Specific Phobias & GAD. JONATHAN GASTON DIRECTOR – EMOTIONAL HEALTH CLINIC CENTRE FOR EMOTIONAL HEALTH. Defining Fear/Anxiety. ‘Fight-Flight Response’ A necessary inbuilt protective response mechanism to protect us from danger and help us survive Only a problem when:
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
DIRECTOR – EMOTIONAL HEALTH CLINIC
CENTRE FOR EMOTIONAL HEALTH
A B C D
Situations Thoughts Feelings Behaviour
“Action on an underlying cognitive belief structure”
‘Fight or Flight’ Response
‘Probability’ & ‘Cost’
Hypervigilance for Danger
‘Scanning for threat’
Look for ‘confirming evidence’
“To modify danger/threat appraisals to become more realistic and adaptive”
‘short term gain vs. long-term change’
A. MARKED AND PERSISTENT FEAR THAT IS EXCESSIVE OR UNREASONABLE AND CUED BY PRESENCE OR ANTICIPATION OF A SPECIFIC OBJECT OR SITUATION.
B. EXPOSURE TO STIMULUS ALMOST INVARIABLE PROVOKES IMMEDIATE ANXIETY.
C. PERSON RECOGNISES EXCESSIVENESS OF FEAR.
D. STIMULUS AVOIDED OR ENDURED WITH DREAD.
E. AVOIDANCE INTERFERES SIGNIFICANTLY WITH NORMAL ROUTINE OR FUNCTIONING
ANIMAL – spiders, snakes, other insects, dogs, birds, sharks, etc
NATURAL ENVIRONMENT – storms, heights, water
BLOOD, INJECTION, INJURY – seeing blood or an injury, receiving an injection or invasive medical procedure (common fainting response)
SITUATIONAL – tunnels, bridges, elevators, flying driving, enclosed spaces, driving
OTHER – choking, vomiting, contracting an illness, loud noises, costumed characters
(Kessler et al., 2005)
(Magee et al., 1996)
A PREPARED STIMULUS IS ONE WHERE:
Three (learning-based) Pathways to Fear:
A NON-ASSOCIATIVE ACCOUNT OF FEAR ACQUISITION ?
1. Variability throughout Exposure
2. Spacing of Exposure Tasks
3. Context Effects
4. Fear Toleration vs. Fear Reduction
C. AT LEAST THREE OF THE FOLLOWING:
D. FOCUS OF WORRY NOT ANOTHER AXIS 1
Many and varied
Two key underlying issues:
People with GAD like control and predictability
(over & under achievement)
(chronic cognitive & physical arousal, avoidance)
(can be aloof or overly-emotional)
(stress, intimacy, genuineness, avoidance, isolation)
Pure GAD is equally as disabling as pure MDD
POSITIVE META-BELIEFS ACTIVATED (STRATEGY SELECTION)
TYPE 1 WORRY
NEGATIVE META-BELIEFS ACTIVATED
TYPE 2 WORRY
“If I am in control and know what will happen,
then I can prevent negative outcomes”
“worry helps me do this”
Controlling others, situations, feelings
Shifting, narrowing attention
Positive meta-beliefs about worry??