558 CHAPTER 14
actually are. In panic disorder, for example, a person might interpret a racing heartbeat
as a sign of a heart attack instead of just a momentary arousal.
Cognitive-behavioral psychologists may see anxiety as related to another distorted
thought process called all-or-nothing thinking, in which a person believes that his or
her performance must be perfect or the result will be a total failure. Overgeneralization
(a single negative event interpreted as a never-ending pattern of defeat), jumping to con-
clusions without facts to support that conclusion, and minimization (giving little or no
emphasis to one’s successes or positive events and traits) are other examples of irratio-
nal thinking. In a recent study with firefighters, a profession with repeated exposure to
trauma, research suggests cognitive flexibility in regulating emotions according to the
demands of particular situations can protect someone from developing PTSD symptoms
(Levy-Gigi et al., 2016).BIOLOGICAL FACTORS Growing evidence exists that biological factors contribute to
anxiety disorders. Several disorders, including generalized anxiety disorder, panic
disorders, phobias, and OCD, tend to run in families, pointing to a genetic basis for
these disorders. Furthermore, genetic factors in PTSD seem to influence both the risk
of developing the disorder and the likelihood individuals may be involved in poten-
tially dangerous situations (Hyman & Cohen, 2013). Functional neuroimaging stud-
ies, to Learning Objective 2.9, have revealed that the amygdala, an area of
the limbic system, is more active in phobic people responding to pictures of spiders
than in nonphobic people (LeDoux, 2003; Rauch et al., 2003) and also more active in
individuals with PTSD and social anxiety disorder, suggesting excessive condition-
ing and exaggerated responses to stimuli that would typically elicit minimal fear -
related responses (Hyman & Cohen, 2013). to Learning Objectives 2.11, 6.12,
and 9.8. Structural neuroimaging studies have also been helpful, to Learning
Objective 2.9, in that specific brain areas have been associated with a variety of anx-
iety disorders, namely reductions of gray matter in the parts of the right ventral
anterior cingulate gyrus (at the bottom and front of the right cingulate gyrus) and left
inferior frontal gyrus (Shang et al., 2014). In a study of individuals across six different
psychological disorders, reductions in gray matter were found in the dorsal anterior
(at the top and front) cingulate gyrus and both the left and right insula (Goodkind
et al., 2015).CULTURAL VARIATIONS Anxiety disorders are found around the world, although the
particular form the disorder takes might be different in various cultures. For exam-
ple, in some Latin American cultures, anxiety can take the form of ataque de nervios,
or “attack of nerves,” in which the person may have fits of crying, shout uncontrol-
lably, experience sensations of heat, and become very aggressive, either verbally or
physically. These attacks usually come after some stressful event such as the death
of a loved one (American Psychiatric Association, 2013). Several syndromes that are
essentially types of phobias are specific to certain cultures. For example, koro, found
primarily in China and a few other South Asian and East Asian countries, involves a
fear that one’s genitals are shrinking (Pfeiffer, 1982), and taijin kyofusho (TKS), found
primarily in Japan, involves excessive fear and anxiety, but in this case it is the fear
that one will do something in public that is socially inappropriate or embarrassing,
such as blushing, staring, or having an offensive body odor (Kirmayer, 1991). Panic
disorder occurs at similar rates in adolescents and adults in the United States and
parts of Europe but is found less often in Asian, African, and Latin American coun-
tries. Within the United States, Native Americans have significantly higher rates,
whereas Latinos, African Americans, Caribbean blacks, and Asian Americans have
significantly lower rates as compared to non-Latino whites (American Psychiatric
Association, 2013).all-or-nothing thinking
the tendency to Delieve that oneos
performance must be perfect or the
result will be a total failure.
overgeneralization
distortion of thinking in which a
person draws sweeping conclusions
based on only one incident or event
and applies those conclusions to
events that are unrelated to the
original; the tendency to interpret a
single negative event as a neverending
pattern of defeat and failure.
minimization
distortions of thinking in which a
person blows a negative event out
of proportion to its importance
( magnification) while ignoring relevant
positive events (minimization).