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What are vulnerability factors and how are they related to anxiety…
What are vulnerability factors and how are they related to anxiety disorders?
Predisposition Model (Diathesis-stress)
Investigated behavioural inhibition (BI)
(predisposition for neuroticism)
Stressor = 'Hassle stress'
Anxious & depressive symptoms measured:
Shyness
Cautiousness
Withdrawal
Introversion
Hypothesis:
#
Does higher BI = higher stress & anxiety?
Does higher BI = more depressive symptoms?
Does BI change the anxiety symptoms according to the model?
Results:
Higher BI + more hassle predicts more anxiety
More hassle predicted more depressive symptoms
Higher BI causes more stress symptoms
Higher BI didn't predict more depressive symptoms
Higher BI causes more anxiety symptoms
Limitations
More difficult to diagnose children
Measured through self-reports
Tested factors vary (hassle isn't stable through life)
Pathoplasticity model
Anxiety sensitivity (AS) is a vulnerability factor
AS is the predisposition --> causes panic disorder
The extent someone thinks anxiety is harmful
Worries come from possible harmful consequences of anxiety
Subscales of AS
Social fears
Isolation + everyone can see anxiety
Cognitive fears
continuous negative thoughts
Physical fears
trembling + increased HR
Hypothesis:
#
AS has significant relationship with panic
AS affects development of anxiety disorders
Results:
High AS and panic disorder highly related
AS related to depression (especially cognitive fears)
#
Consistent with pathoplasticity model
Variability in AS linked to variability in:
symptoms
use of medication
comorbidities
Limitations
Doesn't predict outcome of CBT based on level of AS
Interpersonal Circumplex model
4/8 subtypes have significant interaction with personality:
Exploitable
Non-assertive
Intrusive
Cold
Interaction between the two determines interpersonality position
#
Also influences symptoms
2 dimensions of the model:
Dominance/agency
Love
Results:
Subtypes can be distinguished reliably
Independence of subtypes and disorders
Scar Model
Hypothesis:
#
More stress + panic will increase anxiety sensitivity (AS)
Results:
Mental & physical fears increased AS (not social fears)
People with lower average distress are more affected by panic attacks
Lower baseline distress --> increase amount of panic
this increased stress level --> increasing AS
Panic attacks, before & during training, increased AS
Study of soldiers during & after training
Inquiry of their history of panic attacks
Limitations :
Unique sample, results not generalizable
Only self-report assessment of history
No affect on social fears could be due to environment
Stress from disorder affects the vulnerability factor
Clinical Implications
Pathoplasticity model
Adjust treatment based on the subtype
Behavioural Activation/Approach System (BAS)
Responds to rewards & incentives (lowered for anxiety(
(Dopamine)
Scar model
Mainly for prevention & relapse prevention
Breaking cycle --> also treating AS helps decrease effect on panic
Behavioural Inhibition System (BIS)
Responds to fear & punishment (heightened for anxiety)
(Serotonin)
Predisposition model
Awareness of stressors --> mainly for prevention