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.
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