Lecture 3: Cognitive models Anxiety Flashcards
verschil anxiety and fear
fear: immediate respone when faced with threat
anxiety: stress response just from thoughts
new brain =
imagination, thinking, planning, rumination, mentalizing, self monitoring
wat zei paul gilbert
we have a new brain due to evolution, old brain is what animals also have
old brain =
motives: harm avoidance, reproducing, competing, caring
emotions: anger, anxiety, disgust, sadness, joy
behaviour: fight, flight, freeze, submission
welk brein zorgt voor dingen zoals anxiety
new brain (door rumination and imagination etc)
welke soort memories kan je hebben
verbal/abstract
sensory/perceptual
welk brein hoort bij welke soort memory
verbal/abstract = new brain
sensory/perceptual = old brain
hoe werkt cognition (basic process)
content of cognitions (what we think) <-> cognitive processes (how we think)
worry kenmerken in GAD
- excessive
- disproportional
- difficult to control
prevalentie social anxiety
12%
prevalentie GAD
3%
verschil worry and rumination
worry = worrying about future responses
rumination = repetitive and passive thinking about depression and symptoms
transdiagnostic between GAD and MDD
repetitive negative thinking
officiele definitie worry
“a chain of thoughts, negatively affect-laden and relatively uncontrollable; it represents an attempt to engage in mental problemsolving on an issue whose outcome is uncertain but contains the possibility of one or more negative outcomes”
rumination officiele definitie
“repetitive and passive thinking about one’s
symptoms of depression and the possible causes and consequences of these symptoms”
transdiagnostic: anxiety, depression, SAD
- repetitive
- no control
- negative content
- verbal
- abstract
transdiagnostic model: worry
anxiety
future
transdiagnostic model: rumination
past
depression
transdiagnostic model: post event processing
social situations
self focused
why do people ruminate?
we want to be prepared. een klein beetje is wel effectief, maar te veel is problematisch!
meta cognitive model key aspects
positive beliefs about worry (versterkt zichzelf, pijltjes in rondje om zichzelf) -> negative meta beliefs (versterkt zichzelf, pijltjes in rondjes om zichzelf)
positive beliefs about worrying = geloven dat het effectief is, believing they are problem solving
negative meta beliefs = worrying about worrying
avoidance model key aspects
zie schrift
mensen met anxiety krijgen perception of threat, dan gaan ze worrying: op verbal linguistic manier. hierdoor worden positive worry beliefs versterkt. maar hierdoor minder mental imagery, waardoor normaal een somatic reaction komt die emotional processing zou stimuleren, wat voor minder perception of threat zou leiden (maar doordat worrying mental imagery verlaagd: ook minder emotional processing)
hoe vergelijkt avoidance model dus met verbal/abstract en sensory/perception
normale emotional processing: sensory/perceptual
worry: blijft verbal/abstract, waardoor minder mental imagery, waardoor minder emotional processing
hoe kan je dus zorgen voor minder worry
if you allow yourself to imagine things, you may lower the somatic reaction you get, which leads to better emotional processing
wat heeft dus meer somatische reacties: fear of worrying
fear (want worrying is meer verbaal/abstract)
evidence: is worrying verbal?
- mensen die relaxerende oefening hadden gedaan, hadden veel meer imagery thoughts
- de worry group had meer verbal thoughts
problem solving does not let you experience the fear itself, therefore it may be problematic
volgens het avoidance model
evidence: does worry decreases arousal?
- Participants with fear of public speaking
- Imagine giving a speech
- Conditions: worry - relax - neutral
-> bij worrying geen groot verschil tussen het inbeelden en het echt hebben van worry. -> worrying decreases arousal
wat is een andere uitleg voor ‘evidence: does worry decrease arousal’
people worry to avoid problems, they may also dislike relaxing and then suddenly having to cope with a stressor
= contrast avoidance
wat is bewijs voor contrast avoidance
mensen moesten nadenken over:
neutral activity (wat gedaan dit weekend)
relaxing (instructions on breathing)
worry (think about most worrisome topic)
daarna verschillende filmclips te zien, negative affect levels gemeten
geen groot contrast tussen de worrying group eerst en daarna de plane crash: dus worrying avoids this large contrast!
key maintaining factors of anxiety
- positive worrying beliefs (dysfunctional problem focus, ineffective coping)
- dislike of intense emotions
- cognitive/emotional avoidance (absence of emotional processing)
social anxiety disorder criteria
Marked fear or anxiety about one
or more social situations in which
the individual is exposed to possible
scrutiny by others.
The individual fears that he or she
will act in a way or show anxiety
symptoms that will be negatively
evaluated (i.e., will be humiliating or
embarrassing; will lead to rejection
or offend others).
The social situations almost always
provoke fear or anxiety.
The social situations are avoided or
endured with intense fear or anxiety
waar gaat het model van rapee & heimberg over
perceived audience, mental representation of the self as seen by the audience, perceived internal clues and external indicators of evaluation, attentional resources etc
waar leidt judgement of probability and consequence of evaluation from audience naar toe
behavioural, physical and cognitive symptoms of anxiety
behavioural & physical -> external indicators of evaluation
physical & cognitive -> perceived internal cues
people with SAD engage in…
safety behaviours, which can be contraproductive
welk experiment keek naar die safety behaviours
kijken naar verschil disclosure en openness, en student beoordeelde de participanten op desire for future interaction.
SA: veel minder open, maar wanneer ze instructies kregen deden ze het wel. dus ze kunnen wel open zijn maar doen het gewoon niet.
= safety behaviours due to negative judgement
wat is het gekke aan die safety behaviours
the negative judgement they fear (for which they perform the safety behaviours) are actually perceived as negative (dus viceuze cirkel)
people with SAD dont lack social skills…
they are just too afraid to use em
people with sad blush more, but also largely overestimate their blushing.
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hoe is de attention bias in sad
overattentive voor boze gezichten, dus overattention to negative cues (= external indicators of negative evaluation)
veeeel snellere reactietijd bij angry faces dan bij happy faces. bij controles was dit verschil veel kleiner.
hoe kan cognition behaviour beinvloeden
believing another person likes or dislikes you: behaviours make the beliefs come true
dus hoe ga je van social anxiety naar social rejection
social anxiety -> self-focused attention + negative beliefs -> social performance -> social rejection
a positive bias score betekent
a positive bias score for angry faces indicates faster RTs to probes replacing angry faces than neutral faces, that is, vigilance for threat
hoe interpreteer je de grafiek van low and high speech anxiety bij no threat and social threat
mensen kregen trembling devices
positive values reflect faster detection of external than internal probes, and vice
versa for negative values
mensen met high speech anxiety hadden veel snellere detectie van external (trembling device) dan internal probes bij no threat, maar bij social threat opeens meer internal probes (dus social threat leidt tot internally focused attention ipv op de buitenkant letten)
wat doet selective attention
increases conscious awareness of danger and confirms negative beliefs. socially anxious people become more anxious when you instruct them to focus on themselves.
cognitive bias modification: werkt niet goed als alleen staande therapie
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wat liet het onderzoek met likelihood of negative interpretation of ambiguous social and nonsocial scenarios zien
Results revealed that GSPs (= generalised social phobia) (but not NACs (non anxious controls) or OCs (obsessive compulsive disorder)) tended to choose a negative interpretation for ambiguous social scenarios even when a positive interpretation was available. This bias was specific to self-relevant scenarios, not seen in their evaluation of what a typical person may think. These results support the hypothesis that a specific negative interpretation bias may be involved in the maintenance of social phobia.
wat is het verschil offline vs online
- Offline (slow/elaborated/rule based) – SA have negative interpretations about social situations
- Online (fast/automatic/ associative) – SA lack positivity bias
two routes
- rule based
- associative
rule based =
- controlled
- conscious
- intentional
- inefficient
- slow
- flexible
- logical
associative =
- automatic
- can be unconscious
- non intentional
- efficient
- fast
- rigid
- associative
wat gebeurt er met deze 2 routes in anxiety als je een spin ziet bijvoorbeeld
associative: activation of threat related associations
rule based: interpretation as threat -> validation of threat -> behavioural decision
wat zijn dysfunctional schemata and core beliefs voor soort route
automatic, fast and associative, sometimes not conscious
Cognitive framework that helps organize
knowledge and guide cognitive processes
and behavior.
- Social schema (threat/rejection)
- Self-schema (no control/weak)
- World view (danger)
- Anxiety affects what a person thinks and how a person behaves.
- These processes can be conscious, as well as associatively and unconsciously.
- Processing biases are interconnected, along with other cognition, emotions, and behavior.
- Models assist us in gaining an overview of potential relationships, informing both research and clinical practice.
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