered sense of control, some believing that they have no control over their lives and that it is all down to destiny and fate. People with a lowered sense of their ability to control their situation are susceptible to anxiety.
Rotter explains differences in our sense of control as the result of early childhood experiences. Children who experience consistent reinforcement develop a more stable belief in cause and effect relationships and their own ability to intervene in them.
The cognitive –behavioural view for phobias extends the behavioural view of the conditioning psychological reflexes to the cognitive domain of thinking. It is not only an initial exposure to a fearful situation that innates the phobia as proposed by conditioning theory, rather it is also the persons irrational thoughts about the future possibility of a fearful situation.
- The psychological explanations of the disorder
The psychodynamic explanation of phobias argues that anxiety producing stimulus is repressed into the unconscious part of the psyche where it becomes associated with the irrational id. It is displaced on to another object or person and manifests itself as an irrational phobia. Thus the original anxiety is displaced on the something that should not otherwise elicit such a fear response.
Bowlby (1973) suggested that phobias can be explained by this theory of attachment and separation. For instance, agoraphobia is said to relate to a fear of losing someone to whom the person has become attached (most often the mother). He maintained that the origins lie with the ‘separation anxiety’ in early childhood, particularly where parents are protective. However with respect to phobics, studies tent to show a lack of consistency.
- A conclusion to research
A person with a phobia has intense symptoms of anxiety. But they only arise from time to time in the particular situations that frighten them. At other times they don't feel anxious. If you have a phobia of dogs, you will feel OK if there are no dogs around, if you are scared of heights, you feel OK at ground level, and if you can't face social situations you will feel calm when there are no people around.
A phobia will lead to the sufferer to avoid situations in which they know they will be anxious, but this will actually make the phobia worse as time goes on. It can also mean that the person's life becomes increasingly dominated by the precautions they have to take to avoid the situation they fear. Suffers usually know that there is no real danger, they may feel silly about their fear but they are still unable to control it. A phobia is more likely to go away if it has started after a distressing or traumatic event. About one in every ten people will have troublesome anxiety or phobias at some point in their lives. However, most will never ask for treatment
Some of us seem to be born with a tendency to be anxious - research suggests that it can be inherited through our genes. However, even people who are not naturally anxious can become anxious if they are put under enough pressure. Sometimes it is obvious what is causing anxiety. When the problem disappears, so does the anxiety. However, there are some circumstances that are so upsetting and threatening that the anxiety they cause can go on long after the event. These are usually life-threatening situations like car crashes, train crashes or fires. The people involved can feel nervous and anxious for months or years after the event, even if they have been physically unharmed. This is part of what we now call post-traumatic stress disorder.
Sometimes anxiety may be caused by using street drugs like amphetamines, LSD or Ecstasy. Even the caffeine in coffee can be enough to make some of us feel uncomfortably anxious! On the other hand, it may not be clear at all why a particular person feels anxious, because it is due to a mixture of their personality, the things that have happened to them, or life-changes such as pregnancy.
Object and social phobias are intense and characteristically irrational fears about an object that is unlikely to pose any physical threat, or an event or situation from which nothing dangerous is likely to occur. Phobia sufferers feel compelled to avoid or escape from their phobic-object situation or event. No single explanation has been found for this, and the effectiveness of treatments varies.
According to Beck, people with phobias have a belief system where by they know at a rational level that danger is minimal, yet they so truly believe that their fear object or situation will cause them physical or psychological. Beck and colleagues (1985) also found that people with phobias are more preoccupied with their fear of fear than the actual object or situation it self.
Williams et al (1997) examined this concept by subjecting people with agoraphobia to hierarchy of increasingly scary tasks, supported Beck et al in that participants statements which were tape recorded were mainly a preoccupation with their current anxiety rather than their safety.
However, it may be that their danger thoughts were simply not expressed out loud. Even in situation where there is a good outcome, people with phobias tend to view the out come in a negative way. (Walice and Alden 1997).