what are symptoms of anxiety (DSM-5)
psychological arousal (fearful anticipation/poor concentration/irritability)
autonomic arousal (gastrointestinal ie dry mouth, respiratory, cardiovascular, genitourinary ie frequent micturition, muscle tension, sleep disturbance)
types of anxiety disorders
selective mutism
separation anxiety
specific phobia
social anxiety disorder
agoraphobia
panic disorder
generalised anxiety disorder
what is mowrers 2 factor theory in relation to fear acquisition and maintenance
a behavioural model
phobias caused by maladaptive classical conditioning
BUT maintained by operant conditioning
phobic avoidance -> fear reduction -> reinforced avoidance
what are cognitive biases in anxiety according to grupe et al 2013
increased threat attention, deficient safety learning, behavioural and cognitive avoidance, heightened reactivity to threat uncertainty, disrupted expected value calculation ALL LEADS TO increased threat expectancies
what did mogg and bradley 2018 do
neutral face to threatening face
can measure attentional biases
eyetracking with pairs of faces
those anxious looked at the threatening face more quickly and stronger emotional intensity lead to larger bias
what did aue et al 2013 find about avoidance behaviours
spider phobics were more likely to look at the spider early then avoid it
eye tracking
what did tonsing et al 2022 find in relation to avoidance behaviours
no evidence that gaze anxiety predicts ppts avoiding eye contact
real life interactions face-to-face
what did horley et al 2004 find in relation to cognitive bias
individuals with social phobia have very different attentional biases
shown a face with diff emotions
they are hyper scanning (look at more points on the face) and hypervigilant to a face
eye tracking
what are the key structures in the circuitry underlying emotion activation and regulation
prefrontal mechanisms have involved to downregulate amygdala hyperactivity
we vary enormously in how well we can regulate
-orbital prefrontal cortex and the ventromedial prefrontal cortex
-dorsolateral prefrontal cortex
-amygdala
-anterior cingulate cortex
if these areas/systems are dysregulated alongside the connection between them
what did nitschke et al 2009 find
patients with generalised anxiety disorder have more amgdala hyperactivity
what did mansson et al 2016 find to do with clinical anxiety
amygdala structure (volume) correlates with distress (anticipatory anxiety)?
ppts with social anxiety who had higher anxiety before giving a speech and had a larger amygdala size
what did bishop et al 2004 find about anxiety and prefrontal cortex size
increased anxiety is associated with reduced recruitment of fronto-cortical mechanisms that regulate amygdala activity
ie those with higher anxiety have lower prefrontal cortex activity
fMRI
what did kim & whalen 2009 find to do with the ambygdala-PFP pathway and anxiety
increased anxiety associated with reduced structural integrity in the amygdala-PFC pathway
ie connection between prefrontal cortex and amygdala is less strong in ppts with anxiety
what is the research domain criteria initiative
national institute of mental health
sets aside biases and prejudice about which level is the right level to assess anxiety with
it accounts for all the levels
we should celebrate all levels of analysis ie genes/molecules/circuits/physiology/behaviour/self-reports
what are recommended psychological treatments for diff anxiety disorders
OCD = CBT/thought stopping
PANIC = CBT/anxiety management
SOCIAL PHOBIA = CBT/social skills and assertiveness training
PTSD = CBT/EMDR
GAD = CBT/anxiety management
PHOBIA = CBT
what does the cognitive behavioural model suggest about the maintenance of an anxiety disorder
fear stimulus’ threat is misinterpreted, hence anxiety, hence avoidant coping, hence absence of corrective experience
how do we evaluate CBT at any time as a treatment of anxiety
bring together all the trials and see if they can lead to
I got no clue girl
what are the effects of CBT on brain structure and brain function
CBT group experience lower plasticity in the left and right amygdala
smaller and less active amygdala
what can duloxetine do for anxiety (van Marle et al 2010)
duloxetine drug (60mg x 14 days) significantly reduces activity in extended amygdala circuitry compared to placebo
what are the neural effects of SSRI/SNRI and psychological treatments across mood and anxiety disorders (Nord et al 2021)
pharmacological treatment get straight in to amygdala changes
psychotherapy changes medial prefrontal cortices and then trickles down to amygdala changes
what is a transdiagnostic approach to anxiety
what is attentional control
a transdiagnostic process!!
filtering relevant info in a congested world
how to use attention for therapy
training attention towards mindfulness
people not mind wandering are feeling pretty positive in comparison to people who are mind wandering
is dispositional mindfulness associated with greater attention control and reduced cognitive failures?
yes?
