Differentiating anxiety from fear: an experimental-pharmacological approach

Demarcation of anxiety and fear: Evidence from behavioral genetics

Anxiety and fear are emotions often intertwined in response to aversive stimuli, complicating efforts to differentiate them and understand their distinct consequences. This study explores the common genetic and environmental factors contributing to the co-occurrence of anxiety disorders and dimensions of the revised Reinforcement Sensitivity Theory (rRST). A sample of 356 monozygotic (22.5 % males; M = 25.73, SD = 8.3) and 386 dizygotic (33.9 % males; M = 24.21, SD = 8.33) twins from the Serbian Twin Advanced Registry was analyzed. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) provided scales for panic disorder, agoraphobia, social phobia, and generalized anxiety disorder (GAD), while the Reinforcement Sensitivity Questionnaire (RSQ) measured the Behavioral Inhibition System (BIS), Behavioral Activation System (BAS), and Fight/Flight/Freeze System (FFFS). Common additive genetic effects accounted for most of the variance in BIS, Fight, and panic, agoraphobia, and social phobia, while specific additive genetic effects were highest for Flight. Shared environmental effects were most pronounced for Fight across all models, with additional shared influences on BAS and BIS for panic, and BAS and Freeze for agoraphobia and social phobia. Nonshared environmental effects were the highest specific contributors across variables. Genetic overlap between anxiety disorders and rRST dimensions suggests pleiotropy, with unique environmental factors playing an important role in disorder development. While anxiety and fear may stem from distinct etiologies, their shared symptomatology complicates differentiation, highlighting the importance of considering both genetic and environmental influences in anxiety disorders.

Psychometric properties of the pain anxiety symptom scale among postoperative patients in Amol, Iran

Introduction

So far, the psychometric properties of the Persian version of the Pain Anxiety Symptom Scale have not been assessed in Iran. Therefore, this study was conducted to determine the validity and reliability of the Persian version of the Pain Anxiety Symptom Scale among a group of Iranian patients in Amol.

Methods

This methodological study was conducted in 2023 with a sample of 400 postoperative patients from Amol, Iran, selected through convenience sampling. The dataset was divided into two groups of 200 for exploratory and confirmatory factor analyses. Construct validity was assessed using maximum likelihood exploratory factor analysis with Promax rotation, supported by Horn's parallel analysis and network analysis to visualize item relationships. Confirmatory factor analysis, convergent and discriminant validity was performed on the second dataset. Reliability was evaluated through various statistical measures, including Cronbach's alpha, McDonald's omega, average inter-item correlation coefficient, composite reliability, and maximal reliability (MaxR).

Results

Among the 400 participants, the mean age was 44.38 years (SD = 13.49), with 152 (46.1%) being women and 178 (53.9%) men. Most participants (n = 268, 81.2%) had an education level lower than a diploma, and 93 individuals (28.2%) reported a history of surgery. The results of exploratory factor analysis with Promax rotation developed two factors accounting for 66.29% of the variance comprising 15 items. Also, after necessary modifications during confirmatory factor analysis, the final model was approved. As for reliability, the Cronbach's alpha, composite reliability, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability.

Conclusion

According to the results, the Persian version of the Pain Anxiety Symptom Scale has a valid structure and acceptable reliability. This scale can be used by health professionals in many ways.

Fear and anxiety differ in construal level and scope

The fear-anxiety distinction has been extensively discussed and debated among emotion researchers. In this study, we tested this distinction from a social-cognitive perspective. Drawing on construal level theory and regulatory scope theory, we examined whether fear and anxiety differ in their underlying level of construal and scope. Results from a preregistered autobiographical recall study (N = 200) that concerned either a fear situation or an anxiety situation and a large dataset from Twitter (N = 104,949) indicated that anxiety was associated with a higher level of construal and a more expansive scope than fear. These findings support the notion that emotions serve as mental tools that deal with different challenges. While fear prompts people to seek immediate solutions to concrete threats in the here and now (contractive scope), anxiety prompts them to deal with distant and unknown threats that require more expansive and flexible solutions (expansive scope). Our study contributes to a growing literature on emotions and construal level and points to interesting avenues for further research.

Cholinergic modulation of disorder-relevant human defensive behaviour in generalised anxiety disorder

Drugs that are clinically effective against anxiety disorders modulate the innate defensive behaviour of rodents, suggesting these illnesses reflect altered functioning in brain systems that process threat. This hypothesis is supported in humans by the discovery that the intensity of threat-avoidance behaviour is altered by the benzodiazepine anxiolytic lorazepam. However, these studies used healthy human participants, raising questions as to their validity in anxiety disorder patients, as well as their generalisability beyond GABAergic benzodiazepine drugs. BNC210 is a novel negative allosteric modulator of the alpha 7 nicotinic acetylcholine receptor and we recently used functional Magnetic Resonance Imaging to show it reduced amygdala responses to fearful faces in generalised anxiety disorder patients. Here we report the effect of BNC210 on the intensity of threat-avoidance behaviour in 21 female GAD patients from the same cohort. We used the Joystick Operated Runway Task as our behavioural measure, which is a computerised human translation of the Mouse Defense Test Battery, and the Spielberger state anxiety inventory as our measure of state affect. Using a repeated-measures, within-subjects design we assessed the effect of BNC210 at two dose levels versus placebo (300 mg and 2000 mg) upon two types of threat-avoidance behaviour (Flight Intensity and Risk Assessment Intensity). We also tested the effects of 1.5 mg of the benzodiazepine lorazepam as an active control. BNC210 significantly reduced Flight Intensity relative to placebo and the low dose of BNC210 also significantly reduced self-reported state anxiety. Risk Assessment Intensity was not significantly affected. Results show both human defensive behaviour and state anxiety are influenced by cholinergic neurotransmission and there provide converging evidence that this system has potential as a novel target for anxiolytic pharmacotherapy.

The Role of Personality, Political Attitudes and Socio-Demographic Characteristics in Explaining Individual Differences in Fear of Coronavirus: A Comparison Over Time and Across Countries

Since the emergence of the SARS-CoV-2 pandemic in December 2019 about 500,000 people died within the first 6 months. The virus itself, as well as the related political decisions, intensified an increasing feeling of fear in billions of people worldwide. However, while some people remained unperturbed, others experienced panic over the current situation. In order to investigate individual differences in the perceptions, emotions and behaviors in response to the Coronavirus pandemic, an online survey was conducted between 6th and 27th of March 2020. Participants included 7309 individuals from 96 countries, who provided information on socio-demographics, personality, political orientation and general life satisfaction. To determine the specificity of fear of Coronavirus, we also investigated fear related to two other current political issues: the refugee and the climate crises. Overall, in parallel with the escalation of the pandemic, fear of Coronavirus increased significantly over the 22-day period, with the strongest predictors being the personality variable neuroticism, as well as education, sex and being an at-risk person. A detailed longitudinal analysis of the largest sample, Germany, revealed that political orientation was also an important predictor of fear of Coronavirus. Specifically, conservatives were more afraid of Coronavirus than liberals. However, as the perceived threat of the virus increased, the influence of political orientation disappeared, whereas personality remained a stable predictor. The pattern of results regarding the perceived threat of the refugee and climate crises painted a different picture: political orientation was by far the best predictor, more important even than personality. Conservatives were more worried about the refugees, and liberals about climate change. Cross-cultural analyses showed pronounced differences between countries, dependent on the crisis. Nonetheless, the importance of personality for the prediction of fear of Coronavirus remained stable over time and across the world within the investigated 22-day period.