Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-05T01:41:16.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Bio-psycho-social interactions in anxiety and panic disorders: a speculative perspective

Published online by Cambridge University Press:  13 June 2014

Malcolm Lader
Malcolm Lader*
Affiliation:
Institute of Psychiatry, University of London, De Crespigny Park, London, SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Anxiety states comprise three components, the subjective, the physiological and the behavioural. Anxiety disorders differ from normal anxiety in that cognitive clues inducing the emotion are covert. Anxiety can be induced by a variety of chemical agents, including the catecholamines, caffeine, lactate and some beta-carbolines. Models can be built up from the standpoints of Schachter, Lader and Matthews, and Clark to provide a cohesive theoretical framework for anxiety and panic disorders. Both pharmacological and psychological treatments are effective in these conditions and the model can incorporate the mode of action of these therapies. The ultimate goal is a holistic concept of anxiety combining the bio-psycho-social approaches.

Keywords

Anxiety disorderspanic disorderinduction of anxietyanxiolytics
Type
Perspectives
Information
Irish Journal of Psychological Medicine , Volume 8 , Issue 2 , September 1991 , pp. 154 - 159
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lader, M. The psychophysiology of mental illness. London: Routledge and Kegan Paul, 1975.Google Scholar
2.Coles, MGH, Donchin, E, Porges, SW. eds. Psychophysiology, systems, processes, and applications. Amsterdam: Elsevier, 1986.Google Scholar
3.American Psychiatric Association. Diagnostic Criteria from DSM-III-R. Washington DC: American Psychiatric Association, 1987.Google Scholar
4.Lader, MH, Wing, L. Physiological measures, sedative drugs and morbid anxiety. Maudsley Monograph No. 14. London: Oxford University Press, 1966.Google Scholar
5.Lader, M, Bruce, M. States of anxiety and their induction by drugs. Br J Clin Pharmac 1986; 22: 251–61.CrossRefGoogle ScholarPubMed
6.Mineke, A. Animal models of anxiety-based disorders: their usefulness and limitations. In: Tuma, AH, Maser, JD, eds. Anxiety and the anxiety disorders. New Jersey: Lawrence Erlbaum, 1985.Google Scholar
7.Kanfer, FH. The limitations of animal models in understanding anxiety. In: Tuma, AH, Maser, JD, eds. Anxiety and the anxiety disorders. New Jersey: Lawrence Erlbaum, 1985.Google Scholar
8.Tyrer, PJ, Lader, MH. Physiological and psychological effects of ± propranolol and diazepam in induced anxiety. Br J Clin Pharmac 1974; 1: 379–85.CrossRefGoogle ScholarPubMed
9.Maranon, G. Contribution a l'étude de l'action émotive de l'adrenaline. Rev Fr Endocrinol 1924; 2: 301–25.Google Scholar
10.Schachter, S, Singer, JE. Cognitive, social and physiological determinants of emotional state. Psychol Rev 1962; 69: 379–99.CrossRefGoogle ScholarPubMed
11.Schachter, S, Wheeler, L. Epinephrine, chlorpromazine and amusement. J abnorm soc Psychol 1962; 65: 121–28.CrossRefGoogle ScholarPubMed
12.Schachter, S. The interaction of cognitive and physiological determinants of emotional states. In: Spielberger, CD, editor. Anxiety and behaviour. New York: Academic Press, 1966.Google Scholar
13.Van der Molen, GM, van den Hout, MA, Vroemen, J, Lousberg, H, Griez, E. Cognitive determinants of lactate-induced anxiety. Behav Res Ther 1986; 24: 677–80.CrossRefGoogle ScholarPubMed
14.Greden, JF. Anxiety or caffeinism: a diagnostic dilemma. Am J Psychiat 1974; 131: 1089–92.Google ScholarPubMed
15.Bruce, MS, Lader, M. Caffeine abstention in the management of anxiety disorders. Psychol Med 1989; 19: 211–14.CrossRefGoogle ScholarPubMed
16.Uhde, TW, Boulenger, J-P, Jimerson, DC, Post, RM. Caffeine and behaviour: Relationship to psychopathology and underlying mechanisms. Psychopharm Bull 1984; 20: 426–30.Google Scholar
17.Charney, DS, Heninger, GR, Jatlow, PI. Increased anxiogenic effects of caffeine in panic disorders. Arch gen Psychiat 1985; 42: 233–43.CrossRefGoogle ScholarPubMed
18.Dorow, R, Horowski, R, Paschelke, G, Amin, M, Braestrup, C. Severe anxiety induced by FG 7142, a beta carboline ligand for benzodiazepine receptors. Lancet 1983; ii: 98–9.CrossRefGoogle Scholar
19.Curran, HV, Lader, M. The psychopharmacological effects of repeated doses of fluvoxamine, mianserin and placebo in healthy human subjects. Eur J Clin Pharm 1986; 29: 601–7.CrossRefGoogle ScholarPubMed
20.Lader, MH, Mathews, AM. A physiological model of phobic anxiety and desensitization. Behav Res Ther 1968; 6: 9–17.CrossRefGoogle ScholarPubMed
21.Davis, M. The role of the amygdala and its efferent projections in fear and anxiety. In: Tyrer, P, editor. Psychopharmacology of anxiety. British Association for Psychopharmacology Monograph No. 11. Oxford: Oxford University Press, 1989.Google Scholar
22.Rachman, S, Levitt, K, Lopatka, C. Panic: the links between cognitions and bodily symptoms. I. Behav Res Ther 1987; 25: 411–23.CrossRefGoogle ScholarPubMed
23.Clark, DM. A cognitive approach to panic. Behav Res Ther 1986; 24: 461–70.CrossRefGoogle ScholarPubMed
24.Shear, MK. Pathophysiology of panic: a review of pharmacologic provocative tests and naturalistic monitoring data. J clin Psychiat 1986; 47:6 (Suppl): 18–26.Google Scholar
25.Tyrer, P. The role of bodily feelings in anxiety. Oxford University Press, 1976.Google Scholar
26.de Montigny, C. Cholecystokinin tetrapeptide induces panic-like attacks in healthy volunteers: preliminary findings. Arch Gen Psychiat 1989; 46: 511–517.CrossRefGoogle ScholarPubMed
27.Catalan, J, Gath, DH. Benzodiazepines in general practice: time for a decision. BMJ 1985; 290: 1374–1376.CrossRefGoogle ScholarPubMed
28.Matthews, AM, Gelder, MG, Johnston, DW. Agoraphobia: nature and treatment. New York: Guilford Press, 1981.Google Scholar
29.Jannoun, L, Munby, M, Catalan, J, Gelder, M. A home-based treatment programme for agoraphobia: replication and controlled evaluation. Behav Ther 1980; 11: 294–305.CrossRefGoogle Scholar
30.Butler, G, Mathews, A. Cognitive processes in anxiety. Adv Behav Res Ther 1983; 5: 51–62.CrossRefGoogle Scholar
31.Klein, DF, Fink, M. Psychiatric reaction patterns to Imipramine. Am J Psychiat 1962; 119: 432–8.CrossRefGoogle ScholarPubMed
32.Klein, DF. Importance of psychiatric diagnosis in prediction of clinical drug effects. Arch gen Psychiat 1967; 16: 116–26.CrossRefGoogle ScholarPubMed
33.Tyrer, P, Shawcross, C. Monoamine oxidase inhibitors in anxiety disorders. J Psychiat Res 1988; 22 suppl 1: 87–98.CrossRefGoogle ScholarPubMed
34.Ballenger, JC, Burrows, GD, DuPont, RL, Lesser, IM, Noyes, R, Pecknold, JC, Rifkin, A, Swinson, RP. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. Arch Gen Psychiat 1988; 45: 413–422.CrossRefGoogle ScholarPubMed
35.Ley, R. Agoraphobia, the panic attack and the hyperventilation syndrome. Behav Res Ther 1985; 23: 79–81.CrossRefGoogle ScholarPubMed