Lecture 6: Anxiety Disorders Part 2 Flashcards
Treatments for anxiety disorders include: (4)
- Behavioral interventions
- Cognitive interventions
- Pharmacological interventions
- Insight oriented interventions
Stimuli that cause fear/anxiety are learned through?
Conditioning
Behaviourism
A family of psychological theories and methods by John Watson, Ivan Pavlov and B.F Skinner
What are some behaviorist prescriptive principles?
- Goal of psychology = explain human/other animal behavior
- Mental processes are UNOBSERVABLE = not proper objects of scientific investigation
- Behavior can be explained by 2 associative learning processes - Operant/classiccal
How does respondent/classical conditioning work?
- Unconditioned stimulus (US) produces unconditioned response (UR)
- When an unconditioned stimulus is repeated paired with a conditioning stimulus (CS)
- The unconditioned response (UR) becomes associated with the conditioned stimulus (CS) and produces a conditioned response (CR) in the absence of the unconditioned sitmulus
Where does respondent conditioning appear in?
Wide range of animals! From humans to rodents to birds to fish
Respondent conditioning is mediated where in the brain?
- Cerebellum
- Hippocampus
- Amygdala
Features of respondent conditioning
- One trial learning
- Distal conditioning
- Response shift
- Thought induced conditioning
- People who have intense fear-inducing experiences don’t develop clinically significant fear or anxiety
- Extinction
One trial learning
If US produces intense fear, one event might be enough to create fear inducing association
Eg.
Thunder storm + close lightning strike —> Fear
Thunder storm —> Fear
Distal conditioning
CS need not occur simultaneously with US in order for fearful association to be formed
Eg.
Caregiver leaves + serious injury hours later —> fear
Caregiver leaves —> Fear
Response shift
The UR and CR need NOT be IDENTICAL
Eg. Caregiver leaves + serious injury hours later —> Fear
Caregiver leaves —> Anger
Thought induced conditioning
The CS may be merely a MENTAL REPRESENTATION and a fearful association may be formed
Eg. Caregiver leaves + thoughts of intruder —> Fear
Caregiver leaves —> Fear
Most people who have intense fear-inducing experiences don’t develop clinically significant fear/anxiety. WHY?
Protective factors!
Protective factor
Previous experiences with CS that weren’t fear inducing!
Eg. Experience with 100 dogs that didn’t bite —> less likely to develop fear of dogs after being bit
Risk factor
No previous experience with CS
How is low neuroticism related to anxiety?
It is a protective factor since there’s less disposition towards negative emotions eg. Fear —> leads to less fear conditioning
How is high neuroticism related to anxiety?
It’s a risk factor for anxiety since there are high levels of neuroticism meaning more disposition towards negative emotions eg. Fear/anger
Extinction
If the CS is present but the US is absent eventually the CS will no longer produce the CR
Eg. Dog approach + no dog bite —> fear repeated until
Dog approach + no dog bite —> no fear
Extinction is the basis of the most common treatment method for anxiety disorders namely:
Exposure therapy
Exposure
A type of behavioral therapy in which the person in treatment is exposed to stimuli that make them fearful/anxious while trying to prevent or help them tolerate their typical mental/behavioral responses
Rapid exposure
Exposing to fearful/anxious stimuli all at once
Incremental exposure
Graduated exposure over time
Examples of incremental exposure
- Imaginable exposure
- Pictorial exposure
- VR exposure
- In vivo exposure (IRL)
Often exposure therapies are combined with ________________
Relaxation techniques!
Was are 2 good relaxation techniques?
1) rhythmic breathing
2) progressive muscle relaxation
How does exposure therapy help patients?
- Directs people to APPROACH things they want to AVOID due to fear/anxiety
- When they avoid they SELF CONFIRM that what they’re avoiding IS a threat
- Overall when people approach things that produce fear/anxiety it gives them EVIDENCE that what they’ve been avoiding isn’t a threat it’s something they can MANAGE
Extinct doesn’t involve unlearning the original associated but rather:
Learning a NEW association that interferes with the original association
Recovery of previously extinguished associations have happened due to: (3)
1) The passage of time (spontaneous recovery)
2) Context change after extinction (renewal)
3) Post extinction presentation of US (reinstatement)
Because of the occasional recovery of previously extinguished associations exposure therapy should be:
REPEATED and is aided by conduction exposure interventions in a VARIETY OF CONTEXTS
Grounding
Directing attention away from interception and toward perception
Interception
Representations of stimuli inside the body
Perception
Representations of stimuli outside the body
If you focus attention on interoception too much it can trigger
Panic attacks
To stop/interrupt panic attacks we can focus our attention on
PERCEPTION! - the stimuli’s outside the body instead
Eg. In therapy asking the patient to name 5 colors you see, 3 things you hear etc.
Overall what behavioral interventions are there for anxiety? (3)
- Exposure therapies
- Grounding
- Lifestyle changes
What are the cognitive interventions for anxiety?
Cognitive therapy!
Cognitive therapy
A family of therapeutic methods that aim to identify and modify maladaptive cognitions
eg. Maladaptive thoughts, beliefs, categorizations, inferences, reasoning and problem solving strategies
Fear-based categorization examples
Noise in the house at night gets categorized as an intruder/ headache is interpreted as a brain tumor
Unrealistic inductive reasoning
Generalizing that a stimulus eg. Dog is dangerous to all other stimuli eg. All dogs are dangerous
Unrealistic probabilistic reasoning
Reasoning that there will be a higher probability of something dire happening when in reality it’s rarely the case eg. Can’t go to the grocery store cause probability of mass shooting
Maladaptive in cognitive/anxiety terms means
Cognitions that are either inaccurate, unhelpful, or both
There are two dimensions of adaptedness in cognition:
- Accuracy - accurate/inaccurate cognition
- Utility - helpful/harmful cognition
Example of helpful and inaccurate cognition
70% of people think they’re better than the average driver = positive illusion
Example of harmful and accurate cognition
Therapist telling a patient what their problem is and patient being upset that it’s actually a problem
Cognitive treatment for anxiety (or any other mental disorder) helps a person to: (3)
1) Become aware of maladaptive cognitions
2) Challenge them
3) Replace them with more adaptive cognitions (i.e. more accurate and or more useful ones)
Pharmacological interventions for anxiety
SSRI’s! —-> effective for reducing symptoms of anxiety
Mechanisms of the SSRI’s
1) Reduction of activation of the amygdala
2) Reduction of the RESTING activation in the right prefrontal cortex
Insight oriented interventions
1) Psychoanalytic therapies
2) Psychodynamic therapy
How can insight oriented approaches to treatment help address mental health problems?
1) Identify CONTRIBUTING FACTORS to mental health problems
2) Facilitate AWARENESS of previously unconscious thoughts/beliefs/emotions
3) Facilitate INSIGHT about factors contributing to a person’s mental health problems
4) Facilitate change on the bases of awareness and insight
