Extensive summary lectures Anxiety and Related Disorders
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Kurs
Anxiety And Related Disorders
Hochschule
Universiteit Utrecht (UU)
This is a very extensive summary of all the lectures for the course of Anxiety and Related Disorders. It contains the weeks 1 through 8 (all the weeks).
Lecture 1 – Emotion Theory
- Anxiety is a prominent emotion in all the disorders we’re going to discuss in this course.
What is an emotion?
- The study of emotions was related to ethics a long time ago.
- Aristoteles’ “on virtue and vices” concerned a lot of emotion theoretical approaches.
- He thought that a right amount of emotion was the key to be virtuous.
- Later on, the focus shifted to the function of emotions.
Higher VS Lower emotions
- There are higher and lower emotions.
- In general, it is now thought that all humans are able to experience the 5 basic emotions.
- Basic emotions: happy, anxious, sad, angry, ashamed.
- The general idea is that when you “peel off” the more complex emotions, you will find
one of the basic emotions in the centre of the complex emotion.
Anxiety VS Anxiety disorders
- Anxiety is a very human emotion.
- Because we also see anxiety in other animals, it must be a very useful emotion.
- The emotion theory is not specifically about anxiety but more about emotions in general.
- Specific anxiety disorders have a specific type of anxiety.
- As a psychologist, you have to ask the client what it is he/she is afraid of.
- With anxiety disorders there’s always first something that presents (the stimulus) and the
anxiety (reaction).
Anxiety is an emotion
- Emotion is more than a feeling.
It consists of three different aspects:
Physiological aspects
- E.g., sweating, heartrate goes up, trembling.
Cognitive aspects
- Conscious (experience/feeling) or unconscious.
- We have some sort of cognitive appraisal of a stimulus before it comes to our
conscious mind.
Motoric aspects
- The behavioural aspects of an emotion.
- These aspects usually occur together.
- They are not always present and they’re not always concordant (overeenstemmend?) for
every situation or emotion.
- They are loosely coupled systems.
- You can have a physiological reaction (e.g., heart pounding), but this doesn’t tell you
anything about the emotion.
- E.g.: Heart racing might occur during happiness or anger.
- E.g.: A cognitive appraisal (e.g., seeing a loved one) might be different for the same
physiological aspects.
- This is also true for the motoric aspects.
- We have some control – we can inhibit some of the actions of the 3 aspects.
- In general, we say that these 3 aspects occur when a psychological state of an emotion
occurs, but they are quite loosely coupled systems.
,Related concepts: Mood, attitude, & temperament
- E.g.: Current state, you can experience an emotion and it might be acute.
- Salient object: most noticeable or important object (e.g., a dog barking at you).
- You can also have (e.g.) an attitude towards dogs.
- This attitude is different from a short, provoked state (emotion) – this is more chronic
and present in all your behaviours.
- An attitude is not a current, time-limited state.
- No salient object: there is no concrete stimulus.
- The distinction between mood and emotion is not always clear.
- Mood: a constant psychological state, goes on a positive to negative dimension.
- Anxiety is more often a time-limited emotional state.
- But what if someone has experienced panic for 3 days? They often have a high aroused
mood, because our body isn’t prepared to experience panic for 3 days.
- The state of panic is very exhausting.
- These patients have a high baseline for panic, maybe it’s even more temperamental
condition/disposition to how you react to things.
- Emotion and mood can be intertwined.
- Temperament: a chronic disposition that is independent of a certain object.
- Temperament is more a general disposition of how you react to certain situations in an
affective way/manner.
- Temperament variables are normally distributed, there a little people who score
extremely on temperament variables.
- Neuroticism is a trait that that tends to experience everything in a negative way.
- Patients with anxiety tend to often score high on neuroticism.
Two dimensions
- Vertical: the valence of an emotion (i.e., positive or negative emotion).
- E.g.: Excitement is a very positive and high arousal emotion.
- E.g.: Anger is a negative and high arousal emotion.
- E.g.: Sadness is a negative and low arousal emotion.
- E.g.: Contentment is a positive and low arousal emotion.
- The higher the arousal, the more impact the emotion has on the individual.
,Emotion has functions
- When do emotions occur?
- When “vital interests” are at stake.
- This is survival of self and offspring.
- Frija: Emotions as “action tendencies”.
Emotions
Stimulus Experience Action Tendency Function
Low energy Hunger Consumption of food Energy
Tissue damage Pain Withdrawal/rest Recovery
Sexual arousal Lust/desire Sex/intercourse Reproduction
Threat Anxiety Fight/flight Escape from
threat
Descendants/having Tenderness Protection/reproachment Survival
children
- Action tendency: escaping from the threat so we can protect ourselves.
Theoretical background
- There are a lot of theories about emotions.
Evolutionary theory
James-Lange theory
Cannon-Bard theory
Schachter-Singer theory
Cognitive appraisal theory
- The Schachter-Singer theory and the cognitive appraisal theory are the most recent ones.
- We will focus mainly on the cognitive appraisal theory.
, Schachter-Singer theory
- Also the two-factor theory of emotions.
- Schachter-Singer theory/two-factor theory of emotions: a stimulus causes a physical
arousal (e.g., a bear), we then cognitively label the physical response and associate it with
an emotion, we then feel the emotion.
- E.g.: I’m alone in the night and I see a strange man walking towards you. My heart is
racing and I’m trembling. My rapid heartrate and trembling are caused by anxiety about
what he’ll do – thus I’m scared.
- The process begins with a stimulus (e.g., a strange man), which is followed by a
physiological arousal (e.g., heart racing), then you add a cognitive label (e.g., I’m scared).
Cognitive appraisal theory
- This theory came later than the Schachter-Singer theory.
- Difference: it’s not so much about labelling the physiological arousal.
- Cognitive appraisal theory: a stimulus appears, then thought, labelling the stimulus and
immediate experience of physiological response, then fight, flee, or flight.
- E.g.: You encounter a bear, this leads to the label of fear, this leads to the emotional
experience and the physical reactions, which then provoke your fight/flight/freeze
reaction.
- It is important that when working with patients, you often explain to them (they come to
you for emotions) that how you think and behave has an influence on the emotions.
- Therefore, the appraisal of a stimulus and the behaviour that the emotion provokes are
important.
- We often think that the cognitive appraisal is something we do quite rational, but this is
not true.
- Behaviour is often build up on this cognitive appraisal.
Fight or flight response = fight, freeze, or flight
- Especially in victims of sexual assault, they are so anxious that they’re numbed,
paralyzed.
- They cannot move.
- This is a physiological response to a situation that is very threatening to you.
Cognitive appraisal
- According to the cognitive appraisal theory, emotion requires “interpretation” of
stimulus – this is often (very) fast and sometimes preconscious.
- We have a primary, almost preconscious, and secondary appraisal.
- Your thoughts are important in experiencing anxiety.
- E.g.: Imagine you’re lying in bed and a vase falls in the room next to you. A vase is a
neutral stimulus, it’s your thoughts that make you scared (e.g., the vase is falling because
there’s a burglar).
- It’s the cognitive interpretation (e.g., thinking it could be a burglar) that makes you
scared for a neutral (say in this case) stimulus.
- If you have a different cognitive appraisal (e.g., it was actually my kitten), it will
provoke a different situation and emotion.
- The interpretation of a stimulus is quite important.
- This appraisal takes place in a split second – it doesn’t come up to the conscious level
most of the times.
- It’s the primary appraisal of a situation.
- This is despite being positive or negative.
- It’s kind of the shortcut of the cerebellum.
Neuroticism (trait anxiety/negative affectivity)
- Anxiety is an emotion and is not an easy concept.
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