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Psych 130 Week 5

by: Jennifer Fu

Psych 130 Week 5 Psych 130

Jennifer Fu

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Lecture 6-8 and Section 3-4
Clinical Psychology
Sonia Bishop
Class Notes
clinical, Psychology, anxiety, phobia
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This 7 page Class Notes was uploaded by Jennifer Fu on Monday September 26, 2016. The Class Notes belongs to Psych 130 at University of California Berkeley taught by Sonia Bishop in Fall 2016. Since its upload, it has received 5 views. For similar materials see Clinical Psychology in Psychology at University of California Berkeley.


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Date Created: 09/26/16
LECTURE NOTES Lecture 6 Cognitive Biases in Anxiety - May result from amygdala hyper-responsivity and prefrontal hypo-responsivity Threat-related attentional bias - Evolutionary, it is adaptive to have rapid detection of cues signaling danger Threat-related interpretative bias - In the case of ambiguous cues, priority needs to be given to potential threat-related meanings because the cost of a miss is much greater than a false alarm - Anxious individuals are more likely than control groups to adopt the threatening meaning - Experimental methods used to test the bias o Ask people to write down homophone – by seeing the spelling written down it is possible to see the meaning selected § Limitations: demand bias (an experimental artifact where participants form an interpretation of the experiment's purpose and subconsciously change their behavior to fit that interpretation), word frequency o Sentence completion – examine if an ambiguous sentence is followed by a threat- related or neutral continuation sentence o Lexical decision Emotional Stroop Task - Task: volunteers are asked to color-naming words that are either threat-related or emotionally neutral in meaning - Result: greater average time taken to color-naming threat-related words than for neutral- words - Conclusion: prove threat-related attentional bias, especially for patients with anxiety disorder and people with high anxious trait / slowing tends to be greatest when meaning of word is related to patients’ concern Emotional Stroop Task by McNalley - Task: examined color-naming for three types of threat/panic disorder related words and neutral words - Group: patients with panic disorder / clinicians who treat PD - Three types of words o Fear words o Bodily sensation words o Catastrophe words - Result: PD patients showed greater slowing of color-naming for all 3 categories of threat words than the controls - Conclusion: this provides evidence for attentional capture by threat cues in PD patients Dot Probe Task - Method: fixation in center of screen is followed by 2 pictures/faces/words (one is threat- related and the other one is neutral) for brief second. Afterward, the pictures are replaced and a “probe” is presented in the position where one of the 2 pictures was previously presented - Result: slower probe identification when the probe occurs in the neural picture position – indicate attention capture by threat - Conclusion: anxious patients respond faster to probes placing threatening rather than non- threatening items Lecture 7 Vuilleumeir Study (2001) - Task: match faces or match houses - Factors: attention (faces attended/unattended) / expression (neutral/fearful) - Result: amygdala response stronger when faces are fearful, however, this holds regardless of whether faces or houses are attended - Conclusion: there is no main effect of attention and no interaction of attention x expression Pessoa Study (2002) - Factors: attention (faces attended/unattended) / expression (fear, happy, neutral) - Result: amygdala only responded more strongly to fearful than neutral faces when faces were attended - Conclusion: amygdala response to fearful faces is influences by attentional competition Why are there discrepancies between the 2 studies? - The load or task difficulty explanation: the Vuilleumier task was easier to spare attention was left over for faces even when volunteers were meant to be attending to houses - The individual differences explanation: effects of anxiety were ignored! – if the Vuilleumier and Pessoa studies had different ratios of high or low trait individuals in their participant groups this might account for the different findings (this lead to the Bishop study) Bishop Study (2004) - Factors: attention (faces attended/unattended) / expression (neutral/fearful)/ anxiety level (low/high) - Results: there was an interaction of attention x expression x anxiety level o Low anxious subjects behaved like the volunteers in Pessoa’s study – amygdala activity higher for fearful than neutral faces only when attended o High anxious subjects behaved like the volunteers in Vuilleumier’s study § Amygdala activity to fearful faces higher both when faces attended and when faces unattended - Conclusion o Amygdala activity to unattended fearful faces only notable in high anxious volunteers - Possible problem: we cannot be sure that this is not the consequence of attentional capture by threat rather than the cause of attentional capture by threat Lecture 8 Specific Phobia - marked and persistent (typically 6months+) fear for specific situation/object - exposure (or anticipation of exposure to) feared stimulus provokes immediate anxiety/fear - fear/anxiety is disproportionate to actual danger posed - clinically significant distress or impaired function (interferes with social or work activities) Etiology of Specific Phobias - Mowrer’s two-factor model o Classical conditioning – pairing of stimulus (CS) with aversive UCS leads to fear (CR) o Operant conditioning – avoidance of CS maintained though negative reinforcement – strong fear responses acts as a stimulus or drive for overt avoidance response - Problems o Many people never experience aversive interaction with phobic object § Direct experience § Modelling § Verbal instruction o Not all phobias develop following experiencing/observing/ or learning about aversive interaction with phobic object o The majority of people report no memory of conditioning experience before the onset of a phobia o Assumes that with classical conditioning, any stimulus could become the object of a phobia – however, this is a false assumption because people with phobias tend to fear only certain types of objects (prepared learning) Preparedness - Conditioned response will develop more quickly/strongly to threatening stimuli relevant to mankind of the past - Spider/snakes (phylogenetic fear-relevant) vs gun/electricity plug (ontogenetic fear- relevant) vs mushrooms (neutral) Why do some people develop phobias and not others? - Different aversive interactions with prepared stimuli - Different vulnerability Neurobiology of phobic anxiety - Amygdala is important to the acquisition of conditioned fear - Medial prefrontal cortex is important to the extinction/recall of extinction of conditioned fear We cannot be sure if increased amygdala activity is cause or effect of stronger conditioned fear response Elevated trait anxiety was associated with increased amygdala responsivity to phasic fear cues Amygdala responsivity to phasic fear cues linked to stronger initial acquisition of cued fear Trait anxiety also linked to stronger initial acquisition of cued fear Amygdala responsivity to phasic fear cues mediates relationship between trait anxiety and initial acquisition of cued fear Trait anxiety also linked to reduced recruitment of ventromedial prefrontal cortex which is linked to maintain expression of conditioned fear responses Dysregulation of both amygdala and vmpfc function may be implicated for specific phobia Social Anxiety Disorder (Social Phobia) - Marked, persistent (6 months+) and disproportionate fear of social or performance situations where person is exposed to unfamiliar people and possible scrutiny by others - Lots of parallels with specific phobia, but the conditioned stimulus is social situations Mowrer’s two-factor model has also been applied to understand social anxiety disorder Cognitive biases seem to play a bigger role in social anxiety disorder Adding a cognitive component to behavioral (exposure) therapy seems to make a bigger difference for social anxiety disorder Treatment of Phobias Behavioral treatments emphasize exposure - Systematic desensitization - Flooding Both treatments rely on exposure during relaxation - Goal: when exposed to CS, there is no fear response – CS – UCS association being over- written with a new less negative association (CS – safety/relaxation) - Over-writing of the original negative association with a new one involving the non- occurrence of anything aversive is held to be the basis of extinction of the conditioned fear response - It is critical to have exposure last long enough for anxiety to decrease, otherwise avoidance may be reinforced - More people find systematic desensitization acceptable and comfortable - Desensitization can be imaginal or in vivo – in vivo works much better than imaginal Direct treatment vs direct observation (watching the treatment live) vs indirect observation (watching the treatment via video) – effectiveness: DT > IO > DO CBT - Phobias are maintained by irrational beliefs - CBT patient is taught to dispute the irrational belief (cognitive component) in conjunction with exposure to the feared object (behavioral component) Pharmacotherapy - Two common drug treatments: Benzodiazepines, SSRIs - Benzodiazepines increase GABA transmission – GABA is an inhibitory neurotransmitter - SSRIs has less side effects than Benzodiazepines - Medications may acutely relieve anxiety but may not reduce the anxiety of subsequent experiences – relapse rates after medication termination are high Combined exposure and pharmacotherapy - D-cycloserine can increase effect of exposure - DCS acts on NMDA receptors to increase learning - May speed extinction - Concern: if exposure so brief it leads to reconsolidation of conditioned fear response rather than extinction, DCS can also act to increase this reconsolidation Panic Disorder - Sudden experience of intense fear or discomfort that peaks within minutes - People often experience intense desire to flee whatever situation they are in when a panic attack occurs - Not due to effects of substance, another medical condition or mental disorder SECTION NOTES Section 3 Selective Processing of Threat Cues in Panic Disorder Panic disorder, like other anxiety disorders, is associated with an attentional bias for processing threatening information Method – a computerized Stroop color-naming paradigm (unconscious cognition) Does mere familiarity with threat words produce Stroop interference? - Control group (clinicians) vs Experiment group (patients with panic disorder) Results - Panic patients exhibited more interference across all 4 word types - Catastrophe words produced more interference than did bodily sensation words, fear words, and neutral words - Although bodily sensation and fear words did not produce significantly different interference, both word types produced more interference than did neutral words The magnitude of interference declined over trials for both groups Understand the mechanism will help the clinicians to understand the source and come up with the treatment Interview/questionnaire provides evidence that panic patients tend to worry about bodily harm Cognitive bias paradigms provide evidence that panic patient has attention bias IV – cue types, diagnosis of panic disorder Limitations - Small sample sizes - Few types of cues (do general negative words have the same effect fear words?) Anxiety and the Interpretation of Ambiguity: A Text Comprehension Study Hypothesis – individuals vulnerable to anxiety should - Attend selective to threat-related information (attention) – being supported by many researches - Show facilitated memory for threat-related information (memory) – hasn’t been proved successfully - Show an interpretative bias favoring the more threatening meanings of ambiguous information – received little experimental scrutiny Two particular types of methodological problems consistently have afflicted whose few previous attempts to objectively assess anxiety-linked patterns of interpretation - These methods have commonly introduced the possibility of experimenter demand effects – made it impossible to dissociate a genuine interpretative bias from possible response selection bias effects Individuals who report a high level of vulnerability to anxiety are characterized by a distinctive pattern of cognitive biases when processing emotionally-toned information Interpretational bias Attentional bias: attention is captured by one type of stimuli more than another Interpretational bias: how people interpret an ambiguous cues (die/dye) Section 4 MacLeod & Cohen - IV o Cued condition § Ambiguous § Unambiguous threatening § Unambiguous nonthreatening o Continuation sentence § Nonthreat § Threat o Arousal condition § Pedaling stationary bike at a rate to increase heart rate to 50% higher than resting HR - DV o Reading rate (response time) - Result o For high trait anxious subjects – they respond to threat cue the same speed as no cue – they are constantly anticipating the threats o For low trait anxious subjects – they respond to threat cue faster than reacting to no cue fMRI - Allows you to measure both brain structure and brain function by measuring metabolic changes in the brain - BOLD signal - As neurons fire, blood & oxygen increases Brain bases of attentional bias - Amygdala hyper-response - Frontal hypo-response McNally vs McLeod, and Bishop Papers - All three paper talk about o Anxiety is related to response time o Threat stimuli - Limitations o Low attentional load o # of participants Attentional competition - between frontal cortex and amygdala Bishop Paper Goal: to determine if individual differences in anxiety explains the discrepancies between previous findings Method: house/expression matching task (Vuilleimier task) Result: the pattern of low-anxious subjects is different from high-anxious subjects Take home messages: Individual differences matter! Especially anxiety when measuring fear and attentional biases Trait levels of anxiety account for the differences in previous findings What other individual difference factors may influence performance? - Comorbidity o ADHD


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