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Post  counselor on Mon Oct 15, 2012 11:10 am


From the Latin angere (tighten), the term defines a physical or mental condition characterized by a feeling of apprehension, a sense of oppression connected with a feeling of suffocation, uncertainty, fear and alarm that can occur even in the absence of objective danger . In the A. there is concern for the prefigure of impending danger, from which there is no possibility of escape, and that is considered inevitable. The emotional symptoms are accompanied by autonomic symptoms consisting of increased sweating, rapid heart rate, muscle tension, increased blood pressure, tremors, rapid breathing, dilated pupils, disorders of the digestive and genitourinary etc. Unlike fear, which is an emotional response to a real threat to the. is devoid of the object or triggering this is not clearly recognized as such by the subject. The a. is a physiological manifestation, an innate mechanism that allows to deal with a commensurate increase in the performance of vigilance, attention, attack or escape a possible future danger. The a. plays, therefore, a function of adaptation to the environment, improving performance against emergency situations. The pathological condition is to onset at a time when the level of a. exceeds a certain limit, rather than inhibiting activate the subject and interfering with its performance both physical and motor skills. It appears, therefore, disproportionate to the events, in particular when it is not possible to identify a root cause and when the duration of the crisis is such as to be no longer justified because, in spite of a certain danger. The anxious patient presents a maladaptive behavior for long periods of time and, in certain cases, even for life. In psychoanalytic theory of a. elaborated by Freud, are placed formulations clinical-descriptive models and theoretical interpretation of the genesis of anxiety manifestations. In particular, in a first time Freud identified one of the possible causes of the phenomenon in libidinal repression: the a. would be the result of the transformation of libidinal energy dissatisfied because of external impediments. In a subsequent rielabolazione, put in relation to the. with the psychological reaction of the ego in the face of instinctual forces of the id, with potential for disruptive psychic equilibrium. The a., Then, is a defense mechanism that indicates to the ego the need to erect psychological defenses. They develop as defense mechanisms that are mainly represented by removal, rationalization, displacement, projection, identification, compensation, reaction formation, fantasy, regression and sublimation. From the neurophysiological point of view, the connections between the limbic system and the diencephalon enrich the visceral and emotional stimuli of the emotional component, covering such great importance in the regulation of fear reactions and a. of emotional life in general. Important studies of physiological reactions in conditions of exposure to stressors showed biochemical changes induced in animals and humans that would help to emphasize the biological correlates of fear and from school. Mainly involved systems are GABAergic, noradrenergic and serotonergic. Different stimuli trigger different emotional responses, underpinned by different neural circuits. The integration of noradrenergic and serotonergic pathways at the level of the centers diencefalici lead, under certain conditions, the genesis of a., With the formation of a state of alert and preparing to flee or attack. The autonomic nervous system (ANS) has been recognized as a mediator of somatic components of a. Studies of electrical stimulation in animals have revealed a specific circuit for fear, and for a., Involving various structures of the limbic system such as the hippocampus, amygdala and septal nuclei, at this level, the locus coeruleus would have a function nonspecific activation. The a. is a symptom that is found in several psychiatric disorders of interest and no. In some cases appears to be the predominant symptom of the clinical picture (disorders in.); In other is associated, more or less clearly, to other pathologies. One problem that has arisen is to frame the anxiety symptoms in a precise clinical diagnosis. The patient with anxiety symptoms may receive different clinical diagnoses, such as a neurosis., Was of a., S. anxious, of a psychoneurosis. etc.. These diagnoses are not equivalent to each other and it is set, therefore, the need to create a uniform nomenclature that would allow to classify the various aspects symptom. Today they are as distinct elements qualitatively different from a. anticipatory connected to prefigure a possible danger or in anticipation of a panic attack, the a. generalized, persistent, not linked to a specific stimulus, panic attacks, episodes of short duration but high intensity, associated with fear and a sense of impending death. Phobias represent a more complex picture, in which it is overestimated a danger associated with objects or situations and in which the anxiety component plays an important role. The patient is conscious exaggeration of their level of apprehension, but can not rationally to overcome their fears. As a result, an attitude characterized by avoidance behavior of the situations that would cause the crisis. In DSM-IV-R disorders of a. are divided into disorder, panic disorder with and without agoraphobia, agoraphobia without history of panic disorder, a disorder. generalized, social phobia, specific phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, a disorder. due to medical conditions, to disorder. substance induced. Some epidemiological studies have shown a familiar family of anxiety manifestations, regardless dall'inquadramento diagnosis. Studies of familial transmission, for example, have established a risk in first-degree relatives, significantly higher than the control groups. In addition, there was a higher incidence of simple phobias, agoraphobia and panic disorder in females than in males. Regarding the age of onset, anxiety symptoms seems to take different ways depending on the clinical picture which it presents, showing early onset in the case of simple phobia and social phobia (approximately to 17 years) or later onset disorder in Panic and nell'agorafobia (to 26 years). From the pharmacological point of view, the benzodiazepines (BDZ) certainly represent one of the categories of drugs most widely used for therapy. There is a broad agreement on the use of these drugs in the treatment of a. generalized; yet to be defined, however, the role of benzodiazepines in the management of patients suffering from other disorders in. In an attempt to control a., Patients often resort to strategies that can aggravate the symptoms, proving harmful to health, such as seeking a calming effect in alcohol, smoking and drugs.

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