A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders: Its Not What You Thought It Was Mineka & Zinbarg 2006

Why Care? Lifetime prevalence in the U.S. of approximately 29%. Classical learning theory does not account for why some people develop anxiety disorders while others do not.

Specific Phobia Intense and irrational fears of certain objects or situations they actively avoid. Watson & Rayner (1920) –Little Albert

Other Factors with Specific Phobias Vicarious Conditioning Individual Differences –Personality Variables (High Trait Anxiety, Behaviorally Inhibited) –Genetically based vulnerabilities –Latent Inhibition: Prior exposure to the CS before paired with the US ↓ later conditioning to CS paired w/ US. –Perceived Control of the Situation –Postevent inflation (another experience, more information, mental rehearsal of CS-US relationship) Evolutionary selection of Phobias – more prepared –Fear Relevant vs. Fear Irrelevant Stimuli

Social Phobia Excessive fear of situations in which they might be evaluated or judged. Direct traumatic conditioning – 92% report history of severe teasing in childhood; 50% in panic disorder; 35% in OCD 56% of those with social phobia recalled direct traumatic conditioning experiences

Factors with Social Phobias Vicarious learning (13%) Modeling – parents fears Cultural Norms (Taijin Kyofusho) Preparedness (Social Dominance) Behavioral Inhibition Controllability Notice any patterns?

Panic Disorder With and Without Agoraphobia Recurrent unexpected panic attacks without explicit knowledge of cues or triggers; experience worry anxiety or behavioral change related to having another attack.* Some develop avoidance of situations in which they feel escape might be difficult or embarrassing if they had a panic attack. Risk Factors: –Gender –Employment

Panic vs. Anxiety Panic: strong autonomic arousal, extreme fear, and fight or flight actions Anxiety: apprehension, worry and tension

Theory Exteroceptive Conditioning –CSs interact with external sensory receptors Central to development of agoraphobia Interoceptive Conditioning –CSs are bodies own internal sensations Heart palpitations and dizziness Panic Attacks can occur due to the presence of exteroceptive CSs or interoceptive CSs May cause generalization of agoraphobia due to interoceptive CSs generalizations (caffeine, scary movies, exercise, etc.)

Factors in Panic Disorder Anxiety- may be a precursor to panic attacks –Can be additive (general level of anxiety and CS) Genetic & Personality factors Prior learning –Perceptions of lack of control and helplessness –Engaging in sick role behavior, observing physical suffering as children

PTSD Reexperiencing the trauma, passively avoiding remingers, numbing of affect, heightened general arousal. Trauma Phase –Controllability –Mental defeat Pretrauma Phase –Prior trauma (especially interpersonal trauma) –History of control/readiness - predictable –Genetic liability Posttrauma Phase –Exposure to contexts related to the trauma –Reevaluation inflation –Reinstatement of fear

GAD Chronic excessive worry about several events and/or activities for 6+ months, worry must be difficult to control. Less tolerance for uncertainty than nonanxious controls – need to predict the future Anxiety-Worry-Intrusive thoughts Cycle; Cognitive avoidance

GAD Factors Benefits: –Avoid catastrophe –Avoid deeper emotional topics Costs –Greater sense of danger and anxiety –Negative intrusive thoughts –Suppresses emotional and physiological responses to aversive imagery Factors –Uncontrollable/Unpredictable events (though not as severe as those in PTSD) –Childhood trauma

OCD Unwanted and intrusive thoughts, impulses, or images causing marked anxiety or distress; usually accompanied by compulsive behaviors or mental rituals

Factors in OCD Verbal Conditioning Responsibility and Duty Thought-action fusion –Moral equivalent –Probability increase Cultural Norms Avoidance → Maintenance Evolutionarily relevant themes

Conclusions From this perspective we can identify risk factors associated with future development of anxiety disorders. Strong sense of mastery and exposure to nonanxious models from early age Exposure therapy