The Need For Investigation Of The Fear Relation To Anxiety Disorders

Fear has been characterized as separate from Anxiety. Fear is “a basic emotion that is an adaptive response to threat marked by quick, automatic onset, brief duration, and sympathetic arousal” whereas Anxiety is a “future-focused cognitive association that connects basic emotions (such as fear) to events, meanings and responses”. This definition of Anxiety is consistent with the typical definition of anxious apprehension but has the potential to apply to anxious arousal as well. This is dependent upon how “future-focused cognition” is defined.

The next “big question” in the field of generalized anxiety disorders should evaluate whether anxious apprehension and/or anxious arousal are more prolonged and/or frequent instances of fear. Furthermore, future research should examine whether anxious apprehension and/or anxious arousal are a blend of multiple states of fear, and if they are as stable as other psychological traits which have been well-studied such as as worry, executive flexibility and hypervigilance. Previous studies have found evidence for reliable biomarkers that are indicative of anxious apprehension and anxious arousal. Few have confirmed that these transdiagnostic dimensions of generalized anxiety predict behavioral performance in the context of mildly arousing affective distractors and cognitive load during executive function tasks. Current models suggest that measures of these transdiagnostic anxiety dimensions would correlate with behavioral errors in ecologically-valid, sufficiently arousing experimental contexts. For example, mechanisms supporting compensatory responses to initial failures in top-down control of attention for those high in anxious apprehension are posited to break down in more challenging tasks that include higher cognitive load and/or more arousing affective distractors. Thus, future studies should assess anxious apprehension in the context of more challenging executive function tasks and/or more arousing, threatening stimuli in order to bring about fear.

Clarifying the constructs and separate state (fear) and trait (anxious apprehension/anxious arousal) effects in generalized anxiety disorder can help to explain how trait dimensions relate to cognitive processes, neural mechanisms, and risk for psychopathology. Current, working definitions of anxious apprehension and anxious arousal are based on available theory and data that warrant further empirical testing. If we can address confusions in the literature, it may provide future studies with improved tools to more accurately conceptualize constructs and develop sensitive paradigms with which to examine mechanisms and relationships. A more precise explication of anxious apprehension and anxious arousal phenomena promises to reduce the gap between biological and psychological conceptualizations of anxiety and to refine theoretical frameworks describing how these domains causally relate to each other (if causation is the right way to think of their relationship) and influence the etiology of psychopathology.