Causes of Abnormal Behavior

Anxiety…
Consider how these factors might work together to contribute to an anxiety disorder:
• Genetics
• Sensitive fear pathways
• Attention to threat cues
• Classical conditioning
• Societal/cultural expectations
• Family modeling of anxiety
• Stressful life events
• Sense of lack of control

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you can use your creativity and apply these to specific examples. You also can consider the case of Agnes posted on the

course website; the case of Bob presented in lecture (who had a fear of flying; see “Causes of Abnormal Behavior” topic); or

the case of Anne (mentioned in lecture from the book Dying of Embarrassment: a 7th grader with writer’s block and

test-taking anxiety; Anne knows the material when her mother quizzes her at home, but when she gets to school and goes to

take the test, she freezes and her mind goes blank. One specific outcome of her anxiety is that she ends up with ‘C’ grades

rather than ‘A’ grades.) Again, how might some of the above factors work together to cause and perpetuate Agnes’s, Bob’s,

and/or Anne’s anxiety?

The Case of Agnes
Agnes is a thin, reasonably attractive 43-yearold white female who was brought to the community mental health center in the

eastern seaboard city in which she lived. Her 22-yearold daughter brought her in, stating that Agnes was driving her crazy

with requests that she accompany her everywhere. Agnes reports that she has always been a “tense” person, has experienced

agoraphobic ‘symptoms off and on during the last seven years, but the intensity has increased substantially in the last six

months. For the past four years, Agnes has also suffered with what she refers to as “heart disease.” She has often taken

herself to a cardiologist, complaining of rapid or irregular heartbeats. The physician always reassured her that he saw no

pathology and believed that it was probably a result of anxiety and tension. He advised her to exercise regularly and

prescribed tranquilizers for any severe episodes of anxiety. Agnes occasionally uses the tranquilizers, but not to any

significant extent. It is interesting that she has never experienced any of the symptoms at home, even though she does

rather heavy housework without any assistance. The agoraphobic pattern took a severe turn for the worse six months ago

during the middle of winter, while Agnes was visiting her daughter. Her daughter had taken her own child to a movie, leaving

Agnes alone in their home. There had been a severe snowstorm the day before. It was difficult for cars to get about, and

Agnes became fearful that she was isolated. She tried to call her sister, who lives in a nearby city, only to find that the

phone was dead. At this point, Agnes began to panic, noticed her heart beating rapidly, and thought she was going to have a

heart attack. When Agnes’s daughter eventually came home after the movie and some shopping, Agnes was extremely distraught.

She was lying on the couch, crying and moaning, and had started to drink to try to lose consciousness. After her daughter

returned, Agnes continued to drink, and with the added reassurance of her daughter, she managed to fall asleep. When she

awakened, she felt better and refused to seek help for her fears. In the last six months, she has had other similar

experiences of near panic at the thought of being alone. Agnes’s husband, who is a sales representative for a national

manufacturing company, spends a lot of time on the road. When he is home, he is no longer willing to listen to Agnes’s

complaints. But the problem is not as apparent then, since Agnes relaxes considerably when her husband accompanies her on

outings. Even though she can acknowledge that her behaviors are absurd and not warranted by demands in her environment,

Agnes is still compelled to perform within this pattern. As is often the case with agoraphobia, Agnes shows an accompanying

level of depression, since she has a sense of helplessness about controlling the events of her world. In that sense, she

reflects the phenomenon referred to as “learned helplessness.” Agnes did not have a difficult or 37 unhappy childhood. Her

father was very authoritarian and dis