Anxiety factors essay PDF

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What factors contribute to vulnerability to anxiety disorders? Introduction- Anxiety disorders= a group of disorders- includes generalized anxiety disorder, specific phobia, social anxiety disorder, and trauma and stressor related disorders. Although the various disorders differ in what exactly the stressor is which results in symptoms, they result in similar feelings- autonomic features- feelings of fear or panic, can result in a panic attack with perception of heart rate going through the roof, shaking, overwhelmed. Excessive avoidance- e.g. Use of safety behaviours, symptoms and avoidance causes clinically significant distress and impairment. Unlike fear, which is an emotional response to real or perceived imminent threat, anxiety is anticipation of future threat (i.e. Not immediate, might be imagined an imagined possibility). Higher rates in women- 2:1 predominance. Disorder waxes and wanes over a lifetime (typical of most psych disorders- symptoms build to peak and then decline, can reoccur-particularly without treatment ). Similar to major depression and chronic diseases, such as diabetes, in functional impairment and decreased quality of life. Factors which might contribute to vulnerability in anxiety disorder can be separated into 3 distinct categories: 1. Abnormalities in fear learning- enhanced acquisition, reduced extinction learning 2. Abnormalities in the neurocircuitry- hyper-activation amygdala, hypo-activation PFC 3. Abnormalities in information processing- certain cognitive styles constitute vulnerability factors- attention biased towards processing threat-related information, negative interpretation. *This essay will focus on the cognitive factors which might contribute to vulnerability to anxiety disorders*

1. Prospective studies and direct manipulations of cognitive variables as evidence for cognitive factors underlying disorder Most studies are correlational (performance of participants with anxiety) or with participants in remission from the disorder, so cannot be sure of causal contribution of abnormalities in information processing. Investigate causal role using: A.Prospective approach- if cognitive characteristics play a causal role in mediation of emotional dysfunction, then measures of this variable should predict later disorder Evidence in favour +ve Dunmore et al. (2001) PTSD- Clark and Erhler’s (2000) model predicts that negative interpretation of symptoms is responsible for the sense of continuing threat, such as the inference that the trauma could recur at any time, and that a return to normality is impossible. Consistent with this account, reported negative interpretations of such symptoms within four months of an assault predicted PTSD severity at nine months, even after controlling for perceived assault. Evaluation +veHalligan et al. (2003)- adds reliability to previous finding-self-reported perceptual processing at the time of the assault, disorganization of trauma memories, and negative appraisals of intrusions were all predictive of later PTSD severity, again after controlling for initial symptom levels -Interestingly, many of these same cognitive measures also predicted later comorbid depression, once more highlighting the cognitive overlap between anxiety and depression. -ve=Self-report- susceptible to social-desirability bias/ experimenter demands -ve many studies fail to report depression levels of participants- this might be influencing results… However, a meta-analysis of 172 studies by Bar-Haim et al. (2007) showed that whether or not participants with depression were included in the anxious group did not modulate the attentional bias effect

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B.Directly manipulate cognitive variables and observe impact on emotional experience: Evidence in favour +veGrey and Mathews (2000)- induce interpretative bias- non-anxious participants- extended practise. Homographs were presented as “clues” to be used in resolving a subsequent word fragment (e.g., SINK followed by d-own or b-sin). Groups assigned to practice sessions employing fragments that consistently match negative (or benign) meanings tend to perceive the corresponding emotional meanings of new homographs . Suggests that repeatedly accessing meanings of a particular emotional valence increases the availability of other emotionally congruent meanings, thereby inducing an interpretive bias resembling that seen in emotional disorders. Evaluation -veSalemink (2007)- explicit tasks to examine change in interpretations are open to strategic influences. Recent results showed that participants are fully aware of the valence of their interpretation task. Need training not influenced by knowledge of task… such as dot probe task +veMacLeod et al. (2002) Dot probe task-. Pairs of words, one with a threatening meaning and the other neutral, were presented prior to the to-be-detected probe. For one group, probes always appeared in the location of threat words, with the intention of inducing an attentional bias toward threat. For another group, the probes always appeared in the location of neutral words, with the intention of inducing the reverse bias. In a subsequent non-contingent test phase, the former group was faster to detect targets in the location of new threatening words, and vice versa for the latter group, suggesting that differential bias had indeed been induced. Most critically, in a subsequent stress task involving difficult anagrams, the former group reported greater increases in negative mood than did the latter. By implication, learning to attend to threat cues served to influence how participants processed the later stress task, leading to increased emotional reactivity.

2. Treatments designed to treat cognitive factors

A. Altering attentional bias-Mathews & MacLeod (2002)showed that multiple practice sessions designed to train attentional avoidance of threat in high-trait-anxious students decreased their anxiety scores in response to an impending examination. -ve participants were 64 psychology undergraduates- not patients -ve does this effect generalise to the real world as a treatment? Cristea et al. (2015) meta-analysis of 38 randomised control trials of cognitive bias modification interventions. Found a mean effect size of .37. HOWEVER- effect size became non-significant when outliers were excluded, and they were mostly non-significant for patient samples. Might be due to publication bias. Quality of randomised control trials was also suboptimal. SO- although it might have small effects on mental health problems, it is also possible this is driven by extreme outliers… There is a difference between statistically significant results and clinically meaningful to patients (dampening of effects that feels to them like a change) B. Altering interpretation biases- e.g. Cognitive behavioural therapy to challenge negative interpretations, also to identify and challenge avoidance behaviours +ve Olutanji et al. (2013)- meta-analysis of 269 meta-analytic studies- strong evidence base for CBT reducing symptoms of anxiety

Essay plan (however, additional research needed to examine the efficacy of CBT for randomised-controlled studies) Conclusion -Strong evidence to suggest that cognitive factors have a role in the vulnerability to anxiety disorders. Bar-Haim et al. (2007)- meta-analysis of attentional bias in anxiety disorders- considering diverse phenotypes of different anxiety disorders, the finding of a similar size bias is striking. Suggests bias might be related to a core anxiety component that is common to all anxiety disorders -Future research= into children with anxiety disorders - Implication- change in cognitive processing bias may be the common pathway underlying reductions in vulnerability to emotional disorders, whether due to medication, cognitive training, or conventional psychological treatment....