42 COGNITIVE THEORY AND RESEARCH ON ANXIETY
and learning histories that are causal factors in the anxiety disorders (see Chapter 1).
However, the cognitive model also asserts that particular enduring schemas involving
rules and assumptions about danger and helplessness may predispose an individual to
anxiety. See Chapter 4 for discussion of cognitive, personality, and emotional factors
that may be contributors to the etiology of anxiety.
DesCription of the Cognitive moDelThe cognitive model depicted in Figure 2.1 is divided into an early, immediate phase of
fear response, followed by a slower, more elaborative processing phase that determines
the persistence or termination of the anxious state. Our discussion of the cognitive
model will proceed from the far left of the diagram to the end product at the far right.
Although this allows us to provide a systematic presentation of the cognitive model, in
reality all structures and processes involved in anxiety are activated almost simultane-
ously, and all are so interrelated that reciprocal feed forward and feedback loops are
clearly evident throughout the anxiety program.
Activating Situations, Events, and Stimuli
Environmental factors are important in the cognitive model because anxiety is a response
to an internal or external stimulus that triggers an appraisal of threat. In this sense the
model is more consistent with a diathesis– stress perspective in which particular situa-
tions or cues (the stress) activate the anxiety program in individuals with an enduring
propensity to generate primary appraisals of threat (the diathesis). Although it is pos-
sible for anxiety to occur spontaneously, as in panic attacks that occur “out of the blue,”
the more usual pattern is situation- or cue- activated anxiety.
The types of situations that can trigger anxiety are not randomly distributed. Acti-
vating situations or stimuli will differ according to the type of anxiety disorder with,
for example, social situations as relevant triggers in social phobia, stimuli that trigger
memories of a past trauma relevant to PTSD, and circumstances perceived as elevating
risk of panic attacks relevant to panic disorder. Although the situations that provoke
anxiety are personally idiosyncratic and highly diverse even within specific anxiety dis-
orders, a stimulus will only activate the anxiety program if it is perceived as a threat to
one’s vital interests (Beck et al., 1985, 2005). This threat may be symbolic or hypotheti-
cal, as evident in GAD, or it could be perceived as real, such as when the person with
agoraphobia believes that going to a store could trigger such intense panic that a heart
attack and death could ensue.
Beck et al. (1985, 2005) conceptualized vital interests in terms of highly valued
goals or personal strivings within the social or individual domains. “Sociality” (later
termed “sociotropy”) refers to goals that involve the establishment and maintenance of
close, satisfying, and self- affirming relationships with others, whereas “individuality”
(i.e., “autonomy”) refers to goals relevant for gaining a personal sense of mastery, iden-
tity, and independence. Furthermore, these goals can be expressed in either the public
or the private sphere. From this a classification of vital interests can be constructed that
enables a better understanding of how situations might be interpreted in a threatening
manner (see Table 2.3).