1. Anxiety as a Learnt Conceptual Category: Implications for our Understanding of Anxiety Disorders Graham Davey School of Psychology, University of Sussex Follow me on Twitter @GrahamCLDavey

2. Anxiety & Fear  Anxiety is an emotion dedicated to the anticipation of potential threats (A risk assessment functionality)  Fear is the emotion that is a direct response to threat (underpinned by a survival urgency)  Anxiety & Fear have:  A related functionality  Similar cognitive, behavioural, physiological and attentional characteristics  Similar neuropsychological underpinnings  Both experienced as ‘unpleasant’ feelings  Anxiety is a socio-linguistic label that conveys meaning

3. The Diversity & Elusiveness of the Anxiety Emotion  Anxiety usually is NOT in the list of basic emotions  Anxiety has NO unique neural signature  Poor consensus on a characteristic Facial Expression for Anxiety  Rash of very different historical approaches to understanding Anxiety as an emotion

4. From Perkins, Inchley-Mort et al., 2012

5. Anxiety is…  An evolved innate pattern of expressive behaviour (Darwin, 1872; Izard, 1994)  An emotion with a specific locatable and evolved neural circuitry (LeDoux, 1987; Panksepp, 1982)  An emotion with specific inheritable physiological correlates (Kagan, 1994)  An emotion formed as a learnt adaptation (Watson & Rayner, 1920)  An emotion acquired, regulated and maintained by a range of cognitive processes (Mathews & MacLeod, 1998, 2005)

6. Pinning down the ‘Anxiety’ in Anxiety Disorders  Anxiety is Transdiagnostic  Anxiety is highly comorbid within and beyond anxiety disorders  Anxiety disorders exhibit wide variations in anatomical activation and neurotransmitter action (Kim & Gorman, 2005)  Behavioural manifestations of anxiety are diverse and often unpredictable

7. Does Anxiety Conform with Other Basic Emotions?

8. How should we conceive of emotions?  Emotions as functionally discrete adaptive states  Emotions as psychological constructs forming learned conceptual categories  Emotions as embodied simulated experiences

9. Emotions as functionally discrete adaptive states  Emotions reflect motivational systems with quite specific functional properties  Anxiety therefore comes with a built-in set of reactions to threat that make evolutionary sense:  Deployment of attention towards threat  Threat interpretation biases  Reasoning biases  Systematic processing style

10. Emotions as psychological constructs forming learned conceptual categories  “..An emotional experience is a conceptual structure stored in memory” (Barrett et al., 2007)  When a person is feeling ‘anxious’ they are automatically and pre-consciously categorizing sensations from both their body and the world outside using their own learnt conceptual knowledge of the category “anxiety”

11. Emotions as embodied simulated experiences  Embodiment of emotion (e.g. anxiety) provides the basis for the physical experience of that emotion  Facial expressions of emotion and accessing emotional knowledge

12. How is the conceptual category of ‘anxiety’ learnt?  Anxiety is initially linked to the activation of the evolved, adaptive systems that define its functionality as an emotion to deal with anticipated threat  Repeated co-occurrences of these events within a familial and cultural context creates a conceptual category that inherits the anxiety-eliciting capacities originally restricted to biological evolved and pre-wired systems

13. What are the implications for understanding Anxiety Disorders if anxiety is a conceptual category?

14. From Anxiety Experience to Anxiety Disorders  Differences in controlled, attentional resources to control the activation of the anxiety experience  Differences in granularity of the conceptual category/categories that define anxiety  Incorporating dysfunctional procedural knowledge into the anxiety conceptual criteria (e.g. ‘I must worry when I feel anxious”)  Poor deliberative control of anxiety activation fosters alternative emotion regulation strategies (e.g. checking, worrying, safety behaviours, substance abuse)

15. The role of low Working Memory Capacity (WMC)  WMC is the extent to which goal-relevant information is kept active in WM despite interference of irrelevant information  Individuals low on WMC experience and express more emotion (Schmeichel et al., 2008)  Excessive worry and trait anxiety associated with low WMC  WMC related to ability to ignore or suppress irrelevant or unwanted stimuli and feelings (Brewin & Beaton, 2002)  Low WMC associated with more automatic responding, and greater likelihood of drawing early, erroneous inferences  Low WMC associated with inability to integrate new information into conceptual categories (Rosen & Engle, 1997)

16. Low WMC and Anxiety Disorders  Individuals with learning disabilities reflecting low WMC more likely to be diagnosed with anxiety disorders (Wilson et al., 2009; Rosbrook & Whittingham, 2010)  Stressful and demanding life circumstances are associated with weak cognitive control (Wessel, Huntjens & Verwoerd, 2010) and the onset of anxiety disorders  Personality traits that involve close scrutiny of information (e.g. perfectionism) will make the individual vulnerable to less deliberative control

17. Differences in granularity of the conceptual category/categories that define anxiety  The broader the conceptual category the more frequently the individual will experience anxiety  Less engrained categorization will also lead to a reduced range of specific emotions and confusing of emotions (e.g. anxiety/depression, anxiety/disgust, etc.)  Relying on a small number of defining criteria will give rise to an “all-or-nothing” pattern of emotional responding (Suvak et al., 2011)

18. Poor deliberative control of anxiety activation fosters alternative emotion regulation strategies  Pathological Worrying (GAD)  Compulsive Checking or Washing (OCD)  Avoidance Behaviour (Specific Phobias)  Safety Behaviours (Panic Disorder)  Self Medication (Substance Abuse)

20. Implications for Anxiety-Based Interventions  CT and top-down emotion regulation  Mindfulness and improving WMC (Jha et al., 2007)  Controlling anxious embodiment as a means of controlling how emotional knowledge is accessed and experienced  Strategies for improving WMC