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Chapter 5

PS280 Chapter Notes - Chapter 5: Guided Imagery, Problem Solving, Debriefing


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Kathy Foxall

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PS280 Chapter 5
Anxiety and Related Disorders
The Characteristics of Anxiety
3 distinctive components of emotion:
o Physiological Changes in the autonomic nervous system that result in
respiratory, cardiovascular, and muscular changes in the body
o Cognitive Alterations in consciousness and specific thoughts a person
may have while experiencing a particular emotion
o Behavioural Consequences of certain emotions
Important theoretical distinctions between anxiety, fear, and panic
Anxiety An affective state whereby a person feels threatened by the potential
occurrence of a future negative event
o Future oriented
Fear A more primitive emotion, occurs in response to a real or perceived
current threat
o Present oriented
o Elicits a behavioural response known as “Fight or Flight” Response –
Fear prompts a person to either flee from a dangerous situation or stand
and fight
Panic An extreme fear reaction that is triggered even though there is nothing to
be afraid of
Historical Perspective
Until 1980, anxiety disorders were classified together with the somatoform and
dissociative disorders under the heading Neurosis
Freud was one of earliest theorists to focus on anxiety
o Theorized that there was an important difference between objective fears
and neurotic anxiety
o Proposed that neurotic anxiety is a signal to the ego that an unacceptable
drive is pressing for conscious representation
o Anxiety viewed as a signal to ensure that the ego takes defensive action
against these pressures
o Thought to occur because defence mechanisms failed to repress painful
memories, impulses, or thoughts
In the 1920s behaviourists like John B. Watson began to consider fears and
phobias in terms of conditioning models
Research conducted over the past few decades has greatly expanded our
understanding of the nature of anxiety and its treatment
Diagnostic Organization of Anxiety and Anxiety-Related Disorders
In DSM-5, anxiety-related disorders are categorized into three chapters:
o Anxiety disorders
o Obsessive compulsive and related disorders
o Trauma and stressor related disorders
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Anxiety/anxiety related disorders are very common, more prevalent in women
Approx. 25% of the pop’n may be expected to develop an anxiety/related disorder
Biological Factors
Twin studies suggest moderate level of concordance for anxiety within family
members, suggesting a genetic role
Those with a family member with anxiety are 4-6x more likely to also have
anxiety disorder than those without a family history
Estimated heritabilities range from 30-40%
Studies reveal that environmental factors particular to specific individuals account
for a greater degree of the non-genetic variation in risk for anxiety disorders than
do shared family factors (i.e. place of living)
Genetic risk for anxiety is suggested to be non-specific and more likely to be
passed on as broader dispositional or temperamental traits
Neurotransmitters and Neuroanatomy
Neural fear circuit begins with the thalamus
Info is then sent to parts of amygdala, then to areas of hypothalamus, through
mid-brain to brain stem, and finally to spinal cord; the latter areas are connected
with various autonomic and behavioural outputs
Info transfer between the neuroanatomical structures involved in fear and anxiety
is mediated by complex and interacting neurotransmitter systems such as GABA,
serotonin, and norepinephrine
Benzodiazepines are a class of anti-anxiety medications that operate primarily on
GABA-mediated inhibition of fear
No neurotransmitter system has been found to be solely dedicated to the
expression of fear, anxiety, or panic
Psychological Factors
Behavioural Factors
Mower’s Two-Factor Theory Fears are acquired through classical conditioning
and maintained by operant conditioning; avoiding or escaping is a negative
reinforcer that prevents classically conditioned fears from being unlearned
o Neutral stimulus becomes paired with inherently negative stimulus
o Person lessens anxiety by avoiding the neutral stimulus
o Avoidance can actually increase anxiety over the long haul
o This theory cannot explain development of all phobias
It is also possible to develop fears by observing the reactions of other people
Some people also develop fears by hearing fear-relevant information
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Cognitive Factors
Beck proposed that people are afraid because of the biased perception that they
have about the world, the future, and themselves
Anxious people often see the world as dangerous, future as uncertain, and
themselves as ill-equipped to cope
People prone to anxiety disorders are thought to hold core beliefs that are helpless
and vulnerable and tend to focus on information relevant to their fears
Cognitive models describe schemas, info processing biases, and automatic
thoughts, all thought to be relevant to development/maintenance of anxiety
Interpersonal Factors
Parents who are anxious tend to interact with their children in ways that are less
warm/positive, more critical, less granting of autonomy, etc.
o May foster beliefs of helplessness and uncontrollability in children that
contribute to a general psychological vulnerability to anxiety
Attachment theorists have shown early child-parent interactions can lead to the
development of general belief systems about relationships
o An anxious preoccupied attachment style is predictive of anxiety problems
in adulthood
Comment on Etiology
Clearly no single factor causes anxiety
A complex interplay among biological, psychological, and interpersonal factors
Combination of factors or vulnerabilities likely contributes to an individual’s level
of anxiety when they are faced with life stressors
Anxiety Disorders
Most common of all mental disorders
Without treatment, tend to be chronic and recurrent, associated with significant
distress and suffering
Can impair multiple domains of functioning
Costly in terms of treatment and lost productivity
Panic Disorder
Experience Panic Attacks Sudden rushes of intense fear or discomfort during
which a person experiences a number of physiological and psychological
At least 4 of 13 symptoms outlined on p. 99 must be present
Attack must develop suddenly, reaching peak within minutes
At least 2 unexpected attacks required for diagnosis
Persistent concern about another attack
Worry about consequences of attack
Significant change in behaviour as a result
Must appear out of the blue
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