TOPIC.A simultaneous concept analysis of fear and anxiety.
PURPOSE.To develop a process model that reflects distinct characteristics of fear and anxiety.
SOURCES.Existing biopsychology empirics and theory from peer review with and external to nursing literature.
CONCLUSIONS.Fear and anxiety are distinct diagnoses guided by separate brain mechanisms. The author offers a process model for further critique by peers and clinical populations.
AdolphsK.TranelD.DamasioH.DamasioA. (1994). Impaired recognition of emotion in facial expressions following bilateral damage to the human amygdala. Nature, 372, 669–672.
2.
AdolphsR.TranelD.DamasioH.DamasioA. (1995). Fear and the human amygdala. Journal of Neuroscience, 15, 5879–5891.
3.
AggletonJ. (1993). The contribution of the amygdala to normal and abnormal emotional states. Trends in Neuroscience, 16, 328–332.
4.
BlanchardR.J. (1972). Innate and conditioned reaction to threats in the rat with amygdaloid lesions. Journal of Comparative Psychology, 81, 281–290.
5.
BlanchardR.BlanchardD.C. (1989). Attack and defense in rodents as ethoexperimental models for the study of emotion. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 13, S3–S14.
6.
BollesR.FanselowM. (1980). A perceptual-defensive-recuperative model of fear and pain. Behavioral and Brain Sciences, 3, 291–323.
7.
CarpenitoL. (1997). Nursing diagnosis: Application to clinical practice (7th ed.) Philadelphia: Lippincott.
8.
CharnevD.GrillonC.BremnerJ.D. (1998a). The neurobiological basis of anxiety and fear: Circuits, mechanisms, and neurochemical interactions (Part 1). The Neuroscientist, 4, 35–44.
9.
CharnevD.GrillonC.BremnerJ.D. (1998b). The neurobiological basis of anxiety and fear: Circuits, mechanisms, and neurochemical interactions (Part 2). The Neuroscientist, 4, 122–131.
10.
ClugnetM.LeDouxJ.E. (1990). Synaptic plasticity in fear conditioning circuits: Induction of LTP in the lateral nucleus of the amygdala by stimulation of the medial geniculate body. Journal of Neuroscience, 10, 2818–2823.
11.
DavisM. (1994). The role of the amygdala in emotional learning. International Review of Neurobiology, 36, 225–265.
12.
DavisM. (1997). Neurobiology of fear responses: The role of the amygdala. Journal of Neuropsychiatry and Clinical Neurosciences, 9, 382–402.
13.
deOcaB.DeColaJ.MarenS.FanselowM. (1998). Distinct regions of the periaqueductal gray are involved in the acquisition and expression of defensive responses. Journal of Neuroscience, 18, 3426–3432.
14.
FanselowM. (1984). What is conditioned fearTrends in Neuroscience, 12, 460–462.
15.
GrayJ. (1982). Precis of the neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system. Behavioral and Brain Sciences, 3, 469–483.
16.
GrayJ. (1995). The contents of consciousness: A neuropsychological conjecture. Behavioral and Brain Sciences, 18, 659–722.
17.
HaaseI.BrittT.CowardD.LeidyN.PennP. (1992). Simultaneous concept analysis of spiritual perspective, hope, acceptance and self-transcendence. Image, 24, 429–435.
18.
HaaseJ.LeidyN.CowardD.BrittT.PennP. (1993). Simultaneous concept analysis: A strategy for developing multiple interrelated concepts. In RodgersB.L.KnaflK. A. (eds)., Concept development in nursing foundations, techniques and applications (pp. 175–192). Orlando, FL: Saunders.
19.
HalgrenE. (1992). Emotional neurophysiology of the amygdala within the context of human cognition. In AggletonJ. P. (ed)., The amygdala: Neurobiological aspects of emtion, memory and mental dysfunction (pp. 191–225). New York: Wiley-Liss.
20.
KalinN. (1993). The neurobiology of fear. Scientific American, 5, 94–101.
21.
KimJ.FanselowM. (1992). Modality-specific retrograde amnesia of fear. Science, 256, 675–677.
22.
KimJ.RisonR.FanselowM. (1993). Effects of amygdala, hippocampus, and periaqueductal gray lesions on short and long-term contextual fear. Behavioral Neuroscience, 107, 1093–1098.
23.
LeDouxJ. (1986). Neurobiology of emotion. In LeDouxJ.HirstW. (eds)., Mind and brain (pp. 301–354). New York: Cambridge University Press.
24.
LeDouxJ. (1993). Emotional memory systems in the brain. Behavioral Brain Research, 58, 69–79.
25.
LeDouxJ. (1995). Emotion clues from the brain. Annual Review in Psychology, 46, 209–235.
26.
LeDouxJ. (1996). The emotional brain: The mysterious underpinnings of emotional life. New York: Simon & Schuster.
27.
MarenS. (1996). Synaptic transmission and plasticity in the amygdala. Molecular Neurobiology, 13, 1–22.
28.
MarenS.BaudryM. (1995). Properties and mechanisms of long-term synaptic plasticity in the mammalian brain: Relationships to learning and memory. Neurobiology of Learning and Memory, 63, 1–18.
29.
MorrisJ.S.FrithC.D.PerrettD.I.RowlandD.YoungA.W.CalderA.J.DolanR.J. (1996). A differential neural response in the human amygdala to fearful and happy facial expressions. Nature, 383, 812–814.
30.
North American Nursing Diagnosis Association (1990). Taxonomy I—Revised. St. Louis: Author.
31.
North American Nursing Diagnosis Association (1996). NANDA nursing diagnoses: Definitions and classification 1997–1998. Philadelphia: Author.
32.
PankseppJ. (1982). Toward a general psychobiological theory of emotions. Behavioral and Brain Sciences, 5, 407–467.
33.
PhillipsR.G.LeDouxJ.E. (1992). Differential contribution of amygdala and hippocampus to cued and contextual fear conditioning. Behavioral Neuroscience, 106, 274–285.
ShorsT.WeissC.ThompsonR. (1994). Stress-induced facilitation of classical conditioning. Science, 157, 537–538.
36.
Taylor-LoughranA.O'BrienM.LaChapelleR.RangelS. (1989). Defining characteristics of the nursing diagnoses fear and anxiety: A validation study. Applied Nursing Research, 2, 178–186.
37.
WalkerL.O.AvantK.C. (1995). Strategies for theory construction in nursing (3rd ed.). Norwalk, CT: Appleton & Lange.
38.
WhitleyG. (1992a). Concept analysis of anxiety. Nursing Diagnosis, 3, 107–116.
39.
WhitleyG. (1992b). Concept analysis of fear. Nursing Diagnosis, 3, 155–161.
40.
WhitleyG. (1994). Expert validation and differentiation of the nursing diagnoses anxiety and fear. Nursing Diagnosis, 5, 143–150.
41.
WhitleyG. (1997). A comparison of two methods of clinical validation of nursing diagnosis. In RantzM.LeMoneP. (eds)., Classification of nursing diagnoses: Proceedings of the twelfth conference North American Nursing Diagnosis Association (pp. 103–110). Glendale, CA: CINAHL.
42.
WilsonJ. (1969). Thinking with concepts. New York: Cambridge University Press.
