Levinson H N
New York University Medical Center.
Percept Mot Skills. 1989 Feb;68(1):67-84. doi: 10.2466/pms.1989.68.1.67.
To clarify and test the cerebellar-vestibular (CV) basis of fears/phobias, responses of 4000 learning disabled children, adolescents, and adults with neurological and electronystagmographic (ENG) evidence of CV-dysfunction were analyzed for anxiety-related symptoms. Of this sample, 64.6% indicated fears/phobias; females were significantly more predisposed; mixed-handedness was significantly related to fears of heights and reduced vestibular response or asymmetric vestibular functioning. Also, adults had a higher incidence of the specific fears/phobias characterizing agoraphobia than children and adolescents. Analysis of factors reported as triggering the fears/phobias led to (1) a classification and theory of fears/phobias, obsessions/compulsions, and related anxiety symptoms based on realistic or traumatic, neurotic, and CV- or other CNS-based mechanisms rather than on DSM-III--R surface descriptions; (2) an understanding of the relationships between mitral valve prolapse, agoraphobia and panic episodes, as well as depression; and (3) new insights into differential diagnosis and selective treatment.
为了阐明并检验恐惧/恐惧症的小脑-前庭（CV）基础，对4000名有学习障碍的儿童、青少年及成人进行了分析，这些人有神经学和眼震电图（ENG）证据表明存在CV功能障碍，并分析了他们与焦虑相关的症状。在这个样本中，64.6%的人表示有恐惧/恐惧症；女性更容易患病；混合利手与恐高以及前庭反应降低或前庭功能不对称显著相关。此外，成人中具有广场恐惧症特征的特定恐惧/恐惧症的发病率高于儿童和青少年。对报告的引发恐惧/恐惧症的因素进行分析，得出了以下结果：（1）基于现实或创伤性、神经症性以及基于CV或其他中枢神经系统的机制，而非基于《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）的表面描述，对恐惧/恐惧症、强迫观念/强迫行为及相关焦虑症状进行分类和提出理论；（2）理解二尖瓣脱垂、广场恐惧症和惊恐发作以及抑郁症之间的关系；（3）对鉴别诊断和选择性治疗有了新的认识。
