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Anxiety is a multidimensional experience (systems)

  • Emotional symptoms
  • Cognitive symptoms
  • Physiological symptoms
  • Behavioral symptoms


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Classical Conditioning

- Watson & Raynor (1920): “little Albert”

- extension by Mowrer (1960) conditioning is mediated by motivations such as

desire to reduce fear, accounts for avoidance behavior

Shortcomings (Rachman et al. 1991 for review)

- all stimuli can become feared stimuli (the equipotenitality premise)

- many people experience aversive conditioning but do not develop a phobia

- traumatic etiology is not reported by all phobic individuals

- limited success of studies that have endeavored to condition stable fears in human in an experimental setting

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Vicarious conditioning

  • learning by observing reactions of others Bandura & Rosenthal, 1966 Bobo Doll experiment.
  • Verbal information (e.g. media, Rachmann, 1991)
  • witnessing someone else have a fearful reaction or upsetting social experience
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Seligman (1971) phobic stimuli are biologically threatening humans are biologically prepared to develop fears of stimuli that threaten personal safety

four features of prepared phobias:

- acquired through one-trial conditioning

- non-cognitive

- phobic object involves threat to humankind, result of natural selection

- not easily extinguished

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Multiple pathways

Rachman (1991) several alternative pathways

(direct conditioning, model learning, verbal acquisition)



- Bandura (1966): participants had to watch person receiving electro-shock,

resulted in increase in physiological response by just viewing apparatus

- Cook and Mineka (1989): monkeys watched videotapes of monkeys behaving

fearfully to either fear relevant (snakes, crocodiles) fear irrelevant stimuli (flowers,

rabbits, development of fear of the fear-relevant stimuli, replicated by several studies

- acquisition via verbal information in the epidemics of koro in Singapore and Thailand.

The epidemics were thought to have been caused by verbal transmission via media

(Rachman 1991)

- increases in skin conductance in response to target stimulus after information that stimulus

would be followed by a shock (Cook & Harris 1937)

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Non-associative theory

Phobias may be acquired without previous direct or indirect

associative learning (Menzies and Clarke 1995)


- (Menzies & Clarke, 1993): Interviewing parents of children with water phobia

only 1 percent out of 50 could recall a classical conditioning episode, and 58%

of the parents reported that the fear had always been present

- retrospective reports from phobic patients lack of direct conditioning in height

phobia, spider phobia (Jones and Menzies, 1995)

- separation anxiety in human infants and mammals has been found to be unrelated

to past aversive experiences of separatin (Bowlby 1973)

conclusion: learning experiences (verbal, direct, associative) are not necessary for

the development of phobias, normal childhood concerns become phobias in some

individuals by two means:

- learning to successfully avoid an object (parents used avoidant coping styles, verbal


- dishabituation of childhood fears during stressful periods (Menzies & Clarke, 1993)

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Biological factors

- genetic component: higher risk among first-degree relatives (Fyer et al. 1990)

- mixed results regarding genetic vs. environmental contribution (Bolton et al. 2006)

- genetic contribution varies to subtype – more specific genetic contribution for

blood phobia (Fyer et al. 1990)

- neuropathophysiology remains poorly understood (Fyer et al. 1998)

mixed results about amygdala hyperactivation as in other anxiety disorders

(Gossens et al. 2007)

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Cognitive factors

cognitions play a role in maintainance (Rachmann 1991)

- cognitions increase arousal and likelihood of escape or avoidance (Last 1987)

empirical support:

- exposition to feared situation lead to triggering of negative self-statements, which

heighten physiological activity (Last and Blanchard 1982)

- most patients report at least one unrealistic belief about the harm that could befall

them when confronted with object or situation (Thorbe and Salkovskis 1995)

- attentional bias toward phobia related threats (Burgees 1982, Mogg et al.2004)

- Stroop paradigm: phobic individuals are slower to name the color of threat related

words (Constantine et al, 2001)