Jump to content

Anxiety: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
No edit summary
The page was lacking some information so I did my part.
Line 23: Line 23:
{{Emotion}}
{{Emotion}}


'''Anxiety''' is an [[emotion]] characterized by an unpleasant state of inner turmoil, often accompanied by nervous behaviour such as pacing back and forth, [[Somatic anxiety| somatic complaints]], and [[Rumination (psychology)| rumination]].<ref name="Seligman">{{cite book | vauthors = Seligman ME, Walker EF, Rosenhan DL |author3-link= David Rosenhan |author1-link= Martin Seligman |title= Abnormal psychology |edition= 4th |location= New York |publisher= W.W. Norton & Company}}{{Page needed|date= May 2013}}</ref> It is the subjectively unpleasant feelings of dread over anticipated events, such as [[Death anxiety (psychology) |the feeling of imminent death]].<ref>{{cite book |last= Davison |first= Gerald C. | name-list-format = vanc |title= Abnormal Psychology |year= 2008 |publisher= Veronica Visentin |location= Toronto |isbn= 978-0-470-84072-6 |page= 154}}</ref>{{qn|date=November 2018}} Anxiety is not the same as [[fear]], which is a response to a real or perceived immediate [[threat]],<ref name = "DSM-5 189">{{Cite book | last= American Psychiatric Association | year= 2013 | title= Diagnostic and Statistical Manual of Mental Disorders | edition =Fifth | publisher= American Psychiatric Publishing | location= Arlington, VA | page= 189 | isbn = 978-0-89042-555-8 }}</ref> whereas anxiety involves the expectation of future threat.<ref name = "DSM-5 189"/> Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an [[overreaction]] to a situation that is only subjectively seen as menacing.<ref>{{cite book | vauthors = Bouras N, Holt G |year= 2007 |title= Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities |edition= 2nd |publisher =Cambridge University Press | url = https://books.google.com/books?id=E_9Rlqs4T7oC}}{{Page needed|date= May 2013}}</ref> It is often accompanied by muscular tension,<ref name = "DSM-5 189"/> restlessness, [[Fatigue (medical)| fatigue]] and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an [[anxiety disorder]].<ref name = "DSM-5 189"/>
'''Anxiety''' is an [[emotion]] characterized by an unpleasant state of inner turmoil, often accompanied by nervous behaviour such as pacing back and forth, [[Somatic anxiety| somatic complaints]], and [[Rumination (psychology)| rumination]].<ref name="Seligman">{{cite book | vauthors = Seligman ME, Walker EF, Rosenhan DL |author3-link= David Rosenhan |author1-link= Martin Seligman |title= Abnormal psychology |edition= 4th |location= New York |publisher= W.W. Norton & Company}}{{Page needed|date= May 2013}}</ref> It is the subjectively unpleasant feelings of dread over anticipated events, such as [[Death anxiety (psychology) |the feeling of imminent death]].<ref>{{cite book |last= Davison |first= Gerald C. | name-list-format = vanc |title= Abnormal Psychology |year= 2008 |publisher= Veronica Visentin |location= Toronto |isbn= 978-0-470-84072-6 |page= 154}}</ref><ref>{{Cite web|url=http://www.crystalinks.com/anxiety.html|title=Anxiety - Crystalinks|website=www.crystalinks.com|access-date=2019-02-06}}</ref> Anxiety is not the same as [[fear]], which is a response to a real or perceived immediate [[threat]],<ref name = "DSM-5 189">{{Cite book | last= American Psychiatric Association | year= 2013 | title= Diagnostic and Statistical Manual of Mental Disorders | edition =Fifth | publisher= American Psychiatric Publishing | location= Arlington, VA | page= 189 | isbn = 978-0-89042-555-8 }}</ref> whereas anxiety involves the expectation of future threat.<ref name = "DSM-5 189"/> Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an [[overreaction]] to a situation that is only subjectively seen as menacing.<ref>{{cite book | vauthors = Bouras N, Holt G |year= 2007 |title= Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities |edition= 2nd |publisher =Cambridge University Press | url = https://books.google.com/books?id=E_9Rlqs4T7oC}}{{Page needed|date= May 2013}}</ref> It is often accompanied by muscular tension,<ref name = "DSM-5 189"/> restlessness,[[Fatigue (medical)| fatigue]] and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an [[anxiety disorder]].<ref name = "DSM-5 189"/>


People facing anxiety may withdraw from situations which have provoked anxiety in the past.<ref name="Barker, P. 2003">{{cite book | vauthors = Barker P |year= 2003 |title= Psychiatric and Mental Health Nursing: The Craft of Caring |publisher= Edward Arnold |location= London |isbn= 978-0-340-81026-2}}{{Page needed|date= May 2013}}</ref> There are various types of anxiety. [[Existential]] anxiety can occur when a person faces [[angst]], an [[existential crisis]], or [[Nihilism| nihilistic]] feelings. People can also face [[mathematical anxiety]], [[somatic anxiety]], [[stage fright]], or [[test anxiety]]. [[Social anxiety]] and [[stranger anxiety]] are caused when people are apprehensive around strangers or other people in general. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate [[Irritable bowel syndrome|IBS]]. Anxiety is often experienced by those who have an [[Obsessive–compulsive disorder|OCD]] and is an acute presence in [[panic disorder]]. The first step in the management of a person with anxiety symptoms involves evaluating the possible presence of an underlying medical cause, whose recognition is essential in order to decide the correct treatment.<ref name=WHO2009>{{cite book |author= World Health Organization |date= 2009 |title= Pharmacological Treatment of Mental Disorders in Primary Health Care |url= http://apps.who.int/iris/bitstream/10665/44095/1/9789241547697_eng.pdf |location= Geneva |isbn= 978-92-4-154769-7 |deadurl= no |archive-url= https://web.archive.org/web/20161120132530/http://apps.who.int/iris/bitstream/10665/44095/1/9789241547697_eng.pdf |archive-date= November 20, 2016 |df= mdy-all}}</ref><ref name=TestaGiannuzzi2013partIII>{{cite journal | vauthors = Testa A, Giannuzzi R, Daini S, Bernardini L, Petrongolo L, Gentiloni Silveri N | title = Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 86–99 | date = February 2013 | pmid = 23436670 | url = http://www.europeanreview.org/article/3087 }}{{open access}}</ref> Anxiety symptoms may mask an [[Disease |organic disease]], or appear associated with or as a result of a medical disorder.<ref name=WHO2009 /><ref name=TestaGiannuzzi2013partIII /><ref name=TestaGiannuzzi2013partII>{{cite journal | vauthors = Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Dain S | title = Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 65–85 | date = February 2013 | pmid = 23436669 | url = http://www.europeanreview.org/article/3085 }}{{open access}}</ref><ref name=TestaGiannuzzi2013partI>{{cite journal | vauthors = Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S | title = Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 55–64 | date = February 2013 | pmid = 23436668 | url = http://www.europeanreview.org/article/3083 }}{{open access}}</ref>
People facing anxiety may withdraw from situations which have provoked anxiety in the past.<ref name="Barker, P. 2003">{{cite book | vauthors = Barker P |year= 2003 |title= Psychiatric and Mental Health Nursing: The Craft of Caring |publisher= Edward Arnold |location= London |isbn= 978-0-340-81026-2}}{{Page needed|date= May 2013}}</ref> There are various types of anxiety. [[Existential]] anxiety can occur when a person faces [[angst]], an [[existential crisis]], or [[Nihilism|nihilistic]] feelings. People can also face [[mathematical anxiety]], [[somatic anxiety]], [[stage fright]], or [[test anxiety]]. [[Social anxiety]] and [[stranger anxiety]] are caused when people are apprehensive around strangers or other people in general. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate [[Irritable bowel syndrome|IBS]]. Anxiety is often experienced by those who have an [[Obsessive–compulsive disorder|OCD]] and is an acute presence in [[panic disorder]]. The first step in the management of a person with anxiety symptoms involves evaluating the possible presence of an underlying medical cause, whose recognition is essential in order to decide the correct treatment.<ref name=WHO2009>{{cite book |author= World Health Organization |date= 2009 |title= Pharmacological Treatment of Mental Disorders in Primary Health Care |url= http://apps.who.int/iris/bitstream/10665/44095/1/9789241547697_eng.pdf |location= Geneva |isbn= 978-92-4-154769-7 |deadurl= no |archive-url= https://web.archive.org/web/20161120132530/http://apps.who.int/iris/bitstream/10665/44095/1/9789241547697_eng.pdf |archive-date= November 20, 2016 |df= mdy-all}}</ref><ref name=TestaGiannuzzi2013partIII>{{cite journal | vauthors = Testa A, Giannuzzi R, Daini S, Bernardini L, Petrongolo L, Gentiloni Silveri N | title = Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 86–99 | date = February 2013 | pmid = 23436670 | url = http://www.europeanreview.org/article/3087 }}{{open access}}</ref> Anxiety symptoms may mask an [[Disease |organic disease]], or appear associated with or as a result of a medical disorder.<ref name=WHO2009 /><ref name=TestaGiannuzzi2013partIII /><ref name=TestaGiannuzzi2013partII>{{cite journal | vauthors = Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Dain S | title = Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 65–85 | date = February 2013 | pmid = 23436669 | url = http://www.europeanreview.org/article/3085 }}{{open access}}</ref><ref name=TestaGiannuzzi2013partI>{{cite journal | vauthors = Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S | title = Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms | journal = European Review for Medical and Pharmacological Sciences | volume = 17 Suppl 1 | pages = 55–64 | date = February 2013 | pmid = 23436668 | url = http://www.europeanreview.org/article/3083 }}{{open access}}</ref>


Anxiety can be either a short-term "state" or a long-term "[[Trait theory|trait]]". Whereas trait anxiety represents worrying about future events, anxiety disorders are a group of [[mental disorder]]s characterized by feelings of anxiety and fear.<ref name= DSM5>{{cite book|title= Diagnostic and Statistical Manual of Mental Disorders | author1=American Psychiatric Association |year= 2013|publisher= American Psychiatric Publishing |location= Arlington |isbn= 978-0-89042-555-8 |pages= 189–195 |edition= 5th | url = https://books.google.com/books?id=-JivBAAAQBAJ}}</ref> Anxiety disorders are partly genetic but may also be due to [[Mood disorder#Substance-induced |drug use]], including [[alcohol]], [[caffeine]], and [[benzodiazepines]] (which are often prescribed to treat anxiety), as well as withdrawal from [[Substance abuse |drugs of abuse]]. They often occur with other mental disorders, particularly [[bipolar disorder]], [[eating disorder]]s, [[major depressive disorder]], or certain [[personality disorder]]s. Common treatment options include [[Lifestyle (sociology) | lifestyle]] changes, medication, and [[psychotherapy|therapy]]. [[Metacognitive therapy]] seeks to diminish anxiety through reducing worry, which is seen{{by whom?|date=November 2018}} as a consequence of metacognitive beliefs.<ref>
Anxiety can be either a short-term "state" or a long-term "[[Trait theory|trait]]". Whereas trait anxiety represents worrying about future events, anxiety disorders are a group of [[mental disorder]]s characterized by feelings of anxiety and fear.<ref name= DSM5>{{cite book|title= Diagnostic and Statistical Manual of Mental Disorders | author1=American Psychiatric Association |year= 2013|publisher= American Psychiatric Publishing |location= Arlington |isbn= 978-0-89042-555-8 |pages= 189–195 |edition= 5th | url = https://books.google.com/books?id=-JivBAAAQBAJ}}</ref> Anxiety disorders are partly genetic but may also be due to [[Mood disorder#Substance-induced |drug use]], including [[alcohol]], [[caffeine]], and [[benzodiazepines]] (which are often prescribed to treat anxiety), as well as withdrawal from [[Substance abuse |drugs of abuse]]. They often occur with other mental disorders, particularly [[bipolar disorder]], [[eating disorder]]s, [[major depressive disorder]], or certain [[personality disorder]]s. Common treatment options include [[Lifestyle (sociology) | lifestyle]] changes, medication, and [[psychotherapy|therapy]]. [[Metacognitive therapy]] seeks to diminish anxiety through reducing worry, which is seen by [[Adrian Wells]] as a consequence of metacognitive beliefs.<ref>
{{Cite book
{{Cite book
| title= Metacognitive therapy for anxiety and depression
| title= Metacognitive therapy for anxiety and depression
Line 75: Line 75:
The philosopher [[Søren Kierkegaard]], in ''[[The Concept of Anxiety]]'' (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In ''Art and Artist'' (1932), the psychologist [[Otto Rank]] wrote that the [[psychological trauma]] of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.
The philosopher [[Søren Kierkegaard]], in ''[[The Concept of Anxiety]]'' (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In ''Art and Artist'' (1932), the psychologist [[Otto Rank]] wrote that the [[psychological trauma]] of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.


The [[theology|theologian]] [[Paul Tillich]] characterized existential anxiety<ref name="Tillich">{{cite book |authorlink=Paul Tillich |last=Tillich |first=Paul | name-list-format = vanc |year=1952 |title=The Courage To Be |location=New Haven |publisher=Yale University Press |isbn=978-0-300-08471-9|page=76}}</ref> as "the state in which a [[being]] is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), [[Morality|moral]] ([[guilt (emotion)|guilt]] and condemnation), and [[Spirituality|spiritual]] (emptiness and [[Meaning (existential)|meaninglessness]]). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be [[Acceptance#Self acceptance|accepted]] as part of the [[human condition]] or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by [[tradition]] and [[authority]]" even though such "undoubted certitude is not built on the rock of [[reality]]".<ref name=Tillich />
The [[theology|theologian]] [[Paul Tillich]] characterized existential anxiety<ref name="Tillich">{{cite book |authorlink=Paul Tillich |last=Tillich |first=Paul | name-list-format = vanc |year=1952 |title=The Courage To Be |location=New Haven |publisher=Yale University Press |isbn=978-0-300-08471-9|page=76}}</ref> as "the state in which a [[being]] is aware of its possible non-being" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), [[Morality|moral]] ([[guilt (emotion)|guilt]] and condemnation), and [[Spirituality|spiritual]] (emptiness and [[Meaning (existential)|meaninglessness]]). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be [[Acceptance#Self acceptance|accepted]] as part of the [[human condition]] or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by [[tradition]] and [[authority]]" even though such "undoubted certitude is not built on the rock of [[reality]]".<ref name=Tillich />


According to [[Viktor Frankl]], the author of ''[[Man's Search for Meaning]]'', when a person is faced with extreme mortal dangers, the most basic of all human wishes is to find a [[meaning of life]] to combat the "trauma of nonbeing" as death is near.<ref>{{cite book|last1=Abulof|first1=Uriel | name-list-format = vanc |title=The Mortality and Morality of Nations|date=2015|location=New York|publisher=Cambridge University Press|isbn=978-1-107-09707-0|page=26}}</ref>
According to [[Viktor Frankl]], the author of ''[[Man's Search for Meaning]]'', when a person is faced with extreme mortal dangers, the most basic of all human wishes is to find a [[meaning of life]] to combat the "trauma of nonbeing" as death is near.<ref>{{cite book|last1=Abulof|first1=Uriel | name-list-format = vanc |title=The Mortality and Morality of Nations|date=2015|location=New York|publisher=Cambridge University Press|isbn=978-1-107-09707-0|page=26}}</ref>
Line 96: Line 96:
While the term "test anxiety" refers specifically to students,<ref name="Mathur">{{cite journal |citeseerx=10.1.1.1027.7497 |url=http://medind.nic.in/daa/t11/i2/daat11i2p337.pdf |title=Impact of Hypnotherapy on Examination Anxiety and Scholastic Performance among School |journal=Delhi Psychiatry Journal |year=2011 |volume=14 |issue=2 |pages=337–42 |first1=Shachi |last1=Mathur |first2=Waheeda |last2=Khan | name-list-format = vanc }}</ref> many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.<ref>{{cite web|last1=Hall-Flavin|first1=Daniel K.| name-list-format = vanc |title=Is it possible to overcome test anxiety?|url=http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195|website=Mayo Clinic|publisher=Mayo Foundation for Medical Education and Research|access-date=11 August 2015|deadurl=no|archive-url=https://web.archive.org/web/20150905063635/http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195|archive-date=September 5, 2015|df=mdy-all}}</ref> Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.<ref name="Mathur"/>
While the term "test anxiety" refers specifically to students,<ref name="Mathur">{{cite journal |citeseerx=10.1.1.1027.7497 |url=http://medind.nic.in/daa/t11/i2/daat11i2p337.pdf |title=Impact of Hypnotherapy on Examination Anxiety and Scholastic Performance among School |journal=Delhi Psychiatry Journal |year=2011 |volume=14 |issue=2 |pages=337–42 |first1=Shachi |last1=Mathur |first2=Waheeda |last2=Khan | name-list-format = vanc }}</ref> many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.<ref>{{cite web|last1=Hall-Flavin|first1=Daniel K.| name-list-format = vanc |title=Is it possible to overcome test anxiety?|url=http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195|website=Mayo Clinic|publisher=Mayo Foundation for Medical Education and Research|access-date=11 August 2015|deadurl=no|archive-url=https://web.archive.org/web/20150905063635/http://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/expert-answers/test-anxiety/faq-20058195|archive-date=September 5, 2015|df=mdy-all}}</ref> Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.<ref name="Mathur"/>


===Stranger, social, and intergroup anxiety===
===Stranger, social, and inter-group anxiety===
{{Main|Stranger anxiety|Social anxiety}}
{{Main|Stranger anxiety|Social anxiety}}


Line 107: Line 107:
To the extent that a person is fearful of social encounters with unfamiliar others, some people may experience anxiety particularly during interactions with outgroup members, or people who share different group memberships (i.e., by race, ethnicity, class, gender, etc.). Depending on the nature of the antecedent relations, cognitions, and situational factors, intergroup contact may be stressful and lead to feelings of anxiety. This apprehension or fear of contact with outgroup members is often called interracial or intergroup anxiety.<ref>{{cite journal |doi=10.1111/j.1540-4560.1985.tb01134.x |title=Intergroup Anxiety |journal=Journal of Social Issues |volume=41 |issue=3 |pages=157–175 |year=1985 |last1=Stephan |first1=Walter G. |last2=Stephan |first2=Cookie White | name-list-format = vanc }}</ref>
To the extent that a person is fearful of social encounters with unfamiliar others, some people may experience anxiety particularly during interactions with outgroup members, or people who share different group memberships (i.e., by race, ethnicity, class, gender, etc.). Depending on the nature of the antecedent relations, cognitions, and situational factors, intergroup contact may be stressful and lead to feelings of anxiety. This apprehension or fear of contact with outgroup members is often called interracial or intergroup anxiety.<ref>{{cite journal |doi=10.1111/j.1540-4560.1985.tb01134.x |title=Intergroup Anxiety |journal=Journal of Social Issues |volume=41 |issue=3 |pages=157–175 |year=1985 |last1=Stephan |first1=Walter G. |last2=Stephan |first2=Cookie White | name-list-format = vanc }}</ref>


As is the case the more generalized forms of [[social anxiety]], intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory.<ref>{{cite journal | vauthors = Richeson JA, Trawalter S | title = The threat of appearing prejudiced and race-based attentional biases | journal = Psychological Science | volume = 19 | issue = 2 | pages = 98–102 | date = February 2008 | pmid = 18271854 | doi = 10.1111/j.1467-9280.2008.02052.x }}</ref><ref>{{cite journal | vauthors = Mathews A, Mogg K, May J, Eysenck M | title = Implicit and explicit memory bias in anxiety | journal = Journal of Abnormal Psychology | volume = 98 | issue = 3 | pages = 236–40 | date = August 1989 | pmid = 2768658 | doi = 10.1037/0021-843x.98.3.236 }}</ref><ref>{{cite journal |doi=10.1016/0191-8869(91)90096-t |title=Effects of encoding and anxiety on implicit and explicit memory performance |journal=Personality and Individual Differences |volume=12 |issue=2 |pages=131–139 |year=1991 |last1=Richards |first1=Anne |last2=French |first2=Christopher C. | name-list-format = vanc }}</ref> Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.<ref>{{cite journal | vauthors = Amodio DM, Hamilton HK | title = Intergroup anxiety effects on implicit racial evaluation and stereotyping | journal = Emotion | volume = 12 | issue = 6 | pages = 1273–80 | date = December 2012 | pmid = 22775128 | doi = 10.1037/a0029016 | citeseerx = 10.1.1.659.5717 }}</ref> Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility.<ref>{{cite journal | vauthors = Plant EA, Devine PG | title = The antecedents and implications of interracial anxiety | journal = Personality & Social Psychology Bulletin | volume = 29 | issue = 6 | pages = 790–801 | date = June 2003 | pmid = 15189634 | doi = 10.1177/0146167203029006011 }}</ref> Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.
As is the case the more generalized forms of [[social anxiety]], intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory.<ref>{{cite journal | vauthors = Richeson JA, Trawalter S | title = The threat of appearing prejudiced and race-based attentional biases | journal = Psychological Science | volume = 19 | issue = 2 | pages = 98–102 | date = February 2008 | pmid = 18271854 | doi = 10.1111/j.1467-9280.2008.02052.x }}</ref><ref>{{cite journal | vauthors = Mathews A, Mogg K, May J, Eysenck M | title = Implicit and explicit memory bias in anxiety | journal = Journal of Abnormal Psychology | volume = 98 | issue = 3 | pages = 236–40 | date = August 1989 | pmid = 2768658 | doi = 10.1037/0021-843x.98.3.236 }}</ref><ref>{{cite journal |doi=10.1016/0191-8869(91)90096-t |title=Effects of encoding and anxiety on implicit and explicit memory performance |journal=Personality and Individual Differences |volume=12 |issue=2 |pages=131–139 |year=1991 |last1=Richards |first1=Anne |last2=French |first2=Christopher C. | name-list-format = vanc }}</ref> Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.<ref>{{cite journal | vauthors = Amodio DM, Hamilton HK | title = Intergroup anxiety effects on implicit racial evaluation and stereotyping | journal = Emotion | volume = 12 | issue = 6 | pages = 1273–80 | date = December 2012 | pmid = 22775128 | doi = 10.1037/a0029016 | citeseerx = 10.1.1.659.5717 }}</ref> Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility.<ref>{{cite journal | vauthors = Plant EA, Devine PG | title = The antecedents and implications of interracial anxiety | journal = Personality & Social Psychology Bulletin | volume = 29 | issue = 6 | pages = 790–801 | date = June 2003 | pmid = 15189634 | doi = 10.1177/0146167203029006011 }}</ref> Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.


===Trait===
===Trait===
Line 168: Line 168:


====Gender socialization====
====Gender socialization====
Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.<ref>{{cite journal |doi=10.1080/03634520009379205 |title=Anticipatory anxiety patterns for male and female public speakers |journal=Communication Education |volume=49 |issue=2 |pages=187–195 |year=2000 |last1=Behnke |first1=Ralph R. |last2=Sawyer |first2=Chris R. | name-list-format = vanc }}</ref>{{mcn|date=June 2015}} Research has demonstrated the ways in which facial prominence in photographic images differs between men and women. More specifically, in official online photographs of politicians around the world, women's faces are less prominent than men's. The difference in these images actually tended to be greater in cultures with greater institutional gender equality.<ref>{{cite journal |doi=10.1177/0361684312450004 |title=Understanding Gender Differences in Anxiety |journal=Psychology of Women Quarterly |volume=36 |issue=4 |pages=488–499 |year=2012 |last1=Zalta |first1=Alyson K. |last2=Chambless |first2=Dianne L. | name-list-format = vanc }}</ref>
Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.<ref>{{cite journal |doi=10.1080/03634520009379205 |title=Anticipatory anxiety patterns for male and female public speakers |journal=Communication Education |volume=49 |issue=2 |pages=187–195 |year=2000 |last1=Behnke |first1=Ralph R. |last2=Sawyer |first2=Chris R. | name-list-format = vanc }}</ref><ref>{{Cite web|url=https://journals.sagepub.com/action/captchaChallenge?redirectUrl=https%3A%2F%2Fjournals.sagepub.com%2Fdoi%2Fabs%2F10.1177%2F0361684312450004&|title=SAGE Journals: Your gateway to world-class journal research|website=SAGE Journals|language=en|doi=10.1177/0361684312450004|access-date=2019-02-06}}</ref> Research has demonstrated the ways in which facial prominence in photographic images differs between men and women. More specifically, in official online photographs of politicians around the world, women's faces are less prominent than men's. The difference in these images actually tended to be greater in cultures with greater institutional gender equality.<ref>{{cite journal |doi=10.1177/0361684312450004 |title=Understanding Gender Differences in Anxiety |journal=Psychology of Women Quarterly |volume=36 |issue=4 |pages=488–499 |year=2012 |last1=Zalta |first1=Alyson K. |last2=Chambless |first2=Dianne L. | name-list-format = vanc }}</ref>


==Pathophysiology==
==Pathophysiology==
⚫
Anxiety disorder appears to be a genetically inherited [[neurochemical]] dysfunction that may involve autonomic imbalance; decreased [[GABAergic|GABA-ergic]] tone; allelic polymorphism of the [[catechol-O-methyltransferase]] (COMT) gene; increased adenosine receptor function; increased cortisol.<ref>{{Cite web|url=http://www.health.am/psy/anxiety-disorders/|title=Anxiety Disorders|last=Sutherl|first=July 01 2010-Suzanne M.|last2=M.D.|language=en-us|access-date=2019-02-06}}</ref>
{{Unreferenced section|date=October 2018}}
⚫
Anxiety disorder appears to be a genetically inherited neurochemical dysfunction that may involve autonomic imbalance; decreased GABA-ergic tone; allelic polymorphism of the catechol-O-methyltransferase (COMT) gene; increased adenosine receptor function; increased cortisol.


In the [[central nervous system]] (CNS), the major mediators of the symptoms of anxiety disorders appear to be norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid (GABA). Other neurotransmitters and peptides, such as corticotropin-releasing factor, may be involved. Peripherally, the [[autonomic nervous system]], especially the sympathetic nervous system, mediates many of the symptoms. Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.
In the [[Central nervous system]], the primary arbitrators of the symptoms of [[Anxiety disorder|anxiety disorders]] happen to be [[Norepinephrine|norepinephrine,]] [[dopamine]], [[Gamma-Aminobutyric acid|gamma-aminobutyric acid]], and [[serotonin]]. A neurotransmitter, such as CRF ([[Corticotropin-releasing hormone|corticotropin-releasing factor]]), can also be involved. Marginally, the sympathetic nervous system also mediates a number of systems.<ref>{{Cite journal|date=2019-02-05|title=Anxiety Disorders: Background, Anatomy, Pathophysiology|url=https://emedicine.medscape.com/article/286227-overview#a4}}</ref> Increased flow in the right [[Parahippocampal gyrus|parahippocampal]] region and reduced serotonin type 1A receptor binding in the anterior and posterior [[Cingulate cortex|cingulate]] and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.<ref>{{Cite web|url=https://www.medscape.com/answers/286227-14515/1186336-overview|title=What is the role of serotonin type 1A receptor binding in the pathophysiology of anxiety disorders?|website=www.medscape.com|access-date=2019-02-06}}</ref>


The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Anxiety processing in the basolateral amygdala has been implicated with dendritic arborization of the amygdaloid neurons. SK2 potassium channels mediate inhibitory influence on action potentials and reduce arborization.
The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Anxiety processing in the basolateral amygdala has been implicated with [[dendritic arborization]] of the [[amygdaloid]] neurons. SK2 potassium channels mediate inhibitory influence on action potentials and reduce arborization.<ref>{{Cite web|url=https://www.researchgate.net/publication/26270820_Mineralocorticoid_Receptor_Overexpression_in_Basolateral_Amygdala_Reduces_Corticosterone_Secretion_and_Anxiety|title=Mineralocorticoid Receptor Overexpression in Basolateral Amygdala Reduces Corticosterone Secretion and Anxiety {{!}} Request PDF|website=ResearchGate|language=en|access-date=2019-02-06}}</ref>


[[Joseph E. LeDoux]] and [[Lisa Feldman Barrett]] have both sought to separate automatic threat responses from additional associated cognitive activity within anxiety.<ref>{{Cite web|url=https://ajp.psychiatryonline.org/action/captchaChallenge?redirectUrl=https%3A%2F%2Fajp.psychiatryonline.org%2Fdoi%2F10.1176%2Fappi.ajp.2016.16030353&|title=Psychiatry Online|website=ajp.psychiatryonline.org|doi=10.1176/appi.ajp.2016.16030353|access-date=2019-02-06}}</ref><ref>{{Cite journal|last=Wager|first=Tor D.|last2=Kang|first2=Jian|last3=Johnson|first3=Timothy D.|last4=Nichols|first4=Thomas E.|last5=Satpute|first5=Ajay B.|last6=Barrett|first6=Lisa Feldman|date=2015-04-08|title=A Bayesian Model of Category-Specific Emotional Brain Responses|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390279/|journal=PLoS Computational Biology|volume=11|issue=4|doi=10.1371/journal.pcbi.1004066|issn=1553-734X|pmc=PMC4390279|pmid=25853490}}</ref>
[[Joseph E. LeDoux]] and [[Lisa Feldman Barrett]] have both sought to separate automatic threat responses from additional associated cognitive activity within anxiety.


== See also ==
== See also ==

Revision as of 10:07, 6 February 2019

For other uses, see Anxiety (disambiguation).

Anxiety
A person diagnosed with panphobia, from Alexander Morison's 1843 book The Physiognomy of Mental Diseases.
SpecialtyPsychiatry, psychology
Part of a series on
Emotions
Emotions

Anxiety is an emotion characterized by an unpleasant state of inner turmoil, often accompanied by nervous behaviour such as pacing back and forth, somatic complaints, and rumination.[1] It is the subjectively unpleasant feelings of dread over anticipated events, such as the feeling of imminent death.[2][3] Anxiety is not the same as fear, which is a response to a real or perceived immediate threat,[4] whereas anxiety involves the expectation of future threat.[4] Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing.[5] It is often accompanied by muscular tension,[4] restlessness, fatigue and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an anxiety disorder.[4]

People facing anxiety may withdraw from situations which have provoked anxiety in the past.[6] There are various types of anxiety. Existential anxiety can occur when a person faces angst, an existential crisis, or nihilistic feelings. People can also face mathematical anxiety, somatic anxiety, stage fright, or test anxiety. Social anxiety and stranger anxiety are caused when people are apprehensive around strangers or other people in general. Stress hormones released in an anxious state have an impact on bowel function and can manifest physical symptoms that may contribute to or exacerbate IBS. Anxiety is often experienced by those who have an OCD and is an acute presence in panic disorder. The first step in the management of a person with anxiety symptoms involves evaluating the possible presence of an underlying medical cause, whose recognition is essential in order to decide the correct treatment.[7][8] Anxiety symptoms may mask an organic disease, or appear associated with or as a result of a medical disorder.[7][8][9][10]

Anxiety can be either a short-term "state" or a long-term "trait". Whereas trait anxiety represents worrying about future events, anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear.[11] Anxiety disorders are partly genetic but may also be due to drug use, including alcohol, caffeine, and benzodiazepines (which are often prescribed to treat anxiety), as well as withdrawal from drugs of abuse. They often occur with other mental disorders, particularly bipolar disorder, eating disorders, major depressive disorder, or certain personality disorders. Common treatment options include lifestyle changes, medication, and therapy. Metacognitive therapy seeks to diminish anxiety through reducing worry, which is seen by Adrian Wells as a consequence of metacognitive beliefs.[12]

Fear

A job applicant with a worried facial expression

Anxiety is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat.[13] Anxiety is related to the specific behaviors of fight-or-flight responses, defensive behavior or escape. It occurs in situations only perceived as uncontrollable or unavoidable, but not realistically so.[14] David Barlow defines anxiety as "a future-oriented mood state in which one is not ready or prepared to attempt to cope with upcoming negative events,"[15] and that it is a distinction between future and present dangers which divides anxiety and fear. Another description of anxiety is agony, dread, terror, or even apprehension.[16] In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.[17]

Fear and anxiety can be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear is short lived, present focused, geared towards a specific threat, and facilitating escape from threat; anxiety, on the other hand, is long-acting, future focused, broadly focused towards a diffuse threat, and promoting excessive caution while approaching a potential threat and interferes with constructive coping.[18]

Symptoms

Anxiety can be experienced with long, drawn out daily symptoms that reduce quality of life, known as chronic (or generalized) anxiety, or it can be experienced in short spurts with sporadic, stressful panic attacks, known as acute anxiety.[19] Symptoms of anxiety can range in number, intensity, and frequency, depending on the person. While almost everyone has experienced anxiety at some point in their lives, most do not develop long-term problems with anxiety.

Anxiety may cause psychiatric and physiological symptoms.[7][10]

The risk of anxiety leading to depression could possibly even lead to an individual harming themselves, which is why there are many 24-hour suicide prevention hotlines.[20]

The behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety or negative feelings in the past.[6] Other effects may include changes in sleeping patterns, changes in habits, increase or decrease in food intake, and increased motor tension (such as foot tapping).[6]

The emotional effects of anxiety may include "feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind's gone blank"[21] as well as "nightmares/bad dreams, obsessions about sensations, déjà vu, a trapped-in-your-mind feeling, and feeling like everything is scary."[22]

The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. "You may ... fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or an aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can't get it out of your mind."[23]

The physiological symptoms of anxiety may include:[7][10]

Types

Painting entitled Anxiety, 1894, by Edvard Munch

Existential

Further information: Angst, Existential crisis, and Nihilism

The philosopher Søren Kierkegaard, in The Concept of Anxiety (1844), described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. In Art and Artist (1932), the psychologist Otto Rank wrote that the psychological trauma of birth was the pre-eminent human symbol of existential anxiety and encompasses the creative person's simultaneous fear of – and desire for – separation, individuation, and differentiation.

The theologian Paul Tillich characterized existential anxiety[24] as "the state in which a being is aware of its possible non-being" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness). According to Tillich, the last of these three types of existential anxiety, i.e. spiritual anxiety, is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the human condition or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by tradition and authority" even though such "undoubted certitude is not built on the rock of reality".[24]

According to Viktor Frankl, the author of Man's Search for Meaning, when a person is faced with extreme mortal dangers, the most basic of all human wishes is to find a meaning of life to combat the "trauma of nonbeing" as death is near.[25]

Depending on the source of the threat, psychoanalytic theory distinguishes the following types of anxiety:

  • realistic
  • neurotic
  • moral Hjelle, Larry; Ziegler, Daniel (1981). "Personality Theories: Basic Assumptions, Research, and Applications". McGraw-Hill. p. 494. ISBN 9780070290631.

Test and performance

Main articles: Test anxiety, Mathematical anxiety, Stage fright, and Somatic anxiety

According to Yerkes-Dodson law, an optimal level of arousal is necessary to best complete a task such as an exam, performance, or competitive event. However, when the anxiety or level of arousal exceeds that optimum, the result is a decline in performance.[26]

Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students who have test anxiety may experience any of the following: the association of grades with personal worth; fear of embarrassment by a teacher; fear of alienation from parents or friends; time pressures; or feeling a loss of control. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, uncontrollable crying or laughing and drumming on a desk are all common. Because test anxiety hinges on fear of negative evaluation,[27] debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia.[28] The DSM-IV classifies test anxiety as a type of social phobia.[29]

While the term "test anxiety" refers specifically to students,[30] many workers share the same experience with regard to their career or profession. The fear of failing at a task and being negatively evaluated for failure can have a similarly negative effect on the adult.[31] Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.[30]

Stranger, social, and inter-group anxiety

Main articles: Stranger anxiety and Social anxiety

Humans generally require social acceptance and thus sometimes dread the disapproval of others. Apprehension of being judged by others may cause anxiety in social environments.[32]

Anxiety during social interactions, particularly between strangers, is common among young people. It may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not considered a phobia. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. According to Cutting,[33] social phobics do not fear the crowd but the fact that they may be judged negatively.

Social anxiety varies in degree and severity. For some people, it is characterized by experiencing discomfort or awkwardness during physical social contact (e.g. embracing, shaking hands, etc.), while in other cases it can lead to a fear of interacting with unfamiliar people altogether. Those suffering from this condition may restrict their lifestyles to accommodate the anxiety, minimizing social interaction whenever possible. Social anxiety also forms a core aspect of certain personality disorders, including avoidant personality disorder.[34]

To the extent that a person is fearful of social encounters with unfamiliar others, some people may experience anxiety particularly during interactions with outgroup members, or people who share different group memberships (i.e., by race, ethnicity, class, gender, etc.). Depending on the nature of the antecedent relations, cognitions, and situational factors, intergroup contact may be stressful and lead to feelings of anxiety. This apprehension or fear of contact with outgroup members is often called interracial or intergroup anxiety.[35]

As is the case the more generalized forms of social anxiety, intergroup anxiety has behavioral, cognitive, and affective effects. For instance, increases in schematic processing and simplified information processing can occur when anxiety is high. Indeed, such is consistent with related work on attentional bias in implicit memory.[36][37][38] Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.[39] Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility.[40] Furthermore, when compared to anxiety levels and cognitive effort (e.g., impression management and self-presentation) in intragroup contexts, levels and depletion of resources may be exacerbated in the intergroup situation.

Trait

Anxiety can be either a short-term 'state' or a long-term personality "trait". Trait anxiety reflects a stable tendency across the lifespan of responding with acute, state anxiety in the anticipation of threatening situations (whether they are actually deemed threatening or not).[41] A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders.[42] Such anxiety may be conscious or unconscious.[43]

Personality can also be a trait leading towards anxiety and depression. Through experience many find it difficult to collect themselves due to their own personal nature.[44]

Choice or decision

Anxiety induced by the need to choose between similar options is increasingly being recognized as a problem for individuals and for organizations.[45] In 2004, Capgemini wrote: "Today we're all faced with greater choice, more competition and less time to consider our options or seek out the right advice."[46]

In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making.[47] There are primarily two forms of this anxiety type. The first form refers to a choice in which there are multiple potential outcomes with known or calculable probabilities. The second form refers to the uncertainty and ambiguity related to a decision context in which there are multiple possible outcomes with unknown probabilities.[47]

Anxiety disorders

Main article: Anxiety disorder

Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses.[11] Anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism. The disorder differs by what results in the symptoms. People often have more than one anxiety disorder.[11]

The cause of anxiety disorders is a combination of genetic and environmental factors.[48] Anxiety can stem itself from certain factors: genetics, medicinal side-effects, shortness of oxygen.[49] Risk factors include a history of child abuse, family history of mental disorders, and poverty. Anxiety disorders often occur with other mental disorders, particularly major depressive disorder, personality disorder, and substance use disorder.[50] To be diagnosed symptoms typically need to be present at least six months, be more than would be expected for the situation, and decrease functioning.[11][50] Other problems that may result in similar symptoms including hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.[50][8]

Without treatment, anxiety disorders tend to remain.[11][48] Treatment may include lifestyle changes, counselling, and medications. Counselling is typically with a type of cognitive behavioural therapy.[50] Medications, such as antidepressants or beta blockers, may improve symptoms.[48]

About 12% of people are affected by an anxiety disorder in a given year and between 5-30% are affected at some point in their life.[50][51] They occur about twice as often in women than they do in men, and generally begin before the age of 25.[11][50] The most common are specific phobia which affects nearly 12% and social anxiety disorder which affects 10% at some point in their life. They affect those between the ages of 15 and 35 the most and become less common after the age of 55. Rates appear to be higher in the United States and Europe.[50]

Risk factors

A marble bust of the Roman Emperor Decius from the Capitoline Museum. This portrait "conveys an impression of anxiety and weariness, as of a man shouldering heavy [state] responsibilities".[52]

Neuroanatomy

Neural circuitry involving the amygdala (which regulates emotions like anxiety and fear, stimulating the HPA Axis and sympathetic nervous system) and hippocampus (which is implicated in emotional memory along with the amygdala) is thought to underlie anxiety.[53] People who have anxiety tend to show high activity in response to emotional stimuli in the amygdala.[54] Some writers believe that excessive anxiety can lead to an overpotentiation of the limbic system (which includes the amygdala and nucleus accumbens), giving increased future anxiety, but this does not appear to have been proven.[55][56]

Research upon adolescents who as infants had been highly apprehensive, vigilant, and fearful finds that their nucleus accumbens is more sensitive than that in other people when deciding to make an action that determined whether they received a reward.[57] This suggests a link between circuits responsible for fear and also reward in anxious people. As researchers note, "a sense of 'responsibility', or self-agency, in a context of uncertainty (probabilistic outcomes) drives the neural system underlying appetitive motivation (i.e., nucleus accumbens) more strongly in temperamentally inhibited than noninhibited adolescents".[57]

Genetics

Genetics and family history (e.g., parental anxiety) may predispose an individual for an increased risk of an anxiety disorder, but generally external stimuli will trigger its onset or exacerbation.[58] Genetic differences account for about 43% of variance in panic disorder and 28% in generalized anxiety disorder.[59] Although single genes are neither necessary nor sufficient for anxiety by themselves, several gene polymorphisms have been found to correlate with anxiety: PLXNA2, SERT, CRH, COMT and BDNF.[60][61][62] Several of these genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) which are implicated in anxiety. The epigenetic signature of at least one of these genes BDNF has also been associated with anxiety and specific patterns of neural activity.[63]

Medical conditions

Many medical conditions can cause anxiety. This includes conditions that affect the ability to breathe, like COPD and asthma, and the difficulty in breathing that often occurs near death.[64][65][66] Conditions that cause abdominal pain or chest pain can cause anxiety and may in some cases be a somatization of anxiety;[67][68] the same is true for some sexual dysfunctions.[69][70] Conditions that affect the face or the skin can cause social anxiety especially among adolescents,[71] and developmental disabilities often lead to social anxiety for children as well.[72] Life-threatening conditions like cancer also cause anxiety.[73]

Furthermore, certain organic diseases may present with anxiety or symptoms that mimic anxiety.[7][8] These disorders include certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia),[8][74] metabolic disorders (diabetes),[8][75][76] deficiency states (low levels of vitamin D, B2, B12, folic acid),[8] gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease),[77][78][79] heart diseases, blood diseases (anemia),[8] cerebral vascular accidents (transient ischemic attack, stroke),[8] and brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease), among others.[8][80][81][82]

Substance-induced

Several drugs can cause or worsen anxiety, whether in intoxication, withdrawal or from chronic use. These include alcohol, tobacco, cannabis, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs like heroin), stimulants (such as caffeine, cocaine and amphetamines), hallucinogens, and inhalants.[58] While many often report self-medicating anxiety with these substances, improvements in anxiety from drugs are usually short-lived (with worsening of anxiety in the long term, sometimes with acute anxiety as soon as the drug effects wear off) and tend to be exaggerated. Acute exposure to toxic levels of benzene may cause euphoria, anxiety, and irritability lasting up to 2 weeks after the exposure.[83]

Psychological

Poor coping skills (e.g., rigidity/inflexible problem solving, denial, avoidance, impulsivity, extreme self-expectation, negative thoughts, affective instability, and inability to focus on problems) are associated with anxiety. Anxiety is also linked and perpetuated by the person's own pessimistic outcome expectancy and how they cope with feedback negativity.[84] Temperament (e.g., neuroticism)[42] and attitudes (e.g. pessimism) have been found to be risk factors for anxiety.[58][85]

Cognitive distortions such as overgeneralizing, catastrophizing, mind reading, emotional reasoning, binocular trick, and mental filter can result in anxiety. For example, an overgeneralized belief that something bad "always" happens may lead someone to have excessive fears of even minimally risky situations and to avoid benign social situations due to anticipatory anxiety of embarrassment. In addition, those who have high anxiety can also create future stressful life events.[86] Together, these findings suggest that anxious thoughts can lead to anticipatory anxiety as well stressful events, which in turn cause more anxiety. Such unhealthy thoughts can be targets for successful treatment with cognitive therapy.

Psychodynamic theory posits that anxiety is often the result of opposing unconscious wishes or fears that manifest via maladaptive defense mechanisms (such as suppression, repression, anticipation, regression, somatization, passive aggression, dissociation) that develop to adapt to problems with early objects (e.g., caregivers) and empathic failures in childhood. For example, persistent parental discouragement of anger may result in repression/suppression of angry feelings which manifests as gastrointestinal distress (somatization) when provoked by another while the anger remains unconscious and outside the individual's awareness. Such conflicts can be targets for successful treatment with psychodynamic therapy. While psychodynamic therapy tends to explore the underlying roots of anxiety, cognitive behavioral therapy has also been shown to be a successful treatment for anxiety by altering irrational thoughts and unwanted behaviors.

Evolutionary psychology

An evolutionary psychology explanation is that increased anxiety serves the purpose of increased vigilance regarding potential threats in the environment as well as increased tendency to take proactive actions regarding such possible threats. This may cause false positive reactions but an individual suffering from anxiety may also avoid real threats. This may explain why anxious people are less likely to die due to accidents.[87]

When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.[88][89] In these studies, the participants also reported moderate anxiety. This might indicate that anxiety is a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors.

Social

Social risk factors for anxiety include a history of trauma (e.g., physical, sexual or emotional abuse or assault), early life experiences and parenting factors (e.g., rejection, lack of warmth, high hostility, harsh discipline, high parental negative affect, anxious childrearing, modelling of dysfunctional and drug-abusing behaviour, discouragement of emotions, poor socialization, poor attachment, and child abuse and neglect), cultural factors (e.g., stoic families/cultures, persecuted minorities including the disabled), and socioeconomics (e.g., uneducated, unemployed, impoverished although developed countries have higher rates of anxiety disorders than developing countries).[58][90]

Gender socialization

Contextual factors that are thought to contribute to anxiety include gender socialization and learning experiences. In particular, learning mastery (the degree to which people perceive their lives to be under their own control) and instrumentality, which includes such traits as self-confidence, independence, and competitiveness fully mediate the relation between gender and anxiety. That is, though gender differences in anxiety exist, with higher levels of anxiety in women compared to men, gender socialization and learning mastery explain these gender differences.[91][92] Research has demonstrated the ways in which facial prominence in photographic images differs between men and women. More specifically, in official online photographs of politicians around the world, women's faces are less prominent than men's. The difference in these images actually tended to be greater in cultures with greater institutional gender equality.[93]

Pathophysiology

Anxiety disorder appears to be a genetically inherited neurochemical dysfunction that may involve autonomic imbalance; decreased GABA-ergic tone; allelic polymorphism of the catechol-O-methyltransferase (COMT) gene; increased adenosine receptor function; increased cortisol.[94]

In the Central nervous system, the primary arbitrators of the symptoms of anxiety disorders happen to be norepinephrine, dopamine, gamma-aminobutyric acid, and serotonin. A neurotransmitter, such as CRF (corticotropin-releasing factor), can also be involved. Marginally, the sympathetic nervous system also mediates a number of systems.[95] Increased flow in the right parahippocampal region and reduced serotonin type 1A receptor binding in the anterior and posterior cingulate and raphe of patients are the diagnostic factors for prevalence of anxiety disorder.[96]

The amygdala is central to the processing of fear and anxiety, and its function may be disrupted in anxiety disorders. Anxiety processing in the basolateral amygdala has been implicated with dendritic arborization of the amygdaloid neurons. SK2 potassium channels mediate inhibitory influence on action potentials and reduce arborization.[97]

Joseph E. LeDoux and Lisa Feldman Barrett have both sought to separate automatic threat responses from additional associated cognitive activity within anxiety.[98][99]

See also

References

  1. ^ Seligman ME, Walker EF, Rosenhan DL. Abnormal psychology (4th ed.). New York: W.W. Norton & Company.[page needed]
  2. ^ Davison, Gerald C. (2008). Abnormal Psychology. Toronto: Veronica Visentin. p. 154. ISBN 978-0-470-84072-6. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  3. ^ "Anxiety - Crystalinks". www.crystalinks.com. Retrieved February 6, 2019.
  4. ^ a b c d American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. p. 189. ISBN 978-0-89042-555-8.
  5. ^ Bouras N, Holt G (2007). Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities (2nd ed.). Cambridge University Press.[page needed]
  6. ^ a b c Barker P (2003). Psychiatric and Mental Health Nursing: The Craft of Caring. London: Edward Arnold. ISBN 978-0-340-81026-2.[page needed]
  7. ^ a b c d e World Health Organization (2009). Pharmacological Treatment of Mental Disorders in Primary Health Care (PDF). Geneva. ISBN 978-92-4-154769-7. Archived from the original (PDF) on November 20, 2016. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)CS1 maint: location missing publisher (link)
  8. ^ a b c d e f g h i j Testa A, Giannuzzi R, Daini S, Bernardini L, Petrongolo L, Gentiloni Silveri N (February 2013). "Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases". European Review for Medical and Pharmacological Sciences. 17 Suppl 1: 86–99. PMID 23436670.Open access icon
  9. ^ Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Dain S (February 2013). "Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases". European Review for Medical and Pharmacological Sciences. 17 Suppl 1: 65–85. PMID 23436669.Open access icon
  10. ^ a b c Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S (February 2013). "Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms". European Review for Medical and Pharmacological Sciences. 17 Suppl 1: 55–64. PMID 23436668.Open access icon
  11. ^ a b c d e f American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 189–195. ISBN 978-0-89042-555-8.
  12. ^ Wells, Adrian (2011). Metacognitive therapy for anxiety and depression (Pbk. ed.). New York, NY: Guilford Press. ISBN 978-1-60918-496-4. OCLC 699763619. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  13. ^ Andreas Dorschel, Furcht und Angst. In: Dietmar Goltschnigg (ed.), Angst. Lähmender Stillstand und Motor des Fortschritts. Stauffenburg, Tübingen 2012, pp. 49-54
  14. ^ Öhman, Arne (2000). "Fear and anxiety: Evolutionary, cognitive, and clinical perspectives". In Lewis, Michael; Haviland-Jones, Jeannette M. (eds.). Handbook of emotions. New York: The Guilford Press. pp. 573–93. ISBN 978-1-57230-529-8. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  15. ^ Barlow DH (November 2000). "Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory". The American Psychologist. 55 (11): 1247–63. doi:10.1037/0003-066X.55.11.1247. PMID 11280938.
  16. ^ Iacovou, Susan (July 2011). "What is the Difference Between Existential Anxiety and so Called Neurotic Anxiety?: 'The sine qua non of true vitality': An Examination of the Difference Between Existential Anxiety and Neurotic Anxiety". Existential Analysis. 22 (2): 356–67. ISSN 1752-5616. Archived from the original on August 19, 2014. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  17. ^ Csíkszentmihályi, Mihály (1997). Finding Flow. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)[page needed]
  18. ^ Sylvers P, Lilienfeld SO, LaPrairie JL (February 2011). "Differences between trait fear and trait anxiety: implications for psychopathology". Clinical Psychology Review. 31 (1): 122–37. doi:10.1016/j.cpr.2010.08.004. PMID 20817337.
  19. ^ Rynn MA, Brawman-Mintzer O (October 2004). "Generalized anxiety disorder: acute and chronic treatment". CNS Spectrums. 9 (10): 716–23. PMID 15448583.
  20. ^ "Depression Hotline | Call Our Free, 24 Hour Depression Helpline". PsychGuides.com. Retrieved October 11, 2018.
  21. ^ Smith, Melinda (2008, June). Anxiety attacks and disorders: Guide to the signs, symptoms, and treatment options. Retrieved March 3, 2009, from Helpguide Web site: "HelpGuide.org". Archived from the original on March 7, 2009. Retrieved 2009-03-04. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  22. ^ (1987–2008). Anxiety Symptoms, Anxiety Attack Symptoms (Panic Attack Symptoms), Symptoms of Anxiety. Retrieved March 3, 2009, from Anxiety Centre Website: "Anxiety Symptoms and Signs - over 100 listed". Archived from the original on March 7, 2009. Retrieved March 4, 2009. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  23. ^ (1987–2008). Anxiety symptoms - Fear of dying. Retrieved March 3, 2009, from Anxiety Centre Website: "Fear of dying anxiety symptom". Archived from the original on March 5, 2009. Retrieved March 4, 2009. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  24. ^ a b Tillich, Paul (1952). The Courage To Be. New Haven: Yale University Press. p. 76. ISBN 978-0-300-08471-9. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  25. ^ Abulof, Uriel (2015). The Mortality and Morality of Nations. New York: Cambridge University Press. p. 26. ISBN 978-1-107-09707-0. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  26. ^ Teigen, Karl Halvor (1994). "Yerkes-Dodson: A Law for all Seasons". Theory & Psychology. 4 (4): 525–547. doi:10.1177/0959354394044004. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  27. ^ Liebert RM, Morris LW (June 1967). "Cognitive and emotional components of test anxiety: a distinction and some initial data". Psychological Reports. 20 (3): 975–8. doi:10.2466/pr0.1967.20.3.975. PMID 6042522.
  28. ^ Beidel DC, Turner SM (June 1988). "Comorbidity of test anxiety and other anxiety disorders in children". Journal of Abnormal Child Psychology. 16 (3): 275–87. doi:10.1007/BF00913800. PMID 3403811.
  29. ^ Rapee RM, Heimberg RG (August 1997). "A cognitive-behavioral model of anxiety in social phobia". Behaviour Research and Therapy. 35 (8): 741–56. doi:10.1016/S0005-7967(97)00022-3. PMID 9256517.
  30. ^ a b Mathur, Shachi; Khan, Waheeda (2011). "Impact of Hypnotherapy on Examination Anxiety and Scholastic Performance among School" (PDF). Delhi Psychiatry Journal. 14 (2): 337–42. CiteSeerX 10.1.1.1027.7497. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  31. ^ Hall-Flavin, Daniel K. "Is it possible to overcome test anxiety?". Mayo Clinic. Mayo Foundation for Medical Education and Research. Archived from the original on September 5, 2015. Retrieved August 11, 2015. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  32. ^ Hofmann, Stefan G.; Dibartolo, Patricia M. (2010). "Introduction: Toward an Understanding of Social Anxiety Disorder". Social Anxiety. pp. xix–xxvi. doi:10.1016/B978-0-12-375096-9.00028-6. ISBN 978-0-12-375096-9. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  33. ^ Thomas, Ben; Hardy, Sally; Cutting, Penny, eds. (1997). Mental Health Nursing: Principles and Practice. London: Mosby. ISBN 978-0-7234-2590-8. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)[page needed]
  34. ^ Settipani CA, Kendall PC (February 2013). "Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy". Child Psychiatry and Human Development. 44 (1): 1–18. doi:10.1007/s10578-012-0307-0. PMID 22581270.
  35. ^ Stephan, Walter G.; Stephan, Cookie White (1985). "Intergroup Anxiety". Journal of Social Issues. 41 (3): 157–175. doi:10.1111/j.1540-4560.1985.tb01134.x. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  36. ^ Richeson JA, Trawalter S (February 2008). "The threat of appearing prejudiced and race-based attentional biases". Psychological Science. 19 (2): 98–102. doi:10.1111/j.1467-9280.2008.02052.x. PMID 18271854.
  37. ^ Mathews A, Mogg K, May J, Eysenck M (August 1989). "Implicit and explicit memory bias in anxiety". Journal of Abnormal Psychology. 98 (3): 236–40. doi:10.1037/0021-843x.98.3.236. PMID 2768658.
  38. ^ Richards, Anne; French, Christopher C. (1991). "Effects of encoding and anxiety on implicit and explicit memory performance". Personality and Individual Differences. 12 (2): 131–139. doi:10.1016/0191-8869(91)90096-t. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  39. ^ Amodio DM, Hamilton HK (December 2012). "Intergroup anxiety effects on implicit racial evaluation and stereotyping". Emotion. 12 (6): 1273–80. CiteSeerX 10.1.1.659.5717. doi:10.1037/a0029016. PMID 22775128.
  40. ^ Plant EA, Devine PG (June 2003). "The antecedents and implications of interracial anxiety". Personality & Social Psychology Bulletin. 29 (6): 790–801. doi:10.1177/0146167203029006011. PMID 15189634.
  41. ^ Schwarzer R (December 1997). "Anxiety". Archived from the original on September 20, 2007. Retrieved 2008-01-12. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  42. ^ a b Jeronimus BF, Kotov R, Riese H, Ormel J (October 2016). "Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants". Psychological Medicine. 46 (14): 2883–2906. doi:10.1017/S0033291716001653. PMID 27523506.
  43. ^ Giddey M, Wright H. Mental Health Nursing: From first principles to professional practice. Stanley Thornes.[page needed]
  44. ^ "Gulf Bend MHMR Center". Retrieved October 11, 2018.
  45. ^ Downey, Jonathan (April 27, 2008). "Premium choice anxiety". The Times. London. Archived from the original on February 3, 2014. Retrieved April 25, 2010. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  46. ^ Is choice anxiety costing british 'blue chip' business? Archived December 22, 2015, at the Wayback Machine, Capgemini, Aug 16, 2004
  47. ^ a b Hartley CA, Phelps EA (July 2012). "Anxiety and decision-making". Biological Psychiatry. 72 (2): 113–8. doi:10.1016/j.biopsych.2011.12.027. PMC 3864559. PMID 22325982.
  48. ^ a b c "Anxiety Disorders". NIMH. March 2016. Archived from the original on July 27, 2016. Retrieved August 14, 2016. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  49. ^ The MNT Editorial Team. "What causes anxiety?". {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  50. ^ a b c d e f g Craske MG, Stein MB (December 2016). "Anxiety". Lancet. 388 (10063): 3048–3059. doi:10.1016/S0140-6736(16)30381-6. PMID 27349358.
  51. ^ Kessler RC, Angermeyer M, Anthony JC, DE Graaf R, Demyttenaere K, Gasquet I, et al. (October 2007). "Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative". World Psychiatry. 6 (3): 168–76. PMC 2174588. PMID 18188442.
  52. ^ Scarre, Chris (1995). Chronicle of the Roman Emperors. Thames & Hudson. pp. 168–9. ISBN 978-5-00-050775-9. {{cite book}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)[page needed]
  53. ^ Rosen JB, Schulkin J (April 1998). "From normal fear to pathological anxiety". Psychological Review. 105 (2): 325–50. doi:10.1037/0033-295X.105.2.325. PMID 9577241.
  54. ^ Nolen-Hoeksema, S. (2013). (Ab)normal Psychology (6th edition). McGraw Hill.[page needed]
  55. ^ Fricchione G (2011). Compassion and Healing in Medicine and Society: On the Nature and Use of Attachment Solutions to Separation Challenges. Johns Hopkins University Press. p. 172. ISBN 978-1-4214-0220-8.
  56. ^ Harris J (1998). How the Brain Talks to Itself: A Clinical Primer of Psychotherapeutic Neuroscience. Haworth. p. 284. ISBN 978-0-7890-0408-6.
  57. ^ a b Bar-Haim Y, Fox NA, Benson B, Guyer AE, Williams A, Nelson EE, et al. (August 2009). "Neural correlates of reward processing in adolescents with a history of inhibited temperament". Psychological Science. 20 (8): 1009–18. doi:10.1111/j.1467-9280.2009.02401.x. PMC 2785902. PMID 19594857.
  58. ^ a b c d American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.[page needed]
  59. ^ Bienvenu OJ, Davydow DS, Kendler KS (January 2011). "Psychiatric 'diseases' versus behavioral disorders and degree of genetic influence". Psychological Medicine. 41 (1): 33–40. doi:10.1017/S003329171000084X. PMID 20459884.
  60. ^ Wray NR, James MR, Mah SP, Nelson M, Andrews G, Sullivan PF, Montgomery GW, Birley AJ, Braun A, Martin NG (March 2007). "Anxiety and comorbid measures associated with PLXNA2". Archives of General Psychiatry. 64 (3): 318–26. doi:10.1001/archpsyc.64.3.318. PMID 17339520.[non-primary source needed]
  61. ^ Chen ZY, Jing D, Bath KG, Ieraci A, Khan T, Siao CJ, Herrera DG, Toth M, Yang C, McEwen BS, Hempstead BL, Lee FS (October 2006). "Genetic variant BDNF (Val66Met) polymorphism alters anxiety-related behavior". Science. 314 (5796): 140–3. doi:10.1126/science.1129663. PMC 1880880. PMID 17023662.
  62. ^ Tocchetto A, Salum GA, Blaya C, Teche S, Isolan L, Bortoluzzi A, et al. (September 2011). "Evidence of association between Val66Met polymorphism at BDNF gene and anxiety disorders in a community sample of children and adolescents". Neuroscience Letters. 502 (3): 197–200. doi:10.1016/j.neulet.2011.07.044. PMID 21839144.
  63. ^ Moser DA, Paoloni-Giacobino A, Stenz L, Adouan W, Manini A, Suardi F, et al. (2015). "BDNF Methylation and Maternal Brain Activity in a Violence-Related Sample". PLOS One. 10 (12): e0143427. doi:10.1371/journal.pone.0143427. PMC 4674054. PMID 26649946.
  64. ^ Baldwin J, Cox J (September 2016). "Treating Dyspnea: Is Oxygen Therapy the Best Option for All Patients?". The Medical Clinics of North America. 100 (5): 1123–30. doi:10.1016/j.mcna.2016.04.018. PMID 27542431.
  65. ^ Vanfleteren LE, Spruit MA, Wouters EF, Franssen FM (November 2016). "Management of chronic obstructive pulmonary disease beyond the lungs". The Lancet. Respiratory Medicine. 4 (11): 911–924. doi:10.1016/S2213-2600(16)00097-7. PMID 27264777.
  66. ^ Tselebis A, Pachi A, Ilias I, Kosmas E, Bratis D, Moussas G, Tzanakis N (2016). "Strategies to improve anxiety and depression in patients with COPD: a mental health perspective". Neuropsychiatric Disease and Treatment. 12: 297–328. doi:10.2147/NDT.S79354. PMC 4755471. PMID 26929625.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  67. ^ Muscatello MR, Bruno A, Mento C, Pandolfo G, Zoccali RA (July 2016). "Personality traits and emotional patterns in irritable bowel syndrome". World Journal of Gastroenterology. 22 (28): 6402–15. doi:10.3748/wjg.v22.i28.6402. PMC 4968122. PMID 27605876.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  68. ^ Remes-Troche JM (December 2016). "How to Diagnose and Treat Functional Chest Pain". Current Treatment Options in Gastroenterology. 14 (4): 429–443. doi:10.1007/s11938-016-0106-y. PMID 27709331.
  69. ^ Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. (April 2016). "Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction". The Journal of Sexual Medicine. 13 (4): 538–71. doi:10.1016/j.jsxm.2016.01.019. PMID 27045257.
  70. ^ McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJ (August 2016). "The pathophysiology of acquired premature ejaculation". Translational Andrology and Urology. 5 (4): 434–49. doi:10.21037/tau.2016.07.06. PMC 5001985. PMID 27652216.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  71. ^ Nguyen CM, Beroukhim K, Danesh MJ, Babikian A, Koo J, Leon A (2016). "The psychosocial impact of acne, vitiligo, and psoriasis: a review". Clinical, Cosmetic and Investigational Dermatology. 9: 383–392. doi:10.2147/CCID.S76088. PMC 5076546. PMID 27799808.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  72. ^ Caçola P (2016). "Physical and Mental Health of Children with Developmental Coordination Disorder". Frontiers in Public Health. 4: 224. doi:10.3389/fpubh.2016.00224. PMC 5075567. PMID 27822464.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  73. ^ Mosher CE, Winger JG, Given BA, Helft PR, O'Neil BH (November 2016). "Mental health outcomes during colorectal cancer survivorship: a review of the literature". Psycho-Oncology. 25 (11): 1261–1270. doi:10.1002/pon.3954. PMC 4894828. PMID 26315692.
  74. ^ Samuels MH (October 2008). "Cognitive function in untreated hypothyroidism and hyperthyroidism". Current Opinion in Endocrinology, Diabetes and Obesity. 15 (5): 429–33. doi:10.1097/MED.0b013e32830eb84c. PMID 18769215.
  75. ^ Buchberger B, Huppertz H, Krabbe L, Lux B, Mattivi JT, Siafarikas A (August 2016). "Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis". Psychoneuroendocrinology. 70: 70–84. doi:10.1016/j.psyneuen.2016.04.019. PMID 27179232.
  76. ^ Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (December 2002). "Prevalence of anxiety in adults with diabetes: a systematic review". Journal of Psychosomatic Research. 53 (6): 1053–60. PMID 12479986.
  77. ^ Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, Bai JC (April 2015). "Psychological morbidity of celiac disease: A review of the literature". United European Gastroenterology Journal. 3 (2): 136–45. doi:10.1177/2050640614560786. PMC 4406898. PMID 25922673.
  78. ^ Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F (May 2015). "Systematic review: noncoeliac gluten sensitivity". Alimentary Pharmacology & Therapeutics. 41 (9): 807–20. doi:10.1111/apt.13155. PMID 25753138.
  79. ^ Neuendorf R, Harding A, Stello N, Hanes D, Wahbeh H (August 2016). "Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review". Journal of Psychosomatic Research. 87: 70–80. doi:10.1016/j.jpsychores.2016.06.001. PMID 27411754.
  80. ^ Zhao QF, Tan L, Wang HF, Jiang T, Tan MS, Tan L, et al. (January 2016). "The prevalence of neuropsychiatric symptoms in Alzheimer's disease: Systematic review and meta-analysis". Journal of Affective Disorders. 190: 264–271. doi:10.1016/j.jad.2015.09.069. PMID 26540080.
  81. ^ Wen MC, Chan LL, Tan LC, Tan EK (June 2016). "Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies". European Journal of Neurology. 23 (6): 1001–19. doi:10.1111/ene.13002. PMC 5084819. PMID 27141858.
  82. ^ Marrie RA, Reingold S, Cohen J, Stuve O, Trojano M, Sorensen PS, et al. (March 2015). "The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review". Multiple Sclerosis. 21 (3): 305–17. doi:10.1177/1352458514564487. PMC 4429164. PMID 25583845.
  83. ^ "CDC - The Emergency Response Safety and Health Database: Systemic Agent: BENZENE - NIOSH". www.cdc.gov. Archived from the original on January 17, 2016. Retrieved January 27, 2016. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  84. ^ Gu R, Huang YX, Luo YJ (September 2010). "Anxiety and feedback negativity". Psychophysiology. 47 (5): 961–7. doi:10.1111/j.1469-8986.2010.00997.x. PMID 20374540.[non-primary source needed]
  85. ^ Bienvenu OJ, Ginsburg GS (December 2007). "Prevention of anxiety disorders". International Review of Psychiatry. 19 (6): 647–54. doi:10.1080/09540260701797837. PMID 18092242.
  86. ^ Phillips AC, Carroll D, Der G (2015). "Negative life events and symptoms of depression and anxiety: stress causation and/or stress generation". Anxiety, Stress, and Coping. 28 (4): 357–71. doi:10.1080/10615806.2015.1005078. PMC 4772121. PMID 25572915.
  87. ^ Andrews PW, Thomson JA (July 2009). "The bright side of being blue: depression as an adaptation for analyzing complex problems". Psychological Review. 116 (3): 620–54. doi:10.1037/a0016242. PMC 2734449. PMID 19618990.
  88. ^ Zald DH, Pardo JV (April 1997). "Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation". Proceedings of the National Academy of Sciences of the United States of America. 94 (8): 4119–24. doi:10.1073/pnas.94.8.4119. PMID 9108115.
  89. ^ Zald DH, Hagen MC, Pardo JV (February 2002). "Neural correlates of tasting concentrated quinine and sugar solutions". Journal of Neurophysiology. 87 (2): 1068–75. doi:10.1152/jn.00358.2001. PMID 11826070.
  90. ^ O'Connell, Mary Ellen; Boat, Thomas; Warner, Kenneth E., eds. (2009). "Table E-4 Risk Factors for Anxiety". Prevention of Mental Disorders, Substance Abuse, and Problem Behaviors: A Developmental Perspective. National Academies Press. p. 530. ISBN 978-0-309-12674-8. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help); Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  91. ^ Behnke, Ralph R.; Sawyer, Chris R. (2000). "Anticipatory anxiety patterns for male and female public speakers". Communication Education. 49 (2): 187–195. doi:10.1080/03634520009379205. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  92. ^ "SAGE Journals: Your gateway to world-class journal research". SAGE Journals. doi:10.1177/0361684312450004. Retrieved February 6, 2019.
  93. ^ Zalta, Alyson K.; Chambless, Dianne L. (2012). "Understanding Gender Differences in Anxiety". Psychology of Women Quarterly. 36 (4): 488–499. doi:10.1177/0361684312450004. {{cite journal}}: Unknown parameter |name-list-format= ignored (|name-list-style= suggested) (help)
  94. ^ Sutherl, July 01 2010-Suzanne M.; M.D. "Anxiety Disorders". Retrieved February 6, 2019.{{cite web}}: CS1 maint: numeric names: authors list (link)
  95. ^ "Anxiety Disorders: Background, Anatomy, Pathophysiology". February 5, 2019. {{cite journal}}: Cite journal requires |journal= (help)
  96. ^ "What is the role of serotonin type 1A receptor binding in the pathophysiology of anxiety disorders?". www.medscape.com. Retrieved February 6, 2019.
  97. ^ "Mineralocorticoid Receptor Overexpression in Basolateral Amygdala Reduces Corticosterone Secretion and Anxiety | Request PDF". ResearchGate. Retrieved February 6, 2019.
  98. ^ "Psychiatry Online". ajp.psychiatryonline.org. doi:10.1176/appi.ajp.2016.16030353. Retrieved February 6, 2019.
  99. ^ Wager, Tor D.; Kang, Jian; Johnson, Timothy D.; Nichols, Thomas E.; Satpute, Ajay B.; Barrett, Lisa Feldman (April 8, 2015). "A Bayesian Model of Category-Specific Emotional Brain Responses". PLoS Computational Biology. 11 (4). doi:10.1371/journal.pcbi.1004066. ISSN 1553-734X. PMC 4390279. PMID 25853490.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
Library resources about
Anxiety
Retrieved from "https://en.wikipedia.org/w/index.php?title=Anxiety&oldid=882026257"