Part A- Characteristics and Issues

Unit 4- Psychopathology. Phobias
Part A-

Psychopathology is a branch of psychology concerned with the study of abnormal behaviour-their origins, developments and manifestation.

A phobia is the most common type of anxiety disorder-we all have things with make us feel anxious or fearful when we encounter them. When the fear becomes excessive and unreasonable is it a phobia.
'An uncontrollable, irrational and persistent fear of an object, activity or situation which creates an overwhelming urge to avoid it'.

A panic attack is a feeling of intense fear with physiological symptoms such as rapid breathing, increased heart rate or dizziness. The suffered has a feeling of impending doom and fears dying or losing control. A panic attack occurs without warning, reaches a peak in about 10 minutes and gradually subsides.

Social phobias;
An excessive fear of a particular social situation e.g. eating in restaurants or public speaking. It's not the fear of the situation per se but rather the possibility of embarrassment/humiliation in front of other people. it interferes significantly with the persons working and/or social life- begins in late childhood and can continue with adulthood.
Clinical characteristics;
1) marked and persistent fear of one or more situations when the individual will be exposed to unfamiliar people or scrutiny of other people.
2) exposure to feared social situations produces a higher level of anxiety.
3) feared situations avoided or responded to with great anxiety.
4) phobic reactions interfere significantly with the individuals working or social life
5) anxiety, panic attacks or avoidance are not better accounted by another mental disorder and must last 6 months.
6)person recognises the fear is excessive or unreasonable.

Ao1-inter-rater reliability;
One issue with classification and diagnosis of phobias related to inter-rater reliability as diagnosis depends on the extent to which there's an agreement between different clinicians. For diagnosis to be reliable, the specialists must be consistent in giving similar scores to a person displaying particular symptoms of phobias. High inter-rater reliability indicated every-time measuring tools are used by different specialists-produces the same outcome (same score or diagnosis). E.g. one patient with phobia symptoms is assessed by a group of several clinicians completed, the clinicians split and make their own scores or diagnosis individually. If all them diagnose an individual with phobia, it's said diagnostic test serves as highly reliable tool. Skyre et al assessed inter-rater reliability for diagnosing social phobia and found a higher inter-rater agreement of +72. This finding suggests that the agreement/reliability is high in classifying and diagnosing phobias.

Ao2- supporting evidence for reliability
Research supports the idea that reliability of measurements could be medium to high however it is not consistent across studies and time. Kendler et al used face-to-face and telephone interviews to assess individuals with phobias, using test-retest over a month interval period they found a mean agreement of +.46, over 8 years it was even lower at +.30. On the other hand, Picon et al found good test-retest reliability (better than +.80) with a Portuguese version of SPAI over 14 day interval. This suggests that intra-rater reliability can be good in the short-term however lacking in the long-term.

Ao1- validity- comorbidity.
Phobias occur alongside other mental disorders (called co-morbidity). E.g. social phobia can co-exist with depression-this is an important issue for validity. It has been suggested that social phobia can be a predictor of depression and that it not only increases the risk of developing depression but the severity of symptoms too- which has implications for treatment. Soical anxiety disorder often precedes alcohol abuse and about 20% of those treared for alchol related disorders have social phobia- if it goes undetected the risk of relapse is high. When the phobia is treared the alcohol use appears to improve. Research by Kendler found high levels of comorbidity between social phobias, animal phobias and anxiety disorders/depression. This finding shows that these conditions aren't separate entities and their diagnosis category isn't very useful when deciding what treatment is best.

Ao1- construct validity
Construct validity is also used to assess diagnostic questionnaires and interviews. This measures the extent that a test for phobic disorders really measures a target symptom of phobias, by identifying target behaviours and seeing if people scoring high on phobic test also exhibit target behaviour. E.g. patients with social phobia may ten to underestimate their ability to cope in situations (high levels of anxiety) construct validity would be demonstrated if those also underestimated their ability to cope in social situations. This suggests that construct validity is important in classifying and diagnosing phobic disorders..

Ao2-supporting evidence for concurrent and construct;
Evidence from research studies support the idea that measuring tools do indeed measure and diagnose phobias as a real distinctive mental disorder. Mattick and Clark showed that their Social Phobia Scale correlated well with other standard measures (+.54 - +.69) which indicated that there are methods of diagnosis that agree and appear to be measuring something real.