Abstract

Abstract The aim of the study was to demonstrate how recent research achievements in the neuroscience of emotions can influence practical management of anxiety disorders. Using the data obtained from analysis of psychophysiological mechanisms in one case of panic disorder, the type of threat, key threat stimuli, and the structure of the pathogenic neurotic belief were ascertained and, on this basis, an individually tailored therapeutic procedure was designed. Its application resulted in almost complete dissipation of the neurotic belief, which represented the key p athogenic mechanism in the case studied. The study called attention especially to the importance of detailed diagnostics of memory mechanisms underlying the formation of neurotic belief in the psychotherapy of anxiety disorders.

Highlights

  • The aim of the stud y w as to d em onstrate how recent research achievem ents in the neuroscience of em otions can influence practical m anagem ent of anxiety d isord ers

  • Recent ad vances in anim al and hu m an resear ch elu cid ated the organization p rincip les of system s u nd erlying these p rocesses, their neu ronal circu itry and m olecu lar m echanism s that p rovid e new insights into norm al as w ell as p athological execu tive p rocesses related to these im p ortant behavioral fu nctions

  • Key neu ral circu its of the system p resent lim bic stru ctu res inclu d ing am ygd ala and insu la, as w ell as other interconnected stru ctu res su ch as the p eriaqu ed u ctal gray and hyp othalam u s (LeDou x, Cicchetti, Xagoraris & Rom anski, 1990; LeDou x, 1995; Arm on y & LeDou x, 2000; Phan, Wager, Taylor & Liberzon, 2002; Kober, Barret, Josep h, Bliss-Morreau, Linqu ist & Wager, 2008). All these stru ctu res interact w ith a nu m ber of cortical areas involved in cognitive fu nctions bu t the system m ay act relatively ind ep end ently, w ithou t consciou s recognition of a threatening stim u lu s (Öhm an, Flykt & Lu nd qvist, 2000; Öhm an, 2005)

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Summary

IN TROD UCTION

The d etection of a threatening event and the control of d efense against it are brain cap abilities of basic su rvival valu e. In the p athogenesis of p anic d isord er there are at least tw o su ch contribu ting m echanism s: the Pavlovian fear cond itioning, w hich increases a nu m ber of threat stim u li, and form ation of neu rotic belief, w hich cou ld exp lain am p lification of the p erceived threat and the self-p erp etu ating character of the d isord er In this context, the p resent clinical p ractice stresses the im p ortance of t w o asp ects of brain fu nctioning in anxiety d isord er: (i) frequ ent occu rrence of m alad ap tive p atterns of thinking and (ii) form ation of beliefs that u nd erlie su ch thinking. The creation and ap p lication of an ind ivid u ally shap ed p sychotherap eu tic p roced u re, w hich w as d esigned to m od ify his neu rotic belief, w as the second aim of the stu d y

METHOD S
Type of threat
Key threat stimuli
Intentional evocation of threat states
Structure of the pathogenic belief
Procedure for correcting the pathogenic belief
D ISCUSSION
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