The Language of Feeling and the Feeling of Anxiety: Contributions of the Behaviorisms Toward Understanding The Function-Altering Effects of Language

Why We Are Not Acting to Save Ourselves: ACT, Health, and Culture

Chronic health conditions are increasing at an alarming rate worldwide, and many could be prevented if people were to engage in specific lifestyle behaviors. Intervening on lifestyle behaviors is challenging due to the fact that the consequences associated with unhealthy behaviors are temporally distant and probabilistic, and the aversive functions of covert stimuli may interfere with people's engagement in healthy, preventative behaviors. This article explores the role of relational framing in the promotion of healthy lifestyle behaviors and summarizes research supporting the use of acceptance and commitment training (ACT) as a framework for prevention and intervention. We explore how ACT alters the context in which rigid patterns of rule following occur. ACT loosens the literal functions of stimuli so that experiential-avoidance behaviors are weakened, and healthy, values-consistent behaviors are strengthened. We propose culture-wide interventions inspired by contextual behavior science so that healthier societies can be cultivated.

Related to Anxiety: Arbitrarily Applicable Relational Responding and Experimental Psychopathology Research on Fear and Avoidance

Humans have an unparalleled ability to engage in arbitrarily applicable relational responding (AARR). One of the consequences of this ability to spontaneously combine and relate events from the past, present, and future may, in fact, be a propensity to suffer. For instance, maladaptive fear and avoidance of remote or derived threats may actually perpetuate anxiety. In this narrative review, we consider contemporary AARR research on fear and avoidance as it relates to anxiety. We first describe laboratory-based research on the emergent spread of fear- and avoidance-eliciting functions in humans. Next, we consider the validity of AARR research on fear and avoidance and address the therapeutic implications of the work. Finally, we outline challenges and opportunities for a greater synthesis between behavior analysis research on AARR and experimental psychopathology.

A higher-order theory of emotional consciousness

Emotional states of consciousness, or what are typically called emotional feelings, are traditionally viewed as being innately programmed in subcortical areas of the brain, and are often treated as different from cognitive states of consciousness, such as those related to the perception of external stimuli. We argue that conscious experiences, regardless of their content, arise from one system in the brain. In this view, what differs in emotional and nonemotional states are the kinds of inputs that are processed by a general cortical network of cognition, a network essential for conscious experiences. Although subcortical circuits are not directly responsible for conscious feelings, they provide nonconscious inputs that coalesce with other kinds of neural signals in the cognitive assembly of conscious emotional experiences. In building the case for this proposal, we defend a modified version of what is known as the higher-order theory of consciousness.

Why it is crucial to understand thinking and feeling: An analysis and application to drug abuse

Behavior analysis has long accepted the legitimacy of the analysis of private events in a natural science of behavior. However, the topic has languished as a focus of empirical research in either applied or basic arenas. We argue that recent empirical work examining the bidirectional nature of verbal relations may shed light on the role of private events in complex human behavior. Skinner argued that although it would be possible to analyze private events, we need not, because thoughts and feelings were viewed as co-occuring products of the same contingencies that are responsible for changes in overt responses. However, the bidirectional transformation of stimulus function inherent in verbal behavior changes the way that private events participate in complex behavioral episodes for verbal organisms. We examine why we have reached such a conclusion, with special emphasis on the role of self-awareness. Finally, we conclude with an application of our analysis to the problem of substance abuse.

Transfer of aversive respondent elicitation in accordance with equivalence relations

The present study investigates the transfer of aversively conditioned respondent elicitation through equivalence classes, using skin conductance as the measure of conditioning. The first experiment is an attempt to replicate Experiment 1 in Dougher, Augustson, Markham, Greenway, and Wulfert (1994), with different temporal parameters in the aversive conditioning procedure employed. Match-to-sample procedures were used to teach 17 participants two 4-member equivalence classes. Then, one member of one class was paired with electric shock and one member of the other class was presented without shock. The remaining stimuli from each class were presented in transfer tests. Unlike the findings in the original study, transfer of conditioning was not achieved. In Experiment 2, similar procedures were used with 30 participants, although several modifications were introduced (formation of five-member classes, direct conditioning with several elements of each class, random sequences of stimulus presentation in transfer tests, reversal in aversive conditioning contingencies). More than 80% of participants who had shown differential conditioning also showed the transfer of function effect. Moreover, this effect was replicated within subjects for 3 participants. This is the first demonstration of the transfer of aversive respondent elicitation through stimulus equivalence classes with the presentation of transfer test trials in random order. The latter prevents the possibility that transfer effects are an artefact of transfer test presentation order.

A contemporary behavior analysis of anxiety and avoidance

Despite the central status of avoidance in explaining the etiology and maintenance of anxiety disorders, surprisingly little behavioral research has been conducted on human avoidance. In the present paper, first we provide a brief review of the empirical literature on avoidance. Next, we describe the implications of research on derived relational responding and the transformation of functions for a contemporary behavioral account of avoidance, before providing several illustrative research examples of laboratory-based analogues of key clinical treatment processes. Finally, we suggest some challenges and opportunities that lie ahead for behavioral research on anxiety and avoidance.

Cardiophobia: a critical analysis

Cardiophobia, a clinical syndrome that affects hundreds of thousands of individuals in the USA, is characterized by abrupt, recurrent sensations and pain in the chest in the absence of physical pathology. This conceptual article seeks to address the significance of cardiophobia in western culture and to distinguish it from related disorders. In addition, a model of cardiophobia that highlights the role of heart-focused anxiety and interoceptive conditioning in the generation of limited-symptom panic attacks and acute chest pain is presented and vulnerability factors for cardiophobia are discussed. Future research directions relevant to the assessment and treatment of this clinically significant phenomenon are reviewed.

Transformation of avoidance response functions in accordance with same and opposite relational frames

Research on the emergence of human avoidance behavior in the absence of direct contact with an aversive event is somewhat limited. Consistent with work on derived relational responding, the present study sought to investigate the transformation of avoidance response functions in accordance with the relational frames of Same and Opposite. Participants were first exposed to nonarbitrary and arbitrary relational training and testing in order to establish Same and Opposite relations among arbitrary stimuli. The training tasks were; Same-A1-B1, Same-A1-C1, Opposite-A1-B2, Opposite-A1-C2. Next, all possible combinatorially entailed (i.e., B-C and C-B) relations were tested. During the avoidance-conditioning phase, one stimulus (B1) from the relational network signaled a simple avoidance response that cancelled a scheduled presentation of an aversive image and sound. All but one of the participants who met the criteria for conditioned avoidance also demonstrated derived avoidance by emitting the avoidance response in the presence of C1 and the nonavoidance response in the presence of C2. Control participants who were not exposed to relational training and testing did not show derived avoidance. Implications of the findings for understanding clinically significant avoidance behavior are discussed.

Evaluative differential conditioning of disgust: a sticky form of relational learning that is resistant to extinction

The present study sought to (a) test whether autonomic (i.e., electrodermal) and evaluative conditioning can be differentially established to verbal CSs, and (b) whether extinction procedures can reliably attenuate differential conditioned evaluative responding. Thirty undergraduates underwent a 10-min adaptation period followed by three consecutive conditioning phases: habituation, acquisition, and extinction. Conditioning involved participants viewing two semi-randomly presented words on a computer monitor. During acquisition, one word (CS+) was reliably paired 12 times with the UCS (pictorial stimuli depicting bodily mutilation), whereas the remaining word (CS-) was presented 12 times and reliably followed by neutral pictures (inanimate common objects). As predicted, electrodermal and evaluative responses during acquisition were of larger magnitude to the CS+ compared to the CS-. During extinction, participants continued to evaluate the CS+ as more disgusting relative to the CS-, whereas distress and fear-related emotional ratings attenuated across extinction trials. The implications of these findings for the modifiability of disgust-based evaluative responses in specific anxiety disorders will be discussed.

Multimodal classical conditioning of fear: contributions of direct, observational, and verbal experiences to current fears

The authors propose that a multimodal classical conditioning model be considered when clinicians or clinical researchers study the etiology of fears and anxieties learned by human beings. They argue that fears can be built through the combined effects of direct, observed, and verbally presented classical conditioning trials. Multimodal classical conditioning is offered as an alternative to the three pathways to fear argument prominent in the human fear literature. In contrast to the three pathways position, the authors present theoretical arguments for why "learning by observation" and "learning through the receipt of verbal information" should be considered classical conditioning through observational and verbal modes. The paper includes a demonstration of how data, commonly collected in research on the three pathways to fear, would be studied differently using a multimodal classical conditioning perspective. Finally, the authors discuss implications for assessment, treatment, and prevention of learned fears in humans.

The effects of acceptance versus control contexts on avoidance of panic-related symptoms

The present study compared the effects of creating an acceptance versus a control treatment context on the avoidance of aversive interoceptive stimulation. Sixty high anxiety sensitive females were exposed to two 10-min periods of 10% carbon dioxide enriched air, an anxiogenic stimulus. Before each inhalation period, participants underwent a training procedure aimed at encouraging them either to mindfully observe (acceptance context) or to control symptoms via diaphragmatic breathing (control context). A third group was given no particular training or instructions. We hypothesized that an acceptance rather than control context would be more useful in the reduction of anxious avoidance. Compared to control context and no-instruction participants, acceptance context participants were less avoidant behaviorally and reported less intense fear and cognitive symptoms and fewer catastrophic thoughts during the CO(2) inhalations. We discuss the implications of our findings for an acceptance-focused vs. control-focused context when conducting clinical interventions for panic and other anxiety disorders.

The relations of anxiety sensitivity, experiential avoidance, and alexithymic coping to young adults' motivations for drinking

The authors examined whether motivations for drinking alcohol are associated with the anxiety-related dispositional tendencies of anxiety sensitivity, experiential avoidance, and alexithymic coping. The authors administered the Anxiety Sensitivity Index, Experiential Avoidance Scale, 20-item Toronto Alexithymia Scale, Revised Drinking Motives Questionnaire, and a demographics questionnaire to 182 university drinkers. In multiple regressions, the dispositional factors significantly predicted the risky drinking motives of coping, enhancement, and conformity. Coping and enhancement motives were significantly predicted by experiential avoidance. Conformity motives were significantly and independently predicted by anxiety sensitivity and alexithymia. The process of experiential avoidance mediated the bivariate correlation between anxiety sensitivity and coping-motivated drinking to a greater extent than did the process of alexithymic coping. The authors discuss the observed relations in regard to the psychological functions of drinking behavior that may portend the development of heavy drinking and alcohol problems in dispositionally vulnerable individuals. They also review implications for refinements of behavior therapy for problem drinkers.

Emotion

We review recent trends and methodological issues in assessing and testing theories of emotion, and we review evidence that form follows function in the affect system. Physical limitations constrain behavioral expressions and incline behavioral predispositions toward a bipolar organization, but these limiting conditions appear to lose their power at the level of underlying mechanisms, where a bivalent approach may provide a more comprehensive account of the affect system.

Why behavior analysts should study emotion: the example of anxiety

Historically, anxiety has been a dominant subject in mainstream psychology but an incidental or even insignificant one in behavior analysis. We discuss several reasons for this discrepancy. We follow with a behavior-analytic conceptualization of anxiety that could just as easily be applied to emotion in general. Its primary points are (a) that languageable humans have an extraordinary capacity to derive relations between events and that it is a simple matter to show that neutral stimuli can acquire discriminative functions indirectly with no direct training; (b) that private events can readily acquire discriminative functions; (c) that anxiety disorders seem to occur with little apparent direct learning or that the amount of direct learning is extraordinarily out of proportion with the amount of responding; and (d) that the primary function of anxious behavior is experiential avoidance. We conclude that the most interesting aspects of anxiety disorders may occur as a function of derived rather than direct relations between public events and overt and private responses with avoidance functions. Implicit in this conclusion and explicit in the paper is the assertion that anxiety is a suitable subject for behavior-analytic study.

Unearthing the nonassociative origins of fears and phobias: a rejoinder

In recent years numerous disagreements and controversies have ensued over the place of Pavlovian or associative conditioning in the etiology of specific phobias and other fear-related clinical syndromes. A major source of disagreement emerged from clinical observations suggesting that environmental aversive conditioning events could not be identified for many specific phobias. Part of the controversy can also be traced to disagreements over what constitutes a direct conditioning event and over what exactly is being conditioned in phobic acquisition. More fundamental, however, is confusion over the critical process variables involved in the conditioning etiology of human phobias and fear-related clinical syndromes. We address some of the recent controversies surrounding associative conditioning accounts of phobic onset in light of recent proposals that nonassociative factors account for the etiology of many specific phobias. The viability of the nonassociative position is questioned and alternatives are suggested that emphasize the complex and multifaceted processes involved in the etiology of specific phobias.

Cognitive vs. contextual causation: different world views but perhaps not irreconcilable

In this commentary, we address some of the divisive issues between cognitive theorists and behavior analysts concerning the aims and goals of science and differing views of causality. We suggest that evidence for the causal status of cognition has been inconclusive, largely due to the fact that most of this research can be framed in terms of environmental causes. We examine (1) what we can consider as causes of behavior and (2) how we can manipulate these causes in therapy. We conclude that a rapprochement between cognitivists and behavior analysts will require more careful description of the multiple causal pathways responsible for experimental and therapeutic effects.

"Cleaning-up cognition" in triple-response fear assessment through individualized functional behavior analysis

Improvements in behavioral assessment spurred by the triple-response concept have been overshadowed by a preoccupation with content of assessment and a lack of regard for the context of assessment. The aims of this article are to (a) clarify the imprecise use of the verbal-subjective-cognitive mode and to reinterpret cognitive events based on evidence and methods derived from clinical behavior analysis, (b) discuss the limitations of the triple-response assessment framework, and (c) suggest an alternative functional idiographic approach to assessment and treatment that may direct attention toward behavior relations understood functionally within the context of environmental contingencies; an approach that once was the hallmark of behavior therapy and the basis for therapeutic interventions.

More theory-driven and less diagnosis-based behavior therapy

Individualized treatment based on a functional analysis of problem behavior used to be considered a hallmark of behavior therapy. Yet the relative success of recently developed treatment manuals for DSM-defined disorders has cast doubts as to whether treatment individualization is really necessary. This article evaluates some of the relative merits of assessments and manualized treatments based on DSM categories and discusses data that indicate when a protocol treatment approach is sufficient and when it is not. Finally, a theory-driven approach to conducting behavior therapy is proposed as a way to complement individualized and manualized treatments. This approach is illustrated by presenting a model-based assessment and treatment approach to overcome excessive heart-focused anxiety (cardiophobia).