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Generalized Anxiety Disorder: Cognitive and Behavioral Components
 Generalized
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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