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As disorders in which stress or fear play major roles present an increasing need for psychiatric care around the world, this volume summarizes current research to determine whether a specific group of stress-induced and fear-based disorders form a distinct syndrome independent from other anxiety disorders such as obsessive-compulsive disorder or generalized anxiety. Intended to suggest DSM-V revisions regarding the classification of these disorders, Stress-Induced and Fear Circuitry Disorders reflects findings that may lead to more refined treatments for these specific anxiety disorders based on a better understanding of the biological and environmental factors that contribute to their development and symptoms.
Thirty contributors, all international authorities on
this group of mental illnesses, clarify how these disorders develop and what
factors contribute to symptomatology. Focusing on posttraumatic stress
disorder, panic disorder and agoraphobia, social phobias, and specific
phobia, the authors explore the possibility of linking the classification
and etiology of these conditions by showing that they may be closely related
in terms of brain pathophysiology. In addition to assessing the stability of
disorders across patient lifespans and determining whether they form a
cohesive and distinct group, the authors examine shared etiologies and
biopsychosocial correlates, as well as aspects unique to each disorder.
Among the book's specific insights:
• How minority populations, particularly African Americans, are
differentially affected by these disorders.
• The neuronal mechanisms of
normal fear and anxiety, including how changes in the genetics of the
serotonin system can increase the risk of anxiety.
• The role of
cognition in symptom presentation and treatment, revealing cognitive biases
that favor the processing of threat-related information.
• The
contribution of stress and psychosocial factors, such as peer victimization
and childhood sexual abuse.
• The use of neuroimaging to analyze neural
structure and function for each of the four disorder groups.
• How
neurochemistry and neuroendocrine markers may aid in classification of
anxiety disorders.
• The contribution of substance abuse to the
pathophysiology of these disorders.
Given the importance of changes to DSM for professional education and public health, this book offers important new ways of thinking about stress-induced and fear-based disorders. It not only allows researchers to more accurately assess their diagnostic classifications, but also can help clinicians more effectively communicate with patients regarding the nature of their illness and the importance of adhering to treatment regimens.
Research into the pathophysiology of anxiety disorders is evolving rapidly and this book will give readers a glimpse into important new conceptualizations about these common problems. I highly recommend it.
The research reviews in this volume are extensive and comprehensive, presenting a clear picture of the current state of research as well as suggestions about the most fruitful directions for future research. This volume should be read by any researcher and/or graduate student studying anxiety disorders and will no doubt greatly enhance his or her collection. Indeed, anyone interested in these four disorders could do no better than start with this collection of articles since it represents the most timely and comprehensive overview of research in the area to date.
— Drs. Michael B. Blank and Nuwan Jayawickreme
Gavin Andrews, M.D., is a Professor of Psychiatry in the School of Psychiatry at University of New South Wales in Sydney, Australia.
Dennis S. Charney, M.D., is Dean of the Mount Sinai School of Medicine, Executive Vice President of Academic Affairs of the Mount Sinai Medical Center, and a Professor in the Departments of Psychiatry, Neuroscience, and Pharmacology & Systems Therapeutics at the Mount Sinai School of Medicine in New York, New York.
Paul J. Sirovatka, M.S. (1947-2007), was Associate Director for Research Policy Analysis, Division of Research/American Psychiatric Institute for Research and Education in Arlington, Virginia.
Darrel A. Regier, M.D., M.P.H., is Executive Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Arlington, Virginia.
CONTRIBUTORS
DISCLOSURE STATEMENT
PREFACE
PART
1: Stress-Induced and Fear Circuitry Disorders
Chapter 1. Posttraumatic
Stress Disorder
Chapter 2. Panic Disorder
Chapter 3. Social Phobia
SOCIAL PHOBIA
Chapter 4. Specific Phobias SPECIFIC PHOBIAS
PART 2:
Course and Classification
Chapter 5. Continuity and Etiology of Anxiety
Disorders: Are They Stable Across the Life Course?
Chapter 6.
Stress-Induced And Fear Circuity Anxiety Disorders: Are They A Distinct
Group?
PART 3: Special Topics
Chapter 7. Anxiety Disorders In
African Americans And Other Ethnic Minorities
Chapter 8. The Genetic
Basis Of Anxiety Disorders
Chapter 9. Serotonin, Sensitive Periods, And
Anxiety
Chapter 10. Role Of Cognition In Stress-Induced And Fear
Circuity Disorders
Chapter 11. Stress And Psychosocial Factors In Onset
Of Fear Circuity Disorders
Chapter 12. Neuroimaging And Neuroanatomy Of
Stress-Induced And Fear Circuity Disorders
Chapter 13. Role Of
Neurochemical And Neuroendocrine Markers Of Fear In Classification Of
Anxiety Disorders
Chapter 14. Anxiety And Substance Abuse: Implications
For Pathophysiology And DSM-V
Chapter 15. Concluding
Remarks
INDEX