Sample question and answer for phobic disorders
(from June 2010)
(a) Outline clinical characteristics of one anxiety disorder. (4 marks)
Examiner notes
AO1 = 4 marks The outline might include:
 physiological, behavioural, emotional and cognitive signs/symptoms
 incidence and prevalence
 course and prognosis
 diagnostic criteria
Examiners should bear in mind that there are only 4 marks available here so candidates are
not expected to cover all these points to access top marks.
The list of particular clinical characteristics obviously depends on the choice of anxiety
disorder. Phobic disorder is an umbrella term covering specific phobias, social phobias and
agoraphobia and it is legitimate for candidates to describe just one of these or all three.
However, simply naming different types does not meet the requirement of describing the
clinical characteristics of the disorder, so cannot attract marks unless there is an
accompanying description.
AO1 mark allocation
Student answer
The DSM identifies clinical characteristics that differentiate
between a clinical phobia and a mere fear. Firstly the
individual must recognise that their behaviour is irrational
but continue to act in that way.
Secondly the phobia must
encroach on everyday life, interfering with their day to day,
normal activities, such as going out in public. Moreover the
individual suffering from the phobic disorder will not feel in
control of their actions and the anxiety associated with the
disorder will have a substantial longevity – in children the
disorder must have lasted for at least 6 months. Lastly panic
attacks may accompany the phobia, especially when the
individual is presented with situational cues of the phobia or
comes into direct contact with it – this especially will lead
to irrational behaviour and often crying in children.
(132 words)
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(b) Briefly describe one psychological therapy for the anxiety disorder that you outlined in
your answer to part (a). (5 marks)
Examiner notes
AO1 = 5 marks
AO1 is a brief outline of one psychological therapy for the chosen anxiety disorder. If
candidates outline more than one type of therapy, examiners should look at both accounts
and credit the one which attracts most marks. Answers which describe a biological therapy
eg drugs attract no credit. The most likely therapy is some form of behavioural therapy eg
systematic desensitisation or implosion for phobias, or for OCD, ERP or modelling.
AO1 mark allocation
Student answer
Systematic desensitisation is a psychological therapy used to
help the suffering individual overcome their fear. Joseph
Wolpe originally came up with the therapy and suggested that
deep relaxation is the key to overcoming the fear as
relaxation and anxiety are not able to occur at the same time.
Wolpe came up with the idea of counterconditioning – once an
individual is able to relax fully, it is possible to replace
the conditioned stimuli to which they have attached their
phobia with a more positive conditioned stimuli taking their
place. For example, research was carried out where cats were
conditioned to acquire a phobia of a box in which they were
placed. The researchers gave the cats electric shocks so they
were conditioned to have a phobic response to the box.
Counterconditioning took place when the cats were fed in the
box because they no longer associated it with the box.
In order to relate this to humans, Wolpe invented the idea of
a desensitisation hierarchy, which has many stages and each
brings the phobic closer to confronting their fear. They may
find it is not so scary after all but prior to systematic
desensitisation they were unable to confront it to find out.
Wolpe developed ‘in vivo’ type of systematic desensitisation
and also a ‘covert’ type. The former actually requires the
phobic to physically confront their fear while the covert type
just asks participants to imagine pictures of it. ‘Flooding’
is also associated with systematic desensitisation –
individuals are shown their phobia prior to any therapy.
(254 words)
2
(c) Evaluate psychological therapies for this anxiety disorder. (16 marks)
Examiner notes
AO2/3 = 16 marks
Candidates are required to evaluate psychological therapies appropriate for the anxiety
disorder outlined in (b). Because evaluation can be very generic, partial performance criteria
do not apply. They are likely to consider issues such as appropriateness and effectiveness of
the therapies. They can also consider the quality of the research evidence which supports
the therapies.
AO2/3 mark allocation
3
Student answer
Subsequent research on systematic desensitisation has
confirmed that it is an effective therapy in helping
individuals overcome their fears. A significant number of
participants responded well to the treatment but it was found
that ‘in vivo’ was more effective than the ‘covert’ method.
Also systematic desensitisation may, according to research, be
more effective on specific phobias rather than social phobias.
This may be due to the fact that many specific phobias are
exaggerations of ‘ancient fears’ such as snakes and spiders.
These phobias are less likely to encroach on the lives of
individuals suffering as they are more easily avoidable,
whereas social phobias often effect every aspect of a
sufferer’s life. A further criticism of systematic
desensitisation is that it does not treat the cause of an
individual’s phobia but only desensitises them to the symptoms
they experience when confronted. If, as Freud suggests, their
phobia is a result of early trauma and ego conflict, the
individual may subsequently relay their true fear onto another
object or situation and the cycle will start again.
However, a strength of the theory is that it can be selfadministered and requires little input from participants, so
they can go at their own pace. The research mentioned earlier
concerning the cats (they were placed in a box and
electrocuted to condition a fear response) may have influenced
Joseph Wolpe to come up with systematic desensitisation, but
it has been criticised for being overly reductionist as it is
reducing the complexities of overcoming a phobia to a more
simple organism, which raises issues as it is not
generalisable to the population.
Albert Ellis came up with a different psychological therapy
for phobias. He proposed that Rational Emotive Behaviour
Therapy (REBT) could cure an individual of an addiction by
altering the way in which they think. Phobics have been found
to have delusional thoughts about themselves and things around
themselves and things around them , which may lead them
developing a phobia. Ellis targets these irrational thoughts
in his therapy, proposing the ABC model as a way of aiding
participants to alter their thinking. This has been found to
be effective , especially among social phobics as these are
thought to be derived from irrational thoughts in many cases.
For example, an individual may see a friend in the street who
ignores them (Activating event). They will then display
irrational Belief which will lead to a social phobia of going
out in the street as a Consequence. (The irrational belief
includes irrational thoughts that the person must hate them).
This therapy is effective as it targets the causes of an
individual’s phobia but it has been criticised as individual
differences play a part in its administration. Many people do
not respond to REBT as they do not like to be told what to do
and cannot be helped under strict conditions. Others flourish
under these conditions and their phobias are ‘cured’.
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REBT also takes a long time to carry out and has been
criticised for being too logical – it is not always as
straightforward as that as the phobia has been acquired as a
result of one particular, irrational thought. Therefore, REBT
is also deterministic as there must be other factors involved
or the success rate would be 100%. Also REBT cannot help
phobics who do not suffer from irrational thinking.
(560 words)
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