Merging Our Understanding of Anxiety and Exposure: Using Inhibitory Learning to Target Anxiety Sensitivity in Exposure Therapy

Exposure-based therapies are the gold standard treatment for anxiety disorders, and recent advancements in basic and clinical research point to the need to update the implementation of exposure. Recent research has highlighted the importance of transdiagnostic factors such as anxiety sensitivity (AS), or fear of anxiety-related sensations. Elevated AS is common among all anxiety disorders and contains three dimensions, or expectancies, that can be used to guide treatment. Recently, treatments directly targeting AS have shown potential in reducing symptoms of anxiety. In addition, inhibitory learning theory (ILT) provides an alternative explanation of exposure processes based on basic learning research. ILT extends the current framework by accounting for renewal of fear, which is important given the substantial number of individuals who experience a return of symptoms following treatment. The current paper will provide an overview of ILT and discuss several ILT techniques that can be used to target AS. These two converging bodies of research hold strong potential for optimizing treatment for anxiety.

ADOLESCENT BEHAVIORAL CHANGE DUE TO HOME QUARANTINE: AN EMPIRICAL STUDY

Adolescent behavior changes as an outcome of home quarantine towards fighting COVID 19 infection, formed the basis of exploring adolescent social isolation. The subject Social isolation was studied via psychological dimensions related to fear of anxiety, gloomy, fatigue and their impact with each other and their sub factors. An empirical exploration with a sample comprising of 157, both male and female adolescents, randomly selected by an online survey formed the basis of the study. Self-Evaluation scale developed was used for the study. The study presents its findings from proposed thirteen hypotheses emerging from literature reviewed. The empirical findings projected the relationship between anxiety and fatigue along with its impact on the adolescent’s gloominess and dissatisfaction, during their home quarantine confinement and social disconnect. From the study also emerged the finding that gender difference did not vary the adolescent’s anxiety, gloominess or satisfaction but did have a difference in fatigue experienced. Also the adolescent’s family size, depicted that there existed no significant difference with anxiety experienced, but family size had a bearing on the fatigue, satisfaction and gloominess experienced by adolescents. Who being subjected to their social isolation and confined to their homes. The study findings have a topical importance in addressing the psychological need analysis of the adolescents during the present COVID 19 home quarantine and lockdown.

A preliminary test of the therapeutic potential of written exposure with rescripting for generalized anxiety disorder

This experiment tested a novel written exposure intervention for generalized anxiety disorder (GAD) that consisted of guided rescripting of participants’ worst fear. After describing their worst fear, adults with GAD ( N = 79) were randomly assigned to one of three writing interventions, each consisting of three sessions on consecutive days: (1) standard written exposure (WE), (2) written exposure with rescripting (RWE), and (3) neutral control writing (NC). Measures of symptoms and worry-associated processes were administered at pre- and post-intervention, and at 1-week and 1-month follow-ups. Worry declined significantly in all three conditions. Participants in WE reported significant reductions in fear of anxiety, whereas those in RWE reported significant reductions in fear of anger. Participants in RWE and NC reported a significant decrease in fear of positive emotion. Following RWE, participants perceived their feared scenario as less costly and perceived themselves as better able to cope with it, whereas participants in the WE and NC did not show these changes. Cognitive avoidance, intolerance of uncertainty, and negative problem orientation did not change. Findings suggest overall, RWE was not superior to WE, and that more research is needed to assess their therapeutic potential. Strengths and limitations are discussed for the benefit of future research on exposure for GAD.

Anxiety Sensitivity or Interoceptive Sensitivity

The construct of anxiety sensitivity (AS) – the fear of anxiety-related symptoms – has been highly influential in current conceptualizations of anxiety disorders in general, and panic disorder specifically. However, given documented associations between AS and both non-anxiety psychological disorders as well as medical/health conditions, the extent to which measures of AS are assessing a specific fear or anxiety symptoms versus a broader fear of interoceptive or bodily sensations is unclear. Confirmatory factor analysis of data from 373 participants failed to suggest whether fears of anxiety-related symptoms were factorially distinct from fears of non-anxiety-related bodily sensations, although analyses indicated that while fears of anxiety-related symptoms were more closely associated with panic disorder severity than were fears of non-anxiety-related symptoms, both were similarly and strongly associated with hypochondriacal fears. Implications for the construct of AS, and the broader construct of somatic fears, are discussed.