PSY 215 – NOVA Online Study Guide: Exam 2 Chapter 4 What is the difference between fear and anxiety? Fear- response to a serious threat to one’s well-being Anxiety- response to a vague sense of threat or danger Generalized Anxiety Disorder  Know key features/diagnostic checklist -for 6 months or more the person experiences disproportionate, uncontrollable, and ongoing anxiety and worry about multiple matters -symptoms include edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems -causes significant distress or impairment  Societal and Multicultural Factors -GAD usually develops in those with ongoing social conditions or in those with forms of societal stress (poverty, race, ethnicity)  The Humanistic Perspective- GAD arises when people stop looking at themselves honestly /acceptingly -Carl Rogers' explanation- Lack of unconditional positive regard in childhood leads to conditions of worth (i.e., harsh selfstandards), Threatening self-judgments break through and cause anxiety, setting the stage for GAD to develop -Client-centered approach used to show unconditional positive regard for clients and to empathize with them -Despite optimistic case reports, controlled studies have failed to offer strong support -Only limited support for Rogers' explanation of GAD and other forms of abnormal behavior  The Cognitive Perspective -Problematic behaviors and dysfunctional thinking often cause psychological disorders -Treatment focus involves the nature of behavior and thoughts - Early approaches (Maladaptive or basic irrational assumptions (Ellis), Silent assumptions (Beck)) -Newer= Metacognitive theory (Wells) and meta-worries, Intolerance of uncertainty theory (Koerner and colleagues), Avoidance theory (Borkovec)) -Therapy can include changing maladaptive assumptions and breaking down worrying (mindfulness, acceptance and commitment therapy)  The Biological Perspective -GAD is caused chiefly by biological factors- Fear reactions are tied to brain circuits  Supported by family pedigree studies and brain researchers  Challenged by competing explanation of shared environment o GAD results from a hyperactive fear circuit  GABA: Important neurotransmitter in this circuit o Involves several brain structures  Prefrontal cortex  Anterior cingulate cortex  Insula  Amygdala o Bed nucleus of stria terminals (BNST) may play large or larger role than other structures Phobias  Specific Phobias – know key features o Marked, persistent, and disproportionate fear of a particular object or situation; usually lasting at least 6 months o Exposure to the object produces immediate fear o Avoidance of the feared situation o Significant distress or impairment  Agoraphobia o Pronounced, disproportionate, or repeated fear about being in at least two delineated situations o Avoidance of the agoraphobic situations o Symptoms usually continue for at least 6 months 1 o Significant distress or impairment; often fluctuates o Treatment=exposure therapy (support groups, home-based self-help programs)  What causes phobias? -Cognitive-behavioral perspective o How are fears learned?  Classical conditioning  US: Entrapment  UR: Fear  CS: Running water  CR: Fear  Modeling  Observation  Imitation o What does research indicate?  Early laboratory studies of classical conditioning of fear: Watson and Rayner (Little Albert)  Modeling: Bandura and Rosenthal o Fear reactions not always conditioned  McGabe and Gamble and colleagues  Disorder not ordinarily acquired through classical conditioning or modeling -Behavioral-evolutionary perspective o Some specific phobias are much more common than others o Species-specific biological predisposition to develop certain fears: preparedness o Explains why some phobias (snakes, spiders) are more common than others (meat, houses) o Treatments for specific phobias  Actual contact with the feared object or situation is key to greater success in all forms of exposure treatment  Systematic desensitization (Wolpe) o Covert and in vivo desensitization, including virtual reality  Flooding  Modeling Social Anxiety Disorder – key features, causes and treatments Checklist: • Pronounced, disproportionate, and repeated anxiety about social situation(s) in which the individual could be exposed to scrutiny by others; typically lasting 6 months or more • Fear of being negatively evaluated by or offensive to others • Exposure to the social situation almost always produces anxiety • Avoidance of feared situations • Significant distress or impairment Treatments for social anxiety disorder • Overwhelming social fears: Addressed behaviorally with exposure • Cognitive-behavioral therapy: Exposure therapy and systematic therapy discussions • Medications: Benzodiazepine or antidepressant drugs • Lack of social skills • Social skills and assertiveness training Panic Disorder  Know the key features/diagnostic criteria Checklist: • Unforeseen panic attacks occur repeatedly • One or more of the attacks precede either of the following symptoms: • At least a month of continual concern about having additional attacks • At least a month of dysfunctional behavior changes associated with the attacks (e.g., avoiding new experiences) Features: • Periodic, short bouts of panic that occur suddenly, reach a peak within minutes, and gradually pass • Feature at least four of the following symptoms of panic: • Heart palpitations • Tingling in the hands or feet • Shortness of breath • Sweating • Hot and cold flashes • Trembling • Chest pains • Choking sensations • Faintness • Dizziness • Feeling of unreality (APA, 2013)