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Book Forum: Anxiety DisordersFull Access

Fear and Anxiety: The Benefits of Translational Research

In my opinion, this book constitutes one of the best contributions so far in the fields of neuroscience and psychiatry. The outcomes of translational research along the lines of psychosocial and psychopharmacological approaches, as addressed in this book, have permitted the understanding of the mechanism inherent in anxiety disorders to a level never reached before. Dr. Gorman and the outstanding group of investigators he assembled for the preparation of this book have moved this area of research from rodents to nonhuman primates and ultimately to humans. This major scientific advance has permitted the understanding of the neural circuits involved in the acquisition and manifestation of fear and anxiety.

This text evolved from contributions made during the 92nd annual meeting of the American Psychopathological Association held in March 2002. The entire scientific meeting focused on fear and anxiety as well as emotions and behaviors omnipresent in human and nonhuman life. This meeting’s structure was based on neurosciences, neuroimaging of humans and animals, and clinical observations. The idea was to translate basic, preclinical, and clinical research efforts into viable scientific hypotheses and conclusions based on research evidence.

The message of this book is nicely delineated by means of 14 excellent chapters dealing with a spectrum of topics related to the overall theme—that is, the understanding of the neural circuits responsible for the acquisition and expression of fear. What is unique in this volume is the clarity with which these difficult and complex hypotheses and research observations are described and discussed. From this point of view alone, this book is of major benefit not only for the psychiatrist with expertise in neurosciences but also for the busy clinical psychiatrist as well.

The 14 chapters of this book address key and relevant topics: 1) conditioned fear, manifestations of anxiety, and the role of the amygdala, 2) the role of stress vis-à-vis brain structural damage, 3) the neuropsychobiology of the variable foraging demand paradigm in nonhuman primates, 4) risk factors for anxiety and depression in offspring, 5) pathophysiology of anxiety, 6) psychiatric effects of disasters and terrorism, 7) neuroanatomy of panic disorder, 8) implications for mood and anxiety disorders of neuroimaging studies of nonhuman primates reared under early stressful conditions, 9) neurotoxic effects of childhood trauma, 10) scientific basis of psychological treatments for anxiety disorders, 11) new molecular targets for antianxiety interventions, 12) dissociating components of anxious behavior in young rhesus monkeys, 13) the anatomy of fear, and 14) the role of the amygdala in emotional and social behavior.

What is also unique and highly beneficial in this text is the set of outstanding references offered in every chapter; although they are numerous, they also represent the best that the field can offer in each of the topics covered. In deciphering the neural circuit pertaining to the acquisition and expression of fear, Dr. Gorman and the contributors to this volume have nicely permitted us to view the brain as a functional organ with a myriad of clinical applications to the field of psychiatry. Additionally, what I personally enjoyed most is that this book is written with an integrational approach in mind, where the biopsychosocial model is highly respected and no room for antagonistic behavior is permitted. As a psychosocially oriented psychiatrist, I will always very much value this book in my academic and scientific work. Thus, I strongly recommend it to psychiatrists, neuroscientists, and mental health professionals at large whose work is deeply rooted in the biopsychosocial model.

Edited by Jack M. Gorman, M.D. Washington, D.C., American Psychiatric Publishing, 2002, 284 pp., $39.95 (paper).