A physiological model of phobic anxiety and desensitization

The relationship between arousal and phobic anxiety is discussed with regard to recent psychophysiological studies of habituation in normal subjects and in groups of anxious and phobic patients. A physiological model of the mechanisms underlying generalized and phobic anxiety is postulated. Some criticisms of Wolpe's conception of systematic desensitization are offered and an alternative explanation consistent with the above postulate is put forward. This alternative states that the underlying mechanism of systematic desensitization is identical with that of habituation proceeding under optimal conditions (the “maximal habituation” hypothesis). The two accounts of desensitization are compared and contrasted.     

The effects of ethanol intoxication on phobic anxiety

Behavioral conceptions of alcohol abuse often include the hypothesis that drinking behavior is a negatively reinforced operant, with ethanol intoxication viewed as alleviating aversive environmental and internal states. This hypothesis has not been confirmed or refuted by previous studies which employed mild stressors and limited assessment methodology. In the present experiment, 22 patients with severe phobias approached their phobic animal under two consecutive conditions—first while sober and second after drinking either a placebo or an intoxicating dose of ethanol. The severe anxiety induced was assessed behaviorally, physiologically and by the patient's self-report of fear. The intoxicated patients did not experience decreased anxiety, tachycardia or avoidance, compared to the placebo group. These results have clinical implications and suggest the need to reconsider tension-reduction theories of alcohol abuse.     

The ontological character of anxiety

Conclusion We conclude from our analysis of Tillichian and Rogerian anthropology that anxiety is ontological in character. It is ontological because it is the necessary concomitant condition of the fact and structures of existence. Man is faced with one basic threat—the possibility of non-being. In an absolute form, he is threatened with the total extinction of being. In an absolute form, he is threatened with the total extinction of being. In a relative form, he is threatened with personal death and with the failure of personal fullillment—with the loss of being and becoming. Ontological anxiety has to do with the absolute threat of extinction and ontic anxiety with the relative threat to self-preservation and self-enhancement. From this condition there is no escape. Refusal to accept the inescapable results in neurotic anxiety, a nonessential concomitant of being which, therefore, can be removed. These distinctions are revealed by an ontological and phenomenological analysis of human existence that brings ontology and psychology into a complementary relationship.     

Fears in clinic-referred children: relations with child anxiety sensitivity, maternal overcontrol, and maternal phobic anxiety

Relations among maternal phobic anxiety, maternal overcontrol, child anxiety sensitivity, and child level of fear were explored in 156 children referred to an outpatient clinic for psychological evaluation. In addition, these relations were examined separately in analyses of age, gender, and diagnostic status. Overall, age, gender, and child anxiety sensitivity, along with maternal ratings of an overly controlling parenting strategy were significant predictors of levels of fear. These four variables predicted approximately 50% of the variance associated with fear levels. Surprisingly, maternal phobic anxiety was not a significant predictor in this sample of clinic-referred children. In separate analyses of age, gender, and diagnostic status (presence or absence of an anxiety disorder), anxiety sensitivity was a significant predictor of fear levels for both older and younger children, for both boys and girls, and for both children with and without an anxiety disorder. However, maternal overly controlling parenting strategy was significant only for the younger children (and not the older ones) and only for girls (and not boys). Moreover, maternal overcontrol was a marginally significant predictor for the anxiety-disorder group (and not the non-anxiety-disordered group). Results are discussed within a developmental framework, and implications for treatment are explored.     

Distinctions between separation anxiety and social anxiety in children and adolescents

Separation anxiety and social phobia are intertwined to a considerable degree, and high comorbidity rates have been reported. The present study used latent class analysis (LCA) to investigate if classes of children and adolescents with-simultaneously-high rates of separation anxiety and low rates of social anxiety symptoms, or vice versa, could be identified. Eight- to 18-year-olds from a large general population (n=1000) and referred sample (n=735) were assessed with the Multidimensional Anxiety Scale for Children (MASC). With LCA, a separate class of referred 8-11-year-old children with high separation anxiety scores, and simultaneously lower social anxiety scores was identified, next to a class of children with high scores on separation anxiety and social anxiety. In the other groups (referred 12-18-year-olds and children and adolescents from the general population), a class with individuals who specifically scored high on separation anxiety could not be revealed. The results indicated that separation anxiety represents a different construct than social anxiety in referred children (but not in referred adolescents or in the general population). It can be concluded that, in referred children, research regarding etiology and treatment outcome of anxiety symptoms should be aimed specifically at separation anxiety and social anxiety, instead of just investigating a broader anxiety dimension.     

Brief report--associations of personality disorder with early separation anxiety in patients with adult separation anxiety disorder

A recent study has suggested a link between early separation anxiety and personality disorder. It is possible that this relationship is mediated or confounded by the presence of adult separation anxiety disorder (ASAD). In a clinic study of 397 anxiety patients, we found that ASAD patients with heightened early separation anxiety had higher rates of any Cluster C personality disorder compared to ASAD patients without elevated early separation anxiety, and higher rates of any Cluster B or C personality disorder compared to anxiety patients with low early separation anxiety and no ASAD. Although cross-sectional in design, the study supports a direct link between early separation anxiety and some adult personality disorders, irrespective of the type of adult anxiety disorder present, including ASAD.     

Abusive families and character formation

Family research studies confirm that abusive parents tend to be undifferentiated partners who compete with each other and with their children for attention and nurturance. More or less healthy parents make demands on children to counteract their own injured narcissism, but they do so largely without devaluation and the sadistic use of projective identification. Under sufficient stress abusive parents attack the child who fails to gratify their needs, thereby giving vent to longstanding frustrations and feelings of being threatened by the child's individuation and competency. The emotional atmosphere in such families facilitates ego deficits like those of the borderline personality as it molds the child's efforts to avoid anxiety. Devaluation, loss, and defenses against mourning partially account for depression and paranoid traits in abused youngsters. Early neglect and abuse exposes them to influential models who act out rage and primitive defenses. Some abused individuals project their rage and later become paranoid or antisocial, whereas others fragment or retain infantile defenses. The destructiveness of severe psychological abuse lies in the constriction of the experiencing self and healthy character development, together with the conditioning to repeat abusive relationships and to avoid intimacy. Achieving individuation under these circumstances entails overcoming the internalized abusive relationships and relinquishing the unconscious wish to be transformed from the abused into the abuser.     

Social phobic interoception: effects of bodily information on anxiety, beliefs and self-processing

It has been suggested that body-state information influences self-perception and negative thinking in social phobia [Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment and treatment (pp. 69-93). New York: Guilford Press.]. This study explored the effects of body-state information on anxiety and cognition in patients with generalised social phobia during a feared social interaction. It was hypothesised that information concerning an increase in pulse rate would lead to increments in anxiety, negative beliefs and self-processing whilst information concerning a decrease in pulse rate would have the opposite effect. The results of this study were generally consistent with the hypotheses. These findings are important as they may help to account for fluctuations in anxiety, negative beliefs and self-processing in social situations that do not present objective social threat. In particular, social anxiety appears to be modulated by body-state information. The implications of the present findings for cognitive therapy of social phobia are briefly discussed.     

An analysis of social anxiety in anorexic,bulimic, social phobic,and control women

Responses to the Social Phobia and Anxiety Inventory (SPAI) were examined in 23 women with anorexia nervosa, 54 women with bulimia nervosa, 50 female college undergraduates, and 43 social phobic women. Results indicated that women with anorexia nervosa and bulimia nervosa scored comparably high to social phobic women on measures of social anxiety and that these fears were not limited to fears of eating or drinking in public. This study suggests that fears of negative evaluation in women with eating disorders may generalize beyond the fears of scrutiny of body shape and size to more traditional social situations.