Hassell J E, Nguyen K T, Gates C A, Lowry C A
Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
Curr Top Behav Neurosci. 2019;43:271-321. doi: 10.1007/7854_2018_63.
Anxiety disorders and trauma- and stressor-related disorders, such as posttraumatic stress disorder (PTSD), are common and are associated with significant economic and social burdens. Although trauma and stressor exposure are recognized as a risk factors for development of anxiety disorders and trauma or stressor exposure is recognized as essential for diagnosis of PTSD, the mechanisms through which trauma and stressor exposure lead to these disorders are not well characterized. An improved understanding of the mechanisms through which trauma or stressor exposure leads to development and persistence of anxiety disorders or PTSD may result in novel therapeutic approaches for the treatment of these disorders. Here, we review the current state-of-the-art theories, with respect to mechanisms through which stressor exposure leads to acute or chronic exaggeration of avoidance or anxiety-like defensive behavioral responses and fear, endophenotypes in both anxiety disorders and trauma- and stressor-related psychiatric disorders. In this chapter, we will explore physiological responses and neural circuits involved in the development of acute and chronic exaggeration of anxiety-like defensive behavioral responses and fear states, focusing on the role of the hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid hormones.
焦虑症以及与创伤和应激源相关的障碍，如创伤后应激障碍（PTSD），很常见且与重大的经济和社会负担相关。尽管创伤和应激源暴露被认为是焦虑症发展的风险因素，或者创伤或应激源暴露被认为是PTSD诊断的必要条件，但创伤和应激源暴露导致这些障碍的机制尚未得到充分描述。更好地理解创伤或应激源暴露导致焦虑症或PTSD发生和持续的机制，可能会产生治疗这些障碍的新方法。在此，我们回顾关于应激源暴露导致回避或焦虑样防御行为反应以及恐惧急性或慢性过度增强的机制、焦虑症以及与创伤和应激源相关的精神障碍的内表型的当前最先进理论。在本章中，我们将探讨参与焦虑样防御行为反应和恐惧状态急性和慢性过度增强发展的生理反应和神经回路，重点关注下丘脑 - 垂体 - 肾上腺（HPA）轴和糖皮质激素的作用。
