Week 2 Flashcards
Which maladaptive emotion-regulation strategies are there?
- Surpression: pushing emotions out of awareness instead of addressing them
- Rumination: repeatedly focusing on distressing thoughts, problems, or emotions without finding a resolution
- Catastrophizing: exaggerating the severity of a situation and believing that the worst possible outcome will occur
- avoidance: escaping/ ignoring difficult emotions or situations rather than confronting and processing them
- Denial: refusing to acknowledge emotions, thoughts, or reality, which can delay problem-solving
- Self-blame: Internalizing negative events as personal faults, leading to guilt and low self-esteem.
- Other-blame: Placing responsibility for distressing events on others, which can damage relationships and prevent self-growth.
- Emotional numbing: hutting down emotions to avoid pain, which can lead to a lack of engagement and emotional detachment
- Overgeneralization: Viewing negative events as indicative of a broader, unchangeable pattern (e.g., “I always fail” or “Nothing ever works out for me”).
What is the purpose of fear?
To protect us from potential threats and enhance our chances of survival. It is a fundamental emotion that triggers the fight, flight, or freeze response, preparing the body and mind to react quickly in dangerous situations.
- Survival Mechanism
Fear alerts us to immediate danger (e.g., predators, physical threats) and mobilizes the body for quick action. It increases heart rate, sharpens focus, and heightens awareness to improve survival. - Avoidance of Harm
Fear helps us learn from past experiences by associating danger with specific situations, leading us to avoid risky behaviors (e.g., avoiding deep water after a near-drowning experience). - Social and Cultural Regulation
Fear of social rejection or punishment encourages people to follow societal norms and maintain cooperative relationships, ensuring group survival. - Enhancing Learning and Adaptation
Fear strengthens memory and learning by imprinting important survival-related information. This allows us to recognize and respond to similar threats more effectively in the future. - Motivating Caution and Preparedness
Fear drives us to take precautions in uncertain or potentially dangerous situations (e.g., checking safety equipment before climbing or avoiding risky financial decisions).
What is normal anxiety?
Normal anxiety is a natural and adaptive emotional response to stress, uncertainty, or perceived threats. It helps us stay alert, motivated, and prepared for challenges. normal anxiety is temporary, proportional to the situation, and does not interfere significantly with daily functioning.
- ✅ Proportional to the Situation – The intensity of anxiety matches the level of threat or challenge (e.g., feeling nervous before an exam or job interview).
✅ Temporary – Anxiety subsides once the stressor is resolved (e.g., feeling relief after completing a difficult task).
✅ Motivational – It encourages problem-solving and preparation (e.g., studying harder for a test or practicing before a speech).
✅ Mild Physical Symptoms – Some physical sensations like increased heart rate, sweating, or restlessness may occur but are manageable.
✅ Does Not Significantly Impair Life – Normal anxiety does not prevent a person from functioning in daily life, maintaining relationships, or pursuing goals.
When Anxiety Becomes a Problem
Anxiety is considered abnormal or disordered when:
❌ It is excessive or disproportionate to the actual threat.
❌ It persists for a long time after the stressor is gone.
❌ It interferes with daily life, work, or relationships.
❌ It causes extreme distress or leads to avoidance behaviors.
❌ It includes intense physical symptoms like panic attacks, dizziness, or nausea.
Common Situations That Trigger Normal Anxiety
Public speaking or performance situations
Meeting deadlines or taking exams
Making important decisions
Starting a new job or moving to a new place
Financial concerns
Uncertainty about the future
What is the prevalence of anxiety?
Anxiety disorders are among the most prevalent mental health conditions globally and within the Netherlands.
In 2022, 42% of Dutch residents aged 12 or older reported experiencing feelings of anxiety or depression in the preceding four weeks.
The prevalence of moderate to severe chronic anxiety and depressive symptoms among young adults (18-24 years old) increased from 16.7% before the COVID-19 pandemic to 21.4% after the outbreak
What are risk factors for anxiety?
Biological Factors
- Genetics – A family history of anxiety or other mental health disorders increases the risk.
- Brain Chemistry – Imbalances in neurotransmitters (e.g., serotonin, dopamine, GABA) can contribute to heightened anxiety.
- Overactive Amygdala – The brain’s fear-processing center may be hyperactive, leading to excessive fear responses.
Psychological Factors
Personality Traits – People who are highly sensitive, perfectionistic, self-critical, or prone to negative thinking are more vulnerable.
Low Self-Esteem – Persistent self-doubt and negative self-perception increase anxiety levels.
Environmental and Social Factors
Chronic Stress – Long-term exposure to stressors (e.g., financial difficulties, work pressure, or academic stress) can trigger anxiety.
Trauma and Adverse Childhood Experiences (ACEs) – Childhood neglect, abuse, or significant loss can increase the risk.
Unstable or Unpredictable Environments – Growing up in an unstable household or experiencing frequent life disruptions can contribute to anxiety.
Social Isolation or Peer Pressure – Lack of strong social support or bullying can elevate anxiety levels.
- illness/medication
- big life changes
- poor diet
- poor sleep habits
- lack of physical activity
What are protective factors for anxiety?
Biological & Psychological Factors
✅ Genetic Resilience – A family history of mental health stability may lower the risk.
✅ Emotional Regulation Skills – The ability to identify and manage emotions effectively reduces anxiety.
✅ Optimistic Thinking – A positive mindset and problem-solving approach help in coping with stress.
✅ High Self-Esteem – A strong sense of self-worth and confidence lowers vulnerability to anxiety.
Social & Environmental Factors
✅ Strong Social Support – Close relationships with family, friends, and mentors provide emotional security.
✅ Stable and Predictable Environment – A supportive upbringing with consistent care fosters resilience.
✅ Healthy Work-Life Balance – Managing stress by setting boundaries helps prevent burnout-related anxiety.
✅ Engagement in Meaningful Activities – Hobbies, volunteering, or spiritual practices can enhance emotional well-being.
Coping & Stress Management Skills
✅ Effective Problem-Solving Skills – Finding solutions instead of ruminating reduces anxiety triggers.
✅ Cognitive Flexibility – Adapting to changes and reframing negative thoughts helps build resilience.
✅ Seeking Help When Needed – Therapy, counseling, or talking to a trusted person can prevent anxiety from escalating.
Lifestyle & Behavioral Factors
✅ Regular Exercise – Physical activity releases endorphins and reduces stress hormones.
✅ Healthy Diet – Nutrient-rich foods (e.g., omega-3s, magnesium, B vitamins) support brain function and mood stability.
✅ Good Sleep Hygiene – Consistent, quality sleep helps regulate emotions and stress responses.
✅ Mindfulness & Relaxation Practices – Meditation, deep breathing, and yoga reduce anxiety symptoms.
✅ Limited Substance Use – Avoiding excessive caffeine, alcohol, and nicotine prevents anxiety exacerbation.
How is development of anxiety disorders expained?
- Biological Factors
🧠 Genetic Predisposition – Anxiety disorders often run in families, suggesting a genetic component. Twin studies indicate that genetics contribute 30-50% to anxiety risk.
⚖️ Neurotransmitter Imbalance – Low levels of GABA (gamma-aminobutyric acid) and serotonin (which regulate mood and calm the nervous system) may contribute to excessive fear responses.
🔥 Hyperactive Amygdala – The amygdala, responsible for processing fear, may be overactive, leading to heightened sensitivity to threats.
⚡ Dysregulated HPA Axis – The hypothalamic-pituitary-adrenal (HPA) axis, which controls stress hormones (e.g., cortisol), may be overly responsive, leading to chronic stress and heightened anxiety.
- Psychological Factors
💭 Cognitive Theories (Beck’s Model) – People with anxiety disorders often have negative thought patterns, such as catastrophizing or overestimating threats.
🛑 Avoidance Learning (Mowrer’s Two-Factor Theory) – Anxiety develops through:
Classical Conditioning – A neutral stimulus becomes associated with fear (e.g., a child bitten by a dog develops a lifelong fear of dogs).
Operant Conditioning – Avoiding the feared object or situation reduces fear temporarily, reinforcing the anxiety cycle.
👶 Attachment & Early Life Experiences – Insecure attachment styles, childhood neglect, or overprotective parenting can increase anxiety vulnerability.
- Environmental & Social Factors
⚠️ Trauma & Stressful Life Events – Abuse, bullying, loss of a loved one, or financial stress can trigger anxiety disorders.
👥 Social Learning (Modeling) – Children may develop anxiety by observing anxious behaviors in parents or caregivers.
🌍 Cultural & Societal Pressures – High expectations, social comparison, and unstable environments (e.g., war, economic uncertainty) contribute to anxiety development.
- Evolutionary Perspective
🦴 Anxiety is an adaptive survival mechanism that helped early humans detect threats. However, in modern life, this system may be overactive, leading to excessive worry about non-life-threatening situations (e.g., job interviews, social interactions).
How Do These Factors Interact? (Diathesis-Stress Model)
🔗 Genetic & Biological Vulnerability + Stressful Life Events = Anxiety Disorder
Some people have a genetic predisposition, but anxiety only develops if triggered by environmental stressors (e.g., trauma, major life changes).
What is emotion-regulation?
The processes involved in influencing which emotions one has, when one has them, and how one experiences and expresses these emotions
Emotion regulation refers to the ability to manage and modify emotional responses to different situations in a way that is adaptive and appropriate. It involves recognizing, understanding, and adjusting emotions to achieve desired outcomes in behavior, decision-making, and social interactions.
Key Components of Emotion Regulation
🧠 Awareness & Identification – Recognizing one’s emotions and understanding their cause.
🔄 Cognitive Reappraisal – Changing how one thinks about a situation to modify its emotional impact.
⏸️ Impulse Control – Resisting the urge to react immediately with intense emotions.
🛠️ Emotional Expression – Communicating emotions in a healthy way.
📉 Downregulation of Negative Emotions – Reducing excessive anxiety, sadness, or anger.
📈 Upregulation of Positive Emotions – Enhancing feelings of joy, gratitude, or motivation.
Wat is de rol van emotion-regulation in anxiety disorders?
Name some adaptive emotion-regulation strategies:
1.Cognitive Reappraisal: Reframing negative thoughts in a more positive or neutral way. generating different perspectives on emotion-eliciting situations to change their emotional impact in a positive manner.
2.Mindfulness & Acceptance – Observing emotions without judgment.
- Problem-Solving – Taking active steps to address the cause of distress. Conscious attempts to change situations that elicit emotional responses
- Social Support – Seeking help and comfort from others.
- Relaxation Techniques – Deep breathing, meditation, or progressive muscle relaxation.
- Acceptance: acceptance of experiencing negative emotions and other internal events (thoughts, memories, bodily sensations). Not passively accepting a situation/ giving up.
key point: someone can flexibilly adapt his behaviour to the context. So sometimes a ‘maladaptive’ strategy is adaptive but then he/she can change his strategy in an other situation.
Name some maladaptive emotion-regulation strategies
- Suppression – Pushing emotions away without processing them.
- Rumination – Repeatedly dwelling on negative thoughts.
- Avoidance – Ignoring or escaping from emotional triggers.
- Self-Blame & Catastrophizing – Exaggerating negative outcomes or blaming oneself excessively.
- Substance Use & Risky Behaviors – Using alcohol, drugs, or reckless actions to numb emotions.
What is the purpose of fear?
To signal danger and initiate a response to threats.
What is ‘normal’ anxiety?
A typical emotional response to stressors without causing significant dysfunction.
What is the prevalence of anxiety in childhood?
Varies by age and specific anxiety disorders.
What are risk factors for developing anxiety disorders?
- Genetic predisposition
- Environmental stressors
- Parenting styles
What are protective factors against anxiety disorders?
- Supportive relationships
- Coping skills
- Positive self-esteem
How is the development of anxiety disorders explained?
Through a combination of biological, psychological, and environmental factors.
Define emotion regulation.
The processes involved in influencing which emotions one has, when one has them, and how one experiences and expresses these emotions.
What are the two categories of emotion regulation strategies?
- Adaptive strategies
- Maladaptive strategies
What is an example of an adaptive emotion regulation strategy?
Cognitive reappraisal.
What does cognitive reappraisal involve?
Generating different perspectives on emotion-eliciting situations to change their emotional impact.
What is rumination?
Repetitively focusing on feelings and problems without taking action.
True or False: Avoidance is considered a maladaptive emotion regulation strategy.
True.
What is the relationship between problematic emotion regulation and psychopathology?
Problematic emotion regulation is a common risk factor for developing various psychological disorders.
What are common behavioral problems associated with anxiety in children?
- Disobedience
- Disruptive behavior
- Emotional outbursts
Differentiate between fear, anxiety, and phobia.
- Fear: Emotional response to real or perceived immediate threat
- Anxiety: Anticipation of future threat
- Phobia: Fear of specific objects or situations
What are the emotional symptoms of anxiety?
Anxious feelings.
What are cognitive symptoms of anxiety?
Negative thoughts and tunnel vision.
What physiological symptoms are associated with anxiety?
- Trembling
- Palpitations
- Sweaty hands
- Tension
- Headache
- Abdominal pain
What behaviors are common in children with anxiety?
- Avoidance
- Safety behavior
List developmental threats at ages 0-6 months.
- Loss of support
- Loud noises
What is separation anxiety?
Fear of being alone and separated from attachment figures.
What does selective mutism refer to?
Not speaking in situations where it is expected.
What is social anxiety?
Fear of social situations where critical judgment is expected.
What characterizes panic disorder?
Unexpected panic attacks that peak within minutes.
What is agoraphobia?
Fear of places from which escape can be difficult or embarrassing.
What is generalized anxiety disorder (GAD)?
Excessive worrying across multiple aspects of life.
What are common symptoms of anxiety in children?
- Clinging
- Physical complaints
- Sleep problems
- Concentration problems
What is safety behavior?
Attempts to prevent or avoid feared outcomes perceived as threatening.
True or False: Safety behaviors are effective long-term solutions to anxiety.
False.
What is the relationship between safety behaviors and anxiety maintenance?
Safety behaviors may reduce anxiety in the moment but maintain it by preventing the child from learning to cope.
What are the 4+1 D’s used to check for deviant anxiety?
- Deviant
- Distress
- Dysfunction
- Dangerous
- Duration
What do children attribute the absence of negative experiences to?
Safety behaviour
Children often perceive that their safety behaviours lead to the absence of negative experiences, rather than recognizing their own efforts or abilities.
How can safety behaviour affect feared outcomes?
It can increase them
Engaging in safety behaviours may inadvertently heighten the likelihood of experiencing the feared outcomes.
What are examples of safety behaviours in test anxiety?
- Superstitious behaviours
- Reassurance seeking
- Specific writing utensils
- Good luck charms
- Particular seating arrangements
- Bringing multiple pens or pencils
- Answering last questions quickly
- Drinking coffee before the exam
- Praying or engaging in religious practices
- Re-reviewing answers
- Double-checking for skipped questions
- Attending review sessions
- Studying long before the exam
- Cramming the night before the exam
What is a common fear experienced by Donny?
Fear that his mother will die
Donny’s anxiety manifests in fears related to his mother’s safety and irrational thoughts about wasps.
What psychological assessments have been confirmed for Donny?
Below average IQ and attention problems
These assessments highlight the additional challenges Donny faces beyond his anxiety.
What factors are involved in the system of parents and children?
- Genotype of parents
- Genotype of child
- Phenotype of child
- Rearing environment of child
These factors interact to influence a child’s development and emotional regulation.
What is behavioural inhibition?
Linked to temperament (inhibited)
This refers to a child’s tendency to withdraw or show anxiety in new situations.
What are risk factors for anxiety related to temperament?
- Fear sensitivity
- Disgust sensitivity
These sensitivities can contribute to the development of anxiety disorders.
What can parents do that may model anxious behaviour in children?
Control and protect the child from upsetting situations
Overprotection can inhibit a child’s ability to learn coping mechanisms.
What negative behaviours can parents stimulate in their children?
- Avoidance
- Negative thoughts
- Feeling sick and anxious
These behaviours can be reinforced through parental actions and attitudes.
What are some protective child factors against anxiety?
- Deliberate control
- Attention control
- Behavioural control
- Emotion regulation strategies
- Perceived control
- Sense of security
These factors contribute to a child’s resilience in the face of anxiety.
What is an authoritative parenting style associated with?
Protective system factors
This style fosters a supportive and structured environment, beneficial for emotional regulation.
What are some macro factors that influence anxiety prevalence?
- Socioeconomic status (SES)
- Culture
- Conflict
These broader contextual factors can significantly impact mental health outcomes.
True or False: More females than males report anxiety disorders globally.
True
Gender differences in anxiety prevalence are observed across various studies.
Fill in the blank: Anxiety is caused by _______.
[Three routes to anxiety]
Rachman’s (1991) model outlines various pathways through which anxiety can develop.
What negative life events are considered in the chrono-system?
- Domestic violence
- Death
- Divorce
- Bullying
These events can have lasting impacts on a child’s mental health and development.
What is the relationship between income and anxiety within countries?
The higher the income, the lower the anxiety
This relationship highlights the complexity of socioeconomic factors affecting mental health.
What are the key components of effective parenting styles?
Family support, safety (physical and psychological), predictability, positive climate, mentors
These components contribute to a child’s emotional well-being and development.
What is anxiety?
A psychological condition characterized by excessive fear or worry
Anxiety can manifest in various forms and is influenced by multiple factors.
List the three routes to anxiety according to Rachman (1991).
- Classical conditioning/experiential learning
- Model learning
- Informative learning
These routes highlight different ways a child may develop anxiety.
What are some mechanisms that underlie anxiety?
- Cognitive biases
- Avoidance
These mechanisms can maintain or increase anxiety in individuals.
What is cognitive bias in the context of anxiety?
Automatic, implicit cognitive processes that distort perception of threats
Cognitive biases can lead to exaggerated fears and maintain anxiety.
True or False: Therapy effectively addresses cognitive biases related to anxiety.
False
Therapy may not directly address underlying cognitive biases.
How does avoidance maintain anxiety?
It provides short-term relief but does not help develop coping strategies
Avoidance can lead to increased anxiety over time.
What is the diathesis-stress model?
A psychological theory that describes how predisposition and stress interact to influence mental health
This model suggests that environmental stress can lead to anxiety even in children with low predisposition.
What role does emotion regulation (ER) play in anxiety?
ER strategies can be maladaptive or adaptive, with flexibility in application being crucial
Problematic emotion regulation is linked to various psychological complaints.
Fill in the blank: _______ factors and protective factors in the child and environment influence anxiety.
[Risk]
Understanding these factors can help in addressing anxiety in children.
What contributes to a child’s sense of control regarding anxiety?
Having a sense of deliberate and perceived control
This sense of control can mitigate anxiety symptoms.
What is the impact of parental roles on a child’s anxiety?
Parents can play a significant role in maintaining their child’s anxiety
Parental support and behavior can influence a child’s emotional state.
Explain the transdiagnostic perspective on the role of emotion-regulation in psychopathology
- problematic emotion regulation is a common risk factor for the development of psychopathology.
- Problematic ER is a common risk factor for various psychological disorders (e.g. anxiety, depression, behavioral problems, eating disorders, addiction, obesity)
- Problematic ER can lead to/ worsen multiple mental health conditions.
Explain a different perspective on the role of emotion regulation difficulties in psychopathology.
Instead of seeing problematic ER as a broad risk factor for multiple disorders (as in the previous slide), this perspective suggests that emotion regulation difficulties are specific to certain psychological problems.
The slide focuses on depression, highlighting three key ER difficulties linked to it:
- Rumination (+) – Excessive dwelling on negative thoughts and emotions, which worsens depressive symptoms.
- Avoidance (+) – Avoiding emotions, situations, or problems instead of confronting them, leading to long-term distress.
- Lack of Adaptive ER (-) – Reduced use of healthy coping strategies, such as cognitive reappraisal or problem-solving.
Behavioural problems are for example probably linked to the suppression of vulnerable emotions (e.g. anxiety) but not anger.
The diagram connects anxiety to specific ER strategies, some of which may contribute to maintaining or worsening anxiety symptoms:
Rumination (+): Repeatedly thinking about distressing situations or emotions, which tends to increase anxiety.
Avoidance (+): Trying to escape or ignore anxiety-inducing situations, which can provide short-term relief but reinforces anxiety over time.
Acceptance (-): A lower level of acceptance of emotions, meaning difficulty acknowledging or tolerating anxiety, which can worsen emotional distress.
Cognitive Reappraisal (-): Less frequent use of reinterpreting situations in a more positive or neutral way, which is generally considered an adaptive ER strategy.
What is meant by emotion regulation flexibility?
adapting a strategy to the context.
Explain the difference between fear, anxiety and phobia
- Fear: emotional response to real or perceived immediate threat
- Anxiety: anticipation of future threat
- Phobia: fearful or anxious about or avoidant of circumscribed objects or situations. No specific cognitive ideation
Name 3 functions of anxiety
- alarm signal
- preparing the body to act quickly
- Keep distance from the danger
Name 4 symptoms of anxiety
- Emotional, affect: anxious feeling
- Cognitive: negative thoughts, tunnel vision
- Physiological: trembling, sweaty hands, tension, headache
- Behaviour: avoidance & safety behaviour
Describe the threats that are common in certaing ages.
- 0-6 months: Loss of support, loud noises
- 7-12 months: Strangers, heights, sudden things
- 1 year: Separation from parents
- 2 years: Loud noises, animals, darkness, toilet training
- 3 years: Masks, dark, animals, supernatural creatures, toilet training
- 4 years: Separation from parents, noise, dark, supernatural creatures
- 5 years: Animals, “bad people”, dark, supernatural creatures
- 6 years: Supernatural creatures, dark, physical injury
- 7-8 years: Supernatural creatures, thunderstorm, being alone, death, fear based on media (e.g., natural disaster)
- 9-12 years: School tests and performance, physical injury, death, natural disaster, appearance
van 2-8 jaar noemen we pre-operational state: deze kinderen hebben moeite met het onderscheiden van echt en niet-echt vandaar deze anxietys
How do you decide when anxiety becomes deviant?
- 4D’s:
1. Deviant
2. Distress
3. Dysfunction
4. Dangerous
5. Duration - DSM-criteria
What is separation anxiety?
fear of being alone and separated from attachment figures
What is selective mutism?
not speaking in situations when this is expected
What is specific phobia?
fear of a specific object or a specific situation
What is social anxiety?
fear of social situations in which critical judgement by others and negative judgement about anxiety symptoms is expected
what is panic disorder?
unexpected panic attacks that reach a peek within minutes
What is agoraphobia?
Panic attacks in places from which escape can be difficult or embarrassing
What is generalized anxiety disorder (GAD)?
excessive worrying
Explain the prevalences of the different anxiety disorder by age
9 years - 26 years
1. Any anxiety disorder: U-shape. So higher prevalence at a younger age, then lower, and then high again at a higher age.
2. Separation anxiety: High at a young age, becomes lower by age.
3. Social phobia: Low - higher - low - somewhat higher (only for women)
4. Specific phobia: Becomes higher with age
5. GAD: becomes much higher with age (especially for women)
6. Panic disorder: Begins at the age of 15 and then becomes higher with age. Especially for women
7. Agoraphobia: Starts at the age of 15/16 and then becomes higher until 20 and then becomes lower by age.
Describe the onset of the different anxiety’s
childhood (6-12 jaar):
- specific phobia
- selective mutism
- Separation anxiety
Adolescence first to last:
- Social anxiety
- GAD
- Panic disorder
- Agoraphobia (almost in young adulthood)
How does it look like for the environment when a child is anxious?
The child shows:
- avoidance of certain situations (e.g. staying home from school)
- alarming adults
- clinging
- physical complaints
- sleeping problems
- concentration problems
- feeling small
- getting angry easily
- lying
- perfectionism
- many what if questions and reassurance questions
- a lot of just in case behavior
what is meant by safety behaviour?
Actions or mental strategies that individuals use to reduce anxiety and protect themselves from perceived threats. These behaviors are commonly seen in anxiety disorders and are used to manage distress in the short term but often reinforce and maintain anxiety in the long term. Because:
- Because the child does not experience that the feared outcomes do not occur without the safety behaviour or learn to cope with it
- The child attributes the absence of negative experiences to the safety
behaviour and not to own effort or abilities
- Safety behaviour can increase the feared outcomes
Voorbeelden van safety behaviours:
Describe the difference between superstitious behaviour and reassurance seeking behaviour
Reassurance seeking behaviour can be healthy but often become more extensive and then it becomes maladaptive. Superstitious behaviour often stays the same.
Explain the model of McCartney for parents and children with anxiety.
Het beschrijft hoe genetische en omgevingsfactoren samenwerken bij de ontwikkeling van een kind.
Genotype van de ouders
De genetische samenstelling van de ouders wordt doorgegeven aan het kind.
Dit beïnvloedt zowel het genotype van het kind als de opvoedingsomgeving die de ouders creëren.
Genotype van het kind
Dit is de genetische samenstelling van het kind, die deels wordt bepaald door de genen van de ouders.
Het genotype heeft een directe invloed op de fenotype van het kind (hoe de eigenschappen zich uiten).
Opvoedingsomgeving van het kind
De ouders beïnvloeden niet alleen het genotype van het kind, maar ook de omgeving waarin het kind opgroeit.
Dit wordt gestuurd door genetische kenmerken van de ouders en hun gedragingen, opvoedingsstijl, en de bredere context waarin het kind wordt grootgebracht.
Fenotype van het kind
Dit verwijst naar de zichtbare kenmerken en gedragingen van het kind, zoals intelligentie, persoonlijkheid, en fysieke eigenschappen.
Het fenotype wordt beïnvloed door zowel het genotype van het kind als de opvoedingsomgeving.
Explain the more expanded version of the model of McCartney from the lecture.
Het model laat zien hoe genetische aanleg en opvoedingsinvloeden samen kunnen leiden tot verhoogde angst en gedragsinhibitie.
- Genotype van de ouders → Genotype van het kind
- Het genetische profiel van de ouders wordt doorgegeven aan het kind.
- Specifiek gaat het hier om temperamentkenmerken zoals gedragsinhibitie, verhoogde angstgevoeligheid en walginggevoeligheid.
- Kinderen met deze genetische aanleg zijn gevoeliger voor negatieve prikkels en meer geneigd om angstig gedrag te vertonen. - Genotype van het kind → Fenotype van het kind
- Het temperament van het kind (zoals verhoogde angstgevoeligheid) leidt tot gedragingen zoals vermijdingsgedrag, negatieve gedachten, en gevoelens van angst en misselijkheid in stressvolle situaties.
- Kinderen met deze aanleg hebben een verhoogd risico op angststoornissen. - Genotype van de ouders → Opvoedingsomgeving van het kind
- Ouders die zelf angstig zijn of een genetische aanleg voor angst hebben, kunnen dit overdragen via hun opvoedingsstijl.
- Ze modelleren angstig gedrag, wat betekent dat ze zelf angstig reageren op situaties, en kunnen negatieve interpretaties van onduidelijke situaties stimuleren (bijvoorbeeld “Pas op, dat is gevaarlijk!”).
- Dit creëert een omgeving waarin het kind leert dat veel situaties bedreigend zijn. - Opvoedingsomgeving van het kind → Fenotype van het kind
- Ouders met een hoge mate van controle en bescherming proberen het kind te behoeden voor emotioneel ingrijpende of stressvolle situaties.
- Dit leidt ertoe dat het kind niet leert omgaan met stress en in plaats daarvan situaties vermijdt, wat angstgevoelens versterkt.
- Ouders kunnen vermijdingsgedrag stimuleren door kinderen te helpen situaties uit de weg te gaan en door het bespreken van negatieve ervaringen te ontmoedigen. - Fenotype van het kind → Opvoedingsomgeving van het kind (terugkoppelingslus)
- Wanneer het kind vermijdingsgedrag vertoont, reageren ouders vaak door dit onbewust te versterken (bijvoorbeeld door het kind te helpen situaties te vermijden).
- Dit creëert een vicieuze cirkel waarin angst en vermijding steeds sterker worden en het kind geen coping-mechanismen ontwikkelt.
Wat laat dit model zien?
- Angst en vermijdingsgedrag ontwikkelen zich door een samenspel van genetische aanleg en opvoeding.
- Overbeschermende of angstige opvoeding kan een kind met een aanleg voor angst versterken in het vermijden van spannende situaties.
- Dit leidt tot een self-fulfilling prophecy: het kind leert niet omgaan met angst en wordt steeds angstiger.
Name some risk factors in the system of a child according to the model of
- micro: parental control + rejection
- Macro: SES, Culture, conflict
- Chrono: School + negative life-events (death, divorce, domestic violence)
Explain school as a risk factor for the development of fear in a child
Different stages of school life can be associated with potential anxiety triggers:
1. Early school years (groepen 1-2): separation anxiety
- Young children experience anxiety when transitioning from their home environment to school.
- This separation anxiety is characterized by distress when leaving parents or caregivers and can manifest in crying, clinginess, or reluctance to go to school.
- If not managed well, this can create long-term difficulties with adapting to new environments.
- Primary and Middle school (groepen 3-8): social and performance anxiety:
- Making Friends & Bullying Risk
–As children grow, social interactions become more significant.
–However, some children struggle with making friends and face the risk of bullying, which can lead to low self-esteem, social withdrawal, and heightened anxiety.
- Tests, Presentations, and Performance-Based Anxiety
– Academic pressure increases with tests, presentations, and classroom performance expectations.
–Failures or negative experiences (such as poor grades, public speaking fear, or critical feedback) can reinforce anxiety and fear of failure, leading to avoidance behaviors.
- High school and adolescence (middelbare school): social anxiety disorder:
– relationships and independence
- As adolescents seek more independence, they face challenges in forming relationships, handling peer pressure, and navigating social expectations.
- Fear of social judgment and rejection can develop into social anxiety disorder (SAD), where individuals excessively fear social interactions and avoid situations where they might be scrutinized.
Describe how school refusal can contribute to the development of anxiety.
The contribution of school refusal to the development of anxiety can be explained by the reinforcement theory.
1. Negative reinforcement: Negative reinforcement occurs when a behavior (school refusal) is reinforced by escaping or avoiding an unpleasant situation.
- Avoidance of Negative Affect (e.g., fear, anxiety, stress)
–Some children refuse to attend school to avoid distressing emotions related to school, such as anxiety, depression, or general discomfort.
–Common examples:
—Fear of separation from parents (separation anxiety).
—Anxiety related to school-related stressors like tests or bullying.
- Avoidance of Social Evaluation (e.g., fear of judgment, embarrassment)
–Some students avoid school due to social anxiety, such as fear of being judged, humiliated, or embarrassed in social settings.
–Common examples:
—Avoiding presentations, group activities, or interactions with peers.
—Fear of being teased or ridiculed.
- Positive reinforcement: Positive reinforcement occurs when a behavior (school refusal) is rewarded by obtaining something desirable.
- Seeking Attention
– Some children refuse to go to school to gain attention from parents, caregivers, or others.
– This can occur when the child enjoys the extra care or involvement of parents when staying at home.
– Common examples:
— Clinging behavior that ensures parental attention.
— Complaining of illness to receive comfort and care.
- Pursuit of Tangible Rewards
– Some children skip school because they prefer engaging in more enjoyable activities outside of school.
– Common examples:
— Staying home to play video games, watch TV, or use social media.
— Hanging out with friends or engaging in recreational activities instead of attending school.
Describe the prevalence of anxiety disorders
- more females than males report anxiety disorders. but gender is considered as binary
- 55+ adults report less anxiety disorders than other age categories
- more anxiety disorders in conflict areas than non-conflict areas
- higher prevalence in Euro/Anglo countries than indo/asia, african, central/eastern europe, north africa/ middle east, ibero/latin. But are diagnostic criteria, assessment instruments, perspective on mental health culture-independent?
- Lowest anxiety reported in poorest countries. But within a country, the relation is reverse (the higher the income, the lower the anxiety).
Name some protective child factors for anxiety
- Deliberate control (self-regulation skills): Deliberate control refers to a child’s ability to actively regulate their thoughts, behaviors, and emotions to manage anxiety. It consists of three key components:
- Attention control: The ability to focus on relevant information and ignore distractions that might increase anxiety. Helps prevent rumination (overthinking negative experiences) and excessive worry.
- Behavioral control: The ability to adjust actions based on the situation and avoid impulsive, anxiety-driven behaviors.
Encourages adaptive responses instead of avoidance or emotional outbursts.
- Emotion regulation: The use of adaptive strategies to manage stress and anxiety (e.g., deep breathing, cognitive reframing, problem-solving).
Flexibility in emotional responses, meaning the child can adjust their coping mechanisms depending on the situation. - Perceived control (also linked to self-esteem): Perceived control is a child’s belief in their ability to handle challenges and new situations, which is closely linked to self-esteem.
- Sense of Security & Confidence:
A strong perceived control makes children feel that they can influence and manage difficult situations rather than being overwhelmed by them.
This reduces fear and avoidance behaviors since the child believes they can cope with uncertainty.
Name some protective system factors
Family:
- authoritative parenting style: a balance of warmth, support, and structure. Encourages independence while providing clear expectations and guidance. Helps children develop confidence and emotional regulation skills
- Family support: a strong and supportive family network provides emotional security. Open communication and encouragement reduce anxiety levels
- Safety: a physically safe environment en a psychological safe space where children feel heard, valued, and accepted
- Predictability: consistent routines and stable family dynamics create a sense of security. Helps children feel in control, reducing anxiety
School:
- positive climate: a supportive and inclusive school culture that fosters belonging. Encourages peer support, kindness, and respect, reducing bullying and social anxiety
- mentors: supportive teachers, school counselors, or other mentors provide guidance and emotional support. Having a trusted adult at school enhances a child’s sense of security and self-confidence
- safety
- Predictability: structured routines, clear expectations,and consistent rules help reduce stress and uncertainty.
Explain the routes how anxiety is caused
- Classical conditioning/ experiental learning: Anxiety develops through direct experience with a negative or distressing event. A neutral stimulus becomes associated with fear.
- Model learning: Anxiety is learned by observing others experiencing fear or distress in a particular situation
- Informative learning: anxiety develops through exposure to negative information rather than personal experience
What are 3 mechanisms that underly anxiety?
- Cognitive biases
- Avoidance
- Common and different factors: comorbidity anxiety and depressive disorders
Explain the role of cognitive bias in anxiety
Cognitive bias sustain anxiety.
Key Components of the Model:
1. Situation (Trigger) → The individual is in a situation where anxiety could arise (e.g., being outside).
- Encoding (Processing the Situation)
- Attention Bias: The person over-focuses on the feared stimulus (e.g., seeing spiders everywhere).
- Overactivity of Vulnerability & Danger Schemas: The brain amplifies danger signals (e.g., “Spiders are dangerous, being outside is dangerous”). - Interpretation (Cognitive Distortions)
- Interpretation Bias: The individual misinterprets neutral stimuli as threats (e.g., “If it moves, it’s out for me”).
- Memory Bias: Past negative experiences reinforce fear (e.g., “Spiders always move when I walk by”). - Anxiety Response → The person experiences anxiety, reinforcing the cycle of cognitive bias.
Fast response to a threat stimulus (stressor):
- The brain automatically focuses on a potential danger (e.g., a spider).
- Once detected, attention shifts, but the implicit association remains negative (e.g., “This is dangerous”).
- Negative memories are triggered, reinforcing the fear.
People have little conscious control over these biases.
Therapy often does not directly address cognitive biases, but treatments like CBT and exposure therapy can help modify them.
Explain the role of avoidance in anxiety
Avoidance behaviour maintains and reinforces anxiety through a self-perpetuating cycle. Avoiding feared situations provides temporary relief but ultimately leads to increased anxiety in the long run.
Step-by-Step Breakdown of the Cycle:
1. Situation: A person encounters a situation that could trigger anxiety.
- Example: Seeing a spider.
- Anxiety Cognition: The individual has an anxious thought or belief about the situation.
- Example: “The spider will bite me” or “I can’t handle it.” - Avoidance Behavior: To reduce anxiety, the person avoids the situation entirely.
- Example: Leaving the room or refusing to go outside where spiders might be. - Immediate Consequences:
- Short-term relief: Avoiding the situation provides an immediate sense of comfort, reinforcing the behavior. - Long-term Consequences:
- Anxious thought not invalidated: The person never learns that their fear is exaggerated or irrational because they never face the feared situation.
- No coping skill development: The individual does not learn effective strategies to manage fear or anxiety.
- Increased anxiety: Over time, avoidance strengthens the fear, making the situation seem even more threatening in the future.
Explain the diathesis stress model applied to anxiety.
Emotion Regulation difficulties can contribute to genetic perdisposition, making the individual more vulnerable to anxiety.
Both genetic predisposition and stress contribute to anxiety, but even those with low predisposition can develop anxiety if exposed to extreme stress.
- Predisposition (Diathesis) (Blue Bar)
- Refers to genetic or biological vulnerability to anxiety.
- Some individuals are born with a higher sensitivity to stress and emotional regulation difficulties. - Environmental Stress (Orange Bar)
- Life experiences, trauma, or chronic stress increase the risk of anxiety.
- Even individuals with a low genetic predisposition can develop anxiety if stress levels are high enough. - Interaction Between Stress and Predisposition
- Each factor (stress and diathesis) develops independently but interacts to influence anxiety.
- If both predisposition and stress are high, the likelihood of developing an anxiety disorder is significantly increased.
- If only one factor is high, the risk may still exist but is lower. - Threshold for Anxiety Disorder (Red Line)
- Anxiety levels increase as both factors contribute.
- When the combined anxiety level crosses a certain threshold, an individual may develop clinical anxiety.
