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Stress-Induced and Fear Circuitry Disorders

Stress-Induced and Fear Circuitry Disorders
Refining the Research Agenda for DSM-V

Edited by Gavin Andrews, M.D., Dennis S. Charney, M.D., Paul J. Sirovatka, M.S., and Darrel A. Regier, M.D., M.P.H.
2009
330 pages
ISBN 978-0-89042-344-8
Paperback Also Available In: eBook
Item #2344



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.

Preface. Part 1: Stress-Induced and Fear Circuitry Disorders. Posttraumatic stress disorder. Panic disorder. Social phobia. Specific phobias. Part 2: Course and Classification. Continuity and etiology of anxiety disorders: are they stable across the life course? Stress-induced and fear circuitry anxiety disorders: are they a distinct group? Part 3: Special Topics. Anxiety disorders in African Americans and other ethnic minorities. The genetic basis of anxiety disorders. Serotonin, sensitive periods, and anxiety. Role of cognition in stress-induced and fear circuitry disorders. Stress and psychosocial factors in the onset of fear circuitry disorders. Neuroimaging and neuroanatomy of stress-induced and fear circuitry disorder. Role of neurochemical and neuroendocrine markers of fear in classidication of anxiety disorders. Anxiety and substance abuse: implications for pathophysiology and DSM-V. Concluding remarks. Index.
"This is a very ambitious undertaking by some of the best minds in our field. By offering a clear hypothesis and a research agenda to test it, their effort has the potential not only to place the classification of key anxiety disorders on a more empirical foundation, but also to significantly advance our understanding of their pathophysiology."—Michael R. Liebowitz M.D., Professor of Clinical Psychiatry, Columbia University.

"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."—Doddy Enterprises, 4/24/2009

"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, PsycCRITIQUES

Mark D. Alter, M.D., Ph.D.
Gavin Andrews, M.D.
Carlos Blanco, M.D., Ph.D.
Susan B�gels, Ph.D
Timothy A. Brown, Ph.D.
Richard A. Bryant, Ph.D.
Shawn P. Cahill, Ph.D.
Dennis S. Charney, M.D.
Wayne C. Drevets, M.D.
Thalia C. Eley, Ph.D.
Paul M.G. Emmelkamp, Ph.D.
Carlo Faravelli, M.D.
Edna B. Foa, Ph.D.
Matthew J. Friedman, M.D.
Toshi A. Furukawa, M.D., Ph.D.
Abby J. Fyer, M.D.
HonaLee Harrington, B.A.
Rene Hen, Ph.D.
Jonathan D. Huppert, Ph.D.
Elie G. Karam, M.D.
William B. Lawson, M.D., Ph.D.
Peter McEvoy, Ph.D.
Richard J. McNally, Ph.D.
Edward V. Nunes, M.D.
Daniel S. Pine, M.D.
Richie Poulton, Ph.D.
Ronald M. Rapee, Ph.D.
Scott L. Rauch, M.D.
Darrel A. Regier, M.D., M.P.H.
Paul J. Sirovatka, M.S. (1947�2007)
Tim Slade, Ph.D.
Murray B. Stein, M.D., FRCPC, M.P.H.
Elisabetta Truglia, M.D.
Hans-Ulrich Wittchen, Ph.D.
Rachel Yehuda, Ph.D.
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.