Running Head: ETIOLOGY AND CONSEQUENCES OF PHOBIAS
The Etiology and Consequences of Specific Phobias
While snakes and spiders may have some crawling up the walls, others refuse to look out the windows of tall buildings or even venture outside. Fears and phobias exist on a continuum of severity; phobias often (if not always) create avoidance behaviors which maintain phobic responses. They range in intensity and kind, with specific phobias (heights, spiders, snakes, etc.) being the most common and variable. Phobias are defined as a reaction beyond normal proportion to a situation, one that cannot be explained or reasoned away, is beyond voluntary control and leads to avoidance of the stimuli or situation (Ollendick et al, 2002). Also, the phobic must recognize his reactions as excessive and unreasonable (as cited in Davey, 1997). Generally these phobias onset in childhood and are relatively stable throughout life (Muris et al, 2002). The etiology of specific phobias has been contested since the age of Darwin and still remains a debated facet of psychology today. Currently, three main theories exist attempting to explain the etiology of phobias: evolutionary, behavioral, and cognitive. Alone, each of these theories lacks important considerations. With some slight modifications to each theory, they can be combined to trace a plausible path to phobias.
The evolutionary theory of fears can be first attributed to Darwin. Our proto-technological ancestors would have had to readily deal with stimuli and situations that threatened their reproductive fitness. Through these repeated threatening situations, it is believed that specific threats that were relevant to proto-technological humans are still relevant phobias today (Minika & Ohman, 2002). Supposedly this theory accounts for the amount of spider, snake, and height phobics (among others). Often, parents of children with specific phobias cannot seem to remember when their child first became afraid, citing they have "always" been afraid of the aversive stimuli (Davey, 1997). However, to claim that because one cannot remember the origin of her phobia, does not simply mean it has always been present or that it is evolutionary. The Phobic Origin Questionnaire aims to pin-point the source of phobias, and yet has several limitations because of its self reported nature (Muris et al, 2002). Regardless, if there were an innate evolutionary basis for certain phobias, it would be assumed that heritability would be high, or at the very least, moderate. Behavioral studies have generally not found a high heritability rate among "innate" phobias and have found high environmental influences instead (Muris et al, 2002). It is here that the preparedness theory seems to fall apart if standing alone.
In the company of behavioral theory, however, evolutionary theory stands on slightly firmer ground. Although specific phobias have a low heritability, studies often show that it is easier to condition a participant to be afraid of a spider (or traditionally fearful stimuli) than a non traditional fear stimulus (flower, or mushroom) regardless of prior phobia. The behavioral theory originated with little Albert and training him to fear a white rat. While wildly unethical today, Watson and Reynor (1920) allowed the psychological community to understand the conditioning of fear. Through a series of trials between the unconditioned stimulus and the conditioned stimulus, one can illicit a conditioned response (fear) if the right contingency exists. Direct conditioning leading to a phobia is rare, occurring an average of 10% of the time (Davey, 2002). More frequently, individuals learn phobic responses through vicarious learning, instruction, and outside information (King et al, 1997). This could have an evolutionary throwback because it would be easier for the proto-technological human to learn the appropriate fear responses from other members of the community rather than encountering it himself. However, behavioral and evolutionary theories of phobias give no consideration to cognitive processes that occur, and are both lacking because of it.
Cognitive processes are not typically regarded by behaviorists as likely variables because according to their doctrine, cognitive processes do not technically exist. The evolutionary theory of fear cites an almost encapsulated quality to innate fears that makes them immutable in the face of cognitions (Minika & Ohman, 2002). Despite both of these claims, cognitive processes do play a large role in both the etiology and consequences of specific phobias. This theory introduced the idea that expectancies of certain events, and not simply the events themselves, govern experience (Ollendick & March, 2004). Therefore, the cognitive theory challenges the simple S-R psychology, as well as the event based evolutionary theory (because evolutionary theorists cite the development of fears before cognition). In order to maintain a phobia, one must believe they are still aversive. Beliefs concerning threat and danger play a critical role in maintaining phobic responses (Thorpe & Salkovkis, 1995). Often phobics will over predict the frequency and incidence of aversive stimuli and generally over predict their own fear responses (Thorpe & Salkovkis, 1995). They become not only afraid of the spider, but also of their own response to the spider (such as panicking, freezing, etc.). The negative connotation and harm associated with feelings of fear leads the phobic to avoid fearful situations and stimuli altogether.
Taking into consideration these three theories of phobia, one can create a profile needed to properly assess the consequences of severe phobias. Although it would be evolutionarily advantageous to avoid a cobra, it becomes a severe phobia if one cannot walk on the grass for fear of a garden snake, or begins to avoid any instances where any snake may lurk. Avoiding situations and stimuli are the most popular "solutions" to managing phobias, yet they oftentimes perpetuate the fear. This stimuli and situation avoidance can lead to restrictions in lifestyles or severe anxiety and obsessive compulsive like tendencies. For instance, one may insist upon unmaking and remaking the bed, vacuuming the room, checking furniture and shoes, turning on the closet light, and checking every corner to assure not a single spider is in the room before one goes to sleep (personal correspondence with J. Skowronek, 2007). Believing that the stimuli will cause harm, or that one may panic at the mere sight of it will perpetuate the fear. Through cognitive and behavioral therapy, consequences of severe phobias as mentioned above can be lessened. Personal management of phobias coupled with therapy and exposure can alleviate symptoms of anxiety (Barlow et al, 2005).
Although no single theory encapsulates the etiology of phobias perfectly, each has aspects worth consideration. With modification, each theory adds a piece to the etiological puzzle of phobias. Evolutionary theory, despite the difficulty in obtaining empirical evidence, has ground through the ease at which one can be conditioned to "innately" fearful stimuli or situations. Cognitive theory adds beliefs and expectancies that accompany conditioning and possibly evolution. Through combining these theories one is able to formulate a treatment plan that is sensitive to etiology, and helps ameliorate the anxiety caused by specific phobias.
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