Generalised Anxiety Disorder: A Cognitive Explanation of Phobias (HL IB Psychology)

What is Generalised Anxiety Disorder?

• A cognitive explanation of phobias involves considering how irrational thought processes and cognitive distortions shape the responses of the phobic person to the phobic stimulus

• Generalised Anxiety Disorder (GAD) may involve the following behaviours (according to the DSM-5):

  • Excessive anxiety and worry (known as apprehensive expectation) which has been present for for at least six months

  • This anxiety may be focused on a range of events or activities in the sufferer’s life e.g. attending school, a work project, taking an exam

  • The sufferer finds it difficult to control the anxiety 

  • Restlessness, feeling ‘on edge’

  • Fatigue i.e. ‘tired all the time’ syndrome

  • Irritability

  • Inability to concentrate

  • Sleeplessness

• The anxiety causes great distress to the sufferer and interferes with their daily functioning e.g. absence from work, reduced social contact, reduction in once-pleasurable activities

• The ‘generalised’ aspect of GAD refers to the fact that there is no single specific cause or reason for the anxiety; the sufferer’s anxiety is focused on a range of different issues for different reasons

• Some celebrities who have GAD include Prince Harry, Kendall Jenner, Selina Gomez, Kim Kardashian, Ariana Grande and Jonah Hill

Generalised Anxiety Disorder as an explanation of phobias

• GAD shares some key features in common with the descriptions of phobias e.g. excessive fear of heart attacks, of becoming ill, of being rejected by others

• GAD can produce panic in sufferers which is also associated with a phobic response to adverse stimulus

• Excessive and uncontrollable worry surrounding the phobic stimulus e.g. ‘If I leave the house I might get hit by a car’ is a central element of GAD: this may give rise to  comorbidity i.e. someone who suffers from both GAD and a specific phobia

• Worry and anxiety are not unusual behaviours and may actually be necessary (they direct attention to what is important and what requires action); it is when the worry grows out of proportion to the implied or imagined threat that it may be diagnosed as an anxiety disorder such as a phobia

Evaluation of Generalised Anxiety Disorder as an explanation of phobias

Strengths

• The clear crossover between GAD and phobias means that the phobic person’s symptoms should register as evidence of an anxiety disorder with their clinician rather than being dismissed as ‘hysteria’ (which is how some disorders were negatively labelled in the past)

• There are well-established treatments for anxiety disorders e.g. CBT which are led by trained therapists who are able to guide the sufferer away from their irrational thoughts and towards more positive thought processes

Limitations

• The fact that GAD and phobias share similar features makes it difficult to distinguish between the two (e.g. does the patient have GAD or a specific phobia?) which means that targeted treatment for phobias (e.g. systematic desensitisation) may not be prescribed by the clinician

• GAD does not get to the heart of what phobias are, how they function and why phobias affect some people and not others so it cannot offer a very comprehensive account of this type of anxiety disorder

Which studies investigate a cognitive explanation of phobias?

• DiNardo (1998) - linked excessive worry to anxiety as an explanation of phobias

• Barrera & Norton (2009) - quality of life is negatively impacted by GAD, social phobia and panic disorder