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anxiety
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factoids
{{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 complaints, and rumination.BOOK, Seligman ME, Walker EF, Rosenhan DL, David Rosenhan, Martin Seligman, Abnormal psychology, 4th, New York, W.W. Norton & Company, {{Page needed|date= May 2013}} It is the subjectively unpleasant feelings of dread over anticipated events, such as the feeling of imminent death.BOOK, Davison, Gerald C., vanc, Abnormal Psychology, 2008, Veronica Visentin, Toronto, 978-0-470-84072-6, 154, {{qn|date=November 2018}} Anxiety is not the same as fear, which is a response to a real or perceived immediate threat,BOOK, American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders, Fifth, American Psychiatric Publishing, Arlington, VA, 189, 978-0-89042-555-8, whereas anxiety involves the expectation of future threat. 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.BOOK, Bouras N, Holt G, 2007, Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities, 2nd, Cambridge University Press,weblink 9781139461306, {{Page needed|date= May 2013}} It is often accompanied by muscular tension, restlessness, fatigue and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an anxiety disorder.People facing anxiety may withdraw from situations which have provoked anxiety in the past.BOOK, Barker P, 2003, Psychiatric and Mental Health Nursing: The Craft of Caring, Edward Arnold, London, 978-0-340-81026-2, {{Page needed|date= May 2013}} 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.BOOK, World Health Organization, 2009, Pharmacological Treatment of Mental Disorders in Primary Health Care,weblink Geneva, 978-92-4-154769-7, no,weblink" title="web.archive.org/web/20161120132530weblink">weblink November 20, 2016, mdy-all, JOURNAL, Testa A, Giannuzzi R, Daini S, Bernardini L, Petrongolo L, Gentiloni Silveri N, Psychiatric emergencies (part III): psychiatric symptoms resulting from organic diseases, European Review for Medical and Pharmacological Sciences, 17 Suppl 1, 86–99, February 2013, 23436670,weblink {{open access}} Anxiety symptoms may mask an organic disease, or appear associated with or as a result of a medical disorder.JOURNAL, Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Dain S, Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases, European Review for Medical and Pharmacological Sciences, 17 Suppl 1, 65–85, February 2013, 23436669,weblink {{open access}}JOURNAL, Testa A, Giannuzzi R, Sollazzo F, Petrongolo L, Bernardini L, Daini S, Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms, European Review for Medical and Pharmacological Sciences, 17 Suppl 1, 55–64, February 2013, 23436668,weblink {{open access}}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.BOOK, Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 2013, American Psychiatric Publishing, Arlington, 978-0-89042-555-8, 189–195, 5th,weblink Anxiety disorders are partly genetic, with twin studies suggesting 30-40% genetic influence on individual differences in anxiety.JOURNAL, Reynolds, Chandra A., 2013-06-16, Robert Plomin, John C. DeFries, Valerie S. Knopik, Jenae M. Neiderhiser, Behavioral Genetics (6th Edition), Behavior Genetics, 43, 4, 360–361, 10.1007/s10519-013-9598-6, 0001-8244, Environmental factors are also important. Twin studies show that individual-specific environments have a large influence on anxiety, whereas shared environmental influences (environments that affect twins in the same way) operate during childhood but decline through adolescence.JOURNAL, Smoller, Jordan W., Block, Stefanie R., Young, Mirella M., November 2009, Genetics of anxiety disorders: the complex road from DSM to DNA, Depression and Anxiety, 26, 11, 965–975, 10.1002/da.20623, 19885930, 1091-4269, Specific measured ‘environments’ that have been associated with anxiety include child abuse, family history of mental health disorders, and poverty.JOURNAL, Craske, Michelle G., Stein, Murray B., Eley, Thalia C., Milad, Mohammed R., Holmes, Andrew, Rapee, Ronald M., Wittchen, Hans-Ulrich, 2017-05-04, Anxiety disorders, Nature Reviews Disease Primers, 3, 17024, 10.1038/nrdp.2017.24, 28470168, 2056-676X, Anxiety is also associated with drug use, including alcohol, caffeine, and benzodiazepines (which are often prescribed to treat anxiety).Anxiety disorders often occur with other mental health disorders, particularly major depressive disorder, bipolar disorder, eating disorders, or certain personality disorders. It also commonly occurs with personality traits such as neuroticism. This observed co-occurrence is partly due to genetic and environmental influences shared between these traits and anxiety.JOURNAL, Smoller, Jordan W., Andreassen, Ole A., Edenberg, Howard J., Faraone, Stephen V., Glatt, Stephen J., Kendler, Kenneth S., 2018-03-14, Correction to: Psychiatric genetics and the structure of psychopathology, Molecular Psychiatry, 24, 3, 471, 10.1038/s41380-018-0026-4, 29540840, 1359-4184, JOURNAL, Kendler, Kenneth S., July 2004, Major Depression and Generalised Anxiety Disorder, FOCUS, 2, 3, 416–425, 10.1176/foc.2.3.416, 1541-4094, {{TOC limit|3}}

Fear

(File:Los Angeles, California. Lockheed Employment. A worried applicant waiting to be interviewed - NARA - 532210.tif|thumb|right|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.Andreas Dorschel, Furcht und Angst. In: Dietmar Goltschnigg (ed.), Angst. Lähmender Stillstand und Motor des Fortschritts. Stauffenburg, Tübingen 2012, pp. 49–54 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.BOOK, Öhman, Arne, vanc, 2000, Fear and anxiety: Evolutionary, cognitive, and clinical perspectives, Michael, Lewis, Jeannette M., Haviland-Jones, Handbook of emotions, 573–93, New York, The Guilford Press, 978-1-57230-529-8, 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,"JOURNAL, Barlow DH, Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory, The American Psychologist, 55, 11, 1247–63, November 2000, 11280938, 10.1037/0003-066X.55.11.1247, 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.JOURNAL, Susan, Iacovou, vanc, 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, 1752-5616, 22, 2, 356–67,weblink no,weblink" title="web.archive.org/web/20140819090644weblink">weblink August 19, 2014, mdy-all, In positive psychology, anxiety is described as the mental state that results from a difficult challenge for which the subject has insufficient coping skills.BOOK, Mihaly Csikszentmihalyi, Csíkszentmihályi, Mihály, vanc, Finding Flow, 1997, {{Page needed|date=May 2013}}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.JOURNAL, Sylvers P, Lilienfeld SO, LaPrairie JL, Differences between trait fear and trait anxiety: implications for psychopathology, Clinical Psychology Review, 31, 1, 122–37, February 2011, 20817337, 10.1016/j.cpr.2010.08.004,

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.JOURNAL, Rynn MA, Brawman-Mintzer O, Generalized anxiety disorder: acute and chronic treatment, CNS Spectrums, 9, 10, 716–23, October 2004, 15448583, 10.1017/S1092852900022367, 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.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.NEWS,weblink Depression Hotline {{!, Call Our Free, 24 Hour Depression Helpline|work=PsychGuides.com|access-date=2018-10-11}}The behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety or negative feelings in the past. 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).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"Smith, Melinda (2008, June). Anxiety attacks and disorders: Guide to the signs, symptoms, and treatment options. Retrieved March 3, 2009, from Helpguide Web site: WEB,weblink HelpGuide.org, 2009-03-04, yes,weblink" title="web.archive.org/web/20090307161028weblink">weblink March 7, 2009, mdy, as well as "nightmares/bad dreams, obsessions about sensations, déjà vu, a trapped-in-your-mind feeling, and feeling like everything is scary."(1987–2008). Anxiety Symptoms, Anxiety Attack Symptoms (Panic Attack Symptoms), Symptoms of Anxiety. Retrieved March 3, 2009, from Anxiety Centre Website: WEB,weblink Anxiety Symptoms and Signs – over 100 listed, 2009-03-04, no,weblink" title="web.archive.org/web/20090307132218weblink">weblink March 7, 2009, mdy-all, 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."(1987–2008). Anxiety symptoms – Fear of dying. Retrieved March 3, 2009, from Anxiety Centre Website: WEB,weblink Fear of dying anxiety symptom, 2009-03-04, no,weblink" title="web.archive.org/web/20090305104407weblink">weblink March 5, 2009, mdy-all, The physiological symptoms of anxiety may include:

Types

File:Edvard Munch - Anxiety - Google Art Project.jpg|thumb|upright|Painting entitled Anxiety, 1894, by Edvard MunchEdvard Munch

Existential

{{Further|Angst|Existential crisis|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 anxietyBOOK, Paul Tillich, Tillich, Paul, vanc, 1952, The Courage To Be, New Haven, Yale University Press, 978-0-300-08471-9, 76, 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), 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".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.BOOK, Abulof, Uriel, vanc, The Mortality and Morality of Nations, 2015, New York, Cambridge University Press, 978-1-107-09707-0, 26, Depending on the source of the threat, psychoanalytic theory distinguishes the following types of anxiety:
  • realistic
  • neurotic
  • moral BOOK, Hjelle, Larry, Ziegler, Daniel, 1981, Personality Theories: Basic Assumptions, Research, and Applications, McGraw-Hill, 494, 9780070290631,

Test and performance

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.JOURNAL, 10.1177/0959354394044004, Yerkes-Dodson: A Law for all Seasons, Theory & Psychology, 4, 4, 525–547, 1994, Teigen, Karl Halvor, vanc, 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,JOURNAL, Liebert RM, Morris LW, Cognitive and emotional components of test anxiety: a distinction and some initial data, Psychological Reports, 20, 3, 975–8, June 1967, 6042522, 10.2466/pr0.1967.20.3.975, free, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia.JOURNAL, Beidel DC, Turner SM, Comorbidity of test anxiety and other anxiety disorders in children, Journal of Abnormal Child Psychology, 16, 3, 275–87, June 1988, 3403811, 10.1007/BF00913800, The DSM-IV classifies test anxiety as a type of social phobia.JOURNAL, Rapee RM, Heimberg RG, A cognitive-behavioral model of anxiety in social phobia, Behaviour Research and Therapy, 35, 8, 741–56, August 1997, 9256517, 10.1016/S0005-7967(97)00022-3, While the term "test anxiety" refers specifically to students,JOURNAL, 10.1.1.1027.7497,weblink Impact of Hypnotherapy on Examination Anxiety and Scholastic Performance among School, Delhi Psychiatry Journal, 2011, 14, 2, 337–42, Shachi, Mathur, Waheeda, Khan, vanc, 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.WEB, Hall-Flavin, Daniel K., vanc, Is it possible to overcome test anxiety?,weblink Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 August 2015, no,weblink" title="web.archive.org/web/20150905063635weblink">weblink September 5, 2015, mdy-all, Management of test anxiety focuses on achieving relaxation and developing mechanisms to manage anxiety.

Stranger, social, and intergroup 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.BOOK, 10.1016/B978-0-12-375096-9.00028-6, Introduction: Toward an Understanding of Social Anxiety Disorder, Social Anxiety, xix–xxvi, 2010, Hofmann, Stefan G., Dibartolo, Patricia M., vanc, 978-0-12-375096-9, 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,BOOK, Ben, Thomas, Sally, Hardy, Penny, Cutting, vanc, 1997, Mental Health Nursing: Principles and Practice, Mosby, London, 978-0-7234-2590-8, {{Page needed|date=May 2013}} 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.JOURNAL, Settipani CA, Kendall PC, 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, February 2013, 22581270, 10.1007/s10578-012-0307-0, 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.JOURNAL, 10.1111/j.1540-4560.1985.tb01134.x, Intergroup Anxiety, Journal of Social Issues, 41, 3, 157–175, 1985, Stephan, Walter G., Stephan, Cookie White, vanc, 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.JOURNAL, Richeson JA, Trawalter S, The threat of appearing prejudiced and race-based attentional biases, Psychological Science, 19, 2, 98–102, February 2008, 18271854, 10.1111/j.1467-9280.2008.02052.x, JOURNAL, Mathews A, Mogg K, May J, Eysenck M, Implicit and explicit memory bias in anxiety, Journal of Abnormal Psychology, 98, 3, 236–40, August 1989, 2768658, 10.1037/0021-843x.98.3.236, JOURNAL, 10.1016/0191-8869(91)90096-t, Effects of encoding and anxiety on implicit and explicit memory performance, Personality and Individual Differences, 12, 2, 131–139, 1991, Richards, Anne, French, Christopher C., vanc, Additionally recent research has found that implicit racial evaluations (i.e. automatic prejudiced attitudes) can be amplified during intergroup interaction.JOURNAL, Amodio DM, Hamilton HK, Intergroup anxiety effects on implicit racial evaluation and stereotyping, Emotion, 12, 6, 1273–80, December 2012, 22775128, 10.1037/a0029016, 10.1.1.659.5717, Negative experiences have been illustrated in producing not only negative expectations, but also avoidant, or antagonistic, behavior such as hostility.JOURNAL, Plant EA, Devine PG, The antecedents and implications of interracial anxiety, Personality & Social Psychology Bulletin, 29, 6, 790–801, June 2003, 15189634, 10.1177/0146167203029006011, 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).WEB,weblink Anxiety, Schwarzer R, December 1997, 2008-01-12,weblink" title="web.archive.org/web/20070920115547weblink">weblink September 20, 2007, yes, mdy, A meta-analysis showed that a high level of neuroticism is a risk factor for development of anxiety symptoms and disorders.JOURNAL, Jeronimus BF, Kotov R, Riese H, Ormel J, 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, October 2016, 27523506, 10.1017/S0033291716001653, Such anxiety may be conscious or unconscious.BOOK, Giddey M, Wright H, Mental Health Nursing: From first principles to professional practice, Stanley Thornes, {{Page needed|date=May 2013}}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.NEWS,weblink Gulf Bend MHMR Center, 2018-10-11,

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.NEWS,weblink The Times, London, Premium choice anxiety, April 27, 2008, 2010-04-25, Jonathan, Downey, vanc, no,weblink" title="web.archive.org/web/20140203132027weblink">weblink February 3, 2014, mdy-all, 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."Is choice anxiety costing british 'blue chip' business? {{webarchive|url=https://web.archive.org/web/20151222143245weblink |date=December 22, 2015 }}, Capgemini, Aug 16, 2004In a decision context, unpredictability or uncertainty may trigger emotional responses in anxious individuals that systematically alter decision-making.JOURNAL, Hartley CA, Phelps EA, Anxiety and decision-making, Biological Psychiatry, 72, 2, 113–8, July 2012, 22325982, 3864559, 10.1016/j.biopsych.2011.12.027, 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.

Anxiety disorders

Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses. 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.Anxiety disorders are caused by a complex combination of genetic and environmental factors.[47]  To be diagnosed, symptoms typically need to be present for at least six months, be more than would be expected for the situation, and decrease a person's ability to function in their daily lives.[10][49] Other problems that may result in similar symptoms include hyperthyroidism, heart disease, caffeine, alcohol, or cannabis use, and withdrawal from certain drugs, among others.[49][7]Without treatment, anxiety disorders tend to remain.WEB,weblink Anxiety Disorders, March 2016, NIMH,weblink" title="web.archive.org/web/20160727230427weblink">weblink July 27, 2016, no, 14 August 2016, mdy-all, Treatment may include lifestyle changes, counselling, and medications. Counselling is typically with a type of cognitive behavioural therapy. Medications, such as antidepressants or beta blockers, may improve symptoms.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.JOURNAL, Kessler RC, Angermeyer M, Anthony JC, DE Graaf R, Demyttenaere K, Gasquet I, DE Girolamo G, Gluzman S, Gureje O, Haro JM, Kawakami N, Karam A, Levinson D, Medina Mora ME, Oakley Browne MA, Posada-Villa J, Stein DJ, Adley Tsang CH, Aguilar-Gaxiola S, Alonso J, Lee S, Heeringa S, Pennell BE, Berglund P, Gruber MJ, Petukhova M, Chatterji S, Ustün TB, 6, 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, October 2007, 18188442, 2174588, They occur about twice as often in women than they do in men, and generally begin before the age of 25.JOURNAL, Craske MG, Stein MB, Anxiety, Lancet, 388, 10063, 3048–3059, December 2016, 27349358, 10.1016/S0140-6736(16)30381-6, 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.

Risk factors

File:Emperor Traianus Decius (Mary Harrsch).jpg|thumb|upright|A marble bust of the Roman Emperor Decius from the date=October 2018}}

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.JOURNAL, Rosen JB, Schulkin J, From normal fear to pathological anxiety, Psychological Review, 105, 2, 325–50, April 1998, 9577241, 10.1037/0033-295X.105.2.325, People who have anxiety tend to show high activity in response to emotional stimuli in the amygdala.Nolen-Hoeksema, S. (2013). (Ab)normal Psychology (6th edition). McGraw Hill.{{page needed|date=October 2018}} 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.BOOK, Compassion and Healing in Medicine and Society: On the Nature and Use of Attachment Solutions to Separation Challenges, Fricchione G, 2011, Johns Hopkins University Press, 978-1-4214-0220-8, 172, BOOK, How the Brain Talks to Itself: A Clinical Primer of Psychotherapeutic Neuroscience, Harris J, 1998, Haworth, 978-0-7890-0408-6, 284, 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.JOURNAL, Bar-Haim Y, Fox NA, Benson B, Guyer AE, Williams A, Nelson EE, Perez-Edgar K, Pine DS, Ernst M, 6, Neural correlates of reward processing in adolescents with a history of inhibited temperament, Psychological Science, 20, 8, 1009–18, August 2009, 19594857, 2785902, 10.1111/j.1467-9280.2009.02401.x, 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".

The Gut-Brain Axis

The microbes of the gut can connect with the brain to affect anxiety. There are various pathways along which this communication can take place. One is through the major neurotransmittersJOURNAL, Kennedy, P.J., Cryan, J.F., Dinan, T.G., Clarke, G., 2017, Kynurenine pathway metabolism and the microbiota-gut-brain axis,weblink Neuropharmacology, 112, 399–412, 10.1016/j.neuropharm.2016.07.002, 0028-3908, . The gut microbes such as Bifidobacterium and Bacillus produce the neurotransmitters GABA and dopamine, respectivelyJOURNAL, Dinan, Timothy G., Stilling, Roman M., Stanton, Catherine, Cryan, John F., 2015, Collective unconscious: How gut microbes shape human behavior,weblink Journal of Psychiatric Research, 63, 1–9, 10.1016/j.jpsychires.2015.02.021, 0022-3956, . The neurotransmitters signal to the nervous system of the gastrointestinal tract, and those signals will be carried to the brain through the vagus nerve or the spinal systemJOURNAL, de Weerth, Carolina, 2017, Do bacteria shape our development? Crosstalk between intestinal microbiota and HPA axis,weblink Neuroscience & Biobehavioral Reviews, 83, 458–471, 10.1016/j.neubiorev.2017.09.016, 0149-7634, . This is demonstrated by the fact that altering the microbiome has shown anxiety- and depression-reducing effects in mice, but not in subjects without vagus nervesJOURNAL, Bravo, J. A., Forsythe, P., Chew, M. V., Escaravage, E., Savignac, H. M., Dinan, T. G., Bienenstock, J., Cryan, J. F., 2011-08-29, Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve,weblink Proceedings of the National Academy of Sciences, 108, 38, 16050–16055, 10.1073/pnas.1102999108, 0027-8424, .Another key pathway is the HPA axis, as mentioned above. The microbes can control the levels of cytokines in the body, and altering cytokine levels creates direct effects on areas of the brain such as the hypothalmus, the area that triggers HPA axis activity. The HPA axis regulates production of cortisol, a hormone that takes part in the body's stress response. When HPA activity spikes, cortisol levels increase, processing and reducing anxiety in stressful situations. These pathways, as well as the specific effects of individual taxa of microbes, are not yet completely clear, but the communication between the gut microbiome and the brain is undeniable, as is the ability of these pathways to alter anxiety levels.With this communication comes the potential to treat anxiety. Prebiotics and probiotics have been shown to reduced anxiety. For example, experiments in which mice were given fructo- and galacto-oligosaccharide prebiotics JOURNAL, Burokas, Aurelijus, Arboleya, Silvia, Moloney, Rachel D., Peterson, Veronica L., Murphy, Kiera, Clarke, Gerard, Stanton, Catherine, Dinan, Timothy G., Cryan, John F., 2017, Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice,weblink Biological Psychiatry, 82, 7, 472–487, 10.1016/j.biopsych.2016.12.031, 0006-3223, and lactobacillus probiotics have both demonstrated a capability to reduce anxiety. In humans, results are not as concrete, but promisingJOURNAL, Benton, D, Williams, C, Brown, A, 2006-12-06, Impact of consuming a milk drink containing a probiotic on mood and cognition,weblink European Journal of Clinical Nutrition, 61, 3, 355–361, 10.1038/sj.ejcn.1602546, 0954-3007, JOURNAL, Schmidt, Kristin, Cowen, Philip J., Harmer, Catherine J., Tzortzis, George, Errington, Steven, Burnet, Philip W. J., 2014-12-03, Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers,weblink Psychopharmacology, 232, 10, 1793–1801, 10.1007/s00213-014-3810-0, 0033-3158, .

Genetics

Genetics and family history (e.g. parental anxiety) may put an individual at increased risk of an anxiety disorder, but generally external stimuli will trigger its onset or exacerbation.[57] Estimates of genetic influence on anxiety, based on studies of twins, range from 25–40% depending on the specific type and age-group under study. For example, genetic differences account for about 43% of variance in panic disorder and 28% in generalized anxiety disorder.[58] Longitudinal twin studies have shown the moderate stability of anxiety from childhood through to adulthood is mainly influenced by stability in genetic influence.JOURNAL, Waszczuk, Monika A., Zavos, Helena M. S., Gregory, Alice M., Eley, Thalia C., 2014-08-01, The Phenotypic and Genetic Structure of Depression and Anxiety Disorder Symptoms in Childhood, Adolescence, and Young Adulthood, JAMA Psychiatry, 71, 8, 905–16, 10.1001/jamapsychiatry.2014.655, 24920372, 2168-622X, JOURNAL, Nivard, M. G., Dolan, C. V., Kendler, K. S., Kan, K.-J., Willemsen, G., van Beijsterveldt, C. E. M., Lindauer, R. J. L., van Beek, J. H. D. A., Geels, L. M., 2014-09-04, Stability in symptoms of anxiety and depression as a function of genotype and environment: a longitudinal twin study from ages 3 to 63 years, Psychological Medicine, 45, 5, 1039–1049, 10.1017/s003329171400213x, 25187475, 0033-2917, When investigating how anxiety is passed on from parents to children, it is important to account for sharing of genes as well as environments, for example using the intergenerational children-of-twins design.JOURNAL, Eley, Thalia C., McAdams, Tom A., Rijsdijk, Fruhling V., Lichtenstein, Paul, Narusyte, Jurgita, Reiss, David, Spotts, Erica L., Ganiban, Jody M., Neiderhiser, Jenae M., July 2015, The Intergenerational Transmission of Anxiety: A Children-of-Twins Study, American Journal of Psychiatry, 172, 7, 630–637, 10.1176/appi.ajp.2015.14070818, 25906669, 0002-953X,weblink Many studies in the past used a candidate gene approach to test whether single genes were associated with anxiety. These investigations were based on hypotheses about how certain known genes influence neurotransmitters (such as serotonin and norepinephrine) and hormones (such as cortisol) that are implicated in anxiety. None of these findings are well replicated.[59][60][61], with the possible exception of TMEM132D, COMT and MAO-A.JOURNAL, Howe, A S, Buttenschøn, H N, Bani-Fatemi, A, Maron, E, Otowa, T, Erhardt, A, Binder, E B, Gregersen, N O, Mors, O, 2015-09-22, Candidate genes in panic disorder: meta-analyses of 23 common variants in major anxiogenic pathways, Molecular Psychiatry, 21, 5, 665–679, 10.1038/mp.2015.138, 26390831, 1359-4184, The epigenetic signature of BDNF, a gene that codes for a protein called brain derived neurotrophic factor that is found in the brain, has also been associated with anxiety and specific patterns of neural activity.[62] and a receptor gene for BDNF called NTRK2 was associated with anxiety in a large genome-wide investigation.BIORXIV, 203844, The Common Genetic Architecture of Anxiety Disorders, Purves, Kirstin Lee, Coleman, Jonathan R. I., 2017-10-16, Rayner, Christopher, Hettema, John M, Deckert, Jürgen, McIntosh, Andrew M, Nicodemus, Kristin K, Breen, Gerome, Eley, Thalia C, The reason that most candidate gene findings have not replicated is that anxiety is a complex trait that is influenced by many genomic variants, each of which has a small effect on its own. Increasingly, studies of anxiety are using a hypothesis-free approach to look for parts of the genome that are implicated in anxiety using big enough samples to find associations with variants that have small effects. The largest explorations of the common genetic architecture of anxiety have been facilitated by the UK Biobank, the ANGST consortium and the CRC Fear, Anxiety and Anxiety Disorders.JOURNAL, Martin, Nick, Otowa, Takeshi, Lee, Minyoung, Hartman, Catharina, Oldehinkel, Albertine, Preisig, Martin, Jörgen Grabe, Hans, Middeldorp, Christel, Penninx, Brenda, 2017, Meta-Analysis of Genome-Wide Association Studies of Anxiety Disorders, European Neuropsychopharmacology, 27, S501, 10.1016/j.euroneuro.2016.09.604, 0924-977X, JOURNAL, Deckert, Jurgen, Weber, Heike, Pauli, Paul, Reif, Andreas, 2017, Glrb Allelic Variation Associated with Agoraphobic Cognitions, Increased Startle Response and Fear Network Activation, European Neuropsychopharmacology, 27, S503, 10.1016/j.euroneuro.2016.09.607, 0924-977X,

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.JOURNAL, Baldwin J, Cox J, Treating Dyspnea: Is Oxygen Therapy the Best Option for All Patients?, The Medical Clinics of North America, 100, 5, 1123–30, September 2016, 27542431, 10.1016/j.mcna.2016.04.018, JOURNAL, Vanfleteren LE, Spruit MA, Wouters EF, Franssen FM, Management of chronic obstructive pulmonary disease beyond the lungs, The Lancet. Respiratory Medicine, 4, 11, 911–924, November 2016, 27264777, 10.1016/S2213-2600(16)00097-7, JOURNAL, Tselebis A, Pachi A, Ilias I, Kosmas E, Bratis D, Moussas G, Tzanakis N, Strategies to improve anxiety and depression in patients with COPD: a mental health perspective, Neuropsychiatric Disease and Treatment, 12, 297–328, 2016, 26929625, 4755471, 10.2147/NDT.S79354, Conditions that cause abdominal pain or chest pain can cause anxiety and may in some cases be a somatization of anxiety;JOURNAL, Muscatello MR, Bruno A, Mento C, Pandolfo G, Zoccali RA, Personality traits and emotional patterns in irritable bowel syndrome, World Journal of Gastroenterology, 22, 28, 6402–15, July 2016, 27605876, 4968122, 10.3748/wjg.v22.i28.6402, JOURNAL, Remes-Troche JM, How to Diagnose and Treat Functional Chest Pain, Current Treatment Options in Gastroenterology, 14, 4, 429–443, December 2016, 27709331, 10.1007/s11938-016-0106-y, the same is true for some sexual dysfunctions.JOURNAL, Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C, Nobre P, Wylie K, 6, Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction, The Journal of Sexual Medicine, 13, 4, 538–71, April 2016, 27045257, 10.1016/j.jsxm.2016.01.019, 4442989, JOURNAL, McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJ, The pathophysiology of acquired premature ejaculation, Translational Andrology and Urology, 5, 4, 434–49, August 2016, 27652216, 5001985, 10.21037/tau.2016.07.06, Conditions that affect the face or the skin can cause social anxiety especially among adolescents,JOURNAL, Nguyen CM, Beroukhim K, Danesh MJ, Babikian A, Koo J, Leon A, The psychosocial impact of acne, vitiligo, and psoriasis: a review, Clinical, Cosmetic and Investigational Dermatology, 9, 383–392, 2016, 27799808, 5076546, 10.2147/CCID.S76088, and developmental disabilities often lead to social anxiety for children as well.JOURNAL, Caçola P, Physical and Mental Health of Children with Developmental Coordination Disorder, Frontiers in Public Health, 4, 224, 2016, 27822464, 5075567, 10.3389/fpubh.2016.00224, Life-threatening conditions like cancer also cause anxiety.JOURNAL, Mosher CE, Winger JG, Given BA, Helft PR, O'Neil BH, Mental health outcomes during colorectal cancer survivorship: a review of the literature, Psycho-Oncology, 25, 11, 1261–1270, November 2016, 26315692, 4894828, 10.1002/pon.3954, Furthermore, certain organic diseases may present with anxiety or symptoms that mimic anxiety. These disorders include certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia),JOURNAL, Samuels MH, Cognitive function in untreated hypothyroidism and hyperthyroidism, Current Opinion in Endocrinology, Diabetes and Obesity, 15, 5, 429–33, October 2008, 18769215, 10.1097/MED.0b013e32830eb84c, metabolic disorders (diabetes),JOURNAL, Buchberger B, Huppertz H, Krabbe L, Lux B, Mattivi JT, Siafarikas A, Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis, Psychoneuroendocrinology, 70, 70–84, August 2016, 27179232, 10.1016/j.psyneuen.2016.04.019, JOURNAL, Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ, Prevalence of anxiety in adults with diabetes: a systematic review, Journal of Psychosomatic Research, 53, 6, 1053–60, December 2002, 12479986, 10.1016/S0022-3999(02)00417-8, deficiency states (low levels of vitamin D, B2, B12, folic acid), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease),JOURNAL, Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, Bai JC, Psychological morbidity of celiac disease: A review of the literature, United European Gastroenterology Journal, 3, 2, 136–45, April 2015, 25922673, 4406898, 10.1177/2050640614560786, JOURNAL, Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F, Systematic review: noncoeliac gluten sensitivity, Alimentary Pharmacology & Therapeutics, 41, 9, 807–20, May 2015, 25753138, 10.1111/apt.13155, JOURNAL, Neuendorf R, Harding A, Stello N, Hanes D, Wahbeh H, Depression and anxiety in patients with Inflammatory Bowel Disease: A systematic review, Journal of Psychosomatic Research, 87, 70–80, August 2016, 27411754, 10.1016/j.jpsychores.2016.06.001, heart diseases, blood diseases (anemia), cerebral vascular accidents (transient ischemic attack, stroke), and brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease), among others.JOURNAL, Zhao QF, Tan L, Wang HF, Jiang T, Tan MS, Tan L, Xu W, Li JQ, Wang J, Lai TJ, Yu JT, 6, The prevalence of neuropsychiatric symptoms in Alzheimer's disease: Systematic review and meta-analysis, Journal of Affective Disorders, 190, 264–271, January 2016, 26540080, 10.1016/j.jad.2015.09.069, JOURNAL, Wen MC, Chan LL, Tan LC, Tan EK, Depression, anxiety, and apathy in Parkinson's disease: insights from neuroimaging studies, European Journal of Neurology, 23, 6, 1001–19, June 2016, 27141858, 5084819, 10.1111/ene.13002, JOURNAL, Marrie RA, Reingold S, Cohen J, Stuve O, Trojano M, Sorensen PS, Cutter G, Reider N, 6, The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic review, Multiple Sclerosis, 21, 3, 305–17, March 2015, 25583845, 4429164, 10.1177/1352458514564487,

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.BOOK, Diagnostic and statistical manual of mental disorders, American Psychiatric Association, American Psychiatric Association, 2013, 5th, Arlington, VA, {{page needed|date=October 2018}} 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.WEB, CDC – The Emergency Response Safety and Health Database: Systemic Agent: BENZENE – NIOSH,weblink www.cdc.gov, 2016-01-27, no,weblink" title="web.archive.org/web/20160117001341weblink">weblink January 17, 2016, mdy-all,

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.JOURNAL, Gu R, Huang YX, Luo YJ, Anxiety and feedback negativity, Psychophysiology, 47, 5, 961–7, September 2010, 20374540, 10.1111/j.1469-8986.2010.00997.x, {{primary source inline|date=May 2013}} Temperament (e.g., neuroticism) and attitudes (e.g. pessimism) have been found to be risk factors for anxiety.JOURNAL, Bienvenu OJ, Ginsburg GS, Prevention of anxiety disorders, International Review of Psychiatry, 19, 6, 647–54, December 2007, 18092242, 10.1080/09540260701797837, 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.JOURNAL, Phillips AC, Carroll D, Der G, Negative life events and symptoms of depression and anxiety: stress causation and/or stress generation, Anxiety, Stress, and Coping, 28, 4, 357–71, 2015, 25572915, 4772121, 10.1080/10615806.2015.1005078, 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.JOURNAL, Andrews PW, Thomson JA, The bright side of being blue: depression as an adaptation for analyzing complex problems, Psychological Review, 116, 3, 620–54, July 2009, 19618990, 2734449, 10.1037/a0016242, When people are confronted with unpleasant and potentially harmful stimuli such as foul odors or tastes, PET-scans show increased bloodflow in the amygdala.JOURNAL, Zald DH, Pardo JV, 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, April 1997, 9108115, 20578, 10.1073/pnas.94.8.4119, 1997PNAS...94.4119Z, JOURNAL, Zald DH, Hagen MC, Pardo JV, Neural correlates of tasting concentrated quinine and sugar solutions, Journal of Neurophysiology, 87, 2, 1068–75, February 2002, 11826070, 10.1152/jn.00358.2001, 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).BOOK,weblink Table E-4 Risk Factors for Anxiety, 530, Mary Ellen, O'Connell, Thomas, Boat, Kenneth E., Warner, vanc, National Academies Press, Prevention of Mental Disorders, Substance Abuse, and Problem Behaviors: A Developmental Perspective, 2009, 978-0-309-12674-8, mdy-all,

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.JOURNAL, 10.1080/03634520009379205, Anticipatory anxiety patterns for male and female public speakers, Communication Education, 49, 2, 187–195, 2000, Behnke, Ralph R., Sawyer, Chris R., vanc, {{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.JOURNAL, 10.1177/0361684312450004, Understanding Gender Differences in Anxiety, Psychology of Women Quarterly, 36, 4, 488–499, 2012, Zalta, Alyson K., Chambless, Dianne L., vanc,

Pathophysiology

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

See also

References

{{Reflist}}

External links

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