Different Types Of Anxiety Disorders Research Articles

Characterization of different types of anxiety disorders in relation to structural integration of personality and adverse and protective childhood experiences in psychotherapy outpatients – a cross-sectional study

BackgroundCurrent research has emphasized the role of structural integration of personality and childhood experiences for the understanding of anxiety disorders. In this study, we examined the relationship between anxiety disorders (generalized anxiety disorder vs. panic disorder vs. phobic disorders), the level of structural integration of personality, and negative and protective childhood experiences at the beginning of outpatient psychodynamic psychotherapy treatment. Differences were characterized in comparison to patients with no anxiety disorders.MethodsThe sample included a total of 1646 outpatient psychodynamic psychotherapy treatments, of which 695 treatments included the diagnosis of at least one anxiety disorder. Levels of structural integration of personality were assessed according to the Operationalized Psychodynamic Diagnosis (OPD-2) system. Self-reported negative and protective childhood experiences were examined by using the Questionnaire for the Assessment of Adverse and Protective Childhood Experiences (APC). Associations were tested using single factor ANOVAs.ResultsPatients with anxiety disorders showed lower levels of structural integration of personality and reported more adverse childhood experiences than patients with no anxiety disorders. Regarding the subscales of structural integration of personality, phobic disorders were associated with impaired external communication, whereas for generalized anxiety disorder, an (uncorrected) association with impaired self-regulation was found. Also, generalized anxiety disorder was associated with sexual abuse and other traumatization (accidents etc.) during childhood, while panic disorder and phobic disorders were associated with emotional neglect, abuse, and fewer protective childhood experiences.ConclusionsOur findings emphasize the need of considering structural integration of personality and childhood experiences in order to understand and treat various types of anxiety disorders.

The Comparison between the Effect of the Brain-Gut Axis and Traditional Medicine Treatment on Anxiety and Depression

Depression and Anxiety disorders are the two most prevail mental health conditions, and their proportion among people is growing year by year. Majority Anxiety disorders are generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (SAD). The gut-brain-micro biome (BGM) axis is an emerging area of research that studies two-way communication between the gut micro-biome and the brain. Studies have shown that the BGM axis can affect stress response, anxiety and depression. Interventions in the BGM axis, through probiotics such as Lactobacillus, have some benefits for anxiety and related disorders such as Hyperuricemia. This article briefly describes the different types of anxiety disorders, and discusses the diagnostic criteria, symptoms, morbidity and treatment options for each disorder. It highlights the current state of research on anxiety disorders, with emphasis on genetics, neuroimaging, and the gut-brain-microbiome (BGM) axis. Potential areas for further research and development of new therapeutic approaches were highlighted.

Relationship between Anxiety Disorders and Anthropometric Indices, Risk Factors, and Symptoms of Cardiovascular Disorder in Children and Adolescents.

Objective: Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years. Method : In this community-based study, multistage cluster sampling method was used. We randomly selected 1174 children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10- 14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants. Results: A total of 1035 children and adolescents participated in this study. The results showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, and hypertension. According to the results, FBS and LDL are a predictor for anxiety disorders. Conclusion: There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard.

Coumarins from Seseli devenyense Simonk.: Isolation by Liquid-Liquid Chromatography and Potential Anxiolytic Activity Using an In Vivo Zebrafish Larvae Model.

Different types of anxiety disorders have become the number one mental health issue in developed countries. The search for new, safer and effective drug-like molecules among naturally derived substances faces two difficulties: an efficient method of isolation compounds with a high-purity and high-throughput animal model for activity assay. Thus, the aim of the present study was to isolate by liquid–liquid chromatography high-purity rare coumarins from the fruits of Seseli devenyense Simonk. and evaluate their anxiolytic effect (defined as reversed thimotaxis) using a 5-days post-fertilization (dpf) Danio rerio larvae model. Liquid–liquid chromatography enabled the isolation of one simple hydroxycoumarin (devenyol) and four pyranocoumarins (cis-khellactone, d-laserpitin, isolaserpitin and octanoyllomatin). The anxiolytic effect was defined as a decrease in the time spent in the boundaries of the living space (also described as reversed thigmotaxis). Our results show that all isolated courmarins exerted a significant influence on the anxiety behavior (anxiolytic activity) in the zebrafish larvae model. According to our knowledge, this is the first report of anxiolytic activity of pyranocoumarins and devenyol.

Sex Differences in Anxiety Disorders in Older Adults

Anxiety disorders are the most prevalent mental disorders. Although prevalence estimates are lower in males than females, thedisability associated withanxiety disorders has been increasingin males. This review focuses on recent research studying sex differences in anxiety disorders and associated symptoms in older adults. Females are close to three times more likely than males to report most anxiety disorders. Heterogeneity exists in sex-specific lifetime and past-year estimates. Age-appropriate instruments such as the CIDI65+ show higher estimates than previous research. The profiles of females and males with anxiety with respect to depressive and somatization symptoms are different. Age-appropriate standardized mental disorder instruments have been developed and may be useful to overcome the challenges of observed heterogeneity in anxiety disorders and allow for future cross-country comparisons and a better description of the epidemiology and biopsychosocial factors associated with different types of anxiety disorders in older adults.

A Study On The Impact Of Machine Learning Tools For Detecting Anxiety Disorders In Preschool Children

Nowadays anxiety disorders in preschool children is an interesting area for researchers. There are different types of anxiety disorders in which generalized anxiety disorder and separation anxiety disorders has high chance of occurrence among preschool children. Early identification of anxiety disorders in childhood can often prevent the persistence of these difficulties and appropriate treatments can improve the quality of their life. In light of the high prevalence of these disorders and the associated short and long-term impairment, there is a critical need for developing reliable and valid methods for measuring and monitoring the severity of these disorders and their symptoms. This survey discusses different studies in preschool anxiety disorders and different methods that are used as scales for measuring anxiety disorders. This paper also describes a machine learning technique using ADTree classifier for developing a screening tool for detecting anxiety disorders in preschool children. It was found that ADScore generated by ADTree can be used to measure the severity of disorder.

Case Study of Acceptance and Commitment Therapy and Functional Analysis for Emetophobia

Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that is an empirically supported treatment for various mental health concerns. ACT has been found to be efficacious for treating different types of anxiety disorders. This case study presents the conceptualization (functional analysis), treatment (ACT), and treatment outcomes of a client who presented with emetophobia, a phobia of vomiting, complicated by a metabolic disorder. Measures of emetophobia symptoms, mindfulness, cognitive fusion, thought control strategies, and believability of anxious thoughts and feelings, were collected at pretreatment, posttreatment, 6-month follow-up, and 12-month follow-up. The Reliable Change Index was used to evaluate changes across time. Large and clinically significant decreases on all measures were observed at posttreatment. At 12-month follow-up, improvements were maintained on all measures except the Reappraisal subscale of the Thought Control scale. The implications of this study are discussed, and recommendations are made for clinicians using ACT for the treatment of emetophobia.

Cognitive Schemas Have the Ability to Predict Emotional Schemas in Different Types of Anxiety Disorders

Objective: This study intends to evaluate the Cognitive Schemas have the ability to predict Emotional schemas in different types of anxiety disorders. Method: The study was ex post facto (causal-comparative) is. 109 people suffering from anxiety disorders in six groups of panic disorder, without Through fear, social phobia, specific phobia, obsessive - compulsive disorder, post-traumatic stress and anxiety and acute stress that psychologists and psychiatrists (private and public centers) Tehran, referring and the random sampling method was applied. To evaluate the results of the tests of Young Schema and Leahy Schema, the variance analysis, Tukey and multivariate regression Questionnaire was used. The Cognitive Schemas have the ability to predict Emotional schemas in different types of anxiety disorders. Results: The results showed that, impaired performance (conversely), other-directedness and rejection/disconnection fields have the ability to predict emotional schema of controllability, rejection/disconnection and impaired limits had the ability to predict comprehensibility. The emotional schema of guilt could be predicted by the use of rejection/disconnection and other-directedness, over-vigilance-inhibition (conversely), other-directedness and rejection/disconnection (conversely) have the ability to explain emotional schema of higher values. Results indicate that emotional schema of duration could be predicted by over-vigilance-inhibition (conversely) and rejection/disconnection. Conclusions: In the model of emotional schema of controllability they have an obsessive desire to be under control by others, but this extreme fear of catastrophic events prevents them to trust to anybody. For the same, impaired performance (conversely) is able to determine emotional schema of consensus.

A model of associative stigma on depression and anxiety among children of HIV-infected parents in China.

Human immunodeficiency virus (HIV) carries a high level of stigma to the HIV-infected individuals and their family members. Children of HIV-infected parents in China are particularly affected. The present study examined the relationship between associative stigma, self-esteem, optimism, anxiety and depression among 195 children of HIV-infected parents in rural China. Findings showed that more than one-third (35.4 %) of the participants scored higher than cut-off for depression; and 23.6-67.7 % of them scored higher than cut-off for different types of anxiety disorders. Structural equation modelling revealed that associative stigma had a significant negative relationship on self-esteem and optimism, which were associated with higher levels of depression and anxiety. The indirect effects of associative stigma on depression and anxiety were significant. The overall model showed a satisfactory fit. Findings suggest that associative stigma has a significant negative impact on mental health of children affected by HIV. Interventions to reduce their associative stigma are warranted.

ADad 10: The Impairment in Anxiety Disorders Among Adolescents in a Rural Community Population in India

There is significant paucity of studies on the impairment associated with Anxiety Disorders (AD) among adolescents. This study focuses on the prevalence and pattern of impairment as well as impairment in the context of severity of AD, co-morbidities, suicide, age and gender in this population. In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime to collect the required data. Descriptive statistics and Chi-square tests were done to evaluate the prevalence and profile of impairment, compare the impairment among different types of AD, severity of AD, number of co-morbidities, age and gender on impairment, effect of impairment on the need for suicide prevention. Impairment in adolescents with AD was a rule, noted in 94.4%. Irrespective of the type of AD diagnosed, impairment at home was significant in adolescents with AD. The presentation of impairment among different Anxiety Disorders was different with different functional settings. Severity of AD and the number of co-morbidities was related to the impairment. Need for suicide related interventions were not different in those with and without impairment. Age and gender did not influence the presence of impairment. Anxiety Disorders among adolescents in India result in significant functional impairment. Clinically, in this population assessment of impairment is required. Community policies and plans should have special management strategy to address impairment in adolescents with Anxiety Disorders.

Neural correlates of a computerized attention modification program in anxious subjects.

Computerized attention modification is a relatively new and empirically validated treatment approach for different types of anxiety disorders. However, its neural basis and processes involved are poorly understood. This study examined the effect of a one-time application of an attention modification program (AMP) on neural substrates underlying emotion processing in individuals with high social anxiety. Fourteen individuals with elevated social anxiety symptoms completed an emotional face processing task during functional magnetic resonance imaging before and after AMP, and were subsequently exposed to a laboratory stressor. Results revealed the following: First, there was attenuated activation from pre- to post-AMP in the bilateral amygdala, bilateral insula and subgenual anterior cingulate cortex. Second, post-AMP, individuals exhibited increased activation in several regions of the prefrontal cortex (PFC). Third, those individuals with greater enhancement of ventromedial PFC activation after AMP showed diminished attentional allocation for threat and attenuated anxiety reactivity to the stressor. We conclude that AMP exerts effects that are similar to those previously reported for standard anxiolytics; however, it also appears to foster deployment of top-down brain processes aimed to regulate anxiety.

Construcción de una nueva escala en español para medir ansiedad.

Objective: To construct a scale to evaluate the symptomatology of the different types of anxiety disorders. Materialand Method: After reviewing 25 instruments that assess nonspecific anxiety, generalized anxiety disorder (GAD),panic disorder, agoraphobia and other phobias, social phobia, obsessive-compulsive-disorder (OCD) and posttraumaticstress disorder (PTSD), new items were created and ordered according to the different types of anxiety symptomsand then on the frequency which its content appeared in the reviewed scales. Later, a scale was generated alternatingitems of different anxiety types beginning with the most frequent items of each category. Results: A new anxietyscale of 130 items was created (25 of nonspecific anxiety, 19 of GAD, 33 of panic disorder, agoraphobia and otherphobias, 29 of social phobia, 11 of OCD, and 13 of PTSD). Conclusions: This is the first step to create this newanxiety scale. Its application to healthy subjects and psychiatric patients with and without anxiety disorders toevaluate its psychometric features (factorial structure, internal consistency and validity), and later the modification,deletion and selection of items to generate a simpler and more useful scale, are pending.

Impact of emotion on cognition in trauma survivors: What is the role of posttraumatic stress disorder?

Background Cognitive theories of anxiety disorders postulate an increased attentional bias to environmental cues associated with threat that underlies the exaggerated fear response. The role of trauma, which may represent strong competitive advantage for attention, remains unclear. We investigated the influence of trauma exposure and the presence of anxiety/stress disorders on the impact of emotional distractors on cognitive performance. Methods Fourteen trauma-exposed subjects with PTSD, 12 trauma-exposed subjects with anxiety disorders other than PTSD, 12 trauma-exposed healthy subjects and 19 non-trauma-exposed healthy controls participated in this study. The impact of emotion on cognition was determined by the Affective Stroop task that measures the effect of irrelevant emotional distractors on the speed of operant responding. Results The speed of cognitive performance was significantly reduced in the presence of negative distractors versus neutral or positive distractors in subjects with PTSD, while there was no significant influence of the distractor type on performance in the other diagnostic groups (diagnosis-by-distractor type interaction, p < 0.001). While negative distractors induced the same levels of anxiety and depersonalization in subjects with PTSD and subjects with other anxiety disorders, distractor-induced depersonalization was associated with slowing of cognitive performance in PTSD ( p = 0.02) but not in other groups. Limitations Different types of anxiety disorders in the non-PTSD group might reduce the selectivity of the results; some subjects received medication possibly impacting on their cognitive functioning. Conclusions The cognitive impairments in the presence of negative distractors specifically found in PTSD call for research into novel psychotherapeutic approaches, e.g. attentional training, for PTSD.

Forced choice reaction time paradigm in children with separation anxiety disorder, social phobia, and nonanxious controls

Cognitive distortions refer to cognitive processes that are biased and therefore yield dysfunctional and maladaptive products (e.g., interpretation bias). Automatic aspects of information processing need to be considered and investigating these aspects requires forms of assessment other than self-report. Studies focussing on the specificity of cognitive biases across different types of anxiety disorders in childhood are rare. Thus, a forced choice reaction time paradigm with picture stimuli was used to assess the interpretation bias in anxious children online. The study investigated disorder-specific interpretation bias in 71 children with separation anxiety disorder (SAD), 31 children with social phobia, and 42 children without mental disorders, aged 5–13 years. Results indicated that children with SAD rated ambiguous separation pictures as significantly more unpleasant and more arousing than nonanxious children. However, no support was found that children with SAD and social phobia interpret ambiguous separation or social pictures in a more negative way than nonanxious children. Furthermore, no group differences were found in reaction times to all picture categories.

Association between Anxiety Disorders and Heart Rate Variability in The Netherlands Study of Depression and Anxiety (NESDA)

To determine whether patients with different types of anxiety disorder (panic disorder, social phobia, generalized anxiety disorder) have higher heart rate and lower heart rate variability compared with healthy controls in a sample that was sufficiently powered to examine the confounding effects of lifestyle and antidepressants. The standard deviation of the normal-to-normal intervals (SDNN), heart rate (HR), and respiratory sinus arrhythmia (RSA) were measured in 2059 subjects (mean age = 41.7 years, 66.8% female) participating in The Netherlands Study of Depression and Anxiety (NESDA). Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and Composite International Diagnostic Interview (CIDI), NESDA participants were classified as healthy controls (n = 616), subjects with an anxiety diagnosis earlier in life (n = 420), and subjects with current anxiety diagnosis (n = 1059). Current anxious subjects had a significantly lower SDNN and RSA compared with controls. RSA was also significantly lower in remitted anxious subjects compared with controls. These associations were similar across the three different types of anxiety disorders. Adjustment for lifestyle had little impact. However, additional adjustment for antidepressant use reduced all significant associations between anxiety and HRV to nonsignificant. Anxious subjects who used a tricyclic antidepressant, a selective serotonin reuptake inhibitor, or another antidepressant showed significantly lower mean SDNN and RSA compared with controls (effect sizes = 0.20-0.80 for SDNN and 0.42-0.79 for RSA). Nonmedicated anxious subjects did not differ from controls in mean SDNN and RSA. This study shows that anxiety disorders are associated with significantly lower HR variability, but the association seems to be driven by the effects of antidepressants.

The Wiley Concise Guides to Mental Health

Anxiety disorders manifest in a variety of ways, thus requiring diverse treatment approaches. In an era that is skewed toward pharmacologic approaches, it is very refreshing to find a book that provides psychological aspects of case formulation and treatment in a simple and practical manner. By navigating the readers through diagnostic aspects as well as practical treatment methods, Drs. Kase and Ledley have succeeded in providing an exemplarily concise book for psychiatrists, psychologists, and other mental health professionals. The book is divided into 3 sections: Conceptualization and Assessment (section 1), Treatment of Anxiety Disorders (section 2), and Additional Issues and Treatment Considerations (section 3). The first section deals with a general overview of anxiety disorders, including practical steps in assessment, individually tailored case conceptualization, and treatment planning. The authors also use case illustrations to differentiate how various types of anxiety disorders can manifest. Chapter 2 delves into the application of cognitive-behavioral therapy (CBT) to the different types of anxiety disorders. Chapter 3 deals with the steps needed by clinicians to carry out a thorough evaluation; through the use of tables (Table 3.4 and 3.5), this chapter provides a useful comparison of self-report measures for anxiety and depression. Section 2 broadly describes the most widely used treatments of anxiety disorders. Practicing clinicians may especially appreciate the practical explanations about the use of psychoeducation in understanding the maintenance and thus treatment of anxiety disorders. Table 7.1 (p. 102) gives tips for designing hierarchies, while Table 7.2 gives a sample exposure work sheet. Similarly, in chapter 9, readers are guided through the use of assertiveness and skills training, problem-solving approach, relaxation techniques, and guided imagery. The final section consists of 6 chapters that deal with treatment of children and adolescents with anxiety disorders; group, couples, and family therapy; issues relating to supervision; and consultation and collaboration with multidisciplinary professionals. To describe the treatment of anxiety disorders as without challenges would be unrealistic and counterproductive. The authors consequently use chapter 16 to describe the “Clinicians' Top Ten Concerns and Challenges with the Treatment of Anxiety.” The role of supervision is emphasized throughout the book. The authors also provide other useful resources, including self-help for patients (pp. 235–236). Overall, this book is concise and practical and is recommended for all clinicians who treat anxiety disorders on a regular basis.

Juvenile Mental Health Histories of Adults With Anxiety Disorders

Information about the psychiatric histories of adults with anxiety disorders was examined to further inform nosology and etiological/ preventive efforts. The authors used data from a prospective longitudinal study of a representative birth cohort (N=1,037) from ages 11 to 32 years, making psychiatric diagnoses according to DSM criteria. For adults with anxiety disorders at 32 years, follow-back analyses ascertained first diagnosis of anxiety and other juvenile disorders. Of adults with each type of anxiety disorder, approximately half had been diagnosed with a psychiatric disorder (one-third with an anxiety disorder) by age 15. The juvenile histories of psychiatric problems for adults with different types of anxiety disorders were largely nonspecific, partially reflecting comorbidity at 32 years. Histories of anxiety and depression were most common. There was also specificity. For example, adults with panic disorder did not have histories of juvenile disorders, whereas those with other anxiety disorders did. Adults with posttraumatic stress disorder had histories of conduct disorder, whereas those with other anxiety disorders did not. Adults with specific phobia had histories of juvenile phobias but not other anxiety disorders. Strong comorbidity between different anxiety disorders and lack of specificity in developmental histories of adults with anxiety disorders supports a hierarchical approach to classification, with a broad class of anxiety disorders having individual disorders within it. The early first diagnosis of psychiatric difficulties in individuals with anxiety disorders suggests the need to target research examining the etiology of anxiety disorders and prevention early in life.

The psychobiology of anxiety

When the basic survival mechanism of fear goes awry, the result is often an anxiety disorder. The activation and modulation of the fear system in animals and humans has thus been an active subject of investigation. Neuroimaging studies have attempted to outline which areas of the brain are activated during anxiety-related phenomena; and the amygdala, known for its processing of emotions, has been considered the central relay point for the so-called fear circuit. The amygdala offers ‘upwind’ connections to the higher-order cognitive/psychological modifications of the cortex and subcortex, and ‘downwind’ connections to the physiological HPA neuroendocrine axis. Neurotransmitters assist in the communication and control along this fear circuit. Variations in anatomical activation and/or neurotransmitter action/sensitivity may be responsible for the different types of anxiety disorders, and these variations may partly result from genetic phenotypes and/or neuroendocrine stressors resulting from trauma. Further investigation of this fear system will hopefully lead to various entry points for therapeutic interventions, including medications that work with neurotransmitter systems and/or the HPA axis, as well as therapy that can address cortical fear activation by re-modulating behavioral contexts and psychological interpretations that cause anxiety.

Setting the research and practice agenda for anxiety in children and adolescence: A topic comes of age

Select research and practice issues that merit further attention are described. Specifically, we argue that the pathways for profitable research include studies of normative development, assessment and diagnostic considerations, the role of parents, and the ways to optimize the conduct and evaluation of treatment. At present, the field is too uninformed about the development of emotions (e.g., anxiety) and emotion regulation, about adolescence and particular vulnerabilities associated with adolescence, and about the longitudinal course of anxiety in youth. Improved measures, as well as a better understanding of and recommended solutions for parent-child disagreements are needed. How do parents maintain distressing anxiety in their children, and what is the optimal role for parents in the treatment of anxious children? The role of parents may vary across development, and there may be differential advantages and disadvantages for younger children, middle-aged children, and adolescents, and for the different types of anxiety disorders. Although cognitive-behavioral therapy is a probably efficacious treatment, and well on its way to becoming a well-established treatment, much more information is needed about the potential role of medications and the merits of enhancing the therapeutic alliance. Our discussion focuses on mapping the further evolution and maturation of the field of child anxiety.

Locus coeruleus activity in perinatally protein-deprived rats: effects of fluoxetine administration

We have previously described an increased locus coeruleus activity in perinatally protein-deprived rats. Since locus coeruleus dysfunction has been involved in different types of anxiety disorders and considering the modulating action of serotonergic transmission on locus coeruleus activity, we assessed the effect of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), on locus coeruleus activity as measured by the firing rate and the number of spontaneously active cells/track. Repeated fluoxetine administration reduced locus coeruleus activity in both control and protein-deprived rats, although the reduction was greater in protein-deprived rats. Dose–response curves for the inhibitory effect of clonidine showed subsensitivity of α 2-adrenergic autoreceptors in protein-deprived rats, a phenomenon reversed by fluoxetine treatment. Dose–response curves for the inhibitory effect of 2,5-dimethoxy-4-iodoamphetamine (DOI) were similar in both groups of rats. Following fluoxetine administration, subsensitivity to this effect developed in control but not in protein-deprived rats. Extracellular noradrenaline level in the prefrontal cortex, as measured by microdialysis procedure, was higher in protein-deprived rats compared to controls, and this difference was reduced after fluoxetine administration. A challenge with yohimbine increased the extracellular noradrenaline level in control but not in protein-deprived rats, suggesting subsensitivity of α 2-adrenergic autoreceptors in early protein malnourished animals. These results stress the complexity of plastic changes induced by early protein malnutrition and sustain the hypothesis that perinatally protein-deprived rats may represent a useful animal model for screening antipanic agents.