The Manner in Which People Develop Fears and Phobias

Webster's International Dictionary defines a phobia as, "Nearly always, excessive fear of some particular type of object or situation; fear that is persistent and without sound grounds, or without grounds accepted as reasonable by the sufferer", (Webster's Third International Dictionary, 1981).

Phobias can be characterised by an intense and irrational fear accompanied by great efforts to avoid the particular feared object or situation. The word irrational is important to keep in mind when discussing fears and phobias. A person living in a mountainous area of Canada who constantly worries about bears is not manifesting a phobia. However, a person living in Downtown Manhattan who is also preoccupied with a fear of bears probably does have a phobia. Even though the person living in Downtown Manhattan is aware that their fear is irrational, (it is simply groundless), this does not in anyway diminish the fear or phobia.

According to the DSM, in community samples, "current prevalence rates range from 4% to 8.8%, and lifetime prevalence rates range from 7.2% to 11.3%. Prevalence rates decline in the elderly". (DSM-IV-TR, 2000). This implies that if you were in a room with one hundred people, between seven and eleven of those people may be suffering with a lifetime phobia. This is quite a significant amount considering that between five and ten percent of adults are likely to suffer from a depressive episode.

There are over five-hundred reported specific phobias. These range from the typical agoraphobia and claustrophobia to those like decidophobia (fear of making decisions), gephyrophobia (fear of bridges) and somniphobia (fear of sleep). Some of these phobias seem very irrational and sometimes ludicrous, but to the person suffering from these phobias they are uncontrollable life changing illnesses. The phobic person will almost always develop strategies for avoiding coming into contact with their phobic object or situation. Take for example a person suffering with gephyrophobia, a fear of bridges, this person will insist on driving twenty miles around the city to avoid crossing a bridge when he could have reached his destination in five miles by using the bridge. Likewise, a business executive suffering with acrophobia, a fear of heights, might choose to quit his job rather than accept a promotion that gives him an office with a view from the twentieth floor of the building. It is important to note that these phobias usually expand in scope so that, for example, the man with a fear of bridges can grow to develop a fear of water and boats and so on.

There are several theories which attempt to account for the creation and maintenance of fears and phobias. One theory proposed by John Locke dates back to the late 1600's, Locke believed that fears and phobias were produced by the association of ideas, for example, when a child is read a bedtime story about witches who come only at night, from then on the child is terrified of the dark. This theory is still prevalent in modern psychology but in a more revised and specific manner. Today, the dominant belief is that phobias result from classical conditioning. It is believed that a person who suffers from a specific fear or phobia has at some time in their life, experienced some painful, frightening or embarrassing event and this has lead to them possessing a specific fear of phobia. The classical conditioning model, first introduced by Watson & Morgan (1917) stated that, "an initially neutral, non-anxiety provoking event, when paired with an aversive experience (the unconditioned stimulus or UCS), which results in experienced anxiety (the unconditioned response or UCR), becomes associated with the aversive experience (becomes a conditioned stimulus or CS) and hence is able to elicit a similar anxiety reaction (the conditioned response or CR)". (Edelmann, 1995).

This theory was demonstrated by Watson & Morgan in 1920 when they conducted the famous Little Albert experiment. The experiment began by placing Albert, an eleven month old boy, on a mattress on a table in the middle of a room. A white lab rat was placed beside Albert for him to play with. At this point, the child showed no fear of the rat. He began to reach out to the rat as it moved around him. In later trials, Watson and Rayner made a loud sound behind Albert's back by striking a steel bar with a hammer any time Albert touched the rat. Not surprisingly in these occasions, Albert cried and showed fear as he heard the noise. After several pairings of the two stimuli, Albert was again presented with only the rat. Now, however, he became very distressed as the rat appeared in the room. He cried, turned away from the rat, and tried to move away. Apparently, the baby boy had associated the white rat (original neutral stimulus, now conditioned stimulus) with the loud noise (unconditioned stimulus) and was producing the fearful or emotional response of crying (originally the unconditioned response to the noise, now the conditioned response to the rat). Proceeding the experiment Albert also showed such reactions when presented with similar stimuli like a rabbit, dog, fur coat or cotton. "Just as the right hand touched the rat (CS) the bar was again struck (UCS). Again the infant jumped violently, fell forward and began to whimper (UCR)." (Edelmann, 1995).

Many subsequent studies have also shown supportive evidence for the classical conditioning theory. Lautch, (1971), conducted a study on 34 cases of dental phobia. His study revealed that every subject reported experiencing a traumatic dental event such as fearing suffocation from an anaesthetic. (Rachman, 2001). Di Nardo et al. (1988), conducted a study of people with a fear of dogs. His study revealed that almost two-thirds of the subjects had experienced a traumatic event which involved a dog and in over half of these instances the dog had inflicted pain. (Rachman, 2001).

The classical conditioning account for the onset of phobias seems very plausible, and, infact, many phobias can be traced to some traumatic experience that seems to have precipatated the disorder, just as the classical conditioning account requires. However, this theory cannot account for some of the basic facts we know about phobias. We know that phobias can sometimes develop without any history of conditioning, for example, Di Nardo's study of dog phobics showed that two-thirds of the phobics reported having experienced a thraumatic event which involved a dog, but the one-third that didn't experience any thraumatic event is not accounted for. Another example of phobia development which may not involve any conditioning traumatic event can be seen in the common snake phobia. People often develop a snake phobia even though they have never been in contact with a snake or had a frightening or dangerous encounter with one. In contrast, people often encounter thraumatic events in cars, aeroplanes and in the home, but yet they don't develop fears or phobias associated to these stimuli.

Ivan Pavlov argued that classical conditioning was rooted in an organisms own experiences, however, Mineka & Hamida, (1998), demonstrated the idea of vicarious conditioning which suggests that conditioning occurs when a person acquires a conditioned response to a stimulus merely by observing the fear demonstrated by someone else. They conducted a study on the vicarious acquisition of snake fear in laboratory bred Rhesus monkeys. The experiment provides some of the strongest evidence to date for vicarious learning of fear. The lab monkeys, who initially did not show any fear of snakes, observed wild born monkeys behaving fearfully in the presence of snakes. After only several minutes of observation, the lab monkeys acquired a fear of snakes. "One example illustrating these points stems from an experiment by Mineka and Cook (1986) who noted that prior exposure to non fearful model monkeys behaving nonfearfully with snakes effectively prevented the acquisition of snake fear following later exposure to fearful models behaving fearfully with snakes". (Mineka & Ohman, 2002).

Vicarious conditioning of fears and phobias might also explain why some children often experience the same kind and number of fears as their mothers. Solyom et al. (1974) noted that 30% of mothers of phobic children were also phobic, while Bandura & Menlove (1968) report that 35% of dog phobic children had parents who were also dog phobics. (Solyom, 1974).

Another theory attempting to explain the acquisition of fears is knows as the preparedness theory. This theory implies that humans are born prepared to learn certain associations and therefore learn them quickly, and unprepared for other associations and so learn them slowly. The preparedness is usually understandable in evolutuionary terms, for example, snakes and spiders were relatively common dangers for our primate ancestors and therefore evolution passes this predisposition of fear towards these dangerous species onto us. This theory, therefore, may also account for the acquisition of phobias in which the person does not recall experiencing any thraumitic conditioning event. Preparedness theory has been tested in a number of experimental studies on both humans and animals. Mineka & Cook (1989) report two experiments in which laboratory rared Rhesus monkeys watched wild reared monkeys display intense fear towards stimuli that were fear relevant compared with stimuli that were fear irrelevant. Videotapes were altered so that the model monkeys appeared to be reacting fearfully to both the fear relevant stimuli such as toy snakes or crocodiles and fear irrelevant stimuli such as flowers or toy rabbits. The results showed that the observing monkeys acquired a fear of fear relevant stimuli but not fear irrelevant stimuli. (Mineka & Ohman, 2002).

Another form of learning in regards to the acquisition of fears and phobias is information transfer. Information transfer may occur for example when a person watches a movie which involves a poisonous spider or a devastating plane crash. It can also be learned through other forms of media such as newspaper articles, books etc. Again, this theory could possibly explain the number of phobics who cannot retrace their fear to a specific aversive event. It is easy to recognise from prominent research that multiple theories can explain fear acquisition as having associative grounds, although it cannot be said that fears and phobias are acquired through methods of association alone. Non-associative theories of fear acquisition suggest that some fears may appear without any relevant associative learning experiences, either direct or indirect.

Poulton & Menzies (2002), conducted research in an attempt to find suppotive evidence for non-associative fear acquisition. Their aim was to demonstrate that, "a non-associative perspective can contribute to the understanding of: (i) the non-random distribution of fears; (ii) failures to recall direct or indirect conditioning events in fear onset; and (iii) the apparent paradoxical finding that people with high levels of fear report less direct traumatic events than those without such fear." (Poulton & Menzies, 2002). In their first report, the origins of acrophobia in a sample of students were investigated. After issuing a bettery of questionnaires to the students, it was found that only 18% of the phobics were classified as directly conditioned cases. Similar to this study, Kirkby et al, (1995), found direct conditioning in only 6% of their spider phobic patients, a further 9% were claimed to have acquired their phobias through indirect associative learning pathways. Finally, 45% of the sample claimed to have always been fearful. This is consistent with the non-associative model.

If evidence exists that fears and phobias are not acquired through a learned or associative means, then the biological theories of fear acquisition must be considered. One of the strongest resources available to study the biological or genetic influence in the onset of a fear or phobia is through the study of twins as this may provide some insight into possible genetic factors. If fears and phobias more commonly occur in monozygotic twins in comparison with dizygotic, this higher rate of occurrence would be evidence of a genetic contribution to the phobia. Using a large sample of twins, Kendler et al, (1992), found a concordane rate for social phobia of 24.4% of monozygotic twins compared with 15% for dizygotic twins based on the criteria set out in the DSM. However, the heritability estimate was approximately 30%, and statistical models determined that environmental factors were also important in determining the presence of social phobia. Therefore, data from these twin studies are inconclusive. However there is at least in some cases data to suggest that there is a likely genetic component.

Another method of studying the role of genetics in the occurrence of fears and phobias is to examine the disorders within families. In this case family suggests not only first degree relatives but all adult relatives, parents and children. Overall, the results of these studies have supported the notion that fears and phobias run in families. Noyes et al, (1986), study reported that individuals with fears and phobias are more likely then non-fearful humans to have relatives with a fear or phobia, although not necessarily the same specific fear or phobia. In a study by Fyer et al, (1993), first degree relatives were interviewed directly and the clinician was unaware of the patient's diagnosis. Their findings indicated that 16% of relatives of patients with social phobia also met the DSM criteria for this disorder. This is compared with 5% of relatives of non-phobic controls, this may be considered a significant difference.

From the evidence, it is well established that fears and phobias are possibly familial, although it is unclear whether genetic or family environmental factors exert primary influence or whether they interact in some fashion to produce a phobia. Maybe it should be considered that fears and phobias result from a combination of biological and environmental factors and not simply one or the other. It is also possible that phobias may develop through observational learning, direct conditioning or information transfer. Some may believe that we are born prepared to fear certain stimuli. All of these theories, which are mostly contradictive of eachother, at some stage, have provided evidence to support their own assumptions, each theory convincing in its own argument. Because of this, it simply cannot be said that fears and phobias can be locked down to one particluar theory alone. From this, we can only draw one conclusion - that it is easy to see from these possibilities, each one with supportive evidence, that the precise etiology of fears and phobias will be difficult to completely unravel.