Nothing to fear but fear itself – a study of anxiety and fear

Dr Dawn Collins, Warwick Medical School, University of Warwick

In the ICD11, Anxiety- and fear-related disorders contain a range of generalised (generalised anxiety disorder, social anxiety disorder) and specific conditions (specific phobias) all characterised by significant and debilitating symptom presentation in response to a real, or perceived, threat. In many sufferers of these disorders there is often no direct exposure to the trigger, or threat from the trigger, prior to onset of the disorder, distinguishing them from stress-related disorders (such as post-traumatic stress (PTSD) and grief disorder), which all have identifiable triggers; so how do these conditions develop? The amygdala is a key region of the brain associated with the perception and response to conditioned fear behaviours, so what plastic changes occur within this area that might account for our response to triggers? The amygdala also plays a role in determining the saliency of experiences, so is this the point at which our normal or abnormal experiences become fearful? We’ll discuss and investigate whether fear is the result of our innate (inherited?) survival mechanisms, experience, or whether fear can be a learned behaviour; and if so, whether FDR (or Michel de Montaigne, depending on your viewpoint) was correct in that we really do have ‘nothing to fear, but fear itself.’