essay plan for anxiety

Question 1

critically discuss the aetiology of childhood anxiety disorders

Answer 1

biological

• heritability estimates fairly high and shown by twin and family studies
• link to short allele of 5HTT gene as may increase reactivity to negative stimuli, which may have links to BI if absense of protective factors
• paired with dysregulation of noradrenergic making more observable signs of stress which may induce feelings of anxiousness

family environment

• relation to biological as findings that insecure attachment relates to higher physiological reactions to stress, reflected in higher levels having anxiety
• modelling behaviours of parental expressed anxiety and also when express fear towards something, especially susceptible when have BI
• overprotective and anxious parenting which may be cyclical and linked to BI as increase this when showing signs of BI which makes it worse, or could induce then maintain it, may reflect different levels in asian sample

personal information processing problems

• behavioural inhibition whereby respond fearfully or in a restrained manner towards any novel stimuli
• largely linked to insecure attachment, may be that either causes the other (insecure due to unable to connect or BI due to no suport from insecure), but maintain each other and increases likelihood of anxiety as no resilience factors (self or family)
• more linked to social anxiety disorders
• may lead to anxiety due to increased vulnerability in reaction to negative life events or indeed bring them upon themselves, such as bullying example

Question 2

paragraph 1?

Answer 2

several biological factors which may increase vulnerability towards a diagnosis of anxiety, should a triggering situation occur

• anxiety more prevalent when relatives also have it and heritability higher for MZ twins than others (inidcating genetic component and not just environment) (Ramchandani et al, 2009), indeed, it is suggested that genetics account for 30-40% of variance in contribution to anxiety (Norrholm et al, 2010). higher heritability estimates in girls (Eley, 2001)
• not a specific gene isolated but the short alleles of the 5HTT gene (serotonin transporter) has been linked to an increased responsiveness to events (either positive or negative), indeed it has been found to predict behavioural inhibition (another contributing factor) in childrne whose families have self-reported lack of social support (Fox et al, 2005).
• vulnerability may lie in the dysregulation of the noradrenergic system, resulting in it being more sensitive and preparing the body for stress such as blushing and sweating, which may serve to make the person anxious or increase already anxious feelings (Rector et al, 2016)

Question 3

paragraph 2?

Answer 3

family causes

• insecure attachment found to increase physiological signs of stress when thinking about a stressful situation, implicating a higher susceptibility to anxiety as over-reacting to certain stimuli (characteristic of anxiety) (Diamond et al, 2006)., evidenced by the positive correlation of insecure attachment and anxiety symptoms, which may also be due to the lack of support from family implicated in having an insecure attachment (Colonesie et al, 2011)
• modelling behaviours, 6-18 month oldsmay learn to avoid certain stimuli if their mothers express fearful behaviour towards it (Rapee, 2012) and more specifically, a fear of strangers in socially anxious mothers can be transmitted and the degree may be mediated through existing BI the child may have (de Rosnay et al, 2006)
• overprotection may reduce development of autonomy and includes anxious rearing - this is cyclical as an anxious child may promote anxious parenting which increases anxious behaviour of child (Lebowitz et al, 2012). indeed found in a study comparing asian and european samples that asian parenting was characterised as overcontrolling, which may be linked to the increased level of anxiety symptoms found in the asian sample (Mousavi et al, 2016)

Question 4

paragraph 3?

Answer 4

information processing problems - linked to underlying biological reactivity as short allele 5HTT gene linked to BI

• behavioural inhibition is temperamental pattern of responding by fearfulness or restrain when facing unfamiliar things
• not all those with BI develop anxiety so suggests protective and risk factors, such as parental anxiety: interaction between BI in children and expressed parental anxiety in predicting avoidant behaviour in children (Aktar et al, 2013)
• found that BI was a specific predictive factor for development of anxiety diagnosis over a 3 year period, but also interacted with other factors such as insecure attachment (Muris et al, 2011), supported through interaction of BI with insecure attachment leading to highest rates of anxiety disorders in a sample of children (Shamir-Essakow et al, 2005), compared to these factors on their own. an additional factor found to increase prediction alongside these 2 is overprotective/axious rearing (van Brakel et al, 2006)
• suggestion that fathers expressing anxiety may have a more important role in shaping their child’s BI, perhaps due to the stereotype that fathers should be emotionally strong (Bogels et al, 2007)
• suggested that BI more linked to social anxiety than generalised, as those with BI were 4x more likely to suffer from social phobia than those without (Hayward et al, 1998)
• found in 3 year longitudinal study a high correlation between BI and social phobia (made higher when paired with insecure attachment) and a significantly smaller one for other anxiety disorders, although suggested that longitudinal effect not properly established as only 3 years long (Muris et al, 2011)
• finally, when exhibited BI in childhood, 2-4x more likely to have anxiety disorder in middle childhood, continuing into adolescence (Fox et al, 2005), which may be linked to sensitivity in reaction to negative life events or drawing negative life events to themselves due to how their acting such as being more likely to be bullied or rejected by their peers, which may be due to the anxious behaviours they exhibit in accordance with BI (Grills et al, 2002)