A NEURO-EVOLUTIONARY APPROACH TO THE ANXIETY DISORDERS

Background: Advances in our understanding of the anxiety disorders and in the application of evolutionary principles to medicine provide the possible basis for a neuro-evolutionary approach to these conditions. In this paper, initial steps taken towards such an approach are descr ibed. Methods: Neuro-evolutionary accounts of each of the anxiety diso rders have been offered. Notably, several of these accounts have sugge sted that particular anxiety disorders are mediated by specific brain- based false alarms. This paper reviews the strengths and weaknesses of such accounts. Results: The false suffocation alarm of panic attack i s the most fully elaborated of the neuro-evolutionary accounts of an a nxiety disorder. However, viable neuro-evolutionary approaches have al so been offered for other anxiety disorders, such as obsessive-compuls ive disorder and social phobia. Conclusions: Further work is necessary to consolidate a neuro-evolutionary approach to the anxiety disorders . Although the theoretical basis for such an approach has become incre asingly appealing over the last several years, this foundation require s supplementation by further empirical research. (C) 1997 Elsevier Sci ence Ltd.