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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
Why Care? • 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.
Specific Phobia • Intense and irrational fears of certain objects or situations they actively avoid. • Watson & Rayner (1920) • Little Albert
Other Factors with Specific Phobias • 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
Social Phobia • 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
Factors with Social Phobias • Vicarious learning (13%) • Modeling – parents fears • Cultural Norms (Taijin Kyofusho) • Preparedness (Social Dominance) • Behavioral Inhibition • Controllability • Notice any patterns?
Panic Disorder With and Without Agoraphobia • 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
Panic vs. Anxiety • Panic: strong autonomic arousal, extreme fear, and fight or flight actions • Anxiety: apprehension, worry and tension
Theory • 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.)
Factors in Panic Disorder • 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
PTSD • 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
GAD • 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
GAD Factors • 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
OCD • Unwanted and intrusive thoughts, impulses, or images causing marked anxiety or distress; usually accompanied by compulsive behaviors or mental rituals
Factors in OCD • Verbal Conditioning • Responsibility and Duty • Thought-action fusion • Moral equivalent • Probability increase • Cultural Norms • Avoidance → Maintenance • Evolutionarily relevant themes
Conclusions • 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