Chapter 6 Notes

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14 May 2011

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Anxiety: Unpleasant feeling of fear and apprehension.
DSM-IV poses 6 categories of anxiety: phobias, panic disorder, generalized anxiety disorder,
obsessive-compulsive disorder, PTSD and acute stress disorder.
Comorbidity is when you have more than 1 disorder at any given time and can arise from:
-symptoms of anxiety are not disorder specific. Signs of anxiety such as perspiration, heart
rate etc. can be diagnosed for panic disorder, phobias, PTSD etc.
-etiological factors that give rise to anxiety disorders may be applicable to more than 1
- anxiety disorders are more prevalent in woman and the likelihood decreases with age.
-It is an irrational fear-mediated avoidance of an object that is out of proportion to the
danger it poses, and is recognized by the sufferer as groundless.
-Each term ends with phobia derived from Phobos, a greek god that would scare enemies
-Psychoanalysts focus on content of phobias and regard their origins as symbolic (boy who
is afraid of horses sees black lining around mouth and eyes that resemble his dads glasses
and mustache, thus turning his fear for his father into a fear for horses)
-Behaviourists see acquisition of fear and reduction of fear, they ignore the content of the
Specific Phobias
-unwarranted fears caused by presence or anticipiation of an object
-DSM-IV subdivides into: blood, injuries and injections, situations (plane, small spaces
etc.), animals and natural environments (height, water etc.)
-Recent empirical evidence suggests that fear can be grouped into the following
- [1] Agoraphobia
- [2] fear or heights or water
- [3] threat fears (blood/needles, storms/thunder)
- [4] fears of being observed
- [5] speaking fears
-Fears then classified into 2 categories: specific and social fears.
-Prevelance at 7% men and 16% women
-Fear focused on in a phobia can very cross-culturally (Chinese men scared of cold and
japs scared of causing embarrasement)
Social Phobias
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-irrational fears linked to presence of others
-try to avoid situations in which they are judged/evaluated
-ex. Speaking in public, eating, using the bathroom etc.
-social phobias can be general or specific
- General: involve many different situations and display comorbidity with things such as
alcohol abuse and depression. This type leads to more impairment
- Specific: a single fear such as public speaking
-Prevalence 11% men 15% women
-Diagnosed social phobia linked to marked dissatisfaction and low functioning in terms of
quality of life.
-Positive link between social phobia and school dropouts.
Etiology of Phobias
Proposals for the cause of phobias has been made from psychoanalytic, behavioural and cognitive
points of view as well as in terms of the biological paradigm.
Psychoanalytic Theories
-Freud said phobias were a defense against anxiety caused by repressed id impulses
-Response moved from a feared id impulse to an object that has a connection to it ex:
elevators or closed spaces become the phobic stimuli
-Phobia is egos way of dealing with a repressed childhood conflict
-Arieti said repression stems from problem of childhood, not id impulse.
Behavioural Theories
Focus on learning to acquire phobias. These are types of learning that lead to phobias:
Avoidance conditioning (lil’ albert and the mouse)
-phobic reactions are learned avoidance responses
-avoidance conditioning theory is based on 2 factors
-[1] person can learn to fear neutral stimulus (cs) if it is paired with painful event (the ucs)
-[2] this fear can be reduced by escaping the CS. This leads to positive reinforcement by
the reduction of fear, thus repetition of activity.
-Phobia of a specific object or situation has been reported after a stressful incident
-Also known that fears can develop with people that have had no prior interaction with
that object. How can this be explained? Maybe modeling?
-learning of fears by imitating the reaction of others
-this method I of learning fear by observation is called vicarious learning
-various learning may be accomplished through verbal interactions.
-The anxious-rearing model states that children develop anxiety due to constant parental
warning that increases anxiety at childhood
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Prepared Learning
-theory that physiologically some organisms are likely to fear certain things more than
-explains why some people are afraid of only certain stimuli (spiders)
-classical conditioning experiments show a quick extinction of fear for objects that were
not prepared to be associated with a UCS.
-Basically it means that we are born with the ability to fear certain things more than others
A history of Diathesis
-Why do some people develop fear after a traumatic event while others dont?
-A cognitive diathesis is a pre-disposition to fear. Some people have a tendency to believe
that the same traumatic experience will happen again.
-Another diathesis is a history of not being able to control the environment
Social skills deficits in Social Phobias
-behavioural model of social phobia blames lack of social skills as cause of social anxiety
-person may not have learned how to act properly with others, and is awkward and socially
-studies found their social skills to be lower than others
-this COULD have started form classical conditioning at a young age, and then developed
to low social skills as an adult
Cognitive Theories
-Focuses on how people thought processes can serve as a diathesis and maintain phobia.
-Anxiety is believed to result from attention to negative stimuli, that ambiguous info is
threatening and that negative events are more likely to occur than positives
-Ex: fear of spiders automatically brings up themes of disgust or threat
-Cognitive factors that make social phobia: concerned with other peoples evaluations,
more aware of self image and tries to hide imperfections. Even if they come off well in a
social interaction, they think of themselves negatively
-Cognitive Behavioural models link social phobia to cognitive characteristics:
- [1] an attentional bias to focus on negative social information
- [2] perfectionist standards for accepted social performances
- [3] high degree of public self consciousness
-Social phobia is linked with high self-criticism.
-Socially anxious ppl not only anticipate negative social experiences, but have negative
post-event processing.
Predisposing Biological Factors
-people who are adversely affected by stress may have a biological malfunction (diathesis)
that predisposes them to have a phobia following a traumatic event.
- Autonomic Nervous System
-People differ in the ease in which their nervous system becomes aroused.
-This dimension of autonomic activity has been identified as stability-lability.
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