Generalized Anxiety Disorder and Depression: A Learning Theory Connection

Abstract

Depression and Generalized Anxiety Disorder: A Learning Theory Connection Generalized Anxiety Disorder (GAD) affects a large number of people [1]. While inroads have been made in terms of its treatment, many reviewers of psychotherapeutic treatment for GAD conclude that effectiveness is far from complete and that more about GAD remains to be learned [2,3]. Two features of GAD are prominent. First, GAD is characterized by what can be called a behavioral excess. Sufferers complain of frequent and seemingly uncontrollable worry, so much so that Andrews et al. [4] recommended that the disorder be renamed "generalized worry disorder. " Second, GAD is highly comorbid with depression [5]. The study of GAD has reasonably focused on its prominent symptom; worry. In the clinical and scientific literature, this symptom has been treated according to either a "worry as anxiety" or "worry as avoidance behavior" hypothesis. In the current theoretical paper, the authors make the argument that the addition of a "worry as adjunctive behavior" hypothesis might help complete our understanding of the disorder. The authors summarize the main points of the current hypotheses for worry and direct the reader to representative literature in which those ideas are developed, examined, or applied. The authors next summarize learning theory literature that explains that the experiences that contribute to depression should, in many cases, give rise to small behaviors that produce immediate satisfaction (i.e., adjunctive behaviors). They argue that, in some cases, worry might best be understood as an adjunctive behavior and point to literature that is consistent with this heretofore unexpressed hypothesis.