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

Abstract

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.

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

“…In line with the cross-state continuity assumption, we suggest that the ensemble of emotional-imagery processes constituting fear memories underlies a variety of clinical conditions characterized by anxiety and fear, such as panic disorder, phobia, and PTSD (Foa & Meadows, 1997;Mineka & Zimbarg, 2006;VanOyen Witvliet, 1997) as well as dysphoric dreams and nightmares.…”

Fear Generalization in Humans: Systematic Review and Implications for Anxiety Disorder Research

“…Avoidance may become debilitating and lead to impaired social functioning and, because of this, it is often the sole target of therapeutic change. While there is evidence for perceptual generalization of avoidance (Lommen et al, 2010;van Meurs et al, 2014), extending the analysis of symbolic generalization to include instances of avoidance is important in developing contemporary accounts of the emergence of clinical anxiety (Field, 2006;Friman, Hayes, & Wilson, 1998;Mineka & Zinbarg, 2006;Rachman, 1977). The first supporting evidence for this approach comes from Augustson and Dougher (1997), who trained and tested participants for the formation of two, four-member stimulus equivalence relations (A1-B1-C1-D1 and A2-B2-C2-D2) and then used a differential fear conditioning procedure to establish B1 as CS+ and BS as CS-, respectively.…”

“…Fear learning may, however, go awry or become excessive and lead to the development of psychopathology. In experimental psychopathology, the behavioral mechanisms of fear learning are investigated using the fear-conditioning paradigm-perhaps the most well-established translational model of the acquisition of clinically relevant fear and anxiety (Beckers, Krypotos, Boddez, Effting, & Kindt, 2013;Boddez, Baeyens, Hermans, & Beckers, 2014;Bouton, 2002;Craske, Hermans, & Vansteenwegen, 2006;Mineka & Zinbarg, 2006). Fear-conditioning involves an initially neutral stimulus (the conditioned stimulus or CS), such as a light or a tone, being repeatedly paired with an aversive unconditioned stimulus (US).…”

Generalization of conditioned fear-potentiated startle in humans: Experimental validation and clinical relevance

“…Classical fear-conditioning, the cross-species learning process by which a neutral conditioned stimulus (CS) comes to evoke fear following its repeated pairing with an aversive unconditioned stimulus (US), has long been implicated in the development of pathologic anxiety (for a review, see Mineka & Zinbarg, 2006). A recent meta-analysis of lab-based, fearconditioning studies in the anxiety disorders implicates heightened anxious reactivity to conditioned stimuli (CS's) signaling safety as an important conditioning correlate of clinical anxiety (Lissek et al, 2005).…”