What is an anxiety disorder?

Journal of Neurology and Neuroscience, 2019

Starting from the concept of anxiety, we proceeded to separate the “physiological” form from the “pathological” forms, distinguishing between fear, anguish, panic, phobia, fear, terror and stress, all terms often confused and overlapped in the common jargon. Distinguishing the individual psychopathologies contained in DSM-V anxiety disorders, with a focus on the psychodynamic profile, the analysis focused on the neural correlates involved in anxiety disorders and on the best pharmacological and psychotherapeutic approaches chosen to treat the morbid condition, paying particular attention to the strategic model and the most important clinical techniques.

The role of anxiety sensitivity in the development and treatment of psychiatric disorders is an issue that should receive attention. In this study, it was aimed to examine the existence of cognitive concerns in patients diagnosed

Rivista di psichiatria

The mental defence system plays a central role in ensuring individual and species survival from dangers. The cost of its activation is a decrease in freedom in favour of an increase in safety. Anxiety, fear and panic are the organizing principles of this system: anxiety arising in response to the anticipation of a threat, fear arising in response to external environmental threats and panic arising in response to internal somatic homeostatic threats. Beyond the correct identification of the above-mentioned organizing principles, making correct therapeutic choices is linked to the ability to discriminate among physiological, pathological and pathophysiological anxiety phenomena. The intensity of the defence reaction is inadequate in determining that its pathological nature is related to the subjective evaluation of a disproportional reaction between individual resources and the potential threat. Very often, the anxious defensive reaction, which to an external observer seems disproportional, is coherent and adequate relative to the personal experience of the patient, and thus, it is not pathological.

The Australian and New Zealand journal of psychiatry, 2014

Journal of Anxiety Disorders, 2001

Most research on anxiety sensitivity (AS) and its relation to psychopathology has examined the Anxiety Sensitivity Index (ASI) in various clinical samples. The present study was the first to investigate psychopathological correlates of AS using self-report measures, the anxiety, somatoform, and substance use disorders sections of the Structured Clinical Interview for the DSM-IV (SCID), and open-ended interview questions about the subjective meaning and origins of AS. A college student sample (N=317) was used for the correlational analysis, and subsamples of high-AS (n=44) and low-AS (n=41) participants completed the interviews. Despite having an ASI score (Mean=35.0) that was equivalent to that observed in panic disorder samples, the screening questions in the clinical interview indicated that only 55% of high-AS participants had panic attacks and the diagnostic assessment indicated that only 30% met criteria for an anxiety disorder. Several findings suggested that AS, at least as measured by the ASI, was strongly related to anxiety disorder symptoms and diagnoses, although there was substantial variation within the anxiety disorder classifications. There was also evidence that AS might extend to a broader catastrophic style concerning bodily symptoms and health that go beyond anxiety symptoms per se. The subjective meaning of AS derived from the interview data stressed the need for a formal, structured interview of AS.

Motivation and Emotion, 2018

Generalized anxiety disorder (GAD) is characterized by a range of cognitive and affective disruptions, such as pathological worry. There is debate, however, about whether such disruptions are specifically linked to heightened responses to aversive stimuli, or due to overgeneralized threat monitoring leading to deficits in the ability to discriminate between aversive and non-aversive affective information. The present study capitalized on the temporal and functional specificity of scalp-recorded event-related potentials (ERPs) to examine this question by exploring two targeted neurocognitive responses in a group of adults diagnosed with GAD: 1) visual processing of angry (aversive) versus neutral (non-aversive) faces; and 2) response monitoring of incorrect (aversive) versus correct (non-aversive) responses. Electroencephalography was recorded while 15 adults with GAD and 15 age-matched controls viewed angry and neutral faces prior to individual trials of a flanker task. ERPs to faces were the P1, reflecting attention allocation, the early posterior negativity (EPN), reflecting early affective discrimination, and the N170, reflecting face-sensitive visual discrimination. The error-related negativity (ERN) and positivity (Pe) were generated to incorrect and correct responses. Results showed reduced discrimination between aversive and nonaversive faces and responses in the GAD relative to the control group during visual discrimination (N170) and later-emerging error monitoring (Pe). These effects were driven by exaggerated processing of non-aversive faces and responses, suggesting over-generalized threat monitoring. Implications for cognitive-affective models of GAD are discussed. Generalized anxiety disorder (GAD) is among the most commonly-diagnosed anxiety disorders (Ballenger, Davidson, Lecrubier, Nutt, Borkovec, Rickels, et al., 2001) affecting an estimated 5.7% of the adult population in their lifetime and over 18 million individuals in the U.S. alone (Kessler et al., 2005). Recent theoretical models of GAD (Mennin, Heimberg,

Journal of Behavior Therapy and Experimental Psychiatry, 1980

A review of 41 clinical and 54 analogue studies was undertaken to evaluate the relationship between anxiety response channels-physiological, behavioral and cognitive. The results indicated that congruence among response channels tended to be higher for the clinical populations than for the analogue populations. The data tend best to support Hodgson and Rachman's (1974) theory that anxiety channel congruence increases as a function of intensity of the anxiety. Tentative support was found for Bernstein and Paul's (1971) assertion that analogue and clinical subjects are sufficiently dissimilar as to obstruct the generalization of findings from one population to the other. Lastly, the congruence patterns suggest that behavioral andcognitive measures are less reliable indices of anxiety than physiological measures, especially in analogue samples.

2006

The nosological The nosological organisation of DSM^IVand ICD^10 does organisation of DSM^IVand ICD^10 does not capture the empirical structure of notcapture the empirical structure of the mood and anxiety disorders.Instead, the mood and anxiety disorders.Instead, they form a broad group of 'internalising' they form a broad group of 'internalising' disorders with two subclasses: distress disorders with two subclasses: distress disorders and fear disorders.This disorders and fear disorders.This empirical structure should form the empirical structure should form the basis for revised taxonomies in DSM^V basis for revised taxonomies in DSM^V and ICD^11. and ICD^11.

A wealth of research demonstrates attentional biases toward threat in the anxiety disorders. Several models have been advanced to explain these biases in anxiety, yet the mechanisms comprising and mediating the biases remain unclear. In the present article, we review evidence regarding the mechanisms of attentional biases through careful examination of the components of attentional bias, the mechanisms underlying these components, and the stage of information processing during which the biases occur. Facilitated attention, difficulty in disengagement, and attentional avoidance comprise the components of attentional bias. A threat detection mechanism likely underlies facilitated attention, a process that may be neurally centered around the amygdala. Attentional control ability likely underlies difficulty in disengagement, emotion regulation goals likely underlie attentional avoidance, and both of these processes may be neurally centered around prefrontal cortex functioning. The threat detection mechanism may be a mostly automatic process, attentional avoidance may be a mostly strategic process, and difficulty in disengagement may be a mixture of automatic and strategic processing. Recommendations for future research are discussed.

Behaviour Research and Therapy, 1992