L3: Models of Anxiety

Question 1

what is repetitive negative thinking defined as in GAD vs Depression?

Answer 1

GAD: worry: chain of thoughts, negatively affect-laden and relatively uncontrollable; represents an attempt to engage in mental problem solving on an issue whose outcome is uncertain but contains the possibility of one or more negative outcomes
Depression: Rumination: repetitive and passive thinking about one’s symptoms of depression and the possible causes and consequences of these symptoms

Question 2

what is the difference between fear and anxiety?

Answer 2

fear: stress response from immediate danger
anxiety: stress response just from your thoughts

Question 3

during periods of worry do we experience more “thought” or “image”?

Answer 3

more thought aka worry is verbal! while during relaxation theres more image

Question 4

what does the meta cogntive model say?

Answer 4

ppl worry bcs they have the beliefs about worry (prob solving) but then they worry about worrying (negative meta beliefs) and get stuck in a loop

Question 5

does worry decrease arousal?

Answer 5

no! just avoids contrast between 2 mental states

Question 6

what are the key maintaining factors of anxiety?

Answer 6

• positive beliefs about worry (dysfunctional problem focus, ineffective coping)
• dislike of intense emotions
• cognitive/emotional avoidance (absence of emotional processing)

Question 7

what role does attention play in social anxiety?

Answer 7

• sa individuals become more anxious when you instruct them to focus attention on themselves
• have strong negative attentional biases for social threat
• bias away from positive social info (& general diminished processing of positive social info in the persistence of SAD)
• difficulties regulating attention

Question 8

what factors play a role in social anxiety

Answer 8

• information processing biases
• self focused attention
• emotion & emotion regulation
• safety behaviours
• post event processing

Question 9

what are some interrelations among information processing biases in SAD?

Answer 9

• inhibitory effect of negative self imagry on positive autobio memories
• negative intepretation bias induction produced more negative self related images
• negative self imagery of individuals w SAD interacts w other cognitive processes to maintain excessive anxiety

Question 10

define self focused attention?

Answer 10

an awareness of self referent internally generated info. content of the awareness can include bodily/physical states, thoughts, emotions, beliefs, attitues, memoreis….

Question 11

how does self focused attention play a role in SAD?

Answer 11

• excessive self focus during anxiety provoking social situations, which stops them from attending to external info, thus preventing the opportunity for disconfirmation of negative expections
• instead SAD individuals use internal clues to evaluate their social performance
• may be an attempt to suppress, control, or alter uncomfortable internal experiences

Question 12

how can self focused attention issues be addressed in clients w SAD?

Answer 12

task concentration training: partiipcants taught to reduce self focused attention by focusing on their task and environment
accepatance & minfulness based approahces

Question 13

define emotion regulation

Answer 13

the processes by which an individual influences which emotions he or she experiences, when the emotions are experienced, and how the emotions are experienced and expressed

Question 14

what role do emotions & emotion regulation play in SAD?

Answer 14

• reduced emotionality
• emotional hyperreactivity
• emotion regulation deficits
• poor understanding of emotions

Question 15

how can emotional issues by addressed in clients w SAD?

Answer 15

cognitive reappraisal in CBT to build one sense of self efficacy

Question 16

what informating processing biases play a role in social anxiety?

Answer 16

• attention bias
• interpretation bias
• implicit associations
• imagery & visual memories
• interrelations among info processing biases

Question 17

what are safety behaviours used in SAD? define & examples

Answer 17

broad range of behaviours that the person believes are necessary to completet an interaction without harm
ex: low self disclosure, avoidance of eye contact, attempts to conceal anxiety, over rehearsal
-> lead to more anxiety & negativity

Question 18

define post event processing?

Answer 18

a thought process in which the individual reviews his or her own actions and the reactions of the other individual(s) following a social event or in anticipation of a similar upcoming event

Question 19

what are the subgroups of safety beahviours?

Answer 19

avoidance (like avoiding eye contact) were associated w negative perceptions by observers
impression management (like over rehearsing): not associated w negative perceptions by observers

Question 20

how does interpretation bias play a role in social anxiety?

Answer 20

• lack the nonthreat/positive bias typical of nonanxious individuals
• endorse more negative interpretations of positive events
• negative interpretation of positive events was correlated w perfectionism and severity of interpersonal fears
• quicker detection of high intensity anger and fear under conditions of moderate threat
• in no threat condition, slower detection of low intensity sadness & anger (suggesting the relationship between SA and facial emotion detection may vary according to both state anxiety and intensity of the facial expression)
• more likely to misinterpret disgust faces as exhibiting contempt (while nonanxious ppl interpreted them as happy) but this effect dissapeared when given more time

Question 21

how can interpretation bias issues in SAD patients be addressed?

Answer 21

CBT by teaching clients to generate alternative intepretations for ambigious social situations

Question 22

how can attentional bias issues be addressed in patients with SAD?

Answer 22

attention retraining augmentation of CBT & mindfulness based interventions

Question 23

what role do implicit associations play in SAD?

Answer 23

ppl w SAD
- less likely to have implicit associations between self & positive attributes following speech threat

Question 24

what role do imagery & visual memories play in patients w SAD?

Answer 24

• more likely to imagine recent social interactions as if looking at the self from an observers pov
• imagery in SAD is reported to occur spontaneously during anxiety provoking situations, be negatively tinged, & remain relatively stable over time and across situations
• negative images elicit more negative emotional & cognitive consequences in high SAD group
• negativey self imagery elicited higher self reported anxiety, more observable anxious behaviours, and exaggerated negative self appraisal of performance
• retrieved higher, more unbalanced ratio of negative to positive images and memories

Question 25

how can imagery and visual memories issues be addressed in client w SAD?

Answer 25

• imagery rescripting: begins w period of cognitive restructing focusing on the negative belief reflected in the spontaneous and recurring image reported by the client. rescripting itself involves repeated evocation of the memory, insertion of corrective info & compassionate stance toward the self in imagery
• video feedback: intended to correct faulty self perception by providing contrasting evidence of the adequacy of ones performance

Question 26

what are the two routes? how do they process threats?

Answer 26

rule based:
- controlled
- conscious
- intentional
- inefficient
- slow
- flexible
- logical
threat: interpretation as threat -> validation of threat -> behavioural decision
associative
- automatic
- can be unconscious
- non intentional
- efficient
- fast
- rigid
- associative
threat: activation of threat related associations

Question 27

What are the 5 main models of GAD?

Answer 27

• I Avoidance model of worry and GAD
• C Intolerance of Uncertainty Model
• C Metacognitive Model
• E Emotion Dysregulation Model
• E Acceptance-based Model of GAD
  -> all emphasize avoidance of internal affective experiences like thoughts, emotions, and beliefs
  -> cluster into 3 types: Cognitive, Emotional/Experiential, and an Integrated model

Question 28

What are some good treatments for GAD?

Answer 28

• psychotropic medications
• cognitive behaviour therapy (CBT)

Question 29

what does the avoidance model of anxiety posit?

Answer 29

• worry inhibits vivid mental imagery and associated somatic and emotional activation, hindering emotional processing necessary for habituation and extinction
• worry serves as an ineffective attempt to problem solve and avoid aversive somatic and emotional experiences related to fear.
• Worry is negatively reinforced by the removal of aversive mental images and positive beliefs about worry.

Question 30

what are some maintaining factors of GAD according to the avoidance model?

Answer 30

• poor interpersonal skills
• insecure attachment styles

Question 31

what are some treatment strategies based on the AMW avoidance model of GAD?

Answer 31

CBT techniques like self monitoring, relaxation techniques, cognitive restructuring, and worry outcome monitoring
& interpersonal & emotional processing therapy

Question 32

how does the intolerance of uncertainty model explain GAD?

Answer 32

• individuals with GAD experience chronic worry in response to uncertain or ambiguous situations and believe that worry helps them cope with or prevent feared events.
• Negative problem orientation and cognitive avoidance contribute to maintaining worry, exacerbating anxiety.

Question 33

what treatment does the intolerance of uncertainty model recommend for GAD?

Answer 33

increasing tolerance for uncertainty & acceptance of ambiguity
includes self monitoring, education about IU, evaluating worry beliefs, improving problem orienation, and processing core fears through exposure

Question 34

what does the metacognitive model of GAD by Wells suggest?

Answer 34

that individuals experience 2 types of worry:
- Type 1 worry: Initially triggered by anxiety-provoking situations, leading to positive beliefs about worry.
- Type 2 worry (meta-worry): Arises from negative beliefs about worry and fear that worry is uncontrollable or dangerous. this type distinguishes GAD clients from regular ppl

• Engagement in ineffective coping strategies to control worry reinforces beliefs that worry is uncontrollable and dangerous.

Question 35

what treatment does the emotion dysregulation model of GAD suggest?

Answer 35

• Emotion Regulation Therapy for GAD (ERT) under dev
• Combines elements of CBT with techniques to improve emotion regulation & address emotional avoidance.
• Treatment components include relaxation exercises, belief reframing, emotional education, emotional skills training, and experiential exposure exercises.

Question 35

what does the emotion dysregulation model of GAD posit?

Answer 35

• Consists of 4 central components: emotional hyperarousal, poor understanding of emotions, negative attitudes about emotions, and maladaptive emotion regulation strategies.
  Each component has several tenets:
• Individuals with GAD experience more intense emotions, particularly negative ones.
• They struggle to understand their emotions and hold negative attitudes about them.
• They exhibit maladaptive emotion regulation strategies, such as excessive worry or emotional suppression.

Question 35

what treatment does metacognitive model of GAD suggest?

Answer 35

metacognitive therapy, which aims to alter negative beliefs about worry & introduce alternative coping strategies
include case formulation, socialization, discussion about the uncontrollability and danger of worry, and modifying positive worry beliefs.
- emphasizes altering beliefs about worry rather than directly reducing the amount of worry.

Question 35

what are the four components of the acceptance based model of GAD?

Answer 35

internal experiences, problematic relationship w internal experiences, experiental avoidance, and behavioural restriction

Question 36

what are the limits of the acceptance based model of GAD?

Answer 36

• still in early stages
• lack of tests on the temporal relationship between constructs
• limited research on fusion of internal experiences

Question 37

what is some treatment based on the acceptance based model of GAD?

Answer 37

Comprised of psychoeducation, mindfulness and acceptance exercises, and behavior change.
Aims to promote valued actions rather than reducing distressing internal experiences.

Question 38

what are 2 methodological limitations in studies examining GAD models? how can this be improved?

Answer 38

1. Heavy reliance on self-report measures, which may involve different processes for short-term and long-term recall of emotions.
2. Individuals with GAD respond differently on physiological and self-report measures, highlighting the need for more objective measures.
   use:
   collateral and historical data, observational measures, physiological monitoring, and extended naturalistic monitoring.

Question 39

what do cognitive models focus on? vs emotional models? vs AMW?

Answer 39

cognitive: focus on cognitions as the primary pathogenic mechanism, impacting treatment techniques aimed at evaluating and modifying core beliefs about worry and problem-solving abilities.
emotional: focus on emotions and behaviors as key components, with treatments emphasizing emotion education, exposure exercises, mindfulness/acceptance, and values-based actions.
AMW: integrates cognitive and emotional/behavioral elements, incorporating cognitive restructuring, self-control desensitization, relaxation skills, and interpersonal/emotional processing into treatment.