Anxiety

Craske, Michelle G; Stein, Murray B

doi:10.1016/s0140-6736(16)30381-6

Cited by 640Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychological Treatments and Disorders

Anxiety

Craske, Michelle G, Stein, Murray B·2016·The Lancet

DOI 10.1016/s0140-6736(16)30381-6

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Abstract

Anxiety disorders (separation anxiety disorder, selective mutism, specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalised anxiety disorder) are common and disabling conditions that mostly begin during childhood, adolescence, and early adulthood. They differ from developmentally normative or stress-induced transient anxiety by being marked (ie, out of proportion to the actual threat present) and persistent, and by impairing daily functioning. Most anxiety disorders affect almost twice as many women as men. They often co-occur with major depression, alcohol and other substance-use disorders, and personality disorders. Differential diagnosis from physical conditions-including thyroid, cardiac, and respiratory disorders, and substance intoxication and withdrawal-is imperative. If untreated, anxiety disorders tend to recur chronically. Psychological treatments, particularly cognitive behavioural therapy, and pharmacological treatments, particularly selective serotonin-reuptake inhibitors and serotonin-noradrenaline-reuptake inhibitors, are effective, and their combination could be more effective than is treatment with either individually. More research is needed to increase access to and to develop personalised treatments.

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Evidence suggests that CBT or medication can modify the cascade of responses to real or perceived threat - CBT by altering behavioral avoidance and information processing related to threat detection and coping, and medication by altering neurotransmitter levels that affect the function and structure of brain circuits.
“Evidence suggests that CBT or medication can modify the cascade of responses to real or perceived threat – CBT by altering behavioral avoidance and information processing related to threat detection and coping [56, 57], and medication by altering neurotransmitter levels that affect the function and structure of brain circuits [58–60].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [58]
It is highly probable that medication mechanisms are initiated by effects on altering neurotransmitter levels, which in turn affect the function and structure of brain circuits.
“It is highly probable, however, that those mechanisms are initiated by the effects that medication has on altering neurotransmitter levels, which in turn affect the function and structure of brain circuits [58–60].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [58]
Anxiety disorders are common mental-health problems that are burdensome for sufferers and health services.
“Anxiety disorders are common mental-health problems that are burdensome for sufferers and health services [1].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [1]
Many anxiety sufferers fail to respond to medication and cognitive behavioural therapy, or relapse.
“Treatments include medication and cognitive behavioural therapy (CBT); however, many anxiety sufferers fail to respond, or relapse [1,2].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [1]
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line pharmacological treatments for people with major depressive disorder (MDD) and anxiety disorders.
“Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are first-line pharmacological treatments for people with major depressive disorder (MDD) [1] and anxiety disorders [2].”
From Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report (2021) · cites this paper as [2]

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Quality of and patient satisfaction with primary health care for anxiety disorders
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One-Session Treatment for Specific Phobias: A Review of Öst's Single-Session Exposure with Children and Adolescents
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Augmentation of cognitive and behavioural therapies (CBT) with d-cycloserine for anxiety and related disorders
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Postretrieval new learning does not reliably induce human memory updating via reconsolidation
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The efficacy of a family-based cognitive-behavioral treatment for separation anxiety disorder in children aged 8–13: A randomized comparison with a general anxiety program.
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Internet-Delivered Cognitive Behavior Therapy for Anxiety Disorders Is Here to Stay
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SPECIFIC PHOBIA AMONG U.S. ADOLESCENTS: PHENOMENOLOGY AND TYPOLOGY
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A Randomized Trial of Cognitive-Behavioral Therapy or Selective Serotonin Reuptake Inhibitor or Both Combined for Panic Disorder With or Without Agoraphobia
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The Effect of Glucose on Hippocampal-Dependent Contextual Fear Conditioning
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Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder
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PATIENT-REPORTED OUTCOMES OF QUALITY OF LIFE, FUNCTIONING, AND DEPRESSIVE SYMPTOM SEVERITY IN MAJOR DEPRESSIVE DISORDER COMORBID WITH PANIC DISORDER BEFORE AND AFTER SSRI TREATMENT IN THE STAR*D TRIAL
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A Literature Review of Quetiapine for Generalized Anxiety Disorder
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Vilazodone in patients with generalized anxiety disorder
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Hippocampal GABAergic Inhibitory Interneurons
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Stress, Anxiety, and Depression in People Aged Over 60 in the COVID-19 Outbreak in a Sample Collected in Northern Spain
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Prevalence and risk factors for elevated anxiety symptoms and anxiety disorders in chronic kidney disease: A systematic review and meta-analysis
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The role of adenosine receptors in mood and anxiety disorders
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The Paraventricular Nucleus of the Thalamus as an Integrating and Relay Node in the Brain Anxiety Network
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Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic
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How does sex matter? Behavior, stress and animal models of neurobehavioral disorders
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Maturational Changes in Prefrontal and Amygdala Circuits in Adolescence: Implications for Understanding Fear Inhibition during a Vulnerable Period of Development
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The gut microbiota–brain axis in neurological disorders
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Authors: Craske, M. G., & Stein, M. B.
Affiliations: University of California, Los Angeles (US)
University of California San Diego (US)
Corresponding author: Craske, Michelle G
ORCID: Craske, Michelle G
Stein, Murray B
Venue: The Lancet
Publisher: Elsevier BV
Published: 2016-12
Volume: 388
Issue: 10063
Pages: 3048-3059
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(16)30381-6
OpenAlex: W4210958358
Semantic Scholar: ce576378da8a40906943b52ca22d4d6fc023fb08
Cited by: 640
References: 124
Citations by year: 2026: 53 · 2025: 70 · 2024: 96 · 2023: 81 · 2022: 68 · 2021: 79 · 2020: 57 · 2019: 56 · 2018: 45 · 2017: 31 · 2016: 3 · 2013: 1
FWCI: 5.90
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords: anxiety disorders, separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, comorbid depression, substance use disorders, differential diagnosis, cognitive behavioral therapy, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, combination therapy, personalized treatment
MeSH terms: Anxiety Disorders, Diagnosis, Differential, Humans, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors

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