Cognitive Therapy of Anxiety Disorders

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112 COGNITIVE THEORY AND RESEARCH ON ANXIETY


the second falls under Hypothesis 11, elevated personal vulnerability. Both aspects of
vulnerability must be present for an individual to be cognitively predisposed to anxiety.
Furthermore, we would expect cognitive vulnerability to exhibit a high degree of selec-
tivity within a diathesis– stress framework, so that it would only surface when the vulner-
able person anticipates encountering specific types of potentially threatening situations.
Thus an enduring tendency to misinterpret certain types of potential threat and one’s
ability to manage this threat would remain dormant until activated by relevant trauma or
other forms of perceived stress. Once activated, the threat schemas would dominate the
information- processing system whenever a relevant threat- related cue is encountered.
Like other anxiety researchers, we believe a cognitive vulnerability for anxiety
develops through repeated experiences of neglect, abandonment, humiliation, and even
trauma that can occur during childhood and adolescence (see Barlow, 2002; Chorpita
& Barlow, 1998; Craske, 2003). Certain parenting practices such as overprotection,
restriction of independence and autonomy, preoccupation with potential danger, and
encouraging escape and avoidance in response to anxiety could all contribute to the
development of a cognitive vulnerability to anxiety. Although there is some empirical
evidence that supports this conjecture, much of it is based on retrospective assessment
of childhood experiences (McNally et al., 2001). Large community-based longitudinal
studies that begin in childhood are needed in order to determine the developmental
antecedents of cognitive vulnerability to anxiety.
The present account of cognitive vulnerability is consistent with the proposals of
other cognitive- behavioral researchers. M. W. Eysenck (1992), for example, proposed
a hypervigilance theory of anxiety in which individuals with high trait anxiety have an
attentional system that is oriented toward threat detection when they are in potentially
threatening situations or in a state of high anxiety. Craske (2003) suggested that both
negative affectivity and a threat-based style of emotional regulation (i.e., a response
to arousal and distress characterized by avoidance and danger-laden expectations) are
vulnerability factors for anxiety. Rachman (2004) noted that people may be primed to
detect threat cues and overlook or minimize safety information. Mathews and MacLeod
(2002) argued that attentional and interpretative biases for threat constitute a vulner-
ability to anxiety. And Wells (2000) proposed that enduring metacognitive beliefs (i.e.,
beliefs about one’s thoughts) about worry, judgments of cognitive confidence, and the
importance of monitoring one’s thought processes constitutes a vulnerability for emo-
tional disorders.
Our focus on the cognitive basis of vulnerability to anxiety must be understood
within the context of other etiological factors such as biological and developmental
determinants, NA, trait anxiety, anxiety sensitivity, diminished personal control, and
the like. This broader view of vulnerability is represented in Figure 4.1.
Prepotent threat schemas and perceived personal vulnerability or weakness are more
specific cognitive constructs that directly reflect the slightly broader constructs of high
anxiety sensitivity, diminished personal control, and sensitivity to negative evaluation,
which in turn are related to broad traits of negative emotionality and high trait anxiety.
In this way vulnerability to anxiety disorders involves the interaction of multiple path-
ways emanating from constitutional, developmental, environmental, personality, and
information- processing domains. Based on this framework for vulnerability, we turn to
consider the empirical evidence for the two main components of the model: an enduring
sense of personal vulnerability and the presence of hypervalent threat schemas.

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