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Samenvatting

Summary all lectures & all articles required for "anxiety & related disorders"

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I summarized all articles and all lectures (except for the last lecture) that are required for the course "anxiety and related disorders". All summaries are in detail and contain all necessary information :)

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Geüpload op
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Aantal pagina's
71
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2021/2022
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WEEK 1
A CONTEMPORARY LEARNIG THEORY PERSPECTIVE ON THE ETIOLOGY OF ANXIETY
DISORDERS – MINEKA & ZINBARG (2006)

 Anxiety disorders the most common category of diagnoses
 Behavioral/learning approaches criticized for inability to account for the diverse factors involved in the
origins of people anxieties & individual differences

CONTEMPORARY LEARNING THEORY

 Early learning histories serve as vulnerability factors that can affect the emotional consequences of
traumatic & stressful life events often implicated in the origins of anxiety disorders
 Such learning histories together with temperamental vulnerabilities can serve as diatheses which
makes some individuals more susceptible to adverse & stressful experiences that sometimes lead to
development of anxiety disorder
 Contextual variables during & following traumatic learning events have further influence

ADVANTAGES OVER OTHER APPROACHES:

 Better grounded in theories & methods of experimental psychology
 More comprehensive formulations of the etiology of anxiety disorders
 More explicit analysis of factors promoting or inhibiting the developmental of different anxiety
disorders

SPECIFIC PHOBIA

= intense & irrational fears of certain objects or situations that they usually avoid

CONDITIONING OF FEARS & PHOBIAS

 Phobic-like fears can be learning through observation alone (e.g. tv)

INDIVIDUAL DIFFERENCES

 Modest genetically based vulnerability (contribution to fear conditioning)
 Mediated through personality variables (e.g. trait anxiety, behaviorally inhibited children)
 Differences in life experiences (either before, during or following conditioning)
 Prior experiences
o More previous nontraumatic encounters  immunize
o See parents behave nonfearfully with phobic object/situation  immunize
o Children raised in environments in which they gain sense of control over environment
 Contextual variables
o Having control over traumatic event (e.g. escape)
 Postevent variables
o Inflation effect = person who is exposed to more intense traumatic experience after
conditioning of a mild fear is likely to show an increase in fear of the CS
o Mental rehearsal of CS-US relationship can enhance strength



SELECTIVE ASSOCIATIONS IN CONDITIONING

,  Primates may be evolutionarily prepared to rapidly associate certain kinds of objects with aversive
events (selective advantage in the course of evolution)  “prepared fears”
 Learning with fear-relevant stimuli is more impenetrable to conscious cognitive control than learning
with fear-irrelevant stimuli

SOCIAL PHOBIA

= excessive fears of situations in which they might be evaluated or judged by others & avoid situations or
endure them with marked distress
 Can arise as result of traumatic conditioning (92% reported teasing in school)

SOCIAL LEARNING
 Vicarious conditioning = observing another being ridiculed, humiliated or behaving in an anxious way
in social situations
 Modeling of social anxiety in families
 Culturally transmitted display rules & norms
 Japan (taijin kyfusho) = fear to embarrass or offend others

PREPAREDNESS THEORY
 = social anxiety is a by-product of evolution of dominance hierarchies & therefore predicted that social
stimuli signaling dominance & intraspecific threat (e.g. superior conditioning with angry rather than
happy faces)

BEHAVIORAL INHIBITION AS TEMPERAMENTAL DIATHESIS
 Early behavioral inhibition not only predicts the onset of multiple specific phobias in childhood but
also social phobias in adolescence

UNCONTROLLABILITY
 Uncontrollability (escape deficit) produces learned helplessness & exaggerated fear CRs
 Deleterious effects of social defeat mediated by perceptions of uncontrollability

PANIC DISORDERS (WITH & WITHOUT AGORAPHOBIA)

= recurrent & unexpected panic attacks without being aware of triggers & experience worry, anxiety or
behavioral change related to having attack
 Agoraphobic avoidance of situations in which they perceive that escape might be either
difficult or embarrassing

Interoceptive conditioning = CSs are the body’s own internal sensations  low level somatic sensations of
anxiety precede & are paired with higher levels of anxiety/panic, the low level somatic sensations of anxiety
come to elicit high levels of anxiety and panic

TWO SEPARABLE FACTORS:

 Strong arousal, extreme fear & flight-or-fight action tendencies
 Anxiety accompanied by apprehension, worry & tension

 early internal signs of panic become panic become conditioned when paired with full-blown panic attacks



DEVELOPMENT OF AGORAPHOBIA

,  Agoraphobia (shopping malls, driving, standing, sitting in a theater) develop as result of exteroceptive
conditioning of anxiety of these situations when panic attacks have occurred there
 Generalize to other similar situations
 Aerobic exercise, caffeine, sexual activity e.g. avoided because of interoceptive cues
 Inhibitory CSs for safety  “safety behaviors”
 Risk factors
 Gender (women are far more likely)
 Employment (people who must leave the house to work less likely because exposed with
feared situation)

VULNERABILITY FACTORS
 Moderate nonspecific genetic vulnerability mediated by temperamental & personality vulnerability
factors like neuroticism & trait anxiety
 Prior learning experiences:
 Lack of control & helplessness  psychological vulnerability
 Early experiences with control & mastery  develop ability to cope with stress & anxiety
situations

POSTTRAUMATIC STRESS DISORDER

= reexperiencing the trauma, passively avoiding reminders of the trauma, numbing of affect, and heightened
general arousal  traumatic event is necessary

TRAUMA PHASE

 Uncontrollability & unpredictability during trauma  more likely to result in PTSD
 Psychological state of resistance & fighting back versus giving up & conceding defeat

PRETRAUMA PHASE

 Prior experiences with control or lack of control  immunize
 History or prior trauma associated with increased risk of developing PTSD
 Repeated childhood abuse

POSTTRAUMA PHASE

 Greater reexperiencing associated with more PTSD symptoms
 Mild PTSD can become full-blown PTSD when there is reason to evaluate danger (e.g. later finding out
that rapist was a murderer)

GENERALIZED ANXIETY DISORDER

= chronic excessive worry about a number of events or activities for at least six months & worry much be
experienced as difficult to control

 Likely to have history of childhood trauma
 Far less tolerance for uncertainty & being unable to predict future
 Neuroticism & trait anxiety
 Perceived benefits of worry center around people’s belief that worry helps avoid catastrophe
(suppression of emotional & physiological responses serve to reinforce the process of worry 
prevents from extinction of anxiety)
 Attempt to control thoughts & worry lead to increased experience of intusive thoughts & increase
perception of uncontrollability

, = vicious circle of anxiety, worry, and intrusive thoughts may develop to sense of being unable to control

OBSESSIVE-COMPULSIVE DISORDER

= unwanted & intrusive thoughts, impulses, or images that cause marked anxiety or distress, accompanied by
compulsive behaviors ot mental rituals performed to neutralize or prevent the distressing thoughts or images

Verbal conditioning

 Verbal transmission of dangerous thoughts
 Direct verbal conditioning  neutral idea is paired with scary idea that a person may have
 Social learning
 Thought action fusion = people are taught the idea that thoughts, desires, and impulses are morally
equivalent to actions & thoughts of a specific catastrophe increase the probability that it will actually
occur

ROLE OF AVOIDANCE

 Engage in either behavioral or mental rituals intended to neutralize or prevent obsessions
 Extinguish avoidance by preventing responses & do prolonged exposure

ROLE OF PREPAREDNESS

 Do not typically obsess about random scary thoughts and do not show arbitrary ritualistic behaviors,
rather their thoughts and behaviors have deep evolutionary roots

CONCLUSION

 contemporary learning theory can capture the richness & complexity associated with the development and
course these disorders




ANXIETY DISORDERS: WHY THEY PERSISTENT HOW TO TREAT THEM – CLARK (1999)

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