Topic 12: Fear & Anxiety Reduction Procedures and Cognitive Behavior Modification Flashcards
Fear
-Operant and respondent behavior produced in response to a specific stimulus
-Stimulus situation elicits autonomic nervous system arousal and the individual engages in behavior to escape or avoid the stimulus situation
Anxiety
Respondent behavior involved in autonomic arousal
Respondent behavior
-Involves the bodily responses involved in autonomic arousal
-Can function as an established operation for operant behavior
-EG) rapid heart rate, increased muscle tension
Operant behavior
-Learned behavior
-Involves escape and avoidance responses in the feared situation
-eg) running away or avoiding places a dog will be (park)
Cynophobia
-Feared stimulus (dog) is a CS that elicits the CR of autonomic arousal
-This arousal (fear) can serve as an establishing operation for escape behavior
-Getting away and escaping is very appealing when you are scared
-Dog becomes discriminative stimulus
Anxiety disorders
-Separation anxiety disorder
-Specific phobias
-Social anxiety disorder
-Panic disorder
-Agoraphobia
-Generalized anxiety disorder
Relaxation training procedure
-Train behaviors that produce bodily responses incompatible with autonomic arousal
-Requires practice
-State of anxiety comes to function as a SD for engaging in relaxation techniques which are negatively reinforced in tension
-1) Progressive muscle relaxation (PMR)
-2) Diaphragmatic breathing
-3) Attention focusing
-4) Behavioral relaxation training
1) Progressive muscle relaxation (PMR)
-Tense and relax each muscle group in the body until relaxation is achieved
-Put hands into fists and squeeze with a lot of tension so when you relation, it will feel even better
2) Diaphragmatic breathing
-Focus on deep, slow, rhythmic breathing to produce relaxation
-Breathe from the diaphragm rather than the chest
-Shallow breathing is associated with autonomic arousal (anxiety)
3) Attention focusing
-Focus attention on words or images to remove attention from anxiety-producing thoughts and or images
-Guided imagery, hypnosis, meditation
4) Behavioral relaxation training
-Assume relaxed posture in all major parts in body
-Client learns to behave as a relaxed individual would
-Very similar to progressive muscle relaxation but does not involve tensing prior to relaxation
Fear reduction procedures
-Fear and anxiety are learned respondent behaviors and so we can use our understanding of classical conditioning to reduce their occurrence
-1) Systematic desensitization
-2) In-Vivo Desensitization
-3) Virtual reality
-4) Flooding
-5) Modelling
1) Systematic desensitization
-Client learns relaxation technique
-Client and therapist develop hierarchy of fear producing stimuli (SUDS scale)
-Client practices relaxation techniques while imagining progressively higher-anxiety stimuli from the hierarchy
2) In-Vivo Desensitization
-In Vivo = In real life
-Individual with phobia encounters progressively more frightening stimuli related to the phobia while practicing relaxation techniques
-Prevent escape behavior
-Baby steps
3) Virtual reality
-Can be used for desensitization
-Controlled, virtual reality
-Bridge between imagination and real life
-Safer at times
-High investment of setting up programs for specific phobias
-Limitations for certain phobias
4) Flooding
-Client is exposed to the real feared stimulus at maximum intensity until it no longer produces a fear response
-Can be effective but must be done correctly!
5) Modelling
-Client observes another person engaging with the feared stimulus in a positive way
-Model desirable behavior
-Can be done in person or through video
-Vicarious conditioning
Cognitive behavior
-Allows for inclusion of internal, covert actions
-Self talk, emotions and imagination
Pubic event
-Behavior that is observable by a person other than the one engaging in the behavior
-OVERT behavior
-Can be verified by scientific methods of observation
Private event
-Behavior that is only produced by the person producing it
-COVERT behavior
-All mental/cognitive events
-Does not necessarily have to be mental (could be you sneezing alone)
-Unverifiable
-Inaccurate reports
Defining cognitive behavior
-Covert behaviors are harder to define and measure because they are not outwardly observable (seen by external observer)
-Need to identify specific behaivors
-Pitfall is labelling rather than using an operational definition
Problem with labels
-Labels = circular reasoning
1) Observed behavior given a label
2) Label explains the behavior
-The label becomes the explanation
eg) Timmy is quiet and does not talk to others therefore he is labelled as shy
-Why doesn’t Timmy talk? Because he is shy
-Label is simply a name/descriptor of what is happening and not actually the cause for the behavior (causes for behavior have to come from the environment (internal or external))
Functions of cognitive behavior
-A thought or image can be a discriminative stimulus for other operant behavior
-eg) self-instructions, problem solving can lead to successful behaviors
-A thought/image can function as a reinforcer or punisher
Cognitive behavioral therapy
1) Cognitive restructuring
2) Cognitive coping skills
1) Cognitive restructuring
-Approach where the goal is to replace distressing thoughts with more desirable/functional thoughts
-Maladaptive thoughts to adaptive ones
-Change and restructure thoughts
2) Cognitive coping skills
-Approach where the goal is to learn cognitive skills that help promote the desirable behavior and use them in related problem situations
-Instead of restructuring behavior, you create tools to help deal with behavior when it occurs
-Less problematic
-Accept and work through your thoughts
Cognitive restructuring steps
1) Identify target behavior (distressing thoughts) and situations in which they occur
-Retrospective vs continuous
-2) Identify emotional response, mood or behavior that follows
3) Help client replace distressing thoughts with more rational ones
Cognitive distortions
1) All-or-nothing thinking
2) Overgeneralization
3) Disqualifying the positive
4) Magnification and minimization
5) jumping to conclusions
6) Labelling and mis-labelling
7) Personalization’s
1) All-or-nothing thinking
-Interpret things as black or white with no grey area
-eg) Test scores: “I am so smart” vs “I am an idiot”
2) Overgeneralization
-Overapply evidence from one experience to multiple others
-Learning something in one environment and applying it to many scenarios
-eg) bad mark in class = I am a terrible student and should drop out
3) Disqualifying the positive
-Discount or ignore positive aspects, usually with overweighting of negative aspects
-Dismiss good things but lean into the bad
-eg) They are only being nice because they have to
4) Magnification and minimization
-Blow negative events out of proportion while minimizing the scale of the positive events
5) jumping to conclusions
-Come to negative assumptions without facts to support them
-Lack or misuse of evidence
-eg) Someone frowns at you in crowd = everyone hates you
6) Labelling and mis-labelling
-Applying labels to yourself and others which can change your views and actions
-Act like the label given
-Modify behavior to act more aligned with the label
-Eg) I’m dumb leads to not studying leads to poor test scores
7) Personalization
-Take credit for negative events and deny credit for positive events regardless of your role
-eg) I only did well on the exam because it was easy VS I did bad on the exam because I am dumb
Challenging cognitive distortions
-Do not tell the client how to think and instead lead them to the realization of how to think
-People do not change because they are told to
-Ask leading questions that challenge their distorted thoughts and lead them to see the logical failures
Beck’s 3 questions to challenge cognitive distortions
1) Where is the evidence?
-‘You think X, what experiences lead you to do so”
2) Are there alternative explanations
-“Is that the only reason X can happen”
3) What are the implications?
-‘What could X lead to?”
-“what does it mean for X to have occurred”
Cognitive therapy for depression
1) Activity log to look at behavior and mood
2) Behavioral assignments to increase activity level and access to reinforcers
3) assess activity-mood relationship
4) Assessment of cognitive behavior
5) Assess cognitive behavior-mood relationship
6) Cognitive restructuring
7) Transfer of skills to client
Cognitive coping skills training
1) Self-instructional training *
2) Self-inoculation training
3) Problem solving training
1) Self-instructional training *
1) Identify problem situation and desirable behavior
2) Identify self-instructions to be used in situation
3) Implement behavioral skills training to teach the self-instructions
4) Use self-instructions in problem situation to guide desirable behavior
2) Self-inoculation training
1) Identify self-statements that contribute to stress/anxiety and situations in which they occur
2) Generate new coping self-statements to be used in 4 phases
1) Prep for stressor
2) Confront the stressor
3) Being overwhelmed by stressor
4) Praising self for coping with stressor (primary reinforcer)
3) rehearse coping self-statements in role-plays of the difficult situation
4) Practice in progressively more stressful situations in natural environment
3) Problem solving training
1) Develop problem solving orientation
2) Define problem to be solved
3) Generate possible solutions through brain storming
4) evaluate each potential solution
5) Put the plan into action and evaluate how it works
Acceptance based therapies
-The goal is to accept negative thoughts and feelings, not change them
-Client learns thoughts and feelings can continue to occur but you can react differently
-1) Acceptance and commitment therapy
-2) Mindfulness-based interventions
1) Acceptance and commitment therapy
-Increase psychological flexibility
-Hexaflex model develops 6 types of repertoires
1) Acceptance
2) Values
3) Self-as-context
4) Present moment awareness
5) Committed action
6) Defusion
2) Mindfulness-based interventions
-Mindfulness focuses on: the present moment rather than the post, or worry about the future, or judgement thoughts
-Nonjudgmental awareness of a persons actions and environmental events
-Mindfulness is a skill set that has to be learned
