Imbalance of approach and avoidance: The Yin and Yang of anxiety disorders

Stein, Murray B.; Paulus, Martin P.

doi:10.1016/j.biopsych.2009.09.023

Cited by 114Posttraumatic Stress Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

Imbalance of approach and avoidance: The Yin and Yang of anxiety disorders

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Stein, Murray B., Paulus, Martin P.·2009·Biological Psychiatry

DOI 10.1016/j.biopsych.2009.09.023PMC PMC2825567

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Comorbid anxiety and depression may lead to difficulties resolving approach/avoidance valuation.
“comorbid anxiety and depression may lead to difficulties resolving approach/avoidance valuation”
From United we stand: emphasizing commonalities across cognitive-behavioral therapies. (2013) · cites this paper as Stein & Paulus, 2009
In “Imbalance of Approach and Avoidance: The Yin and Yang of Anxiety Disorders” (page not provided), the authors propose that PTSD involves an approach–avoidance imbalance and suggest that fear and avoidance may predominate early, with depression later. The paper does not specifically say that comorbid anxiety and depression cause difficulty resolving approach/avoidance valuation. (LLM, conf=0.83)
Experimental — accuracy not yet measured
A growing recognition of alterations in reward processing led to a reconceptualization of PTSD as an imbalance between approach (reward-related) and avoidance (fear-related) systems.
“While early research focused on fear-related processes, a growing recognition of alterations in reward processing (115, 116) led to a reconceptualization of PTSD as an imbalance between approach (reward-related) and avoidance (fear-related) systems (117–119).”
From A transdiagnostic perspective on social anhedonia (2019) · cites this paper as [117]

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“Finally, comorbid anxiety and depressionmay lead to difficulties resolving approach/avoidance valuation, which may result when an individual is unable to determine the relative value of simultaneous but ambiguous safety and reward contextual cues (Stein & Paulus, 2009).”
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Authors: Stein, M. B., & Paulus, M. P.
Affiliations: University of California San Diego (US)
Corresponding author: Stein, Murray B.
ORCID: Stein, Murray B.
Paulus, Martin P.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2009-12
Volume: 66
Issue: 12
Pages: 1072-1074
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2009.09.023
PMC: PMC2825567
OpenAlex: W2046151106
Cited by: 114
References: 12
Citations by year: 2026: 1 · 2025: 4 · 2024: 4 · 2023: 8 · 2022: 9 · 2021: 6 · 2020: 26 · 2019: 7 · 2018: 5 · 2017: 3 · 2016: 10 · 2015: 5 · 2014: 5 · 2013: 7 · 2012: 7
FWCI: 4.96
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (K24MH064122, R01MH065413, R01MH075792)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: anxiety disorders, post-traumatic stress disorder, neurobiology of PTSD, translational research, yin and yang
MeSH terms: Anxiety Disorders, Humans, Models, Biological, Yin-Yang

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