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Generalized Anxiety Disorder: Cognitive and Behavioral Components

 

generalized anxiety disorderGeneralized anxiety disorder: What are some of the cognitive and behavioral aspects?

Generalized anxiety disorder includes several conceptualizations that are important to mental health clinicians, including cognitive and behavioral models. The cognitive models for understanding generalized anxiety disorder include an understanding of information processing and the appraisal of situations and circumstances within an individual's environment which precipitate feelings of stress. Behavioral models focus more on the conditioned effect of anxiety and how it becomes a part of your daily life through behavioral repetition. In this series of articles we will also consider some of the combined models of cognitive and behavioral components associated with generalized anxiety disorder.

 

Generalized anxiety disorder: What are some of the behavioral components?

A better understanding of the behavioral components of generalized anxiety disorder have come about through a multitude of researchers over the past half a century or so. A researcher by the name of Wolpe concluded in 1958 that you could pair a neutral stimulus with a fear arousing stimulus resulting in the acquisition of a specific fear. This process of "learning fear” could also be "unlearned" by pairing this same stimuli with another response that is incompatible with the fear such as relaxation or assertiveness. Other researchers have found fear reduction models to including extinction, increased self-efficacy, and situational exposure. Clinicians treating individuals with generalized anxiety disorder frequently draw upon a number of behavioral techniques depending on an individual’s particular needs.

One of the more popular behavioral treatment models and techniques used in dealing with generalized anxiety disorder includes the construction of fear hierarchies and planned exposure to situations the individual fears, as well as feared images, or ideas and then pairing relaxation with exposure to these feared experiences. Specific interventions such as thought stopping, modeling, vicarious reinforcement, assertiveness training and self efficacy training have been used by various therapists in the treatment of this very difficult anxiety disorder.

Generalized anxiety disorder: What are some of the cognitive aspects?

There are also cognitive models for understanding generalized anxiety disorder. In 1985, Aaron Beck concluded that anxiety responses have had adaptive value in the evolution of the human species. Other clinicians and researchers have concluded that such anxiety responses as "fight or flight" are actually protective responses when faced with various types of threats to an individual’s survival. Active defensive measures such as hypervigilance and oversensitivity to sound as well as increased heart rate, may actually help the individual in their effort at “fight or flight". However, the cognitive aspects which include the thoughts associated with these adaptive responses may actually become generalized to other aspects of an individual's life that do not warrant the feared response, or to the degree of severity to which they respond. For example, an individual’s thoughts or fear of losing his or her job may provoke the same fear response as if an individual were faced with a physical threat to their survival. According to the cognitive model "the importance of various distortions in information processing in anxiety-specifically hypervigilance, false alarms, loss of objectivity, generalization of danger to other stimuli, catastrophizing, excessive focus on negative outcomes, no tolerance for uncertainty and ‘lack of habituation’" (Leahy and Holland, 2000) may occur.

Cognitive psychologists who work with generalized anxiety disorder patients believe that while some individuals may be more biologically predisposed toward the perception of threat and the resulting arousal of anxiety than others, once the anxiety initially is aroused it, then becomes maintained or sometimes even increased by the specific cognitive distortions.

References:

Leahy, R. and Holland, S. (2000). Treatment Plans and Interventions for Depression and Anxiety Disorders. The Guilford Press: New York

Web page and additional information by Paul Susic MA Licensed Psychologist Ph.D. Candidate

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