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

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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?

• 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

• 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

• 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

• 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

• 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

• 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

• Panic strong autonomic arousal, extreme fear,
  and fight or flight actions
• Anxiety apprehension, worry and tension

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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.)

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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

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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

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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

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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

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OCD

• 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

• Verbal Conditioning
• Responsibility and Duty
• Thought-action fusion
• Moral equivalent
• Probability increase
• Cultural Norms
• Avoidance ? Maintenance
• Evolutionarily relevant themes

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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

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