Lecture 6: Anxiety Disorders Part 2

Question 1

Treatments for anxiety disorders include: (4)

Answer 1

1. Behavioral interventions
2. Cognitive interventions
3. Pharmacological interventions
4. Insight oriented interventions

Question 2

Stimuli that cause fear/anxiety are learned through?

Answer 2

Conditioning

Question 3

Behaviourism

Answer 3

A family of psychological theories and methods by John Watson, Ivan Pavlov and B.F Skinner

Question 4

What are some behaviorist prescriptive principles?

Answer 4

1. Goal of psychology = explain human/other animal behavior
2. Mental processes are UNOBSERVABLE = not proper objects of scientific investigation
3. Behavior can be explained by 2 associative learning processes - Operant/classiccal

Question 5

How does respondent/classical conditioning work?

Answer 5

1. Unconditioned stimulus (US) produces unconditioned response (UR)
2. When an unconditioned stimulus is repeated paired with a conditioning stimulus (CS)
3. The unconditioned response (UR) becomes associated with the conditioned stimulus (CS) and produces a conditioned response (CR) in the absence of the unconditioned sitmulus

Question 6

Where does respondent conditioning appear in?

Answer 6

Wide range of animals! From humans to rodents to birds to fish

Question 7

Respondent conditioning is mediated where in the brain?

Answer 7

1. Cerebellum
2. Hippocampus
3. Amygdala

Question 8

Features of respondent conditioning

Answer 8

1. One trial learning
2. Distal conditioning
3. Response shift
4. Thought induced conditioning
5. People who have intense fear-inducing experiences don’t develop clinically significant fear or anxiety
6. Extinction

Question 9

One trial learning

Answer 9

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

Question 10

Distal conditioning

Answer 10

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

Question 11

Response shift

Answer 11

The UR and CR need NOT be IDENTICAL

Eg. Caregiver leaves + serious injury hours later —> Fear
Caregiver leaves —> Anger

Question 12

Thought induced conditioning

Answer 12

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

Question 13

Most people who have intense fear-inducing experiences don’t develop clinically significant fear/anxiety. WHY?

Answer 13

Protective factors!

Question 14

Protective factor

Answer 14

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

Question 15

Risk factor

Answer 15

No previous experience with CS

Question 16

How is low neuroticism related to anxiety?

Answer 16

It is a protective factor since there’s less disposition towards negative emotions eg. Fear —> leads to less fear conditioning

Question 17

How is high neuroticism related to anxiety?

Answer 17

It’s a risk factor for anxiety since there are high levels of neuroticism meaning more disposition towards negative emotions eg. Fear/anger

Question 18

Extinction

Answer 18

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

Question 19

Extinction is the basis of the most common treatment method for anxiety disorders namely:

Answer 19

Exposure therapy

Question 20

Exposure

Answer 20

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

Question 21

Rapid exposure

Answer 21

Exposing to fearful/anxious stimuli all at once

Question 22

Incremental exposure

Answer 22

Graduated exposure over time

Question 23

Examples of incremental exposure

Answer 23

1. Imaginable exposure
2. Pictorial exposure
3. VR exposure
4. In vivo exposure (IRL)

Question 24

Often exposure therapies are combined with ________________

Answer 24

Relaxation techniques!

Question 25

Was are 2 good relaxation techniques?

Answer 25

1) rhythmic breathing 2) progressive muscle relaxation

Question 26

How does exposure therapy help patients?

Answer 26

1. Directs people to APPROACH things they want to AVOID due to fear/anxiety 2. When they avoid they SELF CONFIRM that what they’re avoiding IS a threat 3. 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

Question 27

Extinct doesn’t involve unlearning the original associated but rather:

Answer 27

Learning a NEW association that interferes with the original association

Question 28

Recovery of previously extinguished associations have happened due to: (3)

Answer 28

1) The passage of time (spontaneous recovery) 2) Context change after extinction (renewal) 3) Post extinction presentation of US (reinstatement)

Question 29

Because of the occasional recovery of previously extinguished associations exposure therapy should be:

Answer 29

REPEATED and is aided by conduction exposure interventions in a VARIETY OF CONTEXTS

Question 30

Grounding

Answer 30

Directing attention away from interception and toward perception

Question 31

Interception

Answer 31

Representations of stimuli inside the body

Question 32

Perception

Answer 32

Representations of stimuli outside the body

Question 33

If you focus attention on interoception too much it can trigger

Answer 33

Panic attacks

Question 34

To stop/interrupt panic attacks we can focus our attention on

Answer 34

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.

Question 35

Overall what behavioral interventions are there for anxiety? (3)

Answer 35

1. Exposure therapies 2. Grounding 3. Lifestyle changes

Question 36

What are the cognitive interventions for anxiety?

Answer 36

Cognitive therapy!

Question 37

Cognitive therapy

Answer 37

A family of therapeutic methods that aim to identify and modify maladaptive cognitions eg. Maladaptive thoughts, beliefs, categorizations, inferences, reasoning and problem solving strategies

Question 38

Fear-based categorization examples

Answer 38

Noise in the house at night gets categorized as an intruder/ headache is interpreted as a brain tumor

Question 39

Unrealistic inductive reasoning

Answer 39

Generalizing that a stimulus eg. Dog is dangerous to all other stimuli eg. All dogs are dangerous

Question 40

Unrealistic probabilistic reasoning

Answer 40

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

Question 41

Maladaptive in cognitive/anxiety terms means

Answer 41

Cognitions that are either inaccurate, unhelpful, or both

Question 42

There are two dimensions of adaptedness in cognition:

Answer 42

1. Accuracy - accurate/inaccurate cognition 2. Utility - helpful/harmful cognition

Question 43

Example of helpful and inaccurate cognition

Answer 43

70% of people think they’re better than the average driver = positive illusion

Question 44

Example of harmful and accurate cognition

Answer 44

Therapist telling a patient what their problem is and patient being upset that it’s actually a problem

Question 45

Cognitive treatment for anxiety (or any other mental disorder) helps a person to: (3)

Answer 45

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)

Question 46

Pharmacological interventions for anxiety

Answer 46

SSRI’s! —-> effective for reducing symptoms of anxiety

Question 47

Mechanisms of the SSRI’s

Answer 47

1) Reduction of activation of the amygdala 2) Reduction of the RESTING activation in the right prefrontal cortex

Question 48

Insight oriented interventions

Answer 48

1) Psychoanalytic therapies 2) Psychodynamic therapy

Question 49

How can insight oriented approaches to treatment help address mental health problems?

Answer 49

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