Taylor L, Gorman J
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032.
Psychiatr Q. 1992 Winter;63(4):319-42. doi: 10.1007/BF01066762.
Everyone is familiar with that paralyzing state of dread known as anxiety. Although it is unpleasant, the experience of anxiety has adaptive aspects: it can serve as an impetus to effect beneficial life change and can facilitate psychological development. Anxiety becomes of clinical concern, however, when it interferes with intellectual function, or arrests normal social or vocational pursuits. Anxiety disorders are chronic illnesses. Treatment can eliminate many of the disease's debilitating features, but the underlying disorder is not usually cured. Discontinuation of treatment-pharmacological, behavioral, or both-often results in the recurrence of symptoms. The focus of treatment, therefore, generally centers on striking a balance between the goal of alleviating the patient's symptoms, and the need to avoid the deleterious effects which result from long-term treatment (1). The intention of this paper is to review theoretical and therapeutic considerations for four types of anxiety disorder: panic disorder, generalized anxiety disorder, social phobia, and obsessive-compulsive disorder. In doing this, emphasis will be placed on the physiological concomitants and, when possible, neuropsychological bases of these illnesses. Furthermore, pharmacological treatment will be related to the underlying substrata of the disorder whenever possible.
每个人都熟悉那种被称为焦虑的令人瘫痪的恐惧状态。尽管焦虑令人不快，但它的体验具有适应性方面：它可以成为促成有益生活改变的动力，并能促进心理发展。然而，当焦虑干扰智力功能，或阻碍正常的社交或职业追求时，就会成为临床关注的问题。焦虑症是慢性疾病。治疗可以消除该疾病的许多使人衰弱的特征，但潜在的病症通常无法治愈。停止治疗——药物治疗、行为治疗或两者兼而有之——往往会导致症状复发。因此，治疗的重点通常在于在减轻患者症状的目标与避免长期治疗产生的有害影响之间取得平衡（1）。本文的目的是回顾四种焦虑症的理论和治疗考量：惊恐障碍、广泛性焦虑障碍、社交恐惧症和强迫症。在此过程中，将重点关注这些疾病的生理伴随症状，并尽可能关注其神经心理学基础。此外，只要有可能，药物治疗将与该病症的潜在基础相关联。
