Summary all lectures & all articles required for "anxiety & related disorders"
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Kurs
Anxiety And Related Disorders
Hochschule
Universiteit Utrecht (UU)
I summarized all articles and all lectures (except for the last lecture) that are required for the course "anxiety and related disorders". All summaries are in detail and contain all necessary information :)
WEEK 1
A CONTEMPORARY LEARNIG THEORY PERSPECTIVE ON THE ETIOLOGY OF ANXIETY
DISORDERS – MINEKA & ZINBARG (2006)
Anxiety disorders the most common category of diagnoses
Behavioral/learning approaches criticized for inability to account for the diverse factors involved in the
origins of people anxieties & individual differences
CONTEMPORARY LEARNING THEORY
Early learning histories serve as vulnerability factors that can affect the emotional consequences of
traumatic & stressful life events often implicated in the origins of anxiety disorders
Such learning histories together with temperamental vulnerabilities can serve as diatheses which
makes some individuals more susceptible to adverse & stressful experiences that sometimes lead to
development of anxiety disorder
Contextual variables during & following traumatic learning events have further influence
ADVANTAGES OVER OTHER APPROACHES:
Better grounded in theories & methods of experimental psychology
More comprehensive formulations of the etiology of anxiety disorders
More explicit analysis of factors promoting or inhibiting the developmental of different anxiety
disorders
SPECIFIC PHOBIA
= intense & irrational fears of certain objects or situations that they usually avoid
CONDITIONING OF FEARS & PHOBIAS
Phobic-like fears can be learning through observation alone (e.g. tv)
INDIVIDUAL DIFFERENCES
Modest genetically based vulnerability (contribution to fear conditioning)
Mediated through personality variables (e.g. trait anxiety, behaviorally inhibited children)
Differences in life experiences (either before, during or following conditioning)
Prior experiences
o More previous nontraumatic encounters immunize
o See parents behave nonfearfully with phobic object/situation immunize
o Children raised in environments in which they gain sense of control over environment
Contextual variables
o Having control over traumatic event (e.g. escape)
Postevent variables
o Inflation effect = person who is exposed to more intense traumatic experience after
conditioning of a mild fear is likely to show an increase in fear of the CS
o Mental rehearsal of CS-US relationship can enhance strength
SELECTIVE ASSOCIATIONS IN CONDITIONING
, Primates may be evolutionarily prepared to rapidly associate certain kinds of objects with aversive
events (selective advantage in the course of evolution) “prepared fears”
Learning with fear-relevant stimuli is more impenetrable to conscious cognitive control than learning
with fear-irrelevant stimuli
SOCIAL PHOBIA
= excessive fears of situations in which they might be evaluated or judged by others & avoid situations or
endure them with marked distress
Can arise as result of traumatic conditioning (92% reported teasing in school)
SOCIAL LEARNING
Vicarious conditioning = observing another being ridiculed, humiliated or behaving in an anxious way
in social situations
Modeling of social anxiety in families
Culturally transmitted display rules & norms
Japan (taijin kyfusho) = fear to embarrass or offend others
PREPAREDNESS THEORY
= social anxiety is a by-product of evolution of dominance hierarchies & therefore predicted that social
stimuli signaling dominance & intraspecific threat (e.g. superior conditioning with angry rather than
happy faces)
BEHAVIORAL INHIBITION AS TEMPERAMENTAL DIATHESIS
Early behavioral inhibition not only predicts the onset of multiple specific phobias in childhood but
also social phobias in adolescence
UNCONTROLLABILITY
Uncontrollability (escape deficit) produces learned helplessness & exaggerated fear CRs
Deleterious effects of social defeat mediated by perceptions of uncontrollability
PANIC DISORDERS (WITH & WITHOUT AGORAPHOBIA)
= recurrent & unexpected panic attacks without being aware of triggers & experience worry, anxiety or
behavioral change related to having attack
Agoraphobic avoidance of situations in which they perceive that escape might be either
difficult or embarrassing
Interoceptive conditioning = CSs are the body’s own internal sensations low level somatic sensations of
anxiety precede & are paired with higher levels of anxiety/panic, the low level somatic sensations of anxiety
come to elicit high levels of anxiety and panic
TWO SEPARABLE FACTORS:
Strong arousal, extreme fear & flight-or-fight action tendencies
Anxiety accompanied by apprehension, worry & tension
early internal signs of panic become panic become conditioned when paired with full-blown panic attacks
DEVELOPMENT OF AGORAPHOBIA
, Agoraphobia (shopping malls, driving, standing, sitting in a theater) develop as result of exteroceptive
conditioning of anxiety of these situations when panic attacks have occurred there
Generalize to other similar situations
Aerobic exercise, caffeine, sexual activity e.g. avoided because of interoceptive cues
Inhibitory CSs for safety “safety behaviors”
Risk factors
Gender (women are far more likely)
Employment (people who must leave the house to work less likely because exposed with
feared situation)
VULNERABILITY FACTORS
Moderate nonspecific genetic vulnerability mediated by temperamental & personality vulnerability
factors like neuroticism & trait anxiety
Prior learning experiences:
Lack of control & helplessness psychological vulnerability
Early experiences with control & mastery develop ability to cope with stress & anxiety
situations
POSTTRAUMATIC STRESS DISORDER
= reexperiencing the trauma, passively avoiding reminders of the trauma, numbing of affect, and heightened
general arousal traumatic event is necessary
TRAUMA PHASE
Uncontrollability & unpredictability during trauma more likely to result in PTSD
Psychological state of resistance & fighting back versus giving up & conceding defeat
PRETRAUMA PHASE
Prior experiences with control or lack of control immunize
History or prior trauma associated with increased risk of developing PTSD
Repeated childhood abuse
POSTTRAUMA PHASE
Greater reexperiencing associated with more PTSD symptoms
Mild PTSD can become full-blown PTSD when there is reason to evaluate danger (e.g. later finding out
that rapist was a murderer)
GENERALIZED ANXIETY DISORDER
= chronic excessive worry about a number of events or activities for at least six months & worry much be
experienced as difficult to control
Likely to have history of childhood trauma
Far less tolerance for uncertainty & being unable to predict future
Neuroticism & trait anxiety
Perceived benefits of worry center around people’s belief that worry helps avoid catastrophe
(suppression of emotional & physiological responses serve to reinforce the process of worry
prevents from extinction of anxiety)
Attempt to control thoughts & worry lead to increased experience of intusive thoughts & increase
perception of uncontrollability
, = vicious circle of anxiety, worry, and intrusive thoughts may develop to sense of being unable to control
OBSESSIVE-COMPULSIVE DISORDER
= unwanted & intrusive thoughts, impulses, or images that cause marked anxiety or distress, accompanied by
compulsive behaviors ot mental rituals performed to neutralize or prevent the distressing thoughts or images
Verbal conditioning
Verbal transmission of dangerous thoughts
Direct verbal conditioning neutral idea is paired with scary idea that a person may have
Social learning
Thought action fusion = people are taught the idea that thoughts, desires, and impulses are morally
equivalent to actions & thoughts of a specific catastrophe increase the probability that it will actually
occur
ROLE OF AVOIDANCE
Engage in either behavioral or mental rituals intended to neutralize or prevent obsessions
Extinguish avoidance by preventing responses & do prolonged exposure
ROLE OF PREPAREDNESS
Do not typically obsess about random scary thoughts and do not show arbitrary ritualistic behaviors,
rather their thoughts and behaviors have deep evolutionary roots
CONCLUSION
contemporary learning theory can capture the richness & complexity associated with the development and
course these disorders
ANXIETY DISORDERS: WHY THEY PERSISTENT HOW TO TREAT THEM – CLARK (1999)
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