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INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY. Dr Nick White Chartered Clinical Psychologist. THE SUBSYSTEMS AND THEIR INTERACTIONS. The Meaning Subsystems (The Central Engine of Cognition). The Propositional Subsystem Deals with specific meanings that have a truth value

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Interacting cognitive subsytems and anxiety l.jpg

INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY

Dr Nick White

Chartered Clinical Psychologist



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The Meaning Subsystems(The Central Engine of Cognition)

  • The Propositional Subsystem

    Deals with specific meanings that have a truth value

  • The Implicational Subsystem

    Deals with high level, abstract meaning - a holistic sense of the way things are


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Different Levels of Meaning

  • Thoughts do not necessarily lead to anxiety

  • Anxiety is not necessarily caused by thoughts

  • Anxiety = re-generation of threat-related implicational schematic models


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Clinical treatment

  • The treatment aim in anxiety problems = preventing regeneration of threat-related implicational models

  • Similar anxiety symptoms can be maintained by different processes in different individuals

  • Different disorders can be maintained by the same processes


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Propositional-Implicational interlock

  • Implicational subsystem has output to the propositional subsystem and vice-versa

  • Propositional-implicational interlock may act as a feedback loop

  • New or discrepant information is not attended to


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The Sensory Subsystems

  • Acoustic Subsystem

    Processes basic information regarding the nature of sounds eg pitch, volume

  • Visual Subsystem

    Processes basic information about light, such as wavelength

  • Body State Subsystem

    Processes internal sensory information eg temperature, tension, arousal


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Sensory subsystems and anxiety

  • The sensory subsystems have a direct input to the implicational subsystem

  • Acoustic and visual stimuli in PTSD

  • Body state feedback loop and anxiety


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The role of the environment

  • The environment determines what external information is available to the system

  • Factors in the environment may maintain threat-related schematic models

  • Role for problem solving or family therapy




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Key features of ICS information processing

  • Only information from one input data stream can be processed at any one time (selective attention)

  • The transformation processes learn to use heuristics to process information (biased processing)

  • The system is geared towards reducing discrepancies in the information it is processing eg. present state vs goals


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Development of anxiety

  • Initially in the infant certain stimuli are ‘hard-wired’ to produce an anxiety response

  • Anxiety becomes generalised to other stimuli or situations as the implicational system learns the co-occurring regularities

  • Tendency to re-create previous familiar schematic models


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Pattern completion

  • The formation of schematic models is influenced by the memory record

  • A similar process happens in word recognition

    • eg. L _ B _ R _ L P _ N _ C


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Pattern completion

  • Each experience of anxiety leads to an increased chance of future re-generation of threat related implicational level schematic models

  • So new information can be ‘missed’ and treated as irrelevant by the system



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Buffered processing

  • Buffered processing is more efficient

  • It facilitates the integration of new unfamiliar information in the data pattern

  • The central engine of cognition can be in one of three buffering modes at any one time


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Central engine of cognition buffering modes

  • 1) Mindless emoting

    Neither propositional nor implicational subsystem in buffered mode. Individual is focussed on their affective reactions

  • 2) Conceptualising/doing

    Propositional subsystem in buffered mode. Impersonal detached thoughts about the self as object. Goal oriented thinking

  • 3) Mindful experience/being

    Implicational subsystem in buffered mode. Non-evaluative awareness of subjective experience. Most likely to lead to implicational schematic model changes


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Buffered processing and anxiety

  • The buffer will tend to switch to a relevant subsystem in order to problem solve discrepancies in information processing

  • Worrying = Propositional buffering

  • In some anxiety states with a focus on physiology the buffer will be on processing in the body state subsystem


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ICS INFORMED

GROUP CBT


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ANXIETY GROUP PROGRAMME

SESSION ONE: INTRODUCTION/ OUTLINE OF GROUP PROGRAMME

SESSION TWO: UNDERSTANDING WHAT HAPPENS IN ANXIETY

What is anxiety? Outline of the CBT model.

SESSION THREE: ANXIETY MANAGEMENT

Relaxation and distraction

Anxiety management techniques – advantages and disadvantages

SESSION FOUR: AGENDA SET BY GROUP

SESSION FIVE: SAFETY BEHAVIOURS AND BEHAVIOURAL EXPERIMENTS

SESSION SIX: AGENDA SET BY GROUP


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ANXIETY GROUP PROGRAMME

SESSION SEVEN: THOUGHTS AND ANXIETY/ THOUGHT CHALLENGING I

Identifying thoughts

Thinking biases and attention

Alternative explanations

SESSION EIGHT: THOUGHT CHALLENGING II

Evidence and logical reasoning

SESSION NINE: AGENDA SET BY GROUP

SESSION TEN: WORRYING AND MINDFULNESS

SESSION ELEVEN: AGENDA SET BY GROUP

SESSION TWELVE: SUMMARY, FEEDBACK AND GOODBYES

Review of goals and taking things forward


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Disrupt feedback loops

  • Anxiety Management

    • Distraction

    • Relaxation techniques

    • Breathing techniques

  • Effect likely to be only temporary unless repeatedly done

  • May integrate a sense of mastery or self-efficacy into the schematic models generated


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The influence of output on input

  • Change the environment or how the individual interacts with it

  • This may facilitate a change in incoming information

  • To change behaviour it is often necessary to move the buffer, to enable the individual to switch out of ‘doing’ mode


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Propositional level work

  • Thought challenging may be effective at altering elements of schematic models

  • Mainly aimed at helping clients to learn to move the buffer

  • Propositional level work could reinforce a propositional buffering mode


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Re-populating the memory records

  • To prevent relapse the memory records must be re-populated with new memories of more adaptive schematic models

  • This can partly be achieved through repeated behavioural experiments or more prolonged behavioural change

  • Create alternative schematic models that are then activated by the same incoming information


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Moving the buffer

  • Worrying vs mindfulness

  • Attentional control skills

  • Help individual to learn to move the buffer to the implicational subsystem


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CMHT ANXIETY GROUP AVERAGE SCORES – HADS ANXIETY SUBSCALE


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MODERATE ANXIETY GROUP AVERAGE SCORES – HADS ANXIETY SUBSCALE



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