Psychology on Fear and Anxiety

Anxiety Disorders

• Anxiety disorders are characterized by excessive fear and anxiety, along with related behavioral disturbances.
• Fear is an emotional response to a real or perceived immediate threat, often involving physiological changes like increased heart rate or sweating, and thoughts of danger or escape.
• Anxiety is the anticipation of future threat, often associated with increased muscle tension and vigilance, and cautious or avoidant behaviors.

Anxiety: Background

• Anxiety disorders include phobias, fears, and post-traumatic stress disorder (PTSD).
• Biological factors, behavioral and social learning factors, and treatment approaches are considered in understanding anxiety's origins and potential cures.

Mentimeter

• A teaching tool used to gather student perspectives about anxiety through polls and discussion questions.
• Students are prompted to share personal experiences, perceived causes of anxiety, and instances in which anxiety influenced their decision-making.
• Students also asked to describe what anxiety felt like for them.

Anxiety

• Anxiety is an unpleasant emotional state characterized by fearfulness, unwanted, and distressing physical symptoms and thoughts.

Anxiety Disorders (DSM-V)

• Anxiety disorders share traits of excessive fear and anxiety, influencing behaviors.
• Fear is a response to perceived imminent threat, marked by physiological responses that trigger "fight-or-flight” reactions and mental imagery of potential danger.
• Anxiety involves anticipating future threats, evidenced by tension, vigilance, and avoidance.

Behavioural Theory

• Avoidance conditioning suggests that some stimuli can evoke fears, even without exposure.
• Learned fear responses can develop through pairing a neutral stimulus with an inherently fearful one in situations or across one-off events.
• Reinforcement reinforces avoidance behaviors, creating a cycle where the learning isn’t corrected.

Classical Conditioning

• Classical conditioning involves associating a stimulus with a response.
• Pavlov's dogs demonstrated this phenomenon.
• Learning to associate fear with a previously neutral stimulus is explained through classical conditioning; an example is Little Albert.

Further Concepts for Classical Conditioning

• Generalization is when a response to one stimulus is extended to similar stimuli.
• Extinction is the diminishing conditioned response when the conditioned stimulus is presented without the unconditioned stimulus.
• Spontaneous recovery is the reappearance of an extinguished conditioned response after a period of rest.

Operant Conditioning

• Reinforcement influences subsequent behaviors.
• Operant conditioning involves positive and negative reinforcement.
• Context profoundly impacts associative learning, where responses in one environmental setting are altered in a different context.

Associative Learning in Clinical Psychology

• Associative learning plays a role in individual beliefs about the world, and has essential influences across a number of psychiatric diagnoses.
• Anxiety-related disorders like anxiety, depression, and addiction are impacted by how this form of learning is experienced and reflected.
• Learning, then, has implications across everyday feelings, assumptions about the self and the world.

Main Anxiety Disorders in the DSM-V

• Specific phobias, generalized anxiety disorder, social anxiety disorder, panic disorder, and agoraphobia are included.

Specific Phobias

• Specific phobias present a disproportionate fear of a specific object, animal, situation, or environment.
• Instances like a fear of spiders, snakes, heights, flying, blood, enclosed spaces, or clowns represent a range of specific phobias.

Fears and Phobias

• Phobias are diagnosed when a fear response is disproportionate to the object's actual threat.
• Recognition that fear is significantly intrusive to daily routines is a clinical characteristic of a phobia.
• Prevalence of phobias varies by gender, with women more frequently experiencing phobias compared to men.

Phobia DSM-V Diagnostic Criteria

• Specific criteria, like marked fear or anxiety, avoidance or enduring fear, and persistence, are central for a diagnosis.
• Fear is out of proportion to the actual danger presented by the targeted stimuli.

Causes of Phobias

• Experiences of fear can be conditioned through personal experiences, or observed in others.
• Modeling, media portrayal, or a direct experience of fear in a situation or with specific objects can influence the development of a phobia.
• Evolutionary factors play a role, as an innate tendency to be wary of dangers is common.

Treatment of Simple Phobia

• Systematic desensitization is a common treatment to reduce avoidance and fear.
• Steps in treatment might begin with identifying the least worrisome stimuli and systematically increasing exposure to progressively more aversive stimuli while gradually overcoming anxiety using coping mechanisms.
• Alternative interventions might involve coping skills training, breathing exercises, and learning to identify maladaptive thought patterns, such as catastrophic thinking.

Exposure Therapy

• Steps involving assessment, starting with least feared stimuli, exposure sessions, remaining in stressful situations, repetition, and gradual progression are central.

Crane Fly Phobia: Case LM

• A specific example case study of a patient with a phobia involving crane flies.
• The case's course demonstrates the hierarchy’s implementation.
• Treatment and outcomes are presented in the case study.

Referral Letter

• A summary of a case, presenting significant information about the patient, their symptoms, and how they’ve dealt with the incident and subsequent challenges.

Case Illustration: CB Assessment

• Case details, including the patient’s pre-injury history leading to a traumatic brain injury.
• Issues associated with the injury, such as cognitive function and memory recall, detailed in the case.

CB: Self-Report of Symptoms

• Report of symptoms, including difficulties with routine or recalling, or experiences impacting self-confidence and safety.

CB: Scores on Mood Measures

• Data charts describing results from mood assessments (anxiety, depression, and obsessive-compulsive disorder [OCD]) at different points in the process

CB: "Underlying" Emotional Issues

• Attention and memory challenges are presented, along with difficulties with controlling emotions and maintaining a positive self-image.
• The case highlights that the issues stemmed from re-asserting a sense of control, and these routines supported the patient's coping mechanisms.

CB: Interventions

• Interventions involving individual and group therapies to improve cognitive function, anxiety, and memory are given.
• Training using tools such as palm-top organizers and voice organizers aimed at improving future memory are described.
• Exposure therapy, involving incremental exposures to anxiety-provoking situations, is also discussed, alongside breathing and relaxation training.
• Social activities, community mobility, and physical activities are recommended as important components for the patient's recovery.

CB: Working through a Hierarchy

• Steps outlining a hierarchy-based approach to addressing anxiety-provoking situations in the patient’s life.
• Specific examples, like making calls to friends, leaving the house, or social interactions demonstrate the incremental steps.

CB: Anxiety Ratings for Getting Around

• Anxiety ratings for different types of transportation (buses, town, city) are plotted.
• Ratings presented across two points in time to illustrate progress made.

CB: Anxiety Ratings for Socialising

• Anxiety ratings in social situations (calls, pub, clubbing), at two time points, present the patient's gradual improvements.

CB: Scores on Mood Measures, Assessment, and Discharge

• Mood assessment scores, across points of anxiety, depression, and OCD.
• The graph shows improvement over time.

CB Outcome

• Patient's reflections on their experiences and progress in recovering emotional well-being after the traumatic brain injury.

Generalized Anxiety Disorder (GAD) DSM-V Criteria

• Criteria for the diagnosis, including excessive worrying, difficulty controlling worry, and associated symptoms such as restlessness, fatigue, difficulty concentrating, irritability, and sleep disturbance.

Generalized Anxiety Disorder (GAD) DSM-V Criteria cont'd

• Criteria are presented to determine if the anxiety is separate from other mental health issues.
• The criteria suggest that the anxiety is not directly attributable to other medical conditions or substances.

Functional Consequences of Generalized Anxiety Disorder

• Negative consequences of worry-related disorders, such as difficulty with tasks, maintaining concentration, and experiencing stress, affect functioning and daily routines.
• The financial and emotional costs of worry and related disorders can be substantial for individuals, families, and healthcare systems.
• Statistics show the magnitude of this impact in terms of the number of disability days caused by this form of anxiety.

Some Beliefs related to GAD

• Catastrophic thinking, intolerance of uncertainty, over-estimation of threats, perfectionism, need for control, safety behaviors, excessive responsibility, and negative beliefs about worry are considered potential contributors to GAD.

The Cause is Not Well Understood

• Evidence on the causes of GAD suggests potential genetic or familial predispositions.
• Life stressors, trauma, and chronic stress are presented as contributing factors in anxiety disorders.
• Social learning and observations can have influence, suggesting a complex interaction of biological, environmental, and social factors.

Social Anxiety Disorder: DSM-V Diagnostic Criteria

• Marked fear or anxiety in social situations, involving potential scrutiny or evaluation by others.
• Negative self-evaluations and concerns over the potential social consequences drive the fear related behaviours.
• Fear of social situations is present, with avoidance, and an overall impact on daily functioning.

Functional Consequences of Social Anxiety Disorder

• Negative consequences associated with social anxiety include impacts on employment, socioeconomic status, and interpersonal relationships.
• Symptoms can limit participation in social activities, hindering personal and professional success.
• Seeking treatment is often delayed due to the distress associated with social anxiety disorder.

Other Anxiety Disorders and Their Management

• Some commonly seen anxiety disorders are presented; including health anxiety and panic disorder.
• Management strategies, including medication, are presented alongside cognitive behavioral therapy (CBT).

Summary

• Brain has an "approach or avoid" system, influenced by biological wiring for fear responses.
• Anxiety can be learned based on stress occurrences.
• Effective treatment involves addressing the learned response and its associated behaviours.

PTSD

• PTSD is characterized by direct or witnessed experience of threats to self or others involving trauma.
• Symptoms, including flashbacks, nightmares, hyperarousal, hypervigilance, avoidance, numb affect, amnesia, and dissociation, are described.
• The aetiology (origin) is deemed known, unlike other anxiety disorders, representing a crucial distinction.

Explore the key differences between fear and anxiety in this quiz. Test your understanding of physiological responses, cognitive processes, and the role of genetics in phobias. Perfect for psychology students looking to deepen their knowledge of these emotional states.