Explain what is meant by ‘systematic desensitisation’.

Gradual exposure therapy.

The patient is taught relaxation techniques and are gradually exposed to increasing levels of the
object/situation they have a phobia of until their phobic reaction subsides.

Describe the cognitive explanation of phobias.

A phobia may develop due to irrational thoughts.

The person believes that the phobic object/situation as more dangerous or harmful than the object/
situation really is.
Due to these thoughts, when the person sees the object they will have a strong fear reaction.
These irrational thoughts could have developed from a bad experience (e.g. being bitten by a dog)
and the irrational belief that this is likely to happen again in the future.

Explain two strengths of the cognitive explanation of phobias.

Likely strengths include:

Backed up by evidence from the DiNardo study. DiNardo found that dog phobia was more common
in people who had a fearful experience with a dog and also believed that this was likely to happen
again in the future. This evidence supports the explanation as it shows how people with phobias will
have irrational thoughts (‘I will be bitten again by a dog’) compared to those people who had the bad
experience but did not believe it would happen again in the future. This increases the validity of the
cognitive explanation of phobias.
DiNardo is supporting evidence. One strength of this explanation is that it is backed up by evidence
from the DiNardo study which collected both quantitative and qualitative data. This data allowed
comparisons to be made between the fearful and non-fearful participants as well as DiNardo
collecting data on the dog experience and likelihood of a bad experience happening again. This adds
to the validity of the cognitive explanation as the results which back up this explanation are highly
detailed.
Practical applications – CBT is a useful application of this explanation. Can challenge the irrational
thoughts the patient has of the phobic object or situation. Also shows that a traumatic experience in
the past may have led to the irrational thoughts developing and the CBT therapist can discuss this
with their client.
Somewhat holistic as this explanation takes into account both the experience of the phobic
object/situation as well as the person’s cognitions about the phobic object. The person thinks that
there is a high likelihood that the bad experience they had will happen again in the future.

Outline one biomedical/genetic explanation of a phobia.

The explanation is that we are prepared to fear certain situations/objects that might pose a threat to
survival such as dangerous animals/situations.
This has been passed on from one generation to the next via DNA.

Describe one study about classical conditioning of a phobia, e.g. the study of little Albert.

9-month-old baby showed no response to the unconditioned stimulus, a white rat, at the start of the
study.
 Watson and Raynor banged an iron bar behind Little Albert when he touched the white rat and little
Albert would cry (the unconditioned response).
Very soon, little Albert would cry when presented with the conditioned stimulus, a white rat, which
shows he learned to be afraid of it through the process of operant conditioning.

Explain one strength and one weakness of the study you described in (b).
Likely strengths include:

Strengths of longitudinal study e.g. can investigate change over time. • Explanatory power of
classical conditioning • Strengths of qualitative data e.g. in-depth data • Strengths of laboratory
environment. (e.g. reliability, control).
Likely weaknesses include:
Generalisability as just one participant • Ethical issues of teaching a baby a phobia • Weaknesses of
qualitative data e.g. cannot easily make comparisons from the beginning of the conditioning to the
end of the conditioning; cannot use statistical tests to support conclusions • Reductionist and
deterministic view of how phobias develop • Weaknesses of laboratory environment e.g. ecological
validity

For one specific phobia: Identify two characteristics of this phobia.

Blood – Hemophobia or haemophobia is extreme and irrational fear of blood and can extend to
needles. Leads to increase in heart rate and drop in blood pressure can lead to fainting.
Buttons – It is an irrational and persistent fear of buttons (stand alone ones or those on clothing).
People suffering from koumpounophobia tend to avoid clothes with buttons.
Agoraphobia – excessive fear of open spaces. Person will avoid leaving their home.
Zoophobia – extreme fear of animals / specific type of animal. Avoid any activity where they might be
exposed to the animal(s) such as going to the zoo.

Describe the psychoanalytic explanation of phobias (Freud, 1909).

A fear is repressed into the unconscious to protect the ego.

This is as a result of unresolved conflict between the id and the superego.
OR could be due to the repressed urges of the id that are being denied.
Ego uses defence mechanism to repress the conflict such as displacement.
The phobia can be a displaced/redirected fear during an intensely frightening experience (e.g. a
physical attack) onto an object.

Explain one strength and one weakness of the psychoanalytic explanation of phobias.
Likely strengths include:

Backed up by evidence to support the theory of phobias from case studies (e.g. Little Hans) Allow
strength of case studies (e.g. in depth) if linked to how this improves the validity / explanatory power
of this explanation of phobias.  Psychodynamic treatment from this approach to help reduce
phobia. Can resolve the conflict and the phobia will reduce / go away.  Somewhat holistic nature of
the explanation – considers the underlying cause of the phobia.
Likely weaknesses include:
There are problems with the evidence upon which the explanation of phobias is based (e.g. poor
generalisability of case studies, lack of validity of the evidence due to it being collected by a family
member in the case of Little Hans.)  Deterministic nature of the explanation – the ego defence
mechanism will just occur and the person does not have free will to stop it. Therefore no free will
 over the development of a phobia.  Somewhat reductionist as it does not consider, for example
biomedical or cognitive causes.

Describe explanations of phobias.

Explanations of phobias, including the following: • behavioural (classical conditioning, Watson, 1920) •
psychoanalytic (Freud, 1909) • biomedical/genetic (Ost, 1992) • cognitive (DiNardo et al., 1988).

Behavioural (classical conditioning, Watson, 1920) A phobia develops as the neutral stimulus is
paired with something the person is afraid of (the unconditioned stimulus). If enough pairings occur
or the initial UCS is very frightening the person will end up with a fear of the NS. The NS then
becomes the CS. Candidates may describe the case of the little Albert who was conditioned to be
afraid of a rat by Watson banging an iron bar behind the baby which made him cry. Eventually just
the sight of the rat was enough to cause the crying.
Psychoanalytic (Freud, 1909) A fear is repressed into the unconscious to protect the ego. The phobia
can be a redirected fear during an intensely frightening experience (e.g. a physical attack) onto an
object. Candidates can also summarise the case of little Hans. Biomedical/genetic (Ost, 1992) Ost
found that blood-phobic subjects had more first degree relatives with the same phobia compared to
injection-phobic participants (61% vs 29%). In addition, the blood-phobic patients were more likely to
fear they would faint in the phobic situation (77% vs 48%). Concluded that there appears to be a
strong genetic link and more likely to lead to a strong physiological response (fainting).
Cognitive (DiNardo et al., 1988) We have irrational thoughts about an object due to a previous
experience that we believe will be repeated. DiNardo and his colleagues studied a group of people
with dog phobias and found a matched group who did not suffer from that phobia. They found that
over 50% of people with dog phobias could recall being bitten or having a frightening past
experience with a dog. However, 50% of the group with no dog phobia also had memories of being
bitten by dogs and yet had not developed any anxiety about seeing dogs in the future. This shows
that not everyone who is exposed to conditioning would end up developing a phobia, and it may be
explained more through our thought processes after an event than the event itself.

Evaluate explanations of phobias, including a discussion of determinism.

Names issue – Determinism. All of the explanations of phobias are deterministic. E.g. The
behavioural explanation suggest phobias are learned. This is deterministic because the person who
develops the phobia has no choice but to develop it due to their learning experience. For example,
Little Albert learned to be afraid of the white rat because of the noise he associated with the rat not
because he chose to be afraid.
nature versus nurture debate with reference to the various explanations. E.g. biomedical is nature
and behavioural is nurture. • comparisons of different explanations.
Application of psychology to everyday life (with reference to explanations) – Useful as the
explanations can then be used to help someone understand their phobia better and feel reassured
by the explanation. In addition, the explanations lead on to the treatments.
reductionist nature of the explanations – biomedical is reductionist and psychodynamic is more
complex/holistic/less reductionist.
Evidence to support the explanations (and an evaluation of this evidence if linked back to
explanation) e.g. the case study approach used by Watson and Freud, just people with dog phobias
(or no phobia) studied by DiNardo.
GAD is a long-term condition that causes feelings of anxiety about a wide range of situations and
issues, rather than one specific event
 people with GAD feel anxious most days and often struggle to remember the last time they felt
relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.
GAD can cause both psychological (mental) and physical symptoms. These vary from person to
person, but can include: feeling restless or worried, having trouble concentrating or sleeping, having
dizziness or palpitations

‘Even though Little Albert was just one child, the behavioural explanation of anxiety disorders can be
generalised to everyone.’ To what extent do you agree with this statement? Use examples of research
you have studied to support your answer.
For:

The behavioural explanation of learning (classical conditioning) occurs for all people with many
things (not just Little Albert) • The behavioural explanation led to the development of ways in which
fears and phobias can be reduced (e.g. systematic desensitisation). • The principles can be
generalised, not necessarily the specific example.
Against:
People are different and what applies to many people will not apply to many others. • The approach
excludes the role of cognitive factors (such as the DiNardo example with fears of dogs) • The case
study of little Albert had weaknesses – claims that Albert was not a normal child.

Describe the treatment and management of anxiety disorders.

To include the following – Systematic desensitisation (Wolpe, 1958) Applied tension (Ost et al., 1989)
Cognitive-behavioural therapy (Ost and Westling, 1989)

Systematic desensitisation – Wolpe – Behavioural therapy based on classical conditioning and

developed by Wolpe. Patient is taught muscle relaxation and breathing exercises. Secondly, a fear
hierarchy is created with the most feared item/experience at the top down to the least feared at the
bottom. Finally, the patient works their way up the hierarchy practising the relaxation techniques at
each level til they reach the highest fear.
Applied tension – Ost et al. – Developed to help people who have a phobia of blood and/or needles
and faint at the sight of them. This involves tensing the muscles in the body to raise blood pressure
and makes it less likely the person will faint. Study from 1989 with 30 patients who had a phobia of
blood, wounds and injuries. Compared with patients using applied relaxation and a combination of
applied tension and applied relaxation. Found the applied tension patients responded as well as the
other groups and the treatment took less time to complete so therefore was seen as more effective
than applied relaxation.
Cognitive-behavioural therapy – Ost and Westling This therapy is where the patient and therapist
identify faulty thinking about the object/experience that the patient has a phobia about. The patient is
taught relaxation techniques and practices these between sessions when faced with the phobic
object. The patient is also taught to think alternative thoughts about the phobic object when
presented with it (e.g. most dogs do not bite). The study took place over 12 weeks to compare the
effectiveness of CBT with applied relaxation in participants with a panic disorder (many had
agoraphobia). The patients were also followed up at one year. They worked with the therapist to
identify situations when the panic occurred and thought of alternative explanations. They practiced
coming up with these alternative thoughts between sessions. Both the CBT and the applied
relaxation group had a reduction is symptoms. Showing CBT is effective.

Evaluate the treatment and management of anxiety disorders, including a discussion of the longitudinal
research method.
 Named issue – longitudinal method – used by Ost et al and Ost and Westling. These studies show
change over time and the effectiveness of the treatment. In addition, they provide more detail than a
snapshot study on the effectiveness of the treatments in comparison to other treatment methods.
Participants may drop out of the research (even if they continue with therapy).
Determinism versus free-will. All of the treatments are deterministic to some extent but also show the
free will of the patients during the treatment. The panic felt by all of the patients is determined but
they use their free will to reduce the panic felt (or apply tension). For example, systematic
desensitisation is somewhat deterministic as the patient’s experience of panic when exposed to the
phobic stimuli is determined by their experiences. However, it also shows free-will as the patient
(with the help of the therapist) decides to participate in the therapy and allows themselves to be
deliberately exposed to increasingly stressful stimuli to help them to overcome their phobia.
Nature versus nurture debate with reference to the various treatments of anxiety disorders. •
Usefulness (effectiveness) of different treatments • Reductionist nature of the treatments •
Appropriateness of treatments • Cost of treatments • Ethics of treatments

Case studies are often used to study fear-related disorders such as phobias.
Outline the psychodynamic explanation of phobias.

Phobias are a defence mechanism against the unresolved conflicts between the id and the
superego.
The anxiety can be transferred to an object, person or situation which has a symbolic connection to
the anxiety.

Suggest how the psychodynamic explanation can explain why individuals differ in the development of
phobias.

These basic features of the explanation (id, ego and superego) apply to every person.
What differs is how much (or no phobia) and what the anxiety is transferred to, an object, person or
situation (to produce different phobias).

Explain one strength and one weakness of using case studies to study phobias
Strengths:

unique cases can be understood which adds to knowledge about the disorder applied to a phobia. •
a range of different methodologies are often used: interviews, questionnaires, tests (psychometric,
projective and physiological) to study a person in depth applied to a phobia. • knowledge gained from
studying one person may apply to other/all people applied to a phobia.
Weaknesses:
the findings cannot be generalised because a case study can be of one individual / the person is
unique so cannot be applied to all people with the same phobia. • case studies do not usually gather
quantitative data and so there may be no statistics to compare to others with the same phobia.

Billy has a fear of the dark, and has read about Freud’s psychoanalytic explanation of phobias. Billy thinks
this is a good explanation for his fear, but his sister Janet does not agree.
Outline Freud’s psychoanalytic explanation of phobias.

Phobias are defence mechanisms against anxiety created by any unresolved conflict between the id
and the ego.
The ego uses displacement for example to rechannel anxiety to another ‘thing’.
In the classic case little Hans had a fear of horses, displaced from a fear of his father.
Give two limitations of this psychoanalytic explanation of phobias.

There is no scientific evidence that the id, ego or superego exist.

A phobia may be a direct result of an incident (e.g. phobia of a dog after being bitten by a dog) rather
than displaced anxiety.
Very little/no supporting evidence. Only evidence is one case study.

Suggest one alternative explanation for phobias.

Behaviourists believe all behaviour is learned including phobias (e.g. little Albert).
DiNardo et al. (1988) suggest a cognitive explanation. Not all people bitten by a dog develop a
phobia of dogs.

Discuss the advantages and disadvantages of using case studies to study phobias. You should include a
conclusion in your answer.
For:

a case study is a detailed investigation into one ‘thing’, in the case of abnormality; this would be a
person • unique cases can be understood which adds to knowledge about the disorder • a range of
different methodologies are often used: interviews, questionnaires, tests (psychometric, projective
and physiological).
Against:
a case study can be of one individual and so cannot be generalised • individual differences (or
‘everyone is unique’) in disorders (e.g. cognitions) means that what is applied to one person cannot
always be applied to others • people who have disorders are by definition abnormal and so findings
cannot be applied to people without the disorder.

Richard has a fear of oranges and knows about the behavioural explanation of phobias. Richard wants to
be treated using systematic desensitisation (Wolpe, 1958). However, his partner thinks that other
treatments may be better.
Explain what is meant by a ‘behavioural explanation of phobias’.

all behaviours are learned (and so are phobias).

behaviours are learned through association and so are phobias.
example of little Albert (Watson, 1920) may be given.

Explain how systematic desensitisation would be used to treat Richard’s fear of oranges.

Systematic desensitisation (Wolpe (1958): 1 learning of progressive muscle relaxation / deep

breathing.
2 creation of anxiety hierarchy (least fearful to most fearful).

Suggest two ways in which a phobia can be treated, other than systematic desensitisation.

cognitive-behavioural therapy (Ost and Westling, 1995) used applied relaxation which involves
tensing and relaxing muscles to relax muscles, decrease blood pressure and counteract the effects
of stressrelated hormones (e.g. adrenaline and cortisol).
applied tension (Ost et al, 1989) for blood or needle phobia but also vasovagal syncope. Involves
tensing muscles to increase blood pressure.
Discuss the strengths and weaknesses of using systematic desensitisation to treat phobias. You should
include a conclusion in your answer.
Strengths:

the technique can be generalised to many other phobias (and anxiety) • it is effective and has been
used for over 60 years • progressive muscle relaxation can be used anywhere by the ‘patient’ • it
does not involve the use of any drug.
Weaknesses:
behavioural techniques take time and effort from the person (unlike swallowing a pill) • the
techniques do not cure anything, merely make it easier to live with • behavioural techniques alone
may be insufficient. Cognitive behaviour therapy better

Suggest one physiological response statement that could be used for Response X in Fig. 1.1.

My heartbeat speeds up. (b) My palms or armpits sweat. (c) My muscles start to tense. (d) I feel that
I am getting dizzy. (e) I breathe more quickly. (f) I feel a cold sweat all over my body. (g) I feel more
blood pumping in my body. (h) I feel my face is hot. (i) I lose consciousness. (j) I get pale. (k) I faint.
(l) I feel a lump in my throat (m) I feel stomach discomfort.

Suggest two strengths of using a four-point scale to measure anxiety in people with blood injection
phobia.

a four point scale allows a wide range of responses e.g. from ‘never’ to ‘always’ so allows individual
differences in ratings of anxiety.
a four point scale is ‘simple’ i.e. easy to choose from.
a four point scale provides quantitative data that can be statistically analysed*
the BIPI is a four point scale – it is a psychometric test (valid, reliable, etc.)
a four point scale can be used over time to check improvement in a person trying to reduce anxiety
of blood/injection phobia

Suggest one way in which anxiety in people with blood injection phobia could be measured, other than
using a rating scale.
 Observation of the behaviour of the person with blood anxiety such what do they do when they see a
pool of blood on the floor.
Clinical interview with the person with blood anxiety, asking questions about how they feel in certain
situations such as ‘When I see a pool of blood on the floor’

Discuss the strengths and weaknesses of using quantitative data to assess blood injection phobia. You
should include a conclusion in your answer.
Strengths:

responses from participants can be compared with responses from other participants on the same
rating scale. • data can be compared with other studies done previously and in the future. • data can
be analysed statistically • a number isn’t open to question by researchers and researcher bias
doesn’t apply.
Weaknesses:
a reason or explanation cannot be provided by participants • participants can feel uninvolved if they
are not asked for an explanation • reducing a phobia to numbers is not perhaps what a patient would
expect to happen. Note: do not credit demand characteristics – this is not a ‘study’ this is real life
(and people with a real phobia)

‘The cognitive explanation of phobias is better than all other explanations.’ To what extent do you agree
with this statement? Use examples of research you have studied to support your answer.
Better:

cognitive explanations are reductionist and can therefore be studied much more precisely than e.g.
psychodynamic explanations • ‘everyone thinks’ and so a cognitive explanation applies to everyone
(e.g. people have negative thoughts which can be changed to positive thoughts) • cognitive
explanations such as DiNardo’s explain why people behave in certain ways, a strictly behavioural
approach cannot. • cognitive explanations lead to cognitive therapies which have shown to be
successful over many years.
Not better:
other explanations may be more ‘scientific’; cognitive explanations are based on what cannot be
observed. • cognitive explanations are reductionist and do not take into account other explanations
which together may provide a more holistic approach. • cognitive explanations are ‘individual’ rather
than ‘situational’
Give two conclusions from Fig. 1.1.

Both applied relaxation and cognitive behaviour therapy are effective in treating panic disorder. •
There is no difference between applied relaxation and cognitive behaviour therapy in treating panic
disorder • Both therapies are long-lasting (improvement continues after 1 year).

Outline two ways in which Ost and Westling (1995) gathered data during these phases.

Independent assessor ratings by a qualified therapist.

Self-report scales providing quantitative data.
Self-observation of panic attacks: keeping a diary of frequency and severity of attacks.

Explain how the treatment of the applied relaxation (AR) group differed from the treatment of the CBT
group in this study.

The applied relaxation (AR) group were taught progressive muscle relaxation (PMR) to be used in
both panic and non-panic situations. T
he cognitive behaviour therapy CBT group were taught only CBT.

Explain how the physiological effect of applied relaxation is different from the physiological effect of
applied tension.

Applied relaxation involves tensing and relaxing muscles slowly to relax muscles, decrease blood
pressure and counteract the effects of stressrelated hormones (e.g. adrenaline and cortisol)
whereas applied tension involves tensing muscles rapidly to increase blood pressure.

Some treatment and management techniques for anxiety disorders involve learning; these are called
behavioural techniques. Discuss the strengths and weaknesses of using behavioural techniques to treat
anxiety disorders. You should include a conclusion in your answer.
Strengths:

techniques can be applied by anyone, in any place at any time • behavioural techniques focus on
alleviating the symptoms rather than the cause • behavioural techniques are more likely to be
generalised because all people can learn and ‘unlearn’ following the same principles • no medication
 is taken; the patient cannot become addicted to medication. • the therapist will guide the patient
through the treatment.
Weaknesses:
behavioural techniques take time and effort from the person (unlike swallowing a pill) • the
techniques do not cure anything, merely make it easier to live with • behavioural techniques ignore
the role of biochemical • a therapist is needed which is more costly than taking a drug.

‘The genetic explanation of phobias is better than all other explanations.’ To what extent do you agree
with this statement? Use examples of research you have studied to support your answer.
Better:

genetic explanations are reductionist and can therefore be studied much more precisely than say
psychodynamic explanations • genetic findings can be replicated and generalised to everyone if a
specific gene for phobias is identified • genetic explanations provide an underlying cause for how it is
possible for phobias to arise at all (an ultimate i.e. evolutionary explanation) whereas others can only
provide an explanation of a specific phobia in a specific individual.
Not better:
other explanations are also ‘scientific’; behavioural explanations are based on observable behaviour.
• just because an explanation is based on science it does not mean that it is correct. The
psychodynamic explanation has no science, yet it may be correct. • explanations should take a more
holist view, rather than reducing the explanation to one factor.