A contemporary learning theory perspective on the etiology of anxiety disorders: it's not what you thought it was.

The authors describe how contemporary learning theory and research provide the basis for perspectives on the etiology and maintenance of anxiety disorders that capture the complexity associated with individual differences in the development and course of these disorders. These insights from modern research on learning overcome the shortcomings of earlier overly simplistic behavioral approaches, which sometimes have been justifiably criticized. The authors show how considerations of early learning histories and temperamental vulnerabilities affect the short- and long-term outcomes of experiences with stressful events. They also demonstrate how contextual variables during and following stressful learning events affect the course of anxiety disorder symptoms once they develop. This range of variables can lead to a rich and nuanced understanding of the etiology and course of anxiety disorders.

[1]  S. Mineka,et al.  Behavior therapy for fears and phobias: Context specificity of fear extinction , 2007 .

[2]  M. Zvolensky,et al.  Prevention of Anxiety Psychopathology: A Critical Review of the Empirical Literature , 2006 .

[3]  M. Craske,et al.  Mastery of Your Anxiety and Worry: Therapist Guide , 2006 .

[4]  M. Craske,et al.  Exposure Therapy and Extinction: Clinical Studies. , 2006 .

[5]  S. Mineka,et al.  Contemporary Learning Theory Perspectives on the Etiology of Fears and Phobias. , 2006 .

[6]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[7]  H. Leonard,et al.  Obsessive-compulsive disorder. , 2003, Child and adolescent psychiatric clinics of North America.

[8]  Evelyn Behar,et al.  Avoidance Theory of Worry and Generalized Anxiety Disorder. , 2004 .

[9]  Richard G. Heimberg,et al.  Generalized anxiety disorder: Advances in research and practice. , 2004 .

[10]  J. Yiend,et al.  The experimental modification of processing biases , 2004 .

[11]  Robert Ladouceur,et al.  The Role of Intolerance of Uncertainty in Etiology and Maintenance. , 2004 .

[12]  Suzanne R. Best,et al.  Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. , 2008, Psychological bulletin.

[13]  M. Antony,et al.  Preliminary Examination of the Relationship Between Anxiety Disorders in Adults and Self-Reported History of Teasing or Bullying Experiences , 2003, Cognitive behaviour therapy.

[14]  K. Kendler,et al.  A twin study of the genetics of fear conditioning. , 2003, Archives of general psychiatry.

[15]  E. Rassin,et al.  The correlation between thought-action fusion and religiosity in a normal sample. , 2003, Behaviour research and therapy.

[16]  Arne Öhman,et al.  Phobias and preparedness: the selective, automatic, and encapsulated nature of fear , 2002, Biological Psychiatry.

[17]  R. McNally Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic, 2nd ed. , 2002 .

[18]  S. Mineka,et al.  Born to fear: non-associative vs associative factors in the etiology of phobias. , 2002, Behaviour research and therapy.

[19]  R. Poulton,et al.  Non-associative fear acquisition: a review of the evidence from retrospective and longitudinal research. , 2002, Behaviour research and therapy.

[20]  S. Mineka,et al.  Toward a psychological model of the etiology of generalized anxiety disorder , 2002 .

[21]  D. Stein,et al.  Generalized anxiety disorder : symptomatology, pathogenesis and management , 2002 .

[22]  M. Hughes,et al.  Obsessive-compulsive disorder , 2002 .

[23]  D. Clark,et al.  A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault. , 2001, Behaviour research and therapy.

[24]  G. Street,et al.  Paradoxical effects of thought suppression: a meta-analysis of controlled studies. , 2001, Clinical psychology review.

[25]  S. Maier Exposure to the stressor environment prevents the temporal dissipation of behavioral depression/learned helplessness , 2001, Biological Psychiatry.

[26]  S. Mineka,et al.  Fears, phobias, and preparedness: toward an evolved module of fear and fear learning. , 2001, Psychological review.

[27]  S. Mineka,et al.  A modern learning theory perspective on the etiology of panic disorder. , 2001, Psychological review.

[28]  R. Rapee The development of generalized anxiety. , 2001 .

[29]  H. Merckelbach,et al.  The Etiology of Childhood Specific Phobia , 2001 .

[30]  T. Ollendick,et al.  The Developmental Psychopathology of Anxiety , 2001 .

[31]  A Ehlers,et al.  Posttraumatic stress disorder following political imprisonment: the role of mental defeat, alienation, and perceived permanent change. , 2000, Journal of abnormal psychology.

[32]  H. Kraemer,et al.  Predictors of panic attacks in adolescents. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[33]  G. Davey,et al.  Phobias: A Handbook of Theory, Research and Treatment , 2000, Journal of Cognitive Psychotherapy.

[34]  P. Salkovskis,et al.  Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research. , 1999, Behaviour research and therapy.

[35]  A. Wells A Cognitive Model of Generalized Anxiety Disorder , 1999, Behavior modification.

[36]  M. Basoglu Torture and its Consequences: Current Treatment Approaches , 1999 .

[37]  S. Siegel,et al.  Drug-onset cues as signals: intraadministration associations and tolerance. , 1999, Journal of experimental psychology. Animal behavior processes.

[38]  K. Jansen,et al.  Perceptions of control and long-term recovery from rape. , 1999, The American journal of orthopsychiatry.

[39]  H. Kraemer,et al.  Linking self-reported childhood behavioral inhibition to adolescent social phobia. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[40]  Michelle G. Craske,et al.  Anxiety Disorders: Psychological Approaches To Theory And Treatment , 1998 .

[41]  A. Ehlers,et al.  Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. , 1998, Journal of abnormal psychology.

[42]  D H Barlow,et al.  The development of anxiety: the role of control in the early environment. , 1998, Psychological bulletin.

[43]  A. Ohman,et al.  Emotional conditioning to masked stimuli: expectancies for aversive outcomes following nonrecognized fear-relevant stimuli. , 1998, Journal of experimental psychology. General.

[44]  R. Lubow Latent inhibition and behavior pathology: Prophylactic and other possible effects of stimulus preexposure. , 1998 .

[45]  M. Hebert,et al.  Effects of acute social defeat on activity in the forced swim test: Parametric studies in DBA/2 mice using a novel measurement device† , 1998 .

[46]  R. Zinbarg,et al.  Individual differences in the acquisition of affectively valenced associations. , 1998, Journal of personality and social psychology.

[47]  W. O’Donohue Learning and Behavior Therapy , 1997 .

[48]  S. Mineka,et al.  Psychological preparedness for trauma as a protective factor in survivors of torture , 1997, Psychological Medicine.

[49]  R. Zinbarg,et al.  Sexual victimization, generalized perception of control, and posttraumatic stress disorder symptom severity. , 1997, Journal of anxiety disorders.

[50]  Paul M. Salkovskis,et al.  Frontiers of Cognitive Therapy , 1997 .

[51]  J. Kagan Temperament and the reactions to unfamiliarity. , 1997, Child development.

[52]  R. Rapee,et al.  Recall of family factors in social phobia and panic disorder: Comparison of mother and offspring reports , 1997, Depression and anxiety.

[53]  J. Tanaka-Matsumi,et al.  The culturally informed functional assessment (CIFA) interview: A strategy for cross-cultural behavioral practice , 1996 .

[54]  R. Rapee,et al.  Family process and child anxiety and aggression: An observational analysis , 1996, Journal of abnormal child psychology.

[55]  S. Rachman,et al.  Thought-action fusion in obsessive compulsive disorder☆ , 1996 .

[56]  G. Eifert,et al.  Systemic alarms in fear conditioning I: A reappraisal of what is being conditioned , 1996 .

[57]  G. Eifert,et al.  "Cleaning-up cognition" in triple-response fear assessment through individualized functional behavior analysis. , 1996, Journal of Behavior Therapy and Experimental Psychiatry.

[58]  R. Heimberg,et al.  Homework compliance, perceptions of control, and outcome of cognitive-behavioral treatment of social phobia. , 1996, Behaviour research and therapy.

[59]  R. Rapee,et al.  Family enhancement of cognitive style in anxious and aggressive children , 1996, Journal of abnormal child psychology.

[60]  S. Mineka,et al.  Conditioning and ethological models of anxiety disorders: stress-in-dynamic-context anxiety models. , 1996, Nebraska Symposium on Motivation. Nebraska Symposium on Motivation.

[61]  D. Clark Panic disorder: From theory to therapy. , 1996 .

[62]  D. Beidel,et al.  Social phobia: an analysis of possible developmental factors. , 1995, Journal of abnormal psychology.

[63]  B. Rothbaum,et al.  A Prospective Examination of Symptoms of Posttraumatic Stress Disorder in Victims of Nonsexual Assault , 1995 .

[64]  A. Wells,et al.  Worry and the incubation of intrusive images following stress. , 1995, Behaviour research and therapy.

[65]  P. Lang The emotion probe. Studies of motivation and attention. , 1995, The American psychologist.

[66]  R. Kessler,et al.  The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. , 1995, Archives of general psychiatry.

[67]  S. Hollon,et al.  Effects of a safe person on induced distress following a biological challenge in panic disorder with agoraphobia. , 1995, Journal of abnormal psychology.

[68]  M. Craske,et al.  Predicted versus unpredicted panic attacks: acute versus general distress. , 1995, Journal of abnormal psychology.

[69]  J. Kagan,et al.  Galen’s Prophecy , 2018 .

[70]  M. Fanselow Neural organization of the defensive behavior system responsible for fear , 1994, Psychonomic bulletin & review.

[71]  G. Davey,et al.  Unconditioned stimulus rehearsal and the retention and enhancement of differential "fear" conditioning: effects of trait and state anxiety. , 1994, Journal of abnormal psychology.

[72]  Richard J. McNally,et al.  Panic Disorder: A Critical Analysis , 1994 .

[73]  U Dimberg,et al.  Nonconscious associative learning: Pavlovian conditioning of skin conductance responses to masked fear-relevant facial stimuli. , 1994, Psychophysiology.

[74]  R. Heimberg,et al.  Differences in perceptions of parental and personal characteristics between generalized and nongeneralized social phobics , 1994 .

[75]  T. Borkovec,et al.  The nature, functions, and origins of worry. , 1994 .

[76]  R. Zinbarg Therapist's Guide for the Mastery of Your Anxiety and Worry (MAW) Program , 1994 .

[77]  G. Davey,et al.  Worrying: Perspectives on theory, assessment and treatment. , 1994 .

[78]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[79]  L. Roemer,et al.  Generalized Anxiety Disorder , 1994 .

[80]  W R True,et al.  A twin study of genetic and environmental contributions to liability for posttraumatic stress symptoms. , 1993, Archives of general psychiatry.

[81]  B. Dworkin Learning and Physiological Regulation , 1993 .

[82]  A. Ehlers,et al.  Somatic symptoms and panic attacks: a retrospective study of learning experiences. , 1993, Behaviour research and therapy.

[83]  Arne Öhman,et al.  On the automatic nature of phobic fear: conditioned electrodermal responses to masked fear-relevant stimuli. , 1993, Journal of abnormal psychology.

[84]  B. Rothbaum,et al.  Uncontrollability and unpredictability in post-traumatic stress disorder: an animal model. , 1992, Psychological bulletin.

[85]  A. McFarlane Commentary. Posttraumatic stress disorder among injured survivors of a terrorist attack: predictive value of early intrusion and avoidance symptoms. , 1992, The Journal of nervous and mental disease.

[86]  A. Shalev Posttraumatic Stress Disorder among Injured Survivors of a Terrorist Attack: Predictive Value of Early Intrusion and Avoidance Symptoms , 1992, The Journal of nervous and mental disease.

[87]  Capt. J.R. Cusack Fear and Courage, 2nd ed , 1992 .

[88]  R. Kessler,et al.  The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. , 1992, Archives of general psychiatry.

[89]  R. Dantzer,et al.  [Animal models in psychiatry]. , 1992, Annales medico-psychologiques.

[90]  I. Marks,et al.  A Prospective Study of Panic and Anxiety in Agoraphobia with Panic Disorder , 1992, British Journal of Psychiatry.

[91]  Barbara O. Rothbaum,et al.  A prospective examination of post-traumatic stress disorder in rape victims , 1992 .

[92]  D H Barlow,et al.  Cognitive-behavioral approaches to the nature and treatment of anxiety disorders. , 1992, Annual review of psychology.

[93]  M. Schwartz Obsessions and compulsions. , 1991, Hospital & community psychiatry.

[94]  L. Kirmayer,et al.  The Place of Culture in Psychiatric Nosology: Taijin Kyofusho and DSM-III-R , 1991, The Journal of nervous and mental disease.

[95]  G. Steketee,et al.  Religion and guilt in OCD patients , 1991 .

[96]  Mark E. Bouton,et al.  Sources of relapse after extinction in Pavlovian and instrumental learning , 1991 .

[97]  C. E. Walker Clinical psychology : historical and research foundations , 1991 .

[98]  S. Mineka,et al.  Selective associations in the observational conditioning of fear in rhesus monkeys. , 1990, Journal of experimental psychology. Animal behavior processes.

[99]  S. Orr,et al.  Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder. A pilot study. , 1990, Archives of general psychiatry.

[100]  J. Kagan,et al.  Psychiatric correlates of behavioral inhibition in young children of parents with and without psychiatric disorders. , 1990, Archives of general psychiatry.

[101]  Jon L. Williams,et al.  Influence of conspecific and predatory Stressors and their associated odors on defensive burying and freezing responses , 1989 .

[102]  Michael W. Otto,et al.  Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic , 1989 .

[103]  S. Mineka,et al.  Observational conditioning of fear to fear-relevant versus fear-irrelevant stimuli in rhesus monkeys. , 1989, Journal of abnormal psychology.

[104]  R. Rapee,et al.  Qualitative dimensions of worry in DSM-III-R generalized anxiety disorder subjects and nonanxious controls. , 1989, Behaviour research and therapy.

[105]  G. Davey,et al.  Sensory preconditioning and UCS inflation in human 'fear' conditioning. , 1989, Behaviour research and therapy.

[106]  J. Maser,et al.  Panic: Psychological Perspectives , 1988 .

[107]  R. Rescorla Pavlovian conditioning. It's not what you think it is. , 1988, The American psychologist.

[108]  D. Clark A cognitive model of panic attacks. , 1988 .

[109]  W W Rankin,et al.  Fear and courage. , 1988, Journal of pediatric nursing.

[110]  R. Noyes,et al.  Generalized anxiety disorder. , 1987, Primary care.

[111]  S. Mineka,et al.  Immunization against the observational conditioning of snake fear in rhesus monkeys. , 1986, Journal of abnormal psychology.

[112]  S. Mineka,et al.  Control and early socioemotional development: Infant rhesus monkeys reared in controllable versus uncontrollable environments. , 1986 .

[113]  D. M. Lierle,et al.  Effects of stress controllability, immunization, and therapy on the subsequent defeat of colony intruders , 1986 .

[114]  P. Lang,et al.  Preparedness and phobia: effects of stimulus content on human visceral conditioning. , 1986, Journal of abnormal psychology.

[115]  J. Dietch Anxiety Disorders and Phobias: A Cognitive Perspective , 1986 .

[116]  D. Chambless,et al.  Sex, sex-role stereotyping and agoraphobia. , 1986, Behaviour research and therapy.

[117]  J. Maser,et al.  Anxiety and the Anxiety Disorders , 2019 .

[118]  S. Mineka,et al.  Observational conditioning of snake fear in unrelated rhesus monkeys. , 1985, Journal of abnormal psychology.

[119]  R. Bootzin,et al.  Theoretical Issues in Behavior Therapy , 1985 .

[120]  S. Mineka,et al.  Fear conditioned with escapable and inescapable shock: Effects of a feedback stimulus. , 1984 .

[121]  N. Bond Animal models in psychopathology , 1984 .

[122]  S. Rachman,et al.  Does escape behaviour strengthen agoraphobic avoidance? A preliminary study. , 1984, Behaviour research and therapy.

[123]  S. Maier,et al.  Immunization of opioid analgesia: Effects of prior escapable shock on subsequent shock-induced and morphine-induced antinociception , 1983 .

[124]  R. J. Rodgers,et al.  Social conflict activates status-dependent endogenous analgesic or hyperalgesic mechanisms in male mice: Effects of naloxone on nociception and behaviour , 1983, Physiology & Behavior.

[125]  M. Jenike Obsessive compulsive disorder. , 1983, Comprehensive psychiatry.

[126]  J. Gray,et al.  Précis of The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system , 1982, Behavioral and Brain Sciences.

[127]  S. Mineka,et al.  The effects of control and lack of control on active and passive avoidance in rhesus monkeys. , 1982, Behaviour research and therapy.

[128]  H. Eysenck A Model for Personality , 1981 .

[129]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[130]  K. Hugdahl,et al.  Acquisition of phobias and anxiety response patterns in clinical patients. , 1981, Behaviour research and therapy.

[131]  S. Mineka The role of fear in theories of avoidance learning, flooding, and extinction. , 1979 .

[132]  U Dimberg,et al.  Facial expressions as conditioned stimuli for electrodermal responses: a case of "preparedness"? , 1978, Journal of personality and social psychology.

[133]  D. Chambless,et al.  A reanalysis of agoraphobia. , 1978 .

[134]  S. Rachman,et al.  Abnormal and normal obsessions. , 1978, Behaviour research and therapy.

[135]  S. Maier,et al.  Transituational Immunization and Therapy of Learned Helplessness in the Rat. , 1977 .

[136]  J. Maser,et al.  Psychopathology : experimental models , 1977 .

[137]  M. Seligman,et al.  Prepared phobias and obsessions: therapeutic outcome. , 1977, Behaviour research and therapy.

[138]  L. Pohorecky,et al.  Coping Behavior and Neurochemical Changes An Alternative Explanation for the Original "Learned Helplessness" Experiments , 1976 .

[139]  J. Delgado,et al.  Animal Models in Human Psychobiology , 1976, Springer US.

[140]  R. Rescorla,et al.  Reinstatement of fear to an extinguished conditioned stimulus. , 1975, Journal of experimental psychology. Animal behavior processes.

[141]  R. Rescorla Effect of inflation of the unconditioned stimulus value following conditioning. , 1974 .

[142]  M. Seligman Phobias and preparedness , 1971 .

[143]  E. Fischer Conditioned Reflexes , 1942, American journal of physical medicine.

[144]  S. Lovibond PERSONALITY AND CONDITIONING. , 1964, Progress in experimental personality research.

[145]  G. Razran,et al.  The observable unconscious and the inferable conscious in current Soviet psychophysiology: interoceptive conditioning, semantic conditioning, and the orienting reflex. , 1961, Psychological review.

[146]  J. Uhrich The social hierarchy in albino mice. , 1938 .

[147]  J. Watson,et al.  Conditioned emotional reactions , 1920 .