Lecture 3

Question 1

Define anxiety

Answer 1

A mood state characterised by strong negative emotion and bodily symptoms of tension in anticipation of future danger or misfortune.

Question 2

Anxiety disorders

Answer 2

1)Most common group of mental illness
2) Disorders in which the main symptom is excessive or unrealistic anxiety and fearfulness
3) out of proportion to the threat posed by the situation or event
4) Disabling intensity

Question 3

Cognitive, psychological, behavioural

Answer 3

Component:
Cognitive/subjective.
Fear:
I’m in danger
Anxiety:
I’m worried about what might happen.

Component:
Physiological.
Fear.
Increased heart rate, sweating
Anxiety.
Tension. Chronic overarousal

Component:
Behavioural
Fear.
Desire to escape or run
Anxiety.
General avoidance

Question 4

Six main anxiety and stressor-related disorders

Answer 4

Specific Phobia
 Social Anxiety Disorder
 Panic Disorder (PD)
 Generalized Anxiety Disorder (GAD)
 Obsessive compulsive disorder (OCD)
 Post-traumatic stress disorder (PTSD)

Question 5

Comorbidity

Answer 5

Anxiety symptoms
 Anxiety disorders – other psychological disorders

Question 6

Specific phobia

Answer 6

1) An excessive, unreasonable, persistent fear
2) Phobic individual will usually develop a set of avoidance
responses
E.g,Claustrophobia - small, enclosed space.
 Acrophobia- heights.
 Hematophobia – blood
 Trypanophobia –injections
 Odontophobia –dental work

Question 7

DSM 5 Diagnostic criteria for anxiety (7)

Answer 7

1)Marked fear or anxiety about a specific object or situation
2) The phobic object/situation almost always provokes immediate fear or
anxiety.
3)The phobic object or situation is actively avoided or endured with marked fear
or anxiety.
4)The fear or anxiety is out of proportion to the actual danger posed by the
specific object or situation
5) The fear, anxiety or avoidance is persistent, typically lasting six or more months
6) The fear, anxiety, or avoidance cause clinically significant distress or
impairment in social, occupational, or other important areas of functioning.
7) The disturbance is not better accounted for by another mental disorder

Question 8

Specific phobias identified in DSM-5 (6)

Answer 8

1)Animal
2)Natural environment
3)Blood-injection-injury
4)Situational
5)Other
6)Choking, vomiting, “space”

Question 9

Elaborate on Aetiology - Psychoanalytic Explanations, with an example (3)

Answer 9

1)Repressed id urges and desires that are
trying to come into consciousness
2)Phobia as a defense mechanism
3)The fear becomes associated with external
events that has a symbolic relevance to the
repressed urges
 Eg: Little Hans

Question 10

freud’s interpretation of little hans’ phobia of horses

Answer 10

Freud’s interpretation - the large size of horses - Hans
unconsciously identified with the great power of his fatherCastration anxiety
An irrational fear that the father will
castrate his penis, as a punishment

Question 11

Mowrer’s two factor model

Answer 11

Fear acquired through
classical conditioning and
maintained through operant
conditioning

Question 12

Lil’ Albert (Watson & Raynor, 1920) study on conditioning

Answer 12

After several pairings of the rat (CS) with a loud sound (UCS),
Albert begins to fear (CR) the rat

Question 13

Biological preparedness theory

Answer 13

A theory which argues that we have inherent predispositions (inherited abilities) to
fear some things because they have been life-threatening to our ancestors

Question 14

Non-associative fear acquisition

Answer 14

Fear of a set of biologically relevant stimuli develops naturally after
early encounters
 Following repeated exposure to these stimuli - habituation occurs
 Adult phobias - childhood phobias have failed to habituate

Question 15

The amygdala and fear

Answer 15

Two pathways that
detect danger and
trigger fear
responses
 Fast, direct route -
Evolved fear module
(immediate)
 Slower, indirect route
through cortical
processing areas

Question 16

Treatment of specific phobias

Answer 16

Exposure therapies (based on
principles of classical
conditioning)
 1. Counterconditioning
 2. Systematic desensitization
 3. Flooding
Many other therapies:
 E.g. Cognitive therapy techniques
 Cognitive restructuring
 Identifying automatic thoughts
and generating more helpful
thoughts

Question 17

Counterconditioning

Answer 17

Pair phobic object (CS) with a stimulus that elicits an incompatible
response
 Fear of rabbits (CS) was removed by pairing rabbits with a stimuli
that elicited happiness (e.g. milk)

Question 18

Systematic desensitization

Answer 18

Three step process
 Step 1: Construction of fear
hierarchyStep 2: Learning to relax (Deep muscle relaxation)
 Achieving deep and thorough state of relaxation
 Rediscover the distinctions between relaxation and tension of various muscle
 Step 3: Therapist and client will work up the list from least anxiety
provoking to most anxiety provoking

Question 19

Flooding

Answer 19

Rapid and intense exposure to the fear-provoking
situation or object and prevented from making the usual
avoidance or escape response.
 Also known as implosion therapy

Question 20

SOCIAL ANXIETY DISORDER (SAD)

Answer 20

Fear of interacting with others or being in social situations that might
lead to a negative evaluation.
 Overwhelming anxiety by even mundane social situations
 Physical symptoms (blushing, sweating, trembling etc)
 Emotional symptoms (embarrassment, shame etc)

Question 21

DSM-5 criteria for SAD

Answer 21

Marked fear or anxiety about one or more social situations in
which the individual is exposed to possible scrutiny by others.
B The individual fears that he or she will act in a way or show anxiety
symptoms that will be negatively evaluated
C The social situation(s) almost always provoke fear or anxiety
D The social situation(s) are actively avoided or endured with marked
fear or anxiety.
E The fear or anxiety is out of proportion to the actual threat posed
by the social situation.The fear, anxiety, or avoidance is persistent, typically lasting six or more
months
G The fear, anxiety, and avoidance cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
H The disturbance is not attributable to the direct physiological effects of a
substance
I The disturbance is not better accounted for by another mental
disorder

Question 22

Beatty et al (2002) study for genetic evidence

Answer 22

Twin studies provide support for a genetic component in Social
anxiety disorder

Question 23

(Kagan, 1989; Thomas & Chess, 1977; Caspi, 2000)

Answer 23

Temperament: Genetically influenced, inherited tendencies - manifest early in life and
moderately stable across a lifetime

Question 24

Temperament traits Linked to Social anxiety disorder.(Essex, 2010)

Answer 24

Submissiveness,
 Anxiousness,
 Social avoidance,
 Behavioural inhibition

Question 25

Behavioural Inhibition:

Answer 25

Tendency to experience distress and withdraw from
unfamiliar situations, people, or environments

Question 26

Similarities between BI tendencies and safety behaviours in socially anxious
individuals suggest…

Answer 26

BI as a hardwired precursor to SAD (Spence & Rapee, 2016

Question 27

BI at age 4 predicted SAD at…

Answer 27

15, but not other anxiety disorders (Heimberg, Brozovich, & Rapee, 2014

Question 28

(Azab, 2022)

Answer 28

Parenting – key developmental factor
 Incidence rates are highest during childhood and adolescence

Question 29

Direct Instruction

Answer 29

Parents may teach children that social situations are threatening and that negative
outcomes are likely

Question 30

Modeling Behaviors

Answer 30

Parents model avoidance, safety behaviors, and negative post-event processing, which
children may adopt.

Question 31

Influence of parent-child interactive style:

Answer 31

Maternal influence
Paternal influence

Question 32

Maternal influence

Answer 32

Exert greater control (McLeod et al., 2007; Yap et al., 2013)
 Maternal control - moderator in the relationship between BI and development of
social anxiety (Lewis-Morrarty et al., 2012)
 Show less warmth
 Use shame as a method of discipline

Question 33

Paternal influence:

Answer 33

Fathers who playfully encourage risk-taking foster resilience and social
confidence (Paquette, 2004).

Question 34

Self-focused attention:

Answer 34

tendency to shift focus inward onto
themselves and their own anxiety
responses during social performance.Self-focused attention has been shown
to be detrimental in both low and high
social anxiety groups (Leigh, Chiu, Clark, 2021)

Question 35

Other cognitive factors

Answer 35

Information & interpretation bias
 Selective attention to external social threat cues
 Interpret own performance significantly more critically and underestimate
their own skills
 Difficulty in processing positive social feedback

Question 36

Perowne & Manselle (2002)

Answer 36

Naturalistic paradigm
 High and low SA participants asked to
give a speech to 6 observers
 6 Observers:
 2 exhibited only positive expressions 
 2 exhibited only neutral expressions 
 2 exhibited only negative expressions 
 Participants asked to rate on a scale how
much the observers enjoyed their speechHigh SA group
rated observers
enjoyment LOWER
even when these
observers were
asked to give
positive feedback
cues!

Question 37

Miloff, Savva & Carlbring (2005)

Answer 37

Attention bias measured using a dot
probe task (words and pictures)
Task:
 To indicate where the ‘probe’ (arrow) is
 Probe could be:
 consistent (appears at the same location
as negative faces)
 inconsistent (appears at the opposite
location of negative faces)Results:
 Participants diagnosed with social anxiety disorder showed more bias (faster
reaction time) to consistent trials compared to inconsistent trials

Question 38

Treatment of social anxiety disorder - CBT

Answer 38

Exposure therapy
Social skills training
Cognitive restructuring
Pharmacological treatment