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Summary Exam 2 Mood, Anxiety & Psychotic Disorders UvA Year 2
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Summary of Mood, Anxiety & Psychotic Disorders Exam 2
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W1.1ARTICLE BY MINEKA & ZIMBARG (2006) – A CONTEMPORARY LEARNING
THEORY PERSPECTIVE ON THE ETIOLOGY OF ANXIETY DISORDERS
Early behavioural/learning approaches: Dominant empirical perspective on anxiety disorders
from the 1920s until the 1970s – Rooted in behaviourism – Focused on observable behaviours
and the principles of stimulus-response associations
↓
Contemporary learning theory: Place greater emphasis on cognitive processes, such as
attention, memory, problem-solving, and decision-making – Explore how individuals actively
process and organise information, construct meaning and apply knowledge in various contexts
- Can account for such complexity at least as well as the other two prominent
contemporary psychological approaches to anxiety disorders (i.e. cognitive approach
and psychodynamic approach)
- Better grounded in the theories and methods of experimental psychology
- Provide more comprehensive formulations of the etiology of anxiety disorders
- Provide a more explicit analysis of factors promoting or inhibiting the
development of different anxiety disorders
Specific phobia:
- Criticism on early learning approaches: Many people with phobias do not appear to
have had any relevant history of classical conditioning
- Vicarious learning: The idea that simply observing others experiencing a
trauma or behaving fearfully could be sufficient for some phobias to develop
- Experiment: Laboratory-reared young adult rhesus monkeys who
initially were not afraid of snakes served as observers who watched
other monkeys reacting very fearfully in the presence of live and toy
snakes → Rapid acquisition of an intense phobic-like fear of snakes
that did not diminish over a three-month follow-up period
- Criticism on early learning approaches: Many individuals who do undergo traumatic
experiences do not develop phobias
- From a diathesis-stress perspective, there seems to be a modest genetically
based vulnerability for phobias
- Latent inhibition: Simple prior exposure to a CS before the CS and US are ever
paired together, reduces the amount of subsequent conditioning to the CS when
paired with the US (E.g.: children who have had more previous non-traumatic
encounters with a dentist are less likely to develop dental anxiety if
subsequently traumatised at the dentist’s office than are those with fewer prior
encounters when they are traumatised)
- A person’s history of control over important aspects of his or her environment
strongly affects reactions to frightening situations
- Experiment: Monkeys reared with a sense of mastery and control over
their environments later adapted more readily to frightening events and
novel anxiety-provoking situations than monkeys without a sense of
control
, - Having control over a traumatic event has a major impact on how much fear is
conditioned to CSs paired with that trauma
- Inflation effect: A person who is exposed to a more intense traumatic
experience (not paired with the CS) after conditioning of a mild fear is likely to
show an increase in fear of the CS
- Criticism on early learning approaches: Fears and phobias do not occur to any
random group of objects associated with trauma, but people are much more likely to
have phobias of snakes, heights, and enclosed spaces than of bicycles or cars
- Primates may be evolutionarily prepared to associate certain kinds of objects
(such as snakes, spiders, heights) with aversive events → Selective advantage
Mechanisms that may underlie social phobia:
- Social learning: The process through which individuals acquire new knowledge,
behaviours, attitudes and values through observing and interacting with others within
their social environment → Vicarious conditioning: Simply observing another being
ridiculed or humiliated or behaving in a very anxious way in some social situation
- Direct social reinforcement and verbal instruction
- Culturally transmitted display rules and norms – Another form of social learning that
is likely to exert powerful influences on the expression of social anxiety – Illustrated
by the Japanese disorder taijin kyofusho, where people fear that they will do
something to embarrass or offend others
- Preparedness theory → Asserts that social anxiety is rooted in the evolutionary
development of dominance hierarchies among humans – Individuals are predisposed
to fear social stimuli associated with dominance and intra-specific threat
- Experiment: Angry facial expressions elicited superior fear conditioning
compared to other facial expressions
- Experiment: Fear responses can be conditioned even to subliminal
presentations of angry faces
- Behavioural inhibition: A temperament trait characterised by a tendency to be
cautious, shy and restrained in unfamiliar or novel situations
- Perceptions of uncontrollability
- Experiment: Uncontrollable (but not controllable) electric shock increases
submissiveness in animals
Mechanisms that may underlie panic disorder and agoraphobia:
- Exteroceptive conditioning: When CSs impinge on the external sensory receptors
- Interoceptive conditioning: When the CSs are the body’s own internal sensations –
Fear of fear
- Female gender → In American culture it is more acceptable for women than men to
stay home and adopt a traditionally feminine role, so the person is allowed to avoid the
feared situations rather than be exposed to them, which would extinguish anxiety
- People who must leave the house to work are less likely than those who do not work
or who work from home to develop agoraphobia
- Prior learning experiences that lead to perceptions of lack of control and helplessness
, - Ehlers: People who experienced panic attacks as adults (relative to controls) were
likely to have stronger learning histories of having been encouraged to engage in sick
role behaviour when experiencing panic symptoms (but not cold symptoms)
- Chronic illnesses in households while growing up – Observing a lot of physical
suffering may contribute to the evaluation of somatic symptoms as dangerous
Mechanisms that may underlie PTSD:
- Traumas that are perceived to be uncontrollable and unpredictable are more likely to
result in PTSD
- The victim’s psychological state of resistance and fighting back versus giving up and
conceding defeat is predictive of the long-term emotional effects of the torture
- Experiment: Allowing animals to express aggression during uncontrollable
stress attenuated the effects of the stress
- Prior uncontrollable stress sensitises an organism to the harmful effects of subsequent
exposure to such trauma – As repeated exposures to trauma occur, the adverse effects
get larger rather than smaller – A history of prior trauma, especially repeated,
uncontrollable trauma, should be associated with increased risk of developing PTSD
to a recent trauma
- A prior history of control over stressful events can immunise against the harmful
effects of subsequent uncontrollable stress
- Psychological readiness prior to being tortured is associated with a decreased
likelihood of subsequently developing PTSD despite very high levels of trauma
- Greater reexperiencing is associated with a more persistent course of PTSD
- Inflation effect: A person who is exposed to a more intense traumatic experience (not
paired with the CS) after conditioning of a mild fear is likely to show an increase in
fear of the CS
- Re-evaluation effects: The process by which individuals reevaluate or reassess their
beliefs, attitudes or judgements based on new information or changing circumstances
– Mild PTSD symptoms could become full-blown PTSD when there is reason to
reevaluate the danger posed by the original trauma (E.g.: finding out weeks after an
assault that one’s assailant was in fact a convicted murderer)
- Reinstatement of fear: After a CS has extinguished, the CS can regain its ability to
elicit a CR by simply exposing the animal to the US (not paired with the CS) (E.g.: a
posttherapy trauma not linked with any of the cues associated with the original trauma
could lead to a reinstatement of the original trauma symptoms)
Mechanisms that may underlie GAD:
- Less tolerance for uncertainty
- Lack of safety signals (i.e. signs telling us when bad things are unlikely to happen)
- A history of childhood trauma
- People with extensive experience controlling important aspects of their lives may be
immunised against developing GAD
- People high on neuroticism or trait anxiety are especially susceptible to the effects of
uncontrollable and unpredictable aversive events
- Worry is reinforced by suppressing emotional and physiological responses to aversive
imagery – Such processing is necessary if extinction of anxiety is to occur
, - Worry is reinforced because the majority of things people worry about do not happen
- Attempts to control thoughts and worry paradoxically leads to increased experience of
intrusive thoughts and enhanced perception of being unable to control them
Mechanisms that may underlie OCD:
- Verbal transmission of dangerous thoughts (E.g.: ‘my mother told me that dirt and
contamination may be on doorknobs or toilet seats’)
- Parents or teachers who encourage a broad sense of responsibility and rigid rules for
duty and conduct may create a vulnerability for the development of OCD in the child
- Thought–action fusion: When people are taught the idea that thoughts, desires and
impulses are equivalent to actions
- Preparedness theory → Asserts that OCD is rooted in the evolutionary development of
dominance hierarchies among humans
ARTICLE BY LENAERT ET AL. (2014) – AVERSIVE LEARNING AND
GENERALISATION PREDICT SUBCLINICAL LEVELS OF ANXIETY: A SIX-
MONTH LONGITUDINAL STUDY
Aversive learning: The process by which an organism learns to avoid or escape from
unpleasant or aversive stimuli through conditioning→ Can be highly adaptive by motivating
defensive reactions in the face of danger, but abnormalities in aversive learning may
contribute to the development of anxiety disorders
- Impaired discrimination learning: Impaired contrast between safety and danger signals
- Generalisation: Occurs when a conditioned response is elicited by a stimulus different
from but similar to the actual CS
The study focuses on these behavioural vulnerability factors that contribute to the
development of anxiety
- The size assignment of CS+ (small circle) and CS− (large circle) varied among
participants, with the reversal for the other half
- Generalisation stimuli (GSs) comprised eight circles, with diameters increasing
- Unconditional stimuli (US) consisted of nine pictures selected from the International
Affective Picture System, categorised into three levels of aversiveness – Participants
could choose the level of aversiveness for US
- Experimental trials involved presenting a circle (CS+, CS−, or GS) followed by a US,
with the US
The findings suggest that discrimination learning and
generalisation play crucial roles in the development of
anxiety and may be potential targets for interventions
aimed at preventing or mitigating anxiety disorders
LECTURE W1.1
Diathesis-stress model: The theory that mental and
physical disorders develop from a genetic or biological
predisposition for that illness (= diathesis) combined
with stressful conditions that play a precipitating or facilitating role
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