A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders:
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A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders: Its Not What You Thought It Was. Mineka & Zinbarg 2006. Why Care?. Lifetime prevalence in the U.S. of approximately 29%.

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A Contemporary Learning Theory Perspective on the Etiology of Anxiety Disorders: Its Not What You Thought It Was

Mineka & Zinbarg

2006


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Why Care? of Anxiety Disorders:

  • Lifetime prevalence in the U.S. of approximately 29%.

  • Classical learning theory does not account for why some people develop anxiety disorders while others do not.


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Specific Phobia of Anxiety Disorders:

  • Intense and irrational fears of certain objects or situations they actively avoid.

  • Watson & Rayner (1920)

    • Little Albert


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Other Factors with Specific Phobias of Anxiety Disorders:

  • Vicarious Conditioning

  • Individual Differences

    • Personality Variables (High Trait Anxiety, Behaviorally Inhibited)

    • Genetically based vulnerabilities

    • Latent Inhibition: Prior exposure to the CS before paired with the US ↓ later conditioning to CS paired w/ US.

    • Perceived Control of the Situation

    • Postevent inflation (another experience, more information, mental rehearsal of CS-US relationship)

  • Evolutionary selection of Phobias – more prepared

    • Fear Relevant vs. Fear Irrelevant Stimuli


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Social Phobia of Anxiety Disorders:

  • Excessive fear of situations in which they might be evaluated or judged.

  • Direct traumatic conditioning – 92% report history of severe teasing in childhood; 50% in panic disorder; 35% in OCD

  • 56% of those with social phobia recalled direct traumatic conditioning experiences


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Factors with Social Phobias of Anxiety Disorders:

  • Vicarious learning (13%)

  • Modeling – parents fears

  • Cultural Norms (Taijin Kyofusho)

  • Preparedness (Social Dominance)

  • Behavioral Inhibition

  • Controllability

  • Notice any patterns?


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Panic Disorder With and Without Agoraphobia of Anxiety Disorders:

  • Recurrent unexpected panic attacks without explicit knowledge of cues or triggers; experience worry anxiety or behavioral change related to having another attack.*

  • Some develop avoidance of situations in which they feel escape might be difficult or embarrassing if they had a panic attack.

  • Risk Factors:

    • Gender

    • Employment


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Panic vs. Anxiety of Anxiety Disorders:

  • Panic: strong autonomic arousal, extreme fear, and fight or flight actions

  • Anxiety: apprehension, worry and tension


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Theory of Anxiety Disorders:

  • Exteroceptive Conditioning

    • CSs interact with external sensory receptors

      • Central to development of agoraphobia

  • Interoceptive Conditioning

    • CSs are bodies own internal sensations

      • Heart palpitations and dizziness

  • Panic Attacks can occur due to the presence of exteroceptive CSs or interoceptive CSs

  • May cause generalization of agoraphobia due to interoceptive CSs generalizations (caffeine, scary movies, exercise, etc.)


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Factors in Panic Disorder of Anxiety Disorders:

  • Anxiety- may be a precursor to panic attacks

    • Can be additive (general level of anxiety and CS)

  • Genetic & Personality factors

  • Prior learning

    • Perceptions of lack of control and helplessness

    • Engaging in sick role behavior, observing physical suffering as children


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PTSD of Anxiety Disorders:

  • Reexperiencing the trauma, passively avoiding remingers, numbing of affect, heightened general arousal.

  • Trauma Phase

    • Controllability

    • Mental defeat

  • Pretrauma Phase

    • Prior trauma (especially interpersonal trauma)

    • History of control/readiness - predictable

    • Genetic liability

  • Posttrauma Phase

    • Exposure to contexts related to the trauma

    • Reevaluation inflation

    • Reinstatement of fear


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GAD of Anxiety Disorders:

  • Chronic excessive worry about several events and/or activities for 6+ months, worry must be difficult to control.

  • Less tolerance for uncertainty than nonanxious controls – need to predict the future

  • Anxiety-Worry-Intrusive thoughts Cycle; Cognitive avoidance


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GAD Factors of Anxiety Disorders:

  • Benefits:

    • Avoid catastrophe

    • Avoid deeper emotional topics

  • Costs

    • Greater sense of danger and anxiety

    • Negative intrusive thoughts

    • Suppresses emotional and physiological responses to aversive imagery

  • Factors

    • Uncontrollable/Unpredictable events (though not as severe as those in PTSD)

    • Childhood trauma


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OCD of Anxiety Disorders:

  • Unwanted and intrusive thoughts, impulses, or images causing marked anxiety or distress; usually accompanied by compulsive behaviors or mental rituals


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Factors in OCD of Anxiety Disorders:

  • Verbal Conditioning

  • Responsibility and Duty

  • Thought-action fusion

    • Moral equivalent

    • Probability increase

  • Cultural Norms

  • Avoidance → Maintenance

  • Evolutionarily relevant themes


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Conclusions of Anxiety Disorders:

  • From this perspective we can identify risk factors associated with future development of anxiety disorders.

  • Strong sense of mastery and exposure to nonanxious models from early age

  • Exposure therapy


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