The DSM-5-TR does not explicitly define a single “source” for fear, anxiety, and stress but describes their underlying neurobiological and psychological mechanisms throughout different sections of the manual. However, from a scientific and DSM-5-TR perspective, these emotional states are influenced by:
Notice: You may want to take a look at other posts with the same topic:
(1) Psychological Concepts: Fear, Stress, and Anxiety
(2) Psychological Concepts: The Connection between Fear, Stress, and Anxiety
(3) Psychological Concepts: Feedback Loop
(4) Does DSM-5-TR provide direct definitions for Fear, Stress, and Anxiety?
1. Fear – Rooted in the Amygdala and Immediate Threat Processing
Neurobiological Basis:
- The amygdala, particularly the central nucleus, plays a key role in detecting threats and initiating a fight-or-flight response.
- The sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis are activated, leading to physiological arousal (e.g., increased heart rate, sweating).
Source (DSM-5-TR Context):
- Fear arises in response to perceived immediate danger (e.g., a phobic stimulus or panic trigger).
- Found in disorders such as Specific Phobia and Panic Disorder, where the amygdala is hyperactive to perceived threats.
2. Anxiety – Rooted in the Prefrontal Cortex and Anticipatory Threat Processing
Neurobiological Basis:
- Dysregulation in the prefrontal cortex (PFC), particularly in its ability to regulate the amygdala, contributes to excessive worry and fear generalization.
- The bed nucleus of the stria terminalis (BNST), a brain structure functionally connected to the amygdala, is involved in sustained apprehension.
Source (DSM-5-TR Context):
- Anxiety is linked to anticipatory processing, meaning the brain perceives a future threat rather than an immediate danger.
- Disorders like Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder are characterized by persistent activation of anxiety circuits.
3. Stress – Rooted in the Hypothalamic-Pituitary-Adrenal (HPA) Axis and Cortisol Regulation
Neurobiological Basis:
- The HPA axis is central to the body’s stress response, with the hypothalamus signaling the pituitary gland to release adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to release cortisol.
- Chronic stress leads to dysregulation of cortisol levels, affecting emotion regulation, memory (via the hippocampus), and long-term mental health.
Source (DSM-5-TR Context):
- Stress is a key factor in Trauma- and Stressor-Related Disorders (e.g., PTSD, Adjustment Disorder).
- Prolonged exposure to stressors can alter brain function, contributing to both mood and anxiety disorders.
Summary Table: Biological Sources According to DSM-5-TR Concepts
| Concept | Brain Structures | Neurotransmitters | DSM-5-TR Context |
|---|---|---|---|
| Fear | Amygdala, Sympathetic Nervous System | Norepinephrine, Glutamate | Linked to phobias and panic attacks |
| Anxiety | Prefrontal Cortex, Bed Nucleus of the Stria Terminalis (BNST) | GABA (reduced), Serotonin (5-HT), Dopamine | Generalized Anxiety Disorder, Social Anxiety Disorder |
| Stress | Hypothalamus, HPA Axis, Hippocampus | Cortisol, CRH (Corticotropin-Releasing Hormone) | PTSD, Adjustment Disorder |
If you desire more: NEUROBIOLOGICAL BASIS OF ANXIETY DISORDER
