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Abnormal Behavior Lecture Outline Spring Semester ‘24

FEAR AND ANXIETY RESPONSE PATTERNS

  • Fear: A reaction that occurs in response to a perceived imminent threat, typically characterized by a strong emotional response. Fear can trigger a range of physiological effects, including increased heart rate, rapid breathing, and heightened alertness, often referred to as the "fight or flight" response.

  • Anxiety: A more complex emotional response, anxiety represents the ongoing anticipation of future threats. It is characterized by feelings of apprehension and worry, and can manifest in physical symptoms such as muscle tension, restlessness, and fatigue.

OVERVIEW OF THE ANXIETY DISORDERS AND THEIR COMMONALITIES

  • General Characteristics: Anxiety disorders share common features, including a high level of neuroticism, which refers to emotional instability and sensitivity to stress. Individuals with these disorders often experience irrational fears and persistent worry that can impede daily functioning.

  • Effective Treatments:

    • Graduated Exposure: This is widely regarded as the most effective treatment for anxiety, involving a structured approach where individuals gradually face their fears over time, building up their tolerance towards these feared cues or situations.

    • Cognitive Restructuring: This technique offers added benefits for specific disorders, aiding individuals in redefining and reframing their anxious thoughts, thus diminishing the intensity of their anxiety.

SPECIFIC PHOBIAS

  1. Definition & Statistics:

    • Specific phobias represent a significant aspect of anxiety disorders, with a prevalence rate around 12% in the general population. They are notably more common in women, with statistics indicating that 90-95% of individuals with animal phobias are female. The onset of specific phobias typically occurs during childhood or early adolescence, often setting the stage for long-term anxiety issues if not addressed.

  2. Psychological Causal Factors:

    • Psychoanalytic Viewpoint: From this perspective, phobias may function as defensive mechanisms against anxiety stemming from repressed impulses and unresolved conflicts.

    • Learned Behavior: Phobias can develop through classical conditioning, where a fear response is conditioned to neutral stimuli through traumatic experiences.

      • Vicarious Conditioning: Observing a fearful reaction in others can similarly instigate phobias in individuals who witness such reactions.

    • Individual Differences: Certain personal experiences, such as a history of trauma or a family history of anxiety disorders, can heighten vulnerability to specific phobias.

    • Evolutionary Preparedness: Humans have evolutionary tendencies to associate specific objects, such as snakes or spiders, with danger, which can lead to phobias over generations.

  3. Biological Causal Factors:

    • Genetic variables play a crucial role in influencing how individuals condition fear responses, with research indicating that inhibited temperament in toddlers can predict multiple specific phobia developments later in life.

  4. Treatments:

    • Exposure Therapy: This form of therapy involves controlled exposure to feared stimuli, allowing individuals to confront and overcome their fears over time.

    • Participant Modeling: In therapy, modeling behaviors of interacting with the phobic stimulus can help in reducing anxiety.

    • Medication: While medications can help manage anxiety symptoms, they are generally ineffective alone. Some medications can impede the effectiveness of therapeutic interventions, making a combined approach more beneficial.

SOCIAL ANXIETY DISORDER

  1. Definition & Characteristics: Social phobia, or social anxiety disorder, involves an intense fear of social interactions and being judged or scrutinized by others. Those affected often avoid social situations to prevent anxiety.

  2. Causal Factors:

    • Learned Behavior: Social fears can develop and persist due to environmental factors and learned behaviors from past negative experiences.

    • Evolutionary Context: This anxiety is thought to stem from evolutionary instincts where social hierarchies and acceptance are critical for survival and reproduction.

    • Perceptions of Unpredictability: Feelings of being out of control in social settings can exacerbate anxiety symptoms.

    • Cognitive Bias: Negative interpretations of social cues significantly correlate with anxiety in social contexts, emphasizing distorted thought patterns as key contributors to social anxiety (Beck et al. 1985).

  3. Biological Factors:

    • Behavioral inhibition in childhood is a robust predictor for developing social phobia later on in life, often characterized by shyness and reluctance to engage in new experiences. Genetics are also implicated, accounting for approximately 30% of the variance in liability to social anxiety disorder.

  4. Treatments:

    • Cognitive and Behavioral Therapies: These therapies are centered around graduated exposure techniques and cognitive restructuring, effectively addressing and modifying irrational fears associated with social interactions.

    • Medications: Antidepressants, particularly SSRIs and MAOIs, have shown efficacy in reducing symptoms associated with social anxiety. Additionally, behavioral therapies tend to result in lower relapse rates compared to medications alone, highlighting the importance of a combined treatment approach.

GENERALIZED ANXIETY DISORDER (GAD)

  1. Characteristics:

    • GAD involves prolonged and excessive worry about a multitude of aspects of daily life, such as health, finances, and interpersonal relationships. This worry can affect concentration and lead to fatigue and irritability.

  2. Causal Factors:

    • Psychoanalytic View: The psychoanalytic perspective posits that unresolved internal conflicts can cause free-floating anxiety, as individuals struggle to manage conflicting thoughts and emotions.

    • Perceptions of Uncontrollability: A strong sense of helplessness and unpredictability in life circumstances can exacerbate anxiety symptoms.

    • Negative Consequences of Worry: Chronic worrying not only fails to resolve the underlying issues but also perpetuates anxiety and interferes with day-to-day functioning, leading to a cycle of increased distress.

  3. Biological Factors:

    • There is evidence for a genetic predisposition to GAD, with studies suggesting approximately 30% heritability. Neurotransmitter and hormonal irregularities, particularly involving serotonin and norepinephrine, contribute significantly to the etiology of anxiety disorders.

  4. Treatments:

    • Cognitive-Behavioral Therapy (CBT): This therapeutic approach effectively combines behavioral techniques, such as exposure, with cognitive restructuring, resulting in significant symptom reduction for individuals suffering from GAD.

    • Medications: Pharmacological treatment primarily includes the use of benzodiazepines for immediate symptom relief and antidepressants for long-term management of anxiety.

PANIC DISORDER

  1. Characteristics:

    • Panic disorder is characterized by recurrent panic attacks, unexpected periods of intense fear or discomfort, often accompanied by a fear of experiencing future attacks, which may result in agoraphobia and avoidance of specific situations.

  2. Causal Factors:

    • Cognitive Theory: This theory suggests that a heightened awareness of bodily sensations and misinterpretation of those sensations can lead to the experience of panic.

    • Comprehensive Learning Theory: This theory posits that anxiety sensitivity, or the fear of anxiety sensations themselves, can contribute to the development of panic symptoms.

  3. Biological Factors:

    • Genetic factors contribute to panic disorder with a heritability range of 30-34%. Research highlights the role of brain structures, particularly the amygdala, which is crucial in processing fear responses and maintaining anxiety.

  4. Treatments:

    • Behavioral and Cognitive-Behavioral Treatments: These treatments focus extensively on exposure therapies, including interoceptive exposure, which involves triggering panic-like sensations in a controlled environment to diminish fear responses.

    • Medications: Anxiolytics provide quick relief for acute episodes, while antidepressants are typically used for longer-term management of panic disorder symptoms.

CULTURAL PERSPECTIVES

  1. Prevalence Variations: Anxiety disorders display cultural variability in prevalence and presentation, with differing social stressors impacting anxiety levels across populations.

  2. Cultural Expressions:

    • Ataque de nervios: This condition, often seen in Caribbean cultures, encompasses episodes of intense emotional distress, often linked to familial or social stressors.

    • Koro: Noted in certain Asian cultures, this is characterized by a delusional belief that one’s genitals are retracting, reflecting culturally specific anxieties around masculinity and reproductive concerns.

  3. Global Impact: Anxiety disorders remain the most common mental health disorders worldwide. Reports indicate variances in symptom expression based on cultural context, which affect diagnosis and treatment approaches.