Review Article Psychoanalysis 2014;25(2):54-64 pissn / eissn Copyright c 2014 Korean Association of Psychoanalysis Anxiety and Fea

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1 Review Article Psychoanalysis 2014;25(2):54-64 pissn / eissn Copyright c 2014 Korean Association of Psychoanalysis Anxiety and Fear Development: From the Psychoanalysis to the Neurobiological Approach Geon Ho Bahn Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea 불안및공포의발달 : 정신분석부터신경생물학적접근까지 반건호 경희대학교의학전문대학원정신건강의학교실 Anxiety and fear are the essential emotion for the protection of the individual from threat and the reproduction for the preservation of the species. Freud s anxiety theory was developed primarily from compromised formation of conflicts, which was based on the libido theory, and later, signal anxiety theory, which was based on ego structures. In Bowlby s attachment theory, it is known that the quality of the infant s attachment determines the level of anxiety response afterwards, and affects the sociality and formation of interpersonal relationships in the adulthood. Although anxiety and fear are used as a similar concept, through animal experiments and human studies, the correlation between brain development and anxiety and fear, along with specific brain regions and related substances affecting the development of anxiety and fear, is continuously being discovered. Such research results may lead to the development of personalized tailored treatment for anxiety and fear of normal and mentally disabled people. Psychoanalysis 2014;25(2):54-64 KEY WORDS: Anxiety Fear Attachment Treatment Animal Brain. Received: May 16, 2014 Revised: June 16, 2014 Accepted: June 20, 2014 Address for correspondence: Geon Ho Bahn, MD, PhD Department of Psychiatry, Kyung Hee University School of Medicine, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul , Korea Tel: , Fax: , mompeian@khu.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited

2 GH Bahn Table 1. Summary of differences between fear and anxiety Anxiety Items Fear Not present but anticipated Cause of threat Explicit cues or traumatic events earlier in life Increased capacity to adapt & plan for the future Function Protect the individual from an immediate threat Long-term (sustained) Activation pattern Short-term (phasic) Conditioned Conditioning Unconditioned Cognitive and complex cognitions Cognitions Automatic Verbal/worry Sensory process Visual/imagery Lateral bed nucleus of stria terminalis Locus of system Central nucleus of the amygdala

3 Anxiety and Fear Development - Freud Psychoanalysis 2014;25(2):54-64

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5 Anxiety and Fear Development -? - - (Sensitive period)? 58 Psychoanalysis 2014;25(2):54-64

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7 Anxiety and Fear Development -? Oxytocin과 arginine vasopressin Psychoanalysis 2014;25(2):54-64

8 GH Bahn 중추신경계관련물질?

9 Anxiety and Fear Development - - Acknowledgments The theme of this article was presented at the annual meeting of the Korean Academy of Child and Adolescent Psychiatry on 10th May, 2014 at Severance Hospital, Seoul. Conflicts of Interest The author has no financial conflicts of interest. REFERENCES American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association;1980. Bahn GH. From attachment theory to mentalization: historical background and clinical implications. Psychoanalysis 2013;24:9-20. Barlow DH. Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. Am Psychol 2000;55: Beard G. Neurasthenia, or nervous exhaustion. Boston Med Surg J 1869; 80: Blanchard DC, Griebel G, Nutt DJ. Handbook of anxiety and fear. Amsterdam: Elsevier Academic Press;2008. Blass RB. On the fear of death as the primary anxiety: How and why Klein differs from Freud. Int J Psychoanal 2014;95: Bowlby J. A secure base: clinical applications of attachment theory. London: Routledge;1988. Bracha HS, Ralston TC, Matsukawa JM, Williams AE, Bracha AS. Does fight or flight need updating? Psychosomatics 2004;45: Psychoanalysis 2014;25(2):54-64

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