Advances in understanding the anxiety disorders: The cognitive-affective neuroscience of 'false alarms'

Background. There have been significant advances in our understanding of the anxiety disorders; a range of data is now available on their epidemiology, nosology, psychobiology, and management. An integrative framework is required in order to conceptualize this data and to apply it in the clinic. Methods. This is a nonsystematic review of literature on the psychobiology of some the major anxiety disorders, focused on the idea that each of these conditions can be conceptualized in terms of a different "false alarm," mediated by specific neurocircuitry and with a particular evolutionary origin. Results. The "false alarm" concept is able to integrate a range of data on the proximal mechanisms of anxiety disorders (including their mediating neurochemistry and neurogenetics), as well as hypotheses about the distal or evolutionary underpinnings of these conditions. Conclusion. Fortunately, serotonergic antidepressants and cognitive-behavioral psychotherapy appear to be able to normalize the putative "false alarms" in anxiety disorders. A better understanding of the cognitive-affective neuroscience of anxiety disorders will hopefully lead to improved treatments.