اعراض القلق
Anxiety Disorders
I. Definition of Anxiety: An unpleasant state of anticipation,
apprehension, fear, or dread, often accompanied by a physiologic state of
autonomic arousal, alertness, and motor tension.
A. Psychological Symptoms
1. Fear, apprehension, dread, sense of impending
doom
2. Worry, rumination, obsession
3. Nervousness, uneasiness, distress
4. Derealization (the world seems distorted or
unreal), depersonalization (one’s body feels unreal or disconnected)
B. Physiological Symptoms
1. Diaphoresis
(sweating) 10. Pupil dilatation
2. Diarrhea 11. Restlessness
3. Dizziness 12. Shortness of breath
4. Flushing
or chills 13. Syncope (fainting)
5. Hyperreflexia 14. Tachycardia
6. Hyperventilation 15. Tingling
7. Lightheadedness 16. Tremor
8. Numbness 17. Upset stomach (“butterflies”)
9. Palpitations
(pounding heart) 18. Urinary frequency
C. Normal vs. Abnormal Anxiety
1. Normal Anxiety: Adaptive psychological and physiological
response to a stressful or threatening situation
2. Abnormal Anxiety: Maladaptive response to real or imagined
stress or threat
a. Response is disproportionate to stress or
threat
b. Stress or threat is nonexistent, imaginary,
or misinterpreted
c. Symptoms interfere with adaptation or
response to stress or threat
d. Symptoms interfere with other life functions
II. Neurobiology of Anxiety
A. Central Nervous System
1. Frontal Cortex
a. Interpretation of complex stimuli
b. Declarative memory
c. Learning
d. Extinction of condition fear and emotional
memory
2. Limbic System (striatum, thalamus, amygdala,
hippocampus, hypothalamus)
a. Emotional memory (especially the central
nucleus of the amygdala)
b. Fear conditioning
c. Anticipatory anxiety
3. Brainstem (raphe nuclei, locus ceruleus)
a. Arousal, attention, startle
b. Control of autonomic nervous system
c. Respiratory control
B. Peripheral Systems
1. Autonomic arousal (tachycardia, tachypnea,
diarrhea)
2. Hypothalamic-pituitary-adrenal (HPA) axis
activation
3. Visceral sensory activation
C. Neurotransmitters
1. Norepinephrine – locus ceruleus projections
to frontal cortex, limbic system, brainstem, and spinal cord
2. Serotonin – Raphe nuclei projections to
cortex, limbic system, and hypothalamus
3. GABA – cortex, limbic system, hypothalamus,
locus ceruleus
