“Compare and contrast two psychological perspectives on mental health. Critically
evaluate each perspective and support your answer with research evidence.”
Anxiety is the persistent and excessive worry, occurring on most days for at least six
months (American Psychiatric Association, 2013). Symptoms include restlessness, fatigue,
poor concentration, irritability, muscle tension, and sleep disturbance (APA, 2013).
Therefore, this essay will focus on generalised anxiety disorders (GAD) by comparing,
contrasting, and critically evaluating the cognitive and biological approach to anxiety by
outlining neurocognitive mechanisms, functional magnetic resonance imaging (fMRI) and
selective serotonin reuptake inhibitors (SSRIs), whereas the cognitive approach will outline
information processing, generalised anxiety disorder assessment (GAD-7) and cognitive
behavioural therapy (CBT).
First, Beck and Clark (1997) argue that anxiety is due to automatic and strategic
information processing, with three key stages: (1) initial registration, (2) immediate
preparation, and (3) secondary elaboration. Initial registration involves automatic recognition,
in which information is assigned attentional priority. More attentional resources are allocated
to the negative stimuli, due to its ambiguity (Bishop, 2007; Cannistraro & Rauch, 2003),
thereby activating the threat processing – resulting in an anxious state (Beck & Clark, 1997).
Furthermore, immediate preparation involves the primal activation blocking any constructive
information processing, thereby individuals overestimate the severity of the situation, thus
leading to catastrophic thinking (Beck, 1985; Beck & Clark, 1997). Moreover, secondary
elaboration involves two aspects, which are worry and safety signals. Therefore, anxious
individuals either assess available coping mechanisms or let their worry persist (Beck, 1985;
Beck & Clark, 1997) however, selective attentional bias results in any reinterpretation of
, negative stimuli being dominated by primal activation, thus individuals will remain in an
anxious state.
Comparatively, neurocognition suggests that selective attentional bias is due to
amplified signals in the amygdala or reduced signals in the prefrontal circuitry (PFC)
(Bishop, 2007). Like initial registration, disruption in the PFC or amygdala results in changes
in the attentional and interpretative processes that maintain the bias, thus preventing
reinterpretations of the negative stimuli (Bishop, 2007). However, the amygdala response
significantly depends on the individual’s information processing of modulating attention and
anxiety levels (Bishop et al., 2004), thus there is a cognitive element. Therefore, anxiety may
be due to a combination of theories, rather than one approach alone, although the biological
approach provides an important biological context of anxiety through the amygdala.
Moreover, the GAD-7 is a 7-item self-report questionnaire, commonly used to inquire
about symptoms of anxiety, with higher GAD-7 scores indicating severe anxiety (Kroenke et
al., 2010). Findings from Miloff (2015) revealed a positive correlation between higher GAD-
7 scores and a negative bias towards negative-neutral expressions, thus supporting the
cognitive approach, in which individuals with anxiety have a selective attentional bias
towards ambiguous stimuli and interpret them negatively. This is furthered by Rutter et al.
(2019), who found that higher GAD-7 scores correlated with poorer emotional processing
across all facial expressions (happiness, fear, and anger), resulting in lower accuracy in
emotion recognition, thereby supporting both the cognitive and biological approach, as it
indicated that there is a dysfunction in social cognition or the PFC and amygdala. Therefore,
the GAD-7 is a reliable and valid instrument for assessing anxiety (Hinz et al., 2017; Kroenke
et al., 2010; Spitzer et al., 2006), with supporting evidence showing a correlation between
high GAD-7 scores and anxious individuals.
