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Gary Louie

on 12 May 2014

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Transcript of Claustrophobia

So what causes
Causes and Solutions
Claustrophobia is classified as an anxiety disorder, where an individual has a 'morbid fear of being in a confined space', usually in an unfamiliar environment
What is Claustrophobia?
Often results in physical and emotional reactions, which include increasing anxiety among other symptoms.
Originates from the Latin word, 'Claustrum', meaning shut in a place, and the greek word, 'phobos' meaning fear.
Causes of Claustrophobia
Magnetic Resonance
Imaging (MRI)
Role of Conditioning
What is
The Role of Conditioning in the development of this condition
A type of learning known as 'classical conditioning'
"A basic form of learning in which one stimulus or event predicts the occurrence of another stimulus or event"-Gerrig et al, 2012, p205
Creates a change in a behaviour and results in learning
There is an association between two stimuli
First Study of classical conditioning
Russian physiologist Ivan Pavlov
This study came as a result of a digestive study on dogs
Observed that learning may result from associating two different stimuli
Type of Responses
Unconditioned response (UCR)
Conditioned response (CR)
Nature provides UCS-UCR connections
Learning produced by classical conditioning creates the CS-CR connection
Stimulus-response (SR) theories are central to conditioning
Process of Conditioning
Acquisition and Extinction
Stimulus Generalisation
Stimulus Discrimination
Acquisition and Extinction
Process where the CR is first elicited and gradually increases in frequency over repeated trials
Timing is critical
Delay Conditioning
Trace Conditioning
Simultaneous Conditioning
Backward Conditioning
Stimulus Generalisation
"Automatic extensions of responding to stimuli that have never been paired with the original UCS"-Gerrig et al, pg.208
The patient will not only react to the one stimulus
E.g. The patient was once trapped in a large room but may also fear other enclosed spaces, even smaller ones
Stimulus Discrimination
"Process by which an organism learns to respond differently to stimuli that are distinct from the CS on some dimension"-Gerrig et al, 2012, pg.209
The patient should limit its response to a small range of stimuli
Operant Conditioning
Another type of 'conditioning'
A type of learning known as 'operant conditioning'
'Is a form of learning in which responses come to be controlled by their consequences' (Weiten 2013, p.240)
The Law of Effect
Edward L.Thorndike observed American cats trying to escape from puzzle boxes
He analysed that learning was an association between stimuli in the situation and a response that an animal learned to make;a stimulus-response (S-R) connection
The relationship between behaviour and consequence is the law of effect

It is a law of learning where power of a stimulus to evoke a response is strengthened when the response is followed by a rewards and weakened when it is not
B.F.Skinner admired Pavlov's work
Reinforcement Contingences
'Is a consistent relationship between a response and the changes in the environment that it produces' (Gerrig 2012, p.215)
Types of Reinforcers
Positive Reinforcement
Negative Reinforcement
Escape Conditioning
Avoidance Conditioning
This type of conditioning is involved with claustrophobia
In contrast, when the individual thinks about avoiding the situation entirely, they instantly feel better
Reduction in
the Amygdala
Unpleasant Experiences/Classic Conditioning
Observations & Learning
duration: 1 hour
patient must remain still for whole scan
very loud!
No Distress
All Patients
Mild Distress
History of Claustrophobia
Of the 30% distressed patients...
What does this mean?
2 Million scans not being completed annually!!
What Strategies can you use to help?
Support Person
Sedatives (Light)
Good Communication
Physical Comfort
How does this affect the claustrophobic patient
How does this affect the claustrophobic patient?
Operant conditioning is very similar to classical conditioning
Through conditioning, individuals repeatedly associate the fear of confined spaces with terrible anxiety, strengthening the fear
"Those undergoing head-first examinations, female and middle-aged patients were significantly more likely to develop claustrophobia in the logistic regression analysis"-Dewey et al., 2007, pg 1322
Why does this happen?
Emotion and Preferences
You can subconsciously learn an association between two stimuli
eg. being in an enclosed space (CS) and the events that may occur when left alone in that space (UCS)
This effect is not only existent in claustrophobic patients but also in everyday life - think about the level of anxiety that it may cause for a patient
Feelings of disgust or danger out-rule feelings of thinking that something is okay-
Classical Conditioned Response
Fear Conditioning
"Process by which a neutral stimulus comes to evoke fear following its repeated pairing with an aversive stimulus"-Lissek et al, 2005
Explains why even a single traumatic event can condition you to respond with strong physical, emotional and cognitive reactions.

The patient may not have experienced but may have heard of, or been visually stimulated to cause this type of anxiety
Claustrophobia is a morbid fear of enclosed spaces.
What is Claustrophobia?
Quick Recap...
Signs and symptoms of claustrophobic patients include: sweating, shaking, palpatations, nausea and hyperventilation.
What are the Signs?
Biological:Reduction in the Amygdala

Social:Observations & Learning

Psychological:Unpleasant Experiences/Classic Conditioning
Causes of Claustrophobia
There are 3 main factors that cause Claustrophobia:
1. Biological
2. Social
3. Psychological

There are two types of conditioning, classical and operant.

CLASSICAL: "A basic form of learning in which one stimulus or event predicts the occurrence of another stimulus or event"
OPERANT: "Is a form of learning in which responses come to be controlled by their consequences"
loss of money
No diagnosis
How does this relate to you?
As a diagnostic radiographer, you will be required to conduct some MRI examinations
And will encounter some patients that suffer from claustrophobia
One of the main determinants for claustrophobic reactions include the equipment used
Different types of equipment
The space for the patient is minimal
Increasing the room between the patient and the MRI will result in a decrease in image quality.
Equipment and Claustrophobia
In a study by Dewey et al, 2009, it compared different MRI machines for image quality along with the number of claustrophobic reactions
This included comparing Wide Gantry vs Short Gantry
And also open ended MRI scanners with acoustic reduction
There are 5 questions, the team that answers the most correctly wins.
To answer a question, a team member must yell out CLAUSTROPHOBIA!
Each question has a 15 second limit in which it can be answered.
If an answer is incorrect the team that shouted CLAUSTROPHOBIA second will then have an opportunity to answer.
The team that wins, will recieve a prize.
What is Claustrophobia?
Question 1
Claustrophobia is an anxiety disorder, where an individual has a 'morbid fear of being in a confined space', usually in an unfamiliar environment.
What are the five signs and symptoms of a claustrophobic patient?
Question 2
There was a study done to compare two types of gantries, what are the two different types? And why can't we use a much larger Gantry?
Question 3
Part 1:
Wide gantry and short gantry

Part 2:
If they gantry was made larger, i.e. the distance between the image receptor and the patient increased, then there would be a decrease in image quality.
What are the three main factors that cause Claustrophobia?

And by what mechanisms do each factor cause claustrophobia?
Question 4
1. Biological - Mechanism: reduction in the Amygdala.

2. Social - Mechanism: observations & learning.

3. Psychological - Mechanism: Unpleasant Experiences/Classic Conditioning
What type(s) of conditioning play a significant role in causing or reinforcing Claustrophobia?
Question 5
Both classical and operate condition have a major role in the reinforcement and cause of Claustrophobia.

Through these types of conditioning, individuals repeatedly associate the fear of confined spaces with terrible anxiety, strengthening the fear
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