Merging Our Understanding of Anxiety and Exposure: Using Inhibitory Learning to Target Anxiety Sensitivity in Exposure Therapy

2021 ◽  
pp. 014544552110050
Author(s):  
Chandra L. Bautista ◽  
Ellen J. Teng
Keyword(s):  
Anxiety Disorders ◽  
Anxiety Sensitivity ◽  
Alternative Explanation ◽  
Standard Treatment ◽  
Three Dimensions ◽  
Fear Of Anxiety ◽  
Learning Research ◽  
Inhibitory Learning ◽  
Number Of Individuals ◽  
Basic Learning

Exposure-based therapies are the gold standard treatment for anxiety disorders, and recent advancements in basic and clinical research point to the need to update the implementation of exposure. Recent research has highlighted the importance of transdiagnostic factors such as anxiety sensitivity (AS), or fear of anxiety-related sensations. Elevated AS is common among all anxiety disorders and contains three dimensions, or expectancies, that can be used to guide treatment. Recently, treatments directly targeting AS have shown potential in reducing symptoms of anxiety. In addition, inhibitory learning theory (ILT) provides an alternative explanation of exposure processes based on basic learning research. ILT extends the current framework by accounting for renewal of fear, which is important given the substantial number of individuals who experience a return of symptoms following treatment. The current paper will provide an overview of ILT and discuss several ILT techniques that can be used to target AS. These two converging bodies of research hold strong potential for optimizing treatment for anxiety.

scholarly journals Anxiety Sensitivity Factor Structure Among Brazilian Patients with Anxiety Disorders

2008 ◽  
Vol 31 (3) ◽  
pp. 246-255 ◽  
Author(s):  
Maria Rachel Pessanha Gimenes Escocard ◽  
Ana Carolina Monnerat Fioravanti-Bastos ◽  
J. Landeira-Fernandez
Keyword(s):  
Anxiety Disorders ◽  
Factor Structure ◽  
Anxiety Sensitivity ◽  
Sensitivity Factor

How does anxiety sensitivity vary across the anxiety disorders?

1992 ◽  
Vol 6 (3) ◽  
pp. 249-259 ◽  
Author(s):  
Steven Taylor ◽  
William J. Koch ◽  
Richard J. McNally
Keyword(s):  
Anxiety Disorders ◽  
Anxiety Sensitivity

Why Do People Get Better With Exposure Therapy?

2019 ◽  
pp. 19-32
Author(s):  
Carolyn Black Becker ◽  
Nicholas R. Farrell ◽  
Glenn Waller
Keyword(s):  
Eating Disorders ◽  
Anxiety Disorders ◽  
Therapeutic Intervention ◽  
Exposure Therapy ◽  
Therapeutic Benefit ◽  
Evidence Based ◽  
Systematic Desensitization ◽  
Evidence Based Treatments ◽  
Inhibitory Learning

This chapter outlines a theoretically based rationale for using exposure consistently in the treatment of individuals with eating disorders. Due to the substantial overlap between eating disorders and anxiety disorders (both in symptom content and in comorbidity between the conditions), exposure therapy is a sound choice for therapeutic intervention. Indeed, the most evidence-based treatments for eating disorders contain a number of exposure-based strategies that drive much of the therapeutic benefit. The chapter discusses habituation, systematic desensitization, and inhibitory learning and differentiates exposure therapy from systematic desensitization. Using a case study to consider how exposure therapists can help patients learn to tolerate their anxiety by leaning into it rather than engaging in safety behaviors, this chapter lays the foundation for the application of exposure therapy to patients with eating disorders.

scholarly journals Moderators of Change in Social Anxiety during CBT in a Transdiagnostic, Naturalistic Treatment-Seeking Sample

2016 ◽  
Vol 7 (4) ◽  
pp. 655-670 ◽  
Author(s):  
Anu Asnaani ◽  
Antonia N. Kaczkurkin ◽  
Hallie Tannahill ◽  
Hayley Fitzgerald
Keyword(s):  
Social Anxiety ◽  
Anxiety Disorders ◽  
Anxiety Sensitivity ◽  
Behavioral Therapy ◽  
Model Potential ◽  
Treatment Seeking ◽  
Fee For Service ◽  
Moderation Effect ◽  
Time Lagged ◽  
Moderate Change

Background There are a number of hypothesized underlying factors that, while present across a range of anxiety and fear-based disorders, are proposed to be specifically influential in the maintenance of social anxiety (SA) symptoms. Aims This study examined the influence of specific constructs (i.e., anxiety sensitivity, ruminative thinking, and depressive symptoms) on reduction of SA symptoms during a course of cognitive behavioral therapy (CBT). To better model potential causal relationships between observed moderators and social anxiety, time-lagged analyses between SA and significant moderators were also explored. Methods Participants (N = 107) were patients seeking treatment in a fee-for-service clinic specializing in CBT for anxiety disorders, OCD and PTSD. Participants were repeatedly assessed for a variety of symptoms and potential moderators throughout treatment. Results Even though anxiety sensitivity regarding social concerns, rumination, reflection, and depression showed significant within-and between-person relationships with SA symptoms, only rumination was found to uniquely moderate change in SA symptoms over the course of treatment. Specifically, those with higher average levels of ruminative thinking tended to improve greater on SA symptoms than those with lower levels throughout treatment. Further, this observed moderation effect was not found to significantly influence OCD, generalized anxiety, or PTSD symptoms. Finally, a bi-directional relationship was found between rumination and SA with rumination predicting subsequent changes in SA and vice versa. Conclusions High levels of ruminative thinking do not appear to be an impediment to improvement in SA symptoms in a naturalistic, treatment-seeking sample of individuals with anxiety disorders.

The dispersion of a neutral allele considered as a branching process

1976 ◽  
Vol 13 (2) ◽  
pp. 208-218 ◽  
Author(s):  
Kenny S. Crump ◽  
John H. Gillespie
Keyword(s):  
Branching Process ◽  
Spatial Dispersion ◽  
Branching Processes ◽  
Three Dimensions ◽  
Mutant Population ◽  
Multitype Branching Processes ◽  
Number Of Individuals

The spatial dispersion of a neutral allele is described using the theory of multitype branching processes in which the types represent colonies between which individuals can migrate. Each mutant individual averages less than one offspring, so the mutant population faces certain extinction. Expressions are given for the first two moments of the total number of individuals to visit specified colonies in one, two and three dimensions. Data from Drosophila populations are used to show the improbability of the same neutral allele occurring at widely separated localities.

scholarly journals Generalization of Conditioned Contextual Anxiety and the Modulatory Effects of Anxiety Sensitivity

2020 ◽  
Vol 17 (3) ◽  
pp. 1239-1252
Author(s):  
Marta Andreatta ◽  
Dorothea Neueder ◽  
Katharina Herzog ◽  
Hannah Genheimer ◽  
Miriam A. Schiele ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Risk Factor ◽  
Anxiety Disorders ◽  
Unconditioned Stimulus ◽  
Anxiety Sensitivity ◽  
Physiological Responses ◽  
Context Conditioning ◽  
Virtual Office ◽  
Generalization Gradients ◽  
Development Of Anxiety

Abstract Anxiety patients overgeneralize fear responses, possibly because they cannot distinguish between cues never been associated with a threat (i.e., safe) and threat-associated cues. However, as contexts and not cues are discussed as the relevant triggers for prolonged anxiety responses characterizing many anxiety disorders, we speculated that it is rather overgeneralization of contextual anxiety, which constitutes a risk factor for anxiety disorders. To this end, we investigated generalization of conditioned contextual anxiety and explored modulatory effects of anxiety sensitivity, a risk factor for anxiety disorders. Fifty-five participants underwent context conditioning in a virtual reality paradigm. On Day 1 (acquisition), participants received unpredictable mildly painful electric stimuli (unconditioned stimulus, US) in one virtual office (anxiety context, CTX+), but never in a second office (safety context, CTX−). Successful acquisition of conditioned anxiety was indicated by aversive ratings and defensive physiological responses (i.e., SCR) to CTX+ vs CTX−. On Day 2 (generalization), participants re-visited both the anxiety and the safety contexts plus three generalization contexts (G-CTX), which were gradually dissimilar to CTX+ (from 75 to 25%). Generalization of conditioned anxiety was evident for ratings, but less clear for physiological responses. The observed dissociation between generalization of verbal and physiological responses suggests that these responses depend on two distinct context representations, likely elemental and contextual representations. Importantly, anxiety sensitivity was positively correlated with the generalization of reported contextual anxiety. Thus, this study demonstrates generalization gradients for conditioned contextual anxiety and that anxiety sensitivity facilitates such generalization processes suggesting the importance of generalization of contextual anxiety for the development of anxiety disorders.

Examining the Role of Anxiety Sensitivity in Sleep Dysfunction Across Anxiety Disorders

2016 ◽  
Vol 15 (3) ◽  
pp. 216-227 ◽  
Author(s):  
Amanda W. Baker ◽  
Aparna Keshaviah ◽  
Elizabeth M. Goetter ◽  
Eric Bui ◽  
Michaela Swee ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Anxiety Sensitivity ◽  
Sleep Dysfunction
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