Anxiety Disorders

Different aspects of Anxiety Phenomenological –Affective: dread, tension, worry –Cognitive: expectations of an inability to cope, impaired cognitive ability Behavioural –Impaired motor functioning and avoidance Physiological –increased blood pressure, heart rate, breathing; disruptions in GI functioning and dizziness

Types of Anxiety Disorders Panic Disorder Generalized Anxiety Disorder Phobias Posttraumatic Stress Disorder Obsessive-Compulsive Disorder

Panic Disorder Panic Attack Cued (situationally bound) v.s. Uncued (unexpected) panic attacks Panic Disorder

Panic Disorder: Agoraphobia Fear of being in a situation where having a panic attack would be dangerous or where escape would be impossible

Generalized Anxiety Disorder Chronic state of diffuse anxiety

Phobias Phobias involve –intense, persistent fear of something that poses no real threat –avoidance of the feared object/situation Specific Phobia –fear of circumscribed objects or situations

Phobias Algophobia-pain Astraphobia-thunderstorms Pathophobia-disease Monophobia-being alone Mysophobia-contamination Nyctophobia-darkness Ochlophobia-crowds

Phobias: Social Phobia Fear of social embarrassment or humiliation –public speaking –eating in public –using public bathrooms Impact on self confidence and restricts social activity

Posttraumatic Stress Disorder Intense fear and helplessness in response to events involving actual or threatened death or serious injury. Acute Stress Disorder –symptoms last for 2 days - 4 weeks Posttraumatic Stress Disorder –symptoms last at least 1 month

Obsessive-Compulsive Disorder Obsession –unwanted thought or image that keeps intruding into awareness Compulsion –an action that a person feels compelled to repeat again and again despite a lack of desire to do so

The Psychodynamic Approach to Anxiety Anxiety is a signal that the ego is having a hard time mediating between reality, id and superego. Different anxiety disorders are the result of different defense mechanisms used to cope.

The Psychodynamic Approach to Anxiety: Attachment Theories Bowlby –disturbances in parent-child bond leads to “anxious attachment” and a vulnerability to anxiety disorders later in life

The Behavioural Approach to Anxiety Mowrer (1948) Avoidance learning –1) classical (respondent) conditioning –2) negative reinforcement

The Behavioural Approach to Anxiety Barlow (1988) Anxiety Sensitivity or “Fear of Fear”

The Behavioural Approach to Anxiety Treatment: –systematic desensitization –exposure –flooding

The Biological Approach to Anxiety Genetic Component –family and twin studies suggest a genetic component in most anxiety disorders –panic disorder shows the strongest genetic component and generalized anxiety disorder the least

The Biological Approach to Anxiety “Suffocation false alarm hypothesis” of panic disorder serotonin and basal ganglia abnormalities in OCD hormonal theory of PTSD State-dependent learning

The Cognitive Approach to Anxiety Individuals misperceive and misinterpret internal and external stimuli

Cognitive Appraisal Stimulus--->Appraisal---> Response –evaluation of stimulus based on memories, beliefs, and expectations

Information Processing Schema –how we understand the information we take in from the environment Selective Attention –what information we take in

Cognitive Approach to Panic Disorder Catastrophic interpretations of bodily sensations Feeling of control Some Problems: –panic attacks during sleep –why do catastrophic interpretations develop

Anxiety and Selective Attention

Bodybags Nam Firefight Landmine Explosion Airlift

Several cognitive models of anxiety suggest that attentional biases to threat cues cause and maintain anxiety disorders. Empirical findings: –Lavy and van den Hout (1993), individuals with spider phobia show an attentional bias to spiders –Ehlers and Breuer (1995), individuals with panic disorder show an attentional bias towards unpleasant body cues

Attentional bias in Social Phobia

Pair of Pictures: 500ms Fixation Cross: 1000ms F / E judgement Temporal sequence of events for each trial + E Probe Display: until response

Participants Two kinds of participants (high and low social anxiety) Participants were university students selected for high and low social anxiety (FNE, also measured trait anxiety)

Experimental Conditions Two kinds of experimental conditions (threat and no threat) Threat: Half of the participants were told the experiment was an assessment of social skills and public speaking ability.

Picture Displays Three kinds of picture displays (positive, negative and neutral face, each paired with a household object)

Experimental Design Two kinds of participants (high and low social anxiety) Two kinds of experimental conditions (threat and no threat) Three kinds of faces (negative, neutral and positive) each displayed with a household object (clocks, chairs etc.)

Bias Score Bias Score = RT to identify probe when the face and probe are in opposite positions RT to identify probe when the face and probe are in the same position -

Pair of Pictures: 500ms Fixation Cross: 1000ms F / E judgement Temporal sequence of events for each trial + E Probe Display: until response

Results In the social threat condition, the high socially anxious participants avoided negative and positive faces, whereas the low socially anxious participants showed no bias.

Discussion of Results Lavy and van den Hout (1993) found that spider phobics show an attentional bias towards pictures of spiders. –Why are spider phobics and social phobics different?

Discussion of Results How might this attentional bias (to avoid emotionally expressive faces) contribute to the maintenance of social phobia?

Mansell, et al. (1999). Social anxiety and attention away from emotional faces. Cognition and Emotion, 13(6),