Anxiety as a Learnt Conceptual Category: Implications for our Understanding of Anxiety Disorders Graham Davey School of Psychology, University of Sussex.

Anxiety as a Learnt Conceptual Category: Implications for our Understanding of Anxiety DisordersGraham Davey

School of Psychology, University of Sussex

Follow me on Twitter @GrahamCLDavey

Anxiety & Fear Anxiety is an emotion dedicated to the anticipation of

potential threats (A risk assessment functionality) Fear is the emotion that is a direct response to threat

(underpinned by a survival urgency) Anxiety & Fear have:

A related functionality Similar cognitive, behavioural, physiological and attentional

characteristics Similar neuropsychological underpinnings Both experienced as ‘unpleasant’ feelings

Anxiety is a socio-linguistic label that conveys meaning

The Diversity & Elusiveness of the Anxiety Emotion Anxiety usually is NOT in the list of basic emotions Anxiety has NO unique neural signature Poor consensus on a characteristic Facial Expression for

Anxiety Rash of very different historical approaches to understanding

Anxiety as an emotion

From Perkins, Inchley-Mort et al., 2012

Anxiety is… An evolved innate pattern of expressive behaviour (Darwin,

1872; Izard, 1994) An emotion with a specific locatable and evolved neural

circuitry (LeDoux, 1987; Panksepp, 1982) An emotion with specific inheritable physiological correlates

(Kagan, 1994) An emotion formed as a learnt adaptation (Watson & Rayner,

1920) An emotion acquired, regulated and maintained by a range

of cognitive processes (Mathews & MacLeod, 1998, 2005)

Pinning down the ‘Anxiety’ in Anxiety Disorders Anxiety is Transdiagnostic Anxiety is highly comorbid within and beyond anxiety

disorders Anxiety disorders exhibit wide variations in anatomical

activation and neurotransmitter action (Kim & Gorman, 2005) Behavioural manifestations of anxiety are diverse and often

unpredictable

Does Anxiety Conform with Other Basic Emotions?

How should we conceive of emotions? Emotions as functionally discrete adaptive states Emotions as psychological constructs forming learned

conceptual categories Emotions as embodied simulated experiences

Emotions as functionally discrete adaptive states Emotions reflect motivational systems with quite specific

functional properties Anxiety therefore comes with a built-in set of reactions to

threat that make evolutionary sense: Deployment of attention towards threat Threat interpretation biases Reasoning biases Systematic processing style

Emotions as psychological constructs forming learned conceptual categories “..An emotional experience is a conceptual structure stored

in memory” (Barrett et al., 2007) When a person is feeling ‘anxious’ they are automatically and

pre-consciously categorizing sensations from both their body and the world outside using their own learnt conceptual knowledge of the category “anxiety”

Emotions as embodied simulated experiences Embodiment of emotion (e.g. anxiety) provides the basis for

the physical experience of that emotion Facial expressions of emotion and accessing emotional

knowledge

How is the conceptual category of ‘anxiety’ learnt? Anxiety is initially linked to the activation of the evolved,

adaptive systems that define its functionality as an emotion to deal with anticipated threat

Repeated co-occurrences of these events within a familial and cultural context creates a conceptual category that inherits the anxiety-eliciting capacities originally restricted to biological evolved and pre-wired systems

What are the implications for understanding Anxiety Disorders if anxiety is a conceptual category?

From Anxiety Experience to Anxiety Disorders Differences in controlled, attentional resources to control the

activation of the anxiety experience Differences in granularity of the conceptual

category/categories that define anxiety Incorporating dysfunctional procedural knowledge into the

anxiety conceptual criteria (e.g. ‘I must worry when I feel anxious”)

Poor deliberative control of anxiety activation fosters alternative emotion regulation strategies (e.g. checking, worrying, safety behaviours, substance abuse)

The role of low Working Memory Capacity (WMC) WMC is the extent to which goal-relevant information is kept

active in WM despite interference of irrelevant information Individuals low on WMC experience and express more emotion

(Schmeichel et al., 2008) Excessive worry and trait anxiety associated with low WMC WMC related to ability to ignore or suppress irrelevant or

unwanted stimuli and feelings (Brewin & Beaton, 2002) Low WMC associated with more automatic responding, and

greater likelihood of drawing early, erroneous inferences Low WMC associated with inability to integrate new information

into conceptual categories (Rosen & Engle, 1997)

Low WMC and Anxiety Disorders Individuals with learning disabilities reflecting low WMC more

likely to be diagnosed with anxiety disorders (Wilson et al., 2009; Rosbrook & Whittingham, 2010)

Stressful and demanding life circumstances are associated with weak cognitive control (Wessel, Huntjens & Verwoerd, 2010) and the onset of anxiety disorders

Personality traits that involve close scrutiny of information (e.g. perfectionism) will make the individual vulnerable to less deliberative control

Differences in granularity of the conceptual category/categories that define anxiety The broader the conceptual category the more frequently the

individual will experience anxiety Less engrained categorization will also lead to a reduced

range of specific emotions and confusing of emotions (e.g. anxiety/depression, anxiety/disgust, etc.)

Relying on a small number of defining criteria will give rise to an “all-or-nothing” pattern of emotional responding (Suvak et al., 2011)

Poor deliberative control of anxiety activation fosters alternative emotion regulation strategies Pathological Worrying (GAD) Compulsive Checking or Washing (OCD) Avoidance Behaviour (Specific Phobias) Safety Behaviours (Panic Disorder) Self Medication (Substance Abuse)

Implications for Anxiety-Based Interventions CT and top-down emotion regulation Mindfulness and improving WMC (Jha et al., 2007) Controlling anxious embodiment as a means of controlling

how emotional knowledge is accessed and experienced Strategies for improving WMC