Environmental influences to anxiety Flashcards
Why should Psychologists study anxiety disorders?
- prevalence?
- impacts?
- Some fear and anxiety in childhood is normal, but a significant minority of children experience fear/anxiety that persists and affects daily functioning.
- 1 in 14 people around the world at any given time has an anxiety disorder.
- The median global current prevalence of all anxiety disorders in 3-17 years olds is ~6% [95% CI: 3.7-9.3%]
- Start early in development with mean age of onset of ~11 years (Kessler et al., 2005). Therefore seeing anxiety disorders emerging early
- Chronic, debilitating course:
— Lifelong impact on wellbeing and daily functioning.
— Raise risk for other psychological disorders.
— Large societal cost
Abnormal fears and anxiety
- A significant proportion of childhood fears and anxiety reflect clinical anxiety disorders, especially phobias (Muris, Merckelbach, Mayer & Prins, 2000).
— persistent and affecting children’s everyday function
— might see social anxiety as well as phobias
- Childhood phobias and anxiety diagnoses may reflect radicalisations of normal fear and anxiety.
- Both genetic and environmental vulnerability factors implicated in risk for development of childhood anxiety disorders.
Social Anxiety Disorder: DSM-5 Criteria
A. A persistent fear of social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxietysymptoms) that will be embarrassing and humiliating.
B. Exposure to the feared situation almost invariably provokes anxiety.
C. The person recognises that this fear is unreasonable or excessive.
D. The feared situations are avoided or endured with intense anxiety and distress.
E. The avoidance, anxious anticipation, or interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships. (impacting child’s everyday functioning)
F. The fear, anxiety, or avoidance is persistent, typically lasting 6+ months.
G. Not due to physiological effects of a substance, general medical condition or another mental disorder.
Genetic Factors
1- where does social anxiety run?
2- how much heritability?
3- how are we beginning to identify actual genetic variants?
4- what effect does SA disorder have?
1- Social anxiety runs in families- if parent has SA child is more likely to
2- ~30% heritable but estimates vary depending on population studied
3- Beginning to identify actual genetic variants using genome-wide association scans (GWAS)
4- SA disorder has a polygenic effect– many genes of very small effect.
Environmental Factors
- what does some research state?
- what is poorly understood?
- support for?
- what plays a larger role?
Some research states environmental factors are more important than inherited
- Relative contribution of genes and environment to etiology of anxiety is poorly understood.
- Support for direct environmental transmission of anxiety via e.g. verbal information, vicarious learning.
- And for (non-shared) environment factors* playing a larger role than genetic factors (Scaini, Belotti & Ogliari, 2014).
*this is defined as the environmental influences that are not shared (e.g. different friends/teachers) and that make children growing up in the same family different, rather than similar.
What environmental factors might place children at greater risk of experiencing social anxiety? What factors might protect against social anxiety?
Risk factors- trauma, neglect in home environment, bullying, SES (could be protected or risk), negative experiences in social situations
Protect- good parent child interaction
Culture, parenting style, attachment to parent, relations with peers
Etiological Model of Social Anxiety Disorder (Spence & Rapee (2016)
Tries to explain how high levels of social anxiety might emerge through development.
Cultural and Personal Factors: Gender, Age, Culture
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Life interference/ Diagnostic threshold
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Diagnosis
Social Anxiety Disorder
Interplay of Genes/ temperament, Proximal factors, Environmental factors
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Levels of social Anxiety
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Diagnosis Social Anxiety Disorder
Etiological Model of Social Anxiety Disorder (Spence & Rapee (2016)
Genes/ temperament, proximal and environment factors
Genes/ temperament:
- Behavioural inhibition and withdrawal
- Emotional and attentional regulation to threat
Proximal factors:
- Behavioural- poor social skills, poor social performance, safety behaviours
- Cognitive- beliefs, cognitive processes
Environment factors:
- parent influences
- peer influences
- aversive social outcomes
- negative life events
- culture
Explaining Etiological Model of Social Anxiety Disorder (Spence & Rapee (2016)
- Social anxiety existing along a continuum with SA diagnosis being associated with higher levels of SA
- DSM criteria- diagnosis of SA disorder doesn’t just require high levels of SA but also that it impacts their everyday function
- DSM argue that how much these symptoms impact peoples everyday living can be affected by factors such as gender, age and culture
- The model proposes a series of influential risk and protective factors
- Genes/ temperament factors such as behavioural inhibiton (fearful way of reacting to novel environments and novel people) also emotional and attentional regulation to threat
- There are also cognitive factors- this might be biases/ distortions in cognitive processes. Some people might be more likely to interpret information in social situations in a more kind of negative way or engage in post event processing (thinking about how well you did in social situations with specific emphasis on negative aspects of it)
- Behavioural factors- safety behaviours (anxious children might engage in these and they help anxiety in the short time but in the long term anxiety is heightened) eg. avoiding eye contact. These behaviours inhibit the ability to engage in social situations
- Environmental factors
- Risk and protective factors can act in an interactive way to increase social anxiety disorder in childhood
Assumptions
- Risk factors interact
- Equifinality: different pathways and combinations of factors can result in SAD
- Multifinality:* any one risk factor can lead to multiple outcomes, not just SAD- children with similar risk factors can go on to having different outcomes
- Reciprocal risk factors – social anxiety in young person influences probability of experiencing a risk factor, which in turn magnifies young person’s risk for SAD
— e.g. fearful temperament at age 2 elicits overprotective parenting, which in turn predicts social withdrawal 3 years later (Kiel & Buss, 2011)
— e.g. social anxiety symptoms increase risk for peer victimisation, which in turn predicts further aversive social outcomes
Not everyone who has SA experience the same risk factors- equifinality
Aversive Social Outcomes:
How do aversive social learning experiences with peers play a role in the development and maintenance of SAD?
- Excessive teasing
- Criticism
- Bullying and Victimisation
- Rejection
- Ridicule
- Humiliation
- Exclusion by significant others
What Aversive Social Outcomes do socially anxious children experience?
- Have fewer friends
- Have lower quality friendships
- Are less well liked and accepted by peers
- Have more negative peer interactions
- Are more likely to be rejected, neglected and victimised
- Affiliate less with peer crowds
- Are rated as less socially skilled
Adverse social outcomes are a risk factor for future SAD, not just a consequence of social anxiety (Spence & Rapee, 2015)
Why is it that socially anxious young people experience adverse social outcomes?
Poorer performance on social tasks
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Adverse social outcomes/ less positive response from peers
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Heightened anxiety/expectations of future negative outcomes
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Avoidance of future social situations
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Reduced opportunity to acquire social skills
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Poorer performance on social tasks
Blote, Miers & Westenberg (2015)
(Examined impact of social anxiety and social performance on the way children are judged by their peers)
Method
- N = 20 HSA and N = 20 LSA 13-17 years old recorded giving a speech to a pre-recorded audience.
- N = 534 observers (unfamiliar peers) rated HSA and LSA speakers on:
— Rejection using Desire for Future Interaction Scale e.g. Would you like to have this speaker sit next to you in class?
— Attractiveness (not at all good looking – very good looking).
— Performance using Skills Rating Scale for Peers e.g. content, facial expression, body posture and movement, way of speaking. - Additional adult ratings of social skills performance.
- e.g. how friendly did the speaker look?
Blote, Miers & Westenberg (2015)
(Examined impact of social anxiety and social performance on the way children are judged by their peers)
Results
HSA= high socially anxious
HSA adolescents were more rejected by peers
HSA adolescents were judged by their peers and adult observers as having lower social skills performance
HSA adolescents were rated as less physically attractive compared to LSA adolescents
