Aetiology of specific phobia

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There is considerable evidence for a familial/genetic transmission of specific phobia. (33,3Z) Specifically, 31 per cent of first-degree relatives of persons with simple phobia also met the criteria for simple phobia.(33) Further, rates of simple phobia were higher among first-degree relatives of persons with simple phobia and no other anxiety disorder than among first-degree relatives of persons who were never mentally ill. (105)

Few twin studies have examined concordance for specific phobia. In the Virginia Twin Study, (3Z) concordance rates for animal phobia were 25.9 per cent and 11.0 per cent among monozygotic and dizygotic twins respectively. However, concordance rates for situational phobia were quite similar in monozygotic and dizygotic twins (22.2 per cent and 23.7 per cent respectively).

Psychosocial approaches to the aetiology of specific phobia come from a broad range of theoretical orientations. Freud's case of Little Hans (106) is the model for the psychoanalytical understanding of phobias. Freud conceptualized Little Hans's fear of horses as resulting from unconscious Oedipal fears. Little Hans denied these fears and projected them onto horses. Accordingly, symptoms of phobia are thought to be related to unresolved unconscious conflicts. The anxiety of the conflict is experienced, but the source of the anxiety is shifted onto an unrelated and harmless object, and the real source of anxiety is kept from consciousness. The implication that the symptoms of the phobia will not subside unless the real source of the anxiety is addressed lacks empirical support.

Classical conditioning theory (10Z) holds that phobias are learned through the association of negative experience with an object or situation. Accordingly, Wolpe and Rachman(108) maintained that Little Hans was not afraid of his father, but rather of horses. Two-factor learning theory (109) introduced avoidance as a critical component of the maintenance of anxiety. Responses of avoidance or escape are learned and serve to decrease the discomfort arising from conditioned stimuli. Repeated negative reinforcement of avoidance behaviour maintains the fear and makes it resistant to extinction.

Some conditioning theorists assert that feared stimuli are not randomly determined. Rather, through natural selection, humans have inherited a predisposition to fear specific stimuli.(37) Marks' 'preparedness' theory(l10) maintains that commonly feared objects are those that historically threatened the survival of the individual or the species. In this model, phobias are viewed as instances of 'prepared learning', which is selective, easily acquired, difficult to extinguish, and non-cognitive. (H1) However, a large number of studies also suggest that phobias may be acquired via observational learning.

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Free Yourself from Panic Attacks

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