LINKAGES Anxiety Disorders and Learning

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Anxiety Disorders
A predisposition to develop anxiety disorders may also stem from abnormalities in
brain structure (Szeszko et al., 2005) or in the brain’s neurotransmitter systems, which
are discussed in the chapter on biology and behavior. Excessive activity of norepinephrine in certain parts of the brain has been linked with panic disorder, and problems
involving serotonin have been associated with obsessive-compulsive disorder. There is
also evidence that anxiety-generating nerve impulses may run unchecked when the neurotransmitter GABA is prevented from exerting its normal inhibitory influence in certain brain pathways (Friedman, Clark, & Gershon, 1992; Zorumski & Isenberg, 1991).
Psychological Factors Biological predispositions combine with environmental
stressors and psychological factors—especially cognitive processes and learning—to
bring about most anxiety disorders (Mineka & Zinbarg, 2006; Schmidt et al., 2000;
Stein, Chavira, & Jang, 2001). To see the effects of environmental stressors, one need
only look at the dramatic rise in cases of posttraumatic stress disorder following natural disasters or terrorist attacks (Galea, Ahern, et al., 2002; Galea, Resnick, et al., 2002;
Hoven et al., 2005). The impact of learning can be seen, for example, in families in
which parents don’t socialize much, tend to be suspicious of others, and exaggerate life’s
everyday dangers. These parents might unwittingly promote social anxiety in their
children—especially in those born with a tendency toward shyness—by influencing
them to interpret social situations as threatening. Abuse or other traumatic childhood
experiences also increase the risk of developing an anxiety disorder, particularly panic
disorder (Safren et al., 2002).
Learned ways of thinking play their part, too. Many people suffering from anxiety
disorders exaggerate dangers in their environment, thereby creating an unrealistic
expectation that bad things are going to happen (Wenzel et al., 2006; Wilson et al.,
2006). In addition, they tend to underestimate their own capacity for dealing with
threatening events, thus triggering anxiety and desperation when feared events do occur
(Beck & Emery, 1985). Consider the development of a panic attack. Unexplained symptoms of physical arousal may set the stage for a panic attack, but it is the person’s sensitivity to and cognitive interpretation of those symptoms that can determine whether
or not the attack actually develops (Lim & Kim, 2005; Schmidt, Lerew, & Jackson, 1999).
In the chapter on health, stress, and coping we describe a study in which patients with
panic disorder breathed air rich in carbon dioxide. Some were told that they could control the amount of carbon dioxide they were inhaling by turning a dial on a control
panel. Others were told they could not control it. In fact, the dial had no effect for
either group, but the patients who believed they had control were far less likely to have
a full-blown panic attack (Rapee et al., 1992; Sanderson, Rapee, & Barlow, 1989). In
another study, patients with panic disorder who inhaled carbon dioxide in the presence
of a person they associated with safety were significantly less fearful than patients whose
“safe person” was not present (Carter et al., 1995). Results like these suggest that cognitive factors play an important role in panic disorder.
LINKAGES
Can we learn to become
“abnormal”? (a link to
Learning)
M
LINKAGES
oney troubles, illness, final exams,
unhappy relationships, and other
Anxiety Disorders
problems often create upsetting
thoughts. And upsetting thoughts create
and Learning
worry and anxiety, especially for people who
are under stress or feel incapable of dealing
with their problems. As these thoughts become more persistent, anxiety increases. If
doing something such as cleaning the kitchen temporarily relieves the anxiety, that
action may be strengthened through the process of negative reinforcement (see the
learning chapter). But cleaning can’t eliminate the obsessive thoughts, so when they
return, the cleaning may begin again. Eventually, cleaning or other actions may become
compulsive, endlessly repeated rituals that keep the person trapped in a vicious circle