Oh, hi there! This is Daisy and this is Mr Danger Noodle.

Did you know in a classic 1969 study, fear of

Whether it be snakes, clowns or public speaking, our fears and phobias are as varied as the people
who fear them. But what’s the difference between your average, garden-variety fear of snakes and a
clinically significant phobia? And what drives these fears?

This week, we’ll take a look at the symptoms of phobias, the mechanisms that drive their
development and maintenance as well as the treatments that allow people to face their fears and
recover from phobias.

(Intro)

Anxiety disorders form one of the largest disorder categories in DSM-5. Some anxiety disorder that
you might be familiar with are:

Specific Phobia,

Social Phobia,

Panic Disorder and Agoraphobia,

and Generalised Anxiety Disorder.

Some less well-known disorders include Separation Anxiety Disorder and Selective Mutism.

In this course, we’ll be focusing on Specific Phobias and Social Phobia.

Way back in 2012, before DSM-5 was published, Post-Traumatic Stress Disorder (PTSD) and
Obsessive-Compulsive Disorder (OCD) were also classified as Anxiety Disorders. But, in the DSM-5
this has changed. PTSD now comes under Trauma- and Stressor-Related Disorders and OCD comes
under Obsessive-Compulsive and Related Disorders.

Pop Quiz! What do all anxiety disorders have in common?

Er… anxiety?

Very good! And what do people do when they’re afraid of something?

Um… they avoid it?

Exactly. The thing that that is common across all anxiety disorders is not just that someone is really
scared of an object or a situation, they also engage in avoidance behaviours, also known as safety
behaviours. This is important so we’re going to come back to this concept a little bit later when we
discuss scientific models of phobias.

The other thing that all of the anxiety disorders have in common is that they all cause clinically
significant impairment in daily functioning. Now, the thought of holding a snake might send shivers
down your spine but if it doesn’t interfere with your everyday functioning then it’s not a phobia. You
might be really scared of snakes but for the 12.5% of the population living with a clinically diagnosed
phobia, both the fear and the avoidance interferes with their life and stops them doing normal
everyday things.

Someone with a snake phobia might avoid going to the mailbox from fear that there might be a
snake waiting to jump out and get them. They might send their roommate into the living room to
scout around for snakes before they enter. They might avoid going to sleep because they have
persistent nightmares about snakes. They might not be able to buy postage stamps because
Australia Post just love putting all our native animals on them.

And that’s the other thing that anxiety disorders have in common – and why PTDS is no longer
classified as an anxiety disorder – with anxiety disorders, the fear is disproportionate to the actual
level of threat.

I went to school with a girl who has a genuine, clinically diagnosed phobia of buttons. Jeans buttons
were kind of OK because she couldn’t see any holes in them but if there were holes it was bad.
Really bad. And the more holes there were, the more terrifying the button would be.

As a child, the family doctor didn’t believe that her fear was real so he got her to take buttons out of
a jar and line them up on a table, one-by-one. By the time she got to the third button she was so
terrified that she vomited and passed out.

Now, over the last few weeks, you may have noticed that psychologists often use animals like rats to
study mental illness. And this is so that effective treatments can be developed to help the millions of
people who are affected by these disorders.

But why use rats as models? It’s not like hordes of rats are having some sort of anxiety crisis about
the presentation they need to stand up in front of the class and give next week.

When psychologists use animal models they are interested in the biological factors that contribute
to the disorder. Because rats are not really affected by cognitive factors or sociocultural factors that
contribute to human disorders, rat studies remove those effects, isolating the biological factors so
they can be fully understood.
And because we share about 90% of our DNA with rats, they make pretty good biological analogues.
For reference, we also share about 96% of our DNA with our closest living relatives the chimpanzees
and over 60% of our DNA with a banana.

So does this… So, does this count as cannibalism?

One of the other reasons that rats make such great analogues for studying the physiological
symptoms of fear and anxiety is because the symptoms are pretty much the same in all mammals.
And that’s because the physiological symptoms of fear and anxiety are activated by the autonomic
nervous system.

This table, developed by Michael Davis in 1997, hi-lights just how similar the physiological symptoms
are between scared rats and the DSM criteria of Generalised Anxiety Disorder.

So, how do anxiety disorders develop? What makes someone’s every day, normal fear turn into
something so distressing and disabling?

One of the theories that attempts to explain what people are afraid of and why, is Preparedness
Theory, developed by Seligman in 1971.

Seligman recognised that the overwhelming majority of phobias develop towards objects and
situations that our ancestor’s would have needed to avoid in order to keep themselves safe and pass
on their genes. Things like heights, snakes, spiders, electrical storms or dogs - or maybe wolves in
their case…

All these things can genuinely kill you so it would be advantageous if natural selection did us all a
favour and preserved the genes that predisposed us to be wary of these things.

Cheers evolution!
But preparedness theory is not without its criticisms. Firstly, we know that phobias develop to
innocuous things, like buttons. Granted this is very rare but it does happen.

Also, if this was a genetically driven trait then we would expect that someone with a phobia of
snakes would also have a phobia of other dangerous reptiles or other dangerous situations – but this
doesn’t happen. Usually, phobias are pretty specific.

But despite these issues, it still seems like evolution has played a pretty big role in determining what
we’re scared of. It’s just probably not the only thing that’s going on.

As we’ve seen over the last few weeks, learning through experience plays a huge part in helping us
navigate our ever changing environment. If you have a bad experience with a snake or a dog, you’re
probably going to learn that those things are scary and that you should avoid them.

Mowrer’s (1976) Dual-Process Model of Avoidance has formalised this idea in associative learning
terms.

The first part of the dual-process model is the Classical Conditioning Acquisition Paradigm that
you’re already familiar with. A person sees a dog; the sensory experience of the dog is the
conditioned stimulus. So, the shape of the dog, its colour, its size, how it moves – all these things
form part of the CS.

The unconditioned stimulus, the US, is the bad thing that happens. So, the US could be getting
bitten or the dog might suddenly bark or move in a threatening way. This sudden, unexpected noise
or movement provokes a startle response in your body. Now, you don’t need to learn to jump when
you hear a loud noise, so the startle response is the unconditioned response or UR.

What you learned during that encounter is an association between the physical experience of dogs
and the fact that they can make unpredictable, scary noises or that they can bite. The CS has become
associated with the US.

So, classical conditioning is the first part of the dual-process model. That is what made the phobia
develop. The second part of the dual-process model explains what makes the phobia continue. What
maintains the fear?

The answer is instrumental conditioning. Specifically, it is negative reinforcement.

So remember that negative reinforcement is when a behaviour is performed to make something bad
go away or to stop that bad thing from happening in the first place. It’s classified as reinforcement
because the performance of the behaviour – the performance of the avoidance behaviour or the
performance of a safety behaviour – the frequency of performing that behaviour increases.

It’s also classified as negative reinforcement because something bad – fear or anxiety – is being
taken away from the situation when the avoidance behaviour is performed. And every time a person
avoids the scary situation and the behaviour is negatively reinforced, this strengthens the
association between that behaviour and the outcome – if I do this behaviour, scary things don’t
happen.

So, you can see how classical conditioning can make people develop phobias and how instrumental
conditioning – the performance of avoidance behaviours – maintains that phobia through negative
reinforcement.
But what about all those people with snake phobia who’ve never had a negative experience with a
snake before? Just like Preparedness Theory, the Dual-Process Model doesn’t explain everything but
it does explain a lot, especially how avoiding scary situations perpetuates our fears. And when
they’re viewed together, it explains why in a lab situation non-phobic people will learn to fear
evolutionarily relevant stimuli, like pictures of snakes, much faster than they will learn to fear
neutral stimuli like pictures of buttons.

To finish off, I’ll briefly go over some cognitive factors that can play a role in the development and
maintenance of phobias and other anxiety disorders.

In the lectures last week on depression, Josh spoke about Beck’s Cognitive Model of depression and
the tendency for depressed individuals to attend to sad faces and negative stimuli more readily than
they attend to positive ones. Well, interestingly, we see a similar thing in phobias. Although in
everyday life phobic people will actively avoid the thing they’re afraid of, in the lab the object
they’re afraid of will capture their attention more readily and they’ll react faster to words that are
associated with that object. So, if me and a snake-phobic person had a race to see who could press a
button faster when we saw words like “fang” or “slither,” I would probably lose.

People with phobias also experience Perceptual Distortion. So, when people who are afraid of
snakes actually encounter a snake, they will often interpret the snake’s behaviour as being
threatening or chasing them or getting ready to bite them – even if they’re just chillin’ like Daisy
here. And, just like attentional bias, this perceptual distortion is also replicated in the lab.

In 1992, Rachman and Cuk showed a harmless garter snake in a tank to people with and without
snake phobia. Although both groups perceived the snake as being about the same size and the same
length, phobics reported that the snakes tongue was sharper, that it flicked around a lot more and
that its movement was directed at them, whereas the non-phobics just said that the snake was
moving.

When Josh spoke about Cognitive Theory he also mentioned appraisals or the way we interpret
events. Just like depression, we also see negative or faulty appraisals in fear and anxiety. When
fearing pictures of snakes, it’s not the actual danger involved that makes the object or situation
scary, it’s how we interpret the situation that predicts whether we will be afraid of it.

So you might think “Agh! It’s a snake! Snakes are scary! If I go outside, there’s gonna be snakes out
there and they’re gonna wanna bite me! If I see a snake, I’m going to completely freak out and I
won’t be able to cope…” and that’s the clincher. These types of negative appraisals, especially
thoughts of being helpless and powerless, play a really big role in the development and the
maintenance of phobias and other anxiety disorders.

Thanks for watching! In this video we’ve covered:

Types of anxiety disorders and the DSM criteria of phobias

animal models and the physiological symptoms of anxiety disorders

as well as theories and models explaining the development and maintenance of phobias:
Preparedness theory

Mowrer’s Dual-Process Model

and Beck’s Cognitive Model.

In the next video, Josh will take you through how phobias are treated as well as how these models
and theories account for why the treatments work.