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100cosecosi: JESUS \u200b\u200bvs SANTA - Christmas-weapon

100cosecosi: JESUS \u200b\u200bvs SANTA - Christmas-weapon : "MERRY CHRISTMAS TO WINTER pets 'PRESEPAZZO'" compliments to the authors, wish you happy holidays, take the vision of this video, with irony. -------------------------------------------------- -------------------------------------------

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cause: Getting high .. does it hurt? or depends on the type of drugs?

now confirmed and drugs ... it hurts, but the drugs differ from each other There are feelings that give hallucinogenic drugs, and others that enhance both the fears of the mad courage, others leave you oncora that crashed into an illusory nirvana, or percezzioni extra increase bodily or mental, giving extension to the creative abilities of Subjects he make use. These are consecutive ateggiamenti the factor of quantity, or content psicotripo of drugs taken, but keep in mind that any substance you take, there are consequences, both physical and mental alteration in the balance of bodily and emotional capacity of percezzione Actually, I can argue that some drugs like cannabis, can also have narcotics objectives of the pain, CIE be curative for certain diseases, they rightly recognize the scientific value, as the very basis of many painkillers, is derived from morphine, which is in turn obtained the heroin, the same coca leaves are used by Andean peoples from Millennia and as the basis of food consumption, which has as (chewing the leaves), a natural resistance to energy, for those cold and mountainous regions. MA as there are legal drugs ... or indirectly been monopolized by them? How many new drugs that come from pharmaceutical companies for other medical uses, but then end up with slight variations, the drug sales in the market? Cigarettes, alcohol, anabolic painkillers, glue, or paint thinner, etc.. etc.. an infinite product category, scattered all over the world, although they spend billions and billions of $ or €, to counter this market, all run by criminal gangs in the world, fostered also been complacent, or forced to produce for their very survival; The costs of this war, impresionante, deaths from this war than every year, all the other wars in the world, deaths among those taking drugs, but also among produces and who disguises, dead Organizations and gang crime, to have the dominance of commercializazzione, thousands and thousands, whole territories are now sotomessi, too and economic and social system, entire states are seized of these criminals Organizations; the qualities to be countered, are spending figures, which when used for other things, eradicate hunger and disease in many parts of the world. Therefore we can say that the drugs is counterproductive to the individual who is state-owned enterprises, for both health and economic factors. Prohibition, has failed its current method, perhaps a more legislation oriented towards a consumer-controlled, would give more results, costs less but much less exorbitant cancellation, also economic advantage to the criminal mafias. But a esenziale not should be left out, drugs of any kind, if not measured correctly, leading addiction and mental and physical illnesses, recognizing the concept and related mental broadening. many other types of drugs, acting on the human psyche? drug ideological DRUGS; religious http://apocalisselaica.net/focus/notizie-scelte/20634-il-diavolo-veste-prada-no-il-papa Even in this case is undeniable that the psychological damage on many individuals, both ideologies, religions, if the extreme (abuse in quantity), bear, inherent in human beings and the search for the abstract, not palpable, the utopia, the consulate its desired run, when and how the theorizing, and a search of the mind, which goes beyond the living reality, almost a stimulus, a desire to have something more to achieve. PhotoLine not the natural limit imposed on the subject, and theorizes the historical memory in an eternal memory, or a spiritual hope, continuity in other respects of life. These mental factors in primitive human communities, it contestualizavano at certain times, with different cycles and the earth, the solar system, moon and stars, all that was visible but unreachable, or incomprehensible, was interpreted as a sign of superior beings, (Divinity), many times same actors, were themselves considereti by the gods toward the people, giving rise to the factors of first and priestly castes, while the story itself was walking in the evolution of human races, religions and power became a single body, the head of the people was designated heir as a descendant of the Divine, is at once high priest, given the time requiring the same religion, you've conquered peoples and sotomessi, so that the very basis of religion, was interpreted according to the will of the despotic ruler. The build temples and places of worship, was also consequential to the value that they wanted to demonstrate the power derived from the deity, the greater was the place of worship was the greatest power, that the deities lavished on sovereign before the people, whom the king Humanly PARTY, mentally you asogettava also have its symbolisms, I as often happens, is at the service of the deities, for the benefit it stemmed from the sovereign, personal interpretation or the wish. Evolution; that in the historical flow, for its own operation, required equipment and systems pyramid for control over the nations, of different peoples, and they can not always check only by force, is generated doctrinal rules, which were not against a persuasive 'highlighted by the power authority, but against intangible u'autorità protetrice of power, but much more powerful and vindictive in the wrongs that were made; asogettazione The mind of the people, the interpretations of the divine desire, either by the priestly caste, which by state powers, was a continuous execution of offenders, by contrast, most of rebellion against the sovereign and is not real obedience to religious rules, the same one people belonging to a different creed, when this people was sotomesso, also implied the sotomissione have religious obedience, otherwise the weapon destruction and massacres were persuasive ... But at the bottom of it all, is simplified with the obvious power play, domination of man by man, centuries and centuries of psychological processing, the desired, within the framework of certain dogmatic rules, influence and affect the minds and force generation psychic alteration, DNA and became a traditional, A people's identity card, even if divided into different territories, it is recognized in the belief of a deity, but with the rules of usual priestly caste system, which in its historical path, prevailed even over the kings, rulers divvenendo in turn, not with leggiferando concezzione of state, but with the same rules of dogmatic religious belief, weighting the psychological burden of the people , marking the psyche of an inevitability than desired the same reason, fearing punishment materially land, even if those inspired by the divine. The discussion should continue in a more detailed, more specific historical divisions and dotting in time, but considering that a minimum of knowledge the reader has to make his interpretations, I start to closing, to establish itself in yesterday as today , religions and divides contrast, in the interpretation of the deity, both by tradition, that old and new vision. In this war, the actions are no less bloody than those that occur between the criminal gangs to divide an area, killing people of other faiths (other band), corruption or complicity with the powers in the same state for territorial control, transformation of the laws, both in favor, in imposing the constant dogmas which stand them in power, or elsewhere are the same power, as both state law as dogmatic, fearful stories of periods, with assogettazione forced people in the creed of conquerors, leading to the extermination assogettabili not because of another faith, and all set and done in the name of God, the conqueror, although many times, hiding behind that name is the only predator of man power, that does not renounce conquest of populations that are religiously equal, with the protection and well-deserving neutrality, religious apparatus similar. All played with conviction and exaltation, to excuse fideistic, as if a perpetual drip of drugs, toxins injected with mental psyche, altering the reasons, the instincts of the emotions, enhancing the delegate I believe God, the instincts of predation on duty believed God, emptied their feelings, to prevail by force the desired asogetta all that, I believe in the one. Transforming the Human mind, his being human material, a change in behavior similar to the drug addict, who fears not for drug use, but because the drug can fail, because now the drug becomes the single stimulus of the field, so to many acts, the concept of religion, the fear of not finding what you want spiritual, which by now is generational DNA in mental fear that is caused, or by differences of faith or behavior, of those who believe or not believe in another, but physically as their lives, and then to overcome this fear, we want to impose equality of thought and behavior, possibly in compliance with the dogma that the priestly caste, says deriving from the divine. CONCLUSION: if they are believers, be part of a religion, it generates the same systems or problems of those who make use of drugs, creates the same factors as gangs clash Traficante drug apliccano, destroying lives and society, for the acquisition of power and money, dividing peoples and states where the essereUman or there, what prevents me reason to ask for the same consequential act, no systematic barriers to the use of religion?. Or alternatively regulate its use, so if they eliminate the abuse, which destroys like drugs, the psyche of human beings.

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He accused me but I accuse you

few days ends the year 2010 many events have marked the lives of all of us, personal facts, but also made radical networks generated by others, we are good? We're sick? Or we were better in the past? In each of us the single answer, but the social response shows that, saying something is a reality that we do not want We accept, we can not deny that we are still, and as civil society, such as changing society, arts and crafts, in culture and economic development, technology apliccata that in science, there are individual genius, but escape from the country, escaping from pens caste in this country, fleeing from the bureaucracy and corruption of the system of the country, leaving us to our amazement, the impossibly facts without remedy, in the anguish of being unable to change this system. I also YOU, WE HAVE THE GUILT. Work, fighting for the good of the country, so we were told for years to become a people of this state, to live in prosperity in our state, without having to emmigrare. But if young people feel no future run away, run away why? because we let them run away, do not we give them if you have more than we are? I have guilt for not having watched my little world, who did his duty, his job with honesty, his delegated duties to society, I have done and also allowed small cunning, in my little how many times I let it pass, because I do not directly involve? I turned around the other side (of solidarity in social duties?) But it's there, who cares there are others for these things, And day after day, many small drops of indifference, turned into puddles, ponds, and then lakes and rivers that flood, every place is society, where finally happy splashing about those who did not want to see in their cunning, now wallow well with them, even forcing us to wallow in their element, and can not be indifferent to, being that from anywhere you would like to turn, you see them you're surrounded, you drown by their wickedness, they have the power, they are in power, is by law require you to be their power. Remembrance to me when I say, defend your freedom every day and always, if you live in your democracy, Tua because others have also struggled for You, What I'm beginning to be aware, I see children and grandchildren with no prospect of the future, but I fought For my future, I could not know that they too were in my future, and now look at them, looking for a future that, even in my unconscious has become utopia. Tomorrow is another day, for those who will come, but today? Derided by those who govern us, mocked by the world looks at us and derided by those who were behind us and are now running, it is already too far ahead, derided by some for social ethics, should not be together, I in my little ; Alone, I can do!! and where you c. ....... you are!! Perhaps like me to give me an examination of conscience, a mea culpa private, to avoid disturbing other minds, a question of why we were so stupid and blind, or tragicomic destiny, cuttings has been stripped of all dignity as a society and as individuals . Despite the diversity of ideals, who formed the majority in country of millions of citizens, workers, businessmen, housewives, a company also aware, a company that looked to other future, who fought against the institutions to change, but I wanted to do in a democracy, the years we have slipped roofs lean against , now witnesses of the past, in this present we are left with questions to be answered becomes difficult, because we should be critical and severe to ourselves, we should understand where and why we broke away the future of our children, democratic society, cultural freedoms, the continuous renewal of the country, both in its institutional forms in the rules of democratic government. We saw the child's future, but these our boys?? These young people grew up without the right to ask, at least in the right not to lose what they have, being that we have them taken in their right, what we tell him?? We are silent, silent, we think about our mistakes, to our disappointment there, to our being unarmed, and with them we fear to speak, to let him know where we went wrong, lest we repeat the same mistakes for them, We do not we are for them and they are misfits in search of their IO, and in our silence, others (and others), rising to their reproach, forgetting to who they were, what they do, with whom they do and why do; Everyone interprets Democracy at its convenience, when aquisito the power of governing a people, we use ideals or ideologies, it establishes rules that satisfy the personal desire, not the popular will, or the needs of society, which must be governed in its growth factors , base and root of every democratic country in the materiality of meaning, not in theory custom, which transforms the social body, owned by the ruler, who does it for his choice. I let the current reality of the country might be fulfilled, when I was by democratic means, the right and duty to make me feel, to be a vital part, to say look what you have to manage on my behalf, when I knew who they were, but let go, when I knew what they were doing, but I told myself that in my small c. .... I do!; did not want to involve me in their dirty games, but they made me dirty, I was involved as a social individual, as a citizen of this state, I let them do it, now I see is that the Mio does not fight, do not protest, do not ask to leave a future legacy, has destroyed the future of others, and some for my sins, you will have to arrange. Apologizing to the younger generation, is the least we can do, but also look for in their anger, the strength to change, talking and explaining our mistakes. We passed by De Gasperi, you scoundrels, letting us steal the dignity of people; Who taught us the way to democracy, a democracy the people who buy in institutions; Who even if a believer, respected and established itself, for the state in its secularism, who has sold a secular state, also includes the Church; Who is presented to the winners, with the dignity of a people ofrire, who as the dignity of the people in front of powerful, prides itself of its name, an anagram (the only male boss) unaware that another anagram of his name, transforms it into (vil belinus mouse). That's what we got in behind us laugh all over the world, why do not we have prevented, the mice sguazassero institutions in the country, I have my faults, but how many of you I are similar in guilt? -------------------------------------------------- -----------------------------------

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YouTube - Luciana LITTIZZETTO: But why wait until December 14th? Second part (Che tempo che fa? 12/05/2010)

YouTube - Luciana LITTIZZETTO: But why wait until December 14th? second part (Che tempo che fa? 12/05/2010) "- Sent with Google Toolbar" irony can save us ... giving us an awareness of who ... . governs us ???..

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From Saviano a Vespa: "pro-life" or "pro-propaganda ?

From Saviano a Vespa: "pro-life" or "pro-propaganda"? : "...... NEVER BE A HUMAN .... must be owned by a sovereign property .... a child of a father .... a woman's property a husband .... home to a property of a master .... a negro property of a settler .... So there can not be slaves .... ... because the mortals are all alike ... ... These few lines taken from one of the greatest thinkers of the 700 ... ... among the fathers of the Enlightenment (Diderot ).... transhuman present time .... should make it clear to anyone .. . that individual freedom ... even if HE is involved in a social body ... (community people) ... .. requires the highest individual choice when the individual does not alter the social body ... ... . anyone ... tion with social laws ... it with dogma derived from beliefs fideistic ... can change the destiny of choice .... if you do not want to have the claim to ... divvenire masters of the destiny of his fellow human .... entering contradiction ... is in religious dogma dell''Uguaglianza the Divine ... of all .... Human Subjects in both the claim of the government to standardize social ... by law .... personal choice ... forcing the will of the ruler ... - Posted with Google Toolbar "

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Panic Disorder: clinical

CLINICAL FEATURES - Panic disorder

The first panic attack is often quite spontaneous, but occasionally may be the result of excitement, exercise, sexual activity or emotional trauma mo awake.

The DSM-IV stresses that, to meet the diagnostic criteria for panic disorder, at least the first attacks of Vono be unexpected (no trigger).

The physician should try to establish any habit or situation that it typically precedes the panic attack in a given patient. These activities may include the use of caf fein, alcohol, nicotine or other drugs, atypical patterns of are no specific environmental or food and situations, like a bright light in the workplace.

Panic attacks often begin with a 10-minute period of rapid increase in the severity of symptoms.

The main mental symptoms are extreme fear and a sense of impending death or doom. Patients usually are unable to report the source of their fear, they feel confused and have difficulty concentrating. Physical signs often include tachycardia, palpitations, shortness of breath and sweating.

Patients often try to leave any situation in which they are to seek help. The attack usually lasts from 20 to 30 minutes and rarely more than an hour. A formal examination of mental condition during a panic attack may reveal rumination, difficulty speaking, such as stuttering, and alteration of memory.

Those affected may experience depression or depersonalization during an attack.

Symptoms may gradually withdraw or rapid heating. Among

an attack and another patient may have anticipatory anxiety concerning the possibility of having another attack.

The differentiation between anticipatory anxiety and generalized anxiety disorder can be difficult, even if the subjects with panic disorder with anxious anticipation, are able to show stimulation of their anxiety.

fears of physical death due to cardiac or respiratory problems may be the main object of the patient during panic attacks. Subjects may believe that palpitations and chest pain indicating the imminence of death. Up to 20% of them did indeed syncopal episodes during a panic attack.

Typically, patients presenting to the emergency room are young (early twenties), in good physical health and yet claim to be persistently on the verge of dying from a heart attack. Instead of immediately diagnose

un'ipocondria, the emergency doctor vrebbe do consider the diagnosis of panic attack.

The hyper ventilation causes respiratory alkalosis and other symptoms. Sometimes it may be helpful to the old practice of breathing the rare patient in a bag.

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Agoraphobia: diagnostic criteria for panic disorder with agoraphobia

DSM-IV diagnostic criteria for ' agoraphobia

Note: agoraphobia is not a codable disorder . Specify the disorder in which occurs the agoraphobia (eg, panic disorder with agoraphobia or agoraphobia without history of panic disorder).

A.
Anxiety on being in places or situations from which it can be difficult (or embarrassing) or in which help may not be available in case of a panic attack or panic-like symptoms or related to the unexpected situation. The Agoraphobic fears typically involve groups characteristic of situations that include being outside the home alone in a crowd or standing in queue, on a bridge and travel by bus, train or automobile.

Note: Consider the diagnosis of specific phobia if the avoidance is limited to one or a few specific situations, or social phobia if the avoidance is limited to social situations.

B. The
situations are avoided (eg, travel is restricted) or are endured with marked distress or with anxiety about having a panic attack or panic-like symptoms, or require the presence of a companion.

C.
The anxiety or phobic avoidance are not better accounted for by another mental disorder , such as social phobia (eg, avoidance limited to social situations because of fear of embarrassment), specific phobia (eg, the 'avoidance is limited to a single situation, as elevators), obsessive-compulsive disorder (eg, avoidance of dirt in a subject with the obsession of contamination), posttraumatic stress disorder from the stress (eg, avoidance of stimuli associated with a severe stressor), or the disturbance d 'separation anxiety (eg, avoidance of removal from the home or family).

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DSM-IV diagnostic criteria for panic disorder with agoraphobia

A. Either (1) or (2);

(1) recurrent unexpected panic attacks

(2) at least one of the attacks was followed by a month (or more) of one (or more) of the following symptoms:

(a) persistent concern about having other attacks
(b) concern about the implications of the attack or its consequences (eg, losing control, have a heart attack, "going crazy")
(c) significant behavioral changes related to the attacks

B. Presence of agoraphobia.

C. Panic attacks are not due to the direct physiological effects of a substance (for example, a subject of substance abuse, a medication) or a general medical condition (eg, hyperthyroidism).

D. Panic attacks are not better accounted for by another mental disorder , such as social phobia



(for example, occur after exposure to feared social situations), specific phobia

the ;

(for example, following exposure to a specific phobic situation), the

obsessive-compulsive

(for example, upon exposure to dirt a person with an obsession about contamination) ,

the post-traumatic stress disorder

(for example, in response to stimuli associated with a severe stressor)

disorder or separation anxiety

(for example, in response to being away from home or away from close relatives).

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panic disorder: diagnostic criteria

Panic disorder: diagnostic criteria

The DSM-IV contains two diagnostic criteria for panic disorder, agoraphobia, one without and one with agoraphobia, but both require the presence of panic attacks, as shown in Table visible in the post: Diagnosis of Panic Attacks .

AlCu ni population studies have indicated that the attacks pa nico are frequent and a bit of the main aspects in the development of diagnostic criteria for panic disorder has been the determination of a threshold value or frequency of panic attacks to meet the diagnosis. A threshold too low

knows favors a diagnosis of panic disorder in patients without functional alteration following an occasional panic attack, too high a threshold results in a situation where patients who are disturbed by their attacks Panic not meet the diagnostic criteria.

The uncertainty in the determination of threshold is marked by the range of thresholds included in the diagnostic criteria for us. The Research Diagnostic Criteria (RDC) requires six panic attacks in a period of six weeks .

The tenth revision of International Classification of Diseases (ICD-10) requires three attacks in three weeks (moderate disease) or four attacks in four weeks (for severe disease).

The DSM-IV does not specify a number to me synonymous with panic attacks or a period, but requires that at least one attack is followed by a period of at least one month during which the patient is afraid of having another panic attack or is concerned about the implications of AT heel, or a significant change of behavior.

The DSM-IV also requires that panic attacks are generally unexpected, but it also attacks expected or prepared by the situation.


Table: diagnostic criteria for panic disorder without agoraphobia

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DIAGNOSIS
Panic attacks

Unlike the DSM-III-R criteria diagnostic at the heels of panic in the DSM-IV are listed separately (see table).

Panic attacks may occur in mental disorders outside of panic disorder, particularly in specific phobia, social phobia in and posttraumatic stress disorder Stress .

unexpected panic attacks appear from nowhere and are not associated with any identifiable situational stimulus.

However, panic attacks do not necessarily unexpected, because in patients with social phobia and specific are usually expected or otherwise linked to a specific stimulus recognizable.

Cuni Al panic attacks do not fit easily into the distinction between expected and unexpected attacks, in this case are as dicati panic attacks with predisposition situa tion, which may appear or not when a patient is exposed to a specific stimulus, or may occur immediately after exposure, or even with considerable delay.

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Diagnosis of Panic Attacks Panic Attacks: Genetic Components in the psychodynamic hypothesis



Psychosocial factors have been developed theories and cognitive-behavioral and psychoanalytic theories to explain the pathogenesis of panic disorder and dell'agorafobia .

psychoanalytic theories

Psychoanalytic theories consider the panic attacks as a result of the failure of a defense against impulses that cause anxiety.

What was initially a modest signal anxiety becomes an overwhelming feeling of apprehension, combined with somatic symptoms.

Nell ' agoraphobia psychoanalytic theories emphasize the loss of a parent in childhood and a history of separation anxiety. The finding himself alone in public places revives anxiety sen thyrsi abandoned infant.

defense mechanisms used to take with repression, displacement, symbolization and avoidance.

traumatic separations during childhood may influence the development of the baby's nervous system, which consequently becomes susceptible to anxiety as adults.

Many patients describe panic attacks as if they appear out of nowhere, as if psychological factors were not involved, but the exploration of the psychodynamics banks often an obvious psychological motive.

Although panic attacks are related in terms of neurophysiological locus coeruleus, the onset of panic is usually related to environmental factors or psychological.

Subjects with panic disorder have a higher incidence of stressful life events, especially losses, compared to controls, in the months before the onset of panic disorder. In addition, patients typically experience a greater torment against life events than controls.

The hypothesis that psychological stressful events produce mak neurophysiological in panic disorder is so Stegne in a study of female twins. This research has revealed that panic disorder is strongly associated with both the separation of parents and their deaths before the age of 17 years. In a cohort of 1018 pairs of ge melle it was found that early separation from the mother more likely to cause a panic disorder compared to the separation from her father. Another

support for a psychological mechanism in the genesis of panic disorder can be deduced from a study of patients with panic disorder who were treated successfully with psychotherapy. Before therapy, subjects responded to induction by lactate with a panic attack. After successful treatment, the infusion of lactate was no longer able to determine a panic disorder.

Research indicates that the cause of panic attacks probably involves the unconscious meaning of the stressful and even you that their pathogenesis may be related to neuropsychological factors triggered reactions from psychologists.

Psychiatrists psychodynamic should always carried a sanctuary full search of possible triggers every time you perform a diagnostic evaluation on a patient with panic disorder.

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Genetic factors

Although the number of well-controlled studies on the basic policy of the gene and panic disorder dell'agorafobia is reduced, the current data support the conclusion that the disturbances may ave a re different genetic component.

In addition, some data suggest that panic disorder with agoraphobia is but for a severe panic disorder without agoraphobia, and that is much easier to inherit. Several studies have

found an increase of 4-8 times the risk of panic disorder in the pa-rent of first degree relatives of patients with panic disorder re compared with those of subjects with other psychiatric illnesses.

The twin studies conducted to date have shown that identical twins are more likely to concordance for panic disorder than dizygotic twins.

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Neuroimaging of Panic Panic Panic

struc tural neuroimaging studies (eg, magnetic resonance imaging [MRI]) in patients with panic disorder showed a disease of the temporal lobe, particularly the hippocampus.

For example, one study reported MRI abnormalities, especially cortical atrophy in the right temporal lobe of subjects with panic disorder .

neuroinimagine functional studies (eg, the positropi emission tomography [PET]) have shown a dysregulation of cerebral blood flow.

Specified mind, anxiety disorders and panic attacks are associated with cerebral vasoconstriction, which can result in symptoms in the central nervous system, such as dizziness, and peripheral nervous system is, that can be induced by hyperventilation and dall'ipocapnia.

Most neuroimaging studies functional used a substance that induces panic (eg, lactate, yohimbine, caffeine) in combination with PET or computed tomography single photon emission tomography (SPECT) to determine the effects on cerebral blood flow of the substance inducing panic and resulting panic attack.

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induced Factors in organic substances

The substances that trigger panic (sometimes called panicogene) are substances that induce panic attacks in most patients with panic disorder and a lower proportion of subjects sen za or without panic disorder history of panic attacks .

The use of substances that induce panic is closely mitato them to research, there are clinical reasons to stimulate panic attacks in patients.

The so-called panic-inducing substances cause a respiratory respiratory stimulation and a shift in ' acid-base balance, they include carbon dioxide (mixture 5 to 35%), lactate and sodium bicarbonate. The

neurochemicals that induce panic, which act through specific neurotransmitter systems, including yohimbine, an adrenergic receptor antagonist, fenfluramine, a releasing agent serotonin, chlorophenylpiperazine (mCPP), a substance with multiple effects serotonergic drugs μ-carbolines, inverse agonists of GABAB receptors, flumazenil, an antagonist of GABAB receptors, cholecystokinin and caffeine. Although isoproterenol is a substance that causes the panic, although the mechanism of action is unknown.

substances that cause respiratory panic may initially act on the peripheral cardiovascular baroreceptors and release their signal from vagal afferents to the nucleus of the solitary tract nucleus paragigantocellulare and then to the bulb.

The panic-inducing neurochemicals exert presumably their primary effects directly on the central noradrenergic receptors, serotonergic and GABAergic.

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Panic

Research on the biological basis of panic disorder has produced a series of data, according to one interpretation, the symptoms of panic disorder can cause various biological abnormalities in brain structure and function (see also post on biological theories of anxiety ).

Most of the work was done through the use of biological stimulants to induce a panic attack in patients with panic disorder.

These and other studies have suggested that involve pro duct a dysregulation of the peripheral and central nervous system in the pathophysiology of panic distur bo.

The autonomic nervous system of some individuals have an increased sympathetic tone, a slow adaptation to repeated stimuli and an excessive response to stimuli moderates. Research on neuroendocrine function in patients with panic disorder have identified various abnormalities, although the results of the studies were not unique.

The major neurotransmitter systems involved are noradrenergic, serotonergic and GABA-ergic (gamma-ami no-butyrate) .

The totality of biological data has led to a focus on the trunk brain (particularly neurons of the locus coeruleus noradrenergic and serotonergic neurons of the median raphe nucleus), the limbic system (perhaps the origin of ' anticipatory anxiety) and the prefrontal cortex (perhaps the origin of' phobic avoidance ).

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Epidemiological studies have reported a lifetime prevalence of 1 0.5 to 5% for panic disorder and 3 to 5.6% for ' panic attack.

For example, a recent study of more than 1600 randomly selected adults in Texas has found a lifetime prevalence of 3.8% for your trouble panic, 5.6% for panic attacks and 2.2% for panic attacks with limited symptoms that do not fully meet the diagnostic criteria.

Women are 2 to 3 times more affected than men, even if a tendency to under-diagnosed disorder co loaves in men may contribute to this distribution so skewed. The differences among Hispanic, white non-Hispanics and blacks are minimal.

The only social factor identified that could contribute to the development of panic disorder is a recent history of divorce or separation. The distur

bo panic occurs more often among young adults (age average onset is 25 years), but both panic disorder and agoraphobia can develop at any age. For exam ple, the first has also been reported in children and adolescents and is probably underdiagnosed in these groups.

The lifetime prevalence of 'agoraphobia has ranged from a low of 0.6% to a maximum of 6%. The major factor behind this heterogeneity of the estimates is attributable to the use of diagnostic criteria and different assessment methods.

Although studies of 'agoraphobia am in psychiatric environment have reported that at least three-quarters of affected patients also have a panic disorder , sull'agorafobia in community studies have found that up to half of the subjects manifested agoraphobia without panic disorder.

The reasons for such divergent findings are unknown, but probably involve differences in assessment techniques. In many cases the onset dell'agorafobia is following a traumatic event.

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Epidemiology of panic disorder panic disorder

The conceptualization of panic disorder can be traced back to the concept of irritable heart syndrome, which was noticed in soldiers during the American Civil War by Jacob Mendes DaCosta . The

DaCosta syndrome include many of the devas psychic and somatic symptoms that are now in-cluded in the diagnostic criteria for panic disorder.

In 1895, Sigmund Freud introduced the concept of anxiety neurosis , which consisted of acute symptoms and chronic psychological and somatic. The

acute anxiety neurosis Freud was similar to the disorder of the DSM-IV nico pa.

Freud was the first to notice the relationship between panic attacks and agoraphobia. The term

"agoraphobia" was coined in 1871 for the condition in which patients seem to be afraid to venture out in public without being accompanied by friends or relatives.

The word from the shore from the greek agora and phobos, meaning fear of the streets.

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history of panic and agoraphobia: GENERAL '

In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a panic attack is referred to as "a distinct period of intense fear or discomfort", ac companied by at least four somatic symptoms or such as cognitive, among others, palpitations, tremor, tachypnea, sweating and choking.

Since the panic disorder was coded in 1980 had accumulated a significant amount experimental data on the disorder and clinical experiences with patients. The

to panic disorder is characterized by the appearance of spontaneous, unexpected panic attacks , whose frequency can vary from multiple attacks throughout the day, a few attacks during a year. The distur

bo panic is often accompanied by agoraphobia , that pau ra to be alone in a public place (eg, a supermarket), especially in places where it would be impossible for a quick escape if the subject had a panic attack.

Agoraphobia may be the most disabling phobias, as that its presence can significantly interfere with the functioning of the person in social situations and vorative out of their homes. In the U.S., most researchers in the field of panic disorder agoraphobia considers that the application is almost always a complication in patients with panic disorder. In other words, we assume that agoraphobia is caused by the development of the fear of having a panic attack in a public place from which it may be difficult to escape.

Researchers from other Countries are, but also the United States, do not accept this theory. However, the fourth edition of DSM (DSM-IV) considers the disturbance panic as the predominant complaint in the dyad and includes diagnosis of panic disorder with agoraphobia and panic disorder without agoraphobia .

The DSM-IV contains diagnostic criteria for agoraphobia without history of panic disorder. The same panic attacks can occur in a number of mental disorders (eg, in depressive distur bo) and medical conditions (eg, abstinence or poisoning substances); the onset of an attack by nico pa per se does not justify the diagnosis of panic disorder.

Because subjects with panic disorder often go to the emergency Aid, the symptoms may be misdiagnosed as a serious medical condition (eg, myocardial infarction) or as a so-called hysterical symptoms. Nevertheless, the ability of health professionals who deal with mental health to recognize the symptoms of panic disorder has increased since 1980 and have been developed specific treatments.

All caregivers should be now able to recognize the symptoms of panic disorder, so patients can receive appropriate treatment, whether pharmacological or psychotherapeutic.

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medical disorders and generalized anxiety disorder

Generalized Anxiety Disorder and 'disease frequently found in many conditions of general medical condition.

A high prevalence of symptoms of generalized anxiety disorder has been reported in patients with Sjogren's syndrome (based chronic autoimmune inflammatory disease characterized by destruction of exocrine glands, minor salivary glands, lacrimal glands , parotid) and may be related to the effects of Sjogren's syndrome, the subcortical and cortical activity and thyroid function.

The general medical condition with the highest prevalence of symptoms of generalized anxiety disorder seems to be the Graves' disease (the most town of hyperthyroidism, caused by a general hyperactivity of the entire thyroid gland. Disorder known as diffuse toxic goiter "), in which up to two thirds of patients may meet the criteria for generalized anxiety disorder.

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medical disorders and panic attacks

I Anxiety disorders associated with a general medical condition : incidence of panic attacks .

Patients who have a cardiomyopathy may have the highest incidence of panic disorder secondary to a general medical condition.

One study reported that 1'83% of patients with cardiomyopathy pending of cardiac transplant presented symptoms of panic disorder. A
increased noradrenergic tone in these patients could be the stimulus provoking panic.

In some studies, approximately 25% of patients with Parkinson's disease and chronic obstructive pulmonary disease symptoms of panic disorder.

Other medical disorders associated with chronic pain include the primary biliary cirrhosis el ' epilepsy, especially if the outbreak is in the right parahippocampal around.

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anxiety disorder due to a condition general medical

As with most other syndromes (eg, psychosis, and early symptoms mood disorders), the anxiety disorder due to a general medical condition was included in the relevant section to promote the development and consideration of a complete differential diagnosis.

Epidemiology. The symptoms of anxiety related to general medical conditions is common, although the incidence of the disease varies for each specific medical condition ge eral.
Etiology . A wide range of medical conditions can cause symptoms similar to Sare those observed in both disorders also. Hyperthyroidism, hypothyroidism, hypoparathyroidism and vitamin deficiency B12 fre you are associated with anxiety symptoms. A pheochromocytoma secretes adrenaline, which can cause episodes of paroxysmal symptoms of anxiety. It is believed that some brain injuries and were posten cefalitici determine symptoms identical to those observed in obsessive - compulsive . Some other medical condi tions, such as cardiac arrhythmia, can produce physiological symptoms of panic disorder. Hypoglycemia can also mimic the symptoms of an anxiety disorder. The various medical conditions that cause symptoms of anxiety disorder may do so through a common mechanism, the noradrenergic system , although the effects on the serotonergic system are currently under investigation.

diagnosis. The diagnosis of DSM-IV anxiety disorder due to a general medical condition required the presence of symptoms of an anxiety disorder. The DSM-IV allows the doctor to specify whether the disorder is characterized by Zato symptoms of generalized anxiety, panic attacks or obsessive-compulsive symptoms .

The physician should have an increased level of suspicion to the diagnosis when anxiety is associated with chronic or paroxysmal a physical illness that is a known cause of such symptoms in some patients. Bursts of paroxysmal hypertension in a patient anxious it may indicate that it is appropriate to seek a pheochromocytoma. Generates a medical examination can reveal diabetes, an adrenal tumor, but a thyroid disease or a neurological condition. For example, some people with epilepsy have complex partial epi firm of extreme anxiety or fear as the only manifestation of seizure activity.

Clinical features. Symptoms of anxiety disorder do vuto to a general medical condition may be identical to those of primary anxiety disorders. Like syndrome disorder Panic is the most common clinical picture, while a syndrome similar to the three phobia is less common.

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Anxiety disorders and alcohol abuse (DSM-IV)

The DSM-IV lists the following anxiety disorders:

panic disorder with or without agoraphobia ,

agoraphobia without history of panic disorder, specific phobias

and social ,

obsessive-compulsive ,

post-traumatic stress disorder ,

acute stress disorder,

generalized anxiety disorder (all discussed in other sections of this blog),

anxiety disorder due mainly to a general medical condition, anxiety disorder in

product by substances and anxiety disorder Unless otherwise specified, including

disorder mixed anxiety-depression.

Practically anyone drink alcohol used it, at least in some instances, to reduce anxiety, mostly society. On the contrary, carefully controlled studies have shown that the effects of alcohol on anxiety are able and ranges may be significantly influenced sex, amount of alcohol ingested and cultural habits.

Nevertheless, the complaints of abuse of alcohol and other substances are commonly associated with anxiety disorders.

from alcohol abuse disorders are about four times more common among patients with panic disorder than the general population, about 3.5 times more common among the projects subject with obsessive-compulsive disorder and about 2.5 times more common among those with phobias.

Committee Several studies have reported data suggestive of a genetic diathesis for both distur bi anxiety and for those with alcohol abuse can co-exist in some families.

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Anxiety: Anxiety

The biological theories on anxiety developed from preclinical studies with animal models of anxiety, the study of patients in whom biological factors were highlighted, from the increasing knowledge of basic neuroscience and the actions of psychoactive drugs. One school of thought argues that biological variation in patients with measurable distur bo anxiety reflect the result of psychological conflicts. One side asserts that current biological events prior psychological conflicts. The two situations may coexist in certain subjects and a whole range of feelings with a biological basis may exist among individuals with symptoms of anxiety disorder.


autonomic nervous system.

Stimulation of the autonomic nervous system causes certain symptoms - cardiovascular (eg, tachycardia), muscle (eg, headache), gastrointestinal ones (eg, diarrhea) and respiratory (eg, tachypnea). These peripheral manifestations of anxiety are neither unique nor necessarily of anxiety disorders related to the subjective experience of anxiety.

Currently it is generally believed that anxiety precedes the central nervous system manifestations of anxiety devices, except when there is a specific Because device, such as when the subject has a pheochromocytoma. Some individuals with anxiety disorders, particularly panic disorder , have an autonomic nervous system shows an increase of sympathetic tone, it adapts slowly to repeated stimuli and responds to stimuli too moderate.


Neurotransmitters

The three main neurotransmitters associated with anxiety on the basis of animal studies and drug response are adrenaline, serotonin and gamma-amino butyric acid (GABA). Much of the information of the basic sciences neuro anxiety derived from animal experiments involving behavioral paradigms and psychoactive substances. One of these animal models of anxiety is the test of the conflict, in which the animal is simultaneously shown that stimuli are positive (eg, food) and negative (eg, electric shock). The anti-anxiety drugs (eg, zodiazepine well) tend to facilitate the adjustment of the soul in this situation, while other drugs (eg, amfeta mine) that do not worsen the behavioral response of the animal.

Noradrenaline

The general theory on the role of noradrenaline in anxiety disorders is that the patient may have hit a noradrenergic system is poorly regulated that has occasional bursts of activity. The cell bodies of the noradrenergic system are located mainly in the rostral locus coeruleus in the pons and project their axons to the cerebral cortex, the system lim bique, the trunk and spinal cord.

Human studies have found that in patients with disorder pa nico adrenergic agonists (eg, isoproterenol) and adrenergic antagonists (eg, yohimbine) can cause you frequent and severe attacks panic.

On the contrary, clonidine, an adrenergic agonist, reduces symptoms of anxiety in some experimental and therapeutic situations. Less frequently, patients with the disorder anxiety, particularly panic disorder have high levels of urinary or CSF noradrenergic metabolite 3-methoxy-4-hydroxy-sifenilglicole (MHPG).

SEROTONIN

The identification of many types of receptors if rotonina has stimulated the search for a role in the pathogenesis of anxiety disorders. The interest in this report was originally motivated by the observation that serotonergic antidepressants have some therapeutic effects in anxiety disorders - for example, clomipramine in obsessive-compulsive disorder. The efficacy of buspirone, an agonist of the serotonin receptor na lA receptor (5-HT1A) in the treatment of anxiety disorders also suggests the possibility of an association between anxiety and serotonin.

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biological theories: psychoanalytic theory

Although Freud originally believed that anxiety resulted from a physiological increase libido, in the end he redefined 'anxiety as a signal in the range of the conscious presence of a hazard.

Anxiety was seen as the result of a psychic conflict between unconscious desires of a sexual or aggressive and the corresponding threats from the superego or external reality. In response to this signal, the ego mobilizes the defense mechanisms to prevent unacceptable thoughts and feelings emerge into consciousness. In his classic work

Inhibitions, Symptoms and Anxiety, Freud says that "it is the anxiety that causes the repression and not, as previously believed, repression which pro duce anxiety." One of the negative consequences to consider the symptom of anxiety as a disorder rather than as a signal that the underlying sources of anxiety can be ignored.

one psychodynamic perspective, the goal of therapy is not necessarily eliminate all the anxiety, but to improve the tolerance of anxiety itself, ie the ability to feel the anxiety by using it as a signal to investigate the underlying conflict that caused it.

with anxiety seems in response to various situations during the life cycle and an attempt to eliminate it by means psychopharmacological can do nothing to address the existential situation or its related internal and led the state of anxiety.

To fully understand the anxiety of a particular patient is often useful to think in terms of a hierarchy of development which links the source of anxiety to development issues.

the most primitive level, this can be an anxiety of disintegration. This anxiety may derive either from fear of losing their sense of self or its know boundaries through the merger with an object, or by concern that the ego fragments because others do not respond with the necessary confirmation and validation.

On one level a bit 'higher anxiety or paranoid persecution can be linked to the perception that a person is likely to be invaded and set aside by a malevolent outside force.

A more advanced source of anxiety is less of a problem, but a child may be anxious for fear of losing the love or approval of a parent or a beloved object.

castration anxiety, related to the Oedipus phase in boys development, concerns the fear against a vengeful parent figure, usually the father, which damages the genitals or otherwise cause physical damage.

At the most mature, the 'superego anxiety is explained as related to guilt for the failure to live up to internalized models derived from the default behavior of parents.

Often a psychodynamic interview can clarify the main level of anxiety that goes against the patient to face.

Some form of anxiety is obviously related to multiple conflicts at various levels of development.

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pathological anxiety: epidemiology

I anxiety disorders are one of the most common psychiatric disorders. The National Comorbidity Study

reported that four an individual meets the diagnostic criteria for at least one anxiety disorder and that there is an annual prevalence rate of 17.70 / 100.

women (lifetime prevalence of 30.50 / 100) have a higher probability of having an anxiety disorder than men (lifetime prevalence of 19.20 / 100).

Finally, the prevalence of anxiety disorders decreases with increasing socioeconomic status .

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psychological and cognitive symptoms of anxiety panic

The experience of anxiety has two components:

1) awareness of physiological sensations (such as palpitations and sweating) and
2) the feeling of being nervous or scared.

The anxiety may be heightened by a sense of shame ver - "Others will find that I'm scared."

Many people are amazed to discover that others are not aware of their anxiety or, if they are, do not appreciate the intensity.

addition to the motor effects and visceral anxiety affects thought, perception and learning. It tends to create confusion and distortion of perception, not only that of time and space, but also of people and the meaning of events. These distortions can interfere with learning rire reducing the concentration, the ability to recall learned and limiting the ability to relate an object with another, or to make associations.

An important aspect of emotions is represented by its effects on the selectivity of attention.
anxious individuals tend to select certain aspects of their environment and neglecting others, in an effort to prove that they JUSTIFY in considering the terrible situation and acting accordingly. If falsely justify

their fear, their anxiety is increased by the selective response, establishing a vicious cycle of anxiety, distorted perception and anxiety additio king.

Conversely, if falsely reassure themselves at thinking through a selective, appropriate anxiety may be reduced and may not be able to take the necessary precautions.

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Stress, conflict and anxiety

The fact that an event is perceived as stressful depends on its nature and resources of the person, from his psychological defenses and its mechanisms of reaction.

This involves the ego, collective abstraction to define the process by which a person perceives, thinks and acts on the basis of external events or internal impulses.

A person whose ego is functioning properly in the budget is adaptive to the outside world with both the inner and if the ego is not working properly and launched sbi result persists long enough, the person to alert the ' chronic anxiety.

Whether this imbalance is external, between the pressures of the outside world and the ego of the subject, or internal, between the impulses of the patient (eg, aggressive impulses, sexual or dependence) and consciousness, it determines a conflict.

conflicts caused by external events are usually interpersonal, while those caused by internal events are intrapsychic or intrapersonal.

A combination of both is pos sible, as in the case of employees who have a more critical or demanding too much and need to control their impulses to strike for fear of losing their jobs.

with the interpersonal and intrapsychic conflicts are in fact usually combined, because human beings are social and their main conflicts are usually with other individuals.

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adaptive functions of anxiety

If considered simply as an alert signal, the anxiety may be practically considered an emotion similar to fear.

Anxiety warns of an external threat or internal quality and designed to save lives.

At a lower level anxiety warns of threats against the body, do the lore, impotence, a potential punishment, the frustration of social needs or injury, separation from loved ones, to be a threat to success or status of a person, as a last resort, to its unity and completeness.

It causes the person to take the necessary measures to prevent the threat or minimize their consequences.

Examples of avoidance of a threat in everyday life are applied to the study to prepare for an exam, the dodge a ball thrown against his head, back furtive mind in the dorm after the time set for definition and can avoid a rush to catch the last flight to the commuter train.

This anxiety prevents damage alerting the person carrying out certain measures that prevent the danger.

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Fear and anxiety

Anxiety is a signal to alert: a warning of imminent danger im, and allows the person to take measures to address a threat.

Fear, which is a similar warning should be differentiated from.

Fear manifests itself in response to a known threat, external, adopted or otherwise non-confrontational in origin, the anxiety is manifested in response to an unknown threat, internal, vague or conflictual in origin.

The distinction between fear and anxiety arose by chance.

The first translator of Freud mistakenly translated the word angst and fear in German, such as anxiety. Freud himself generally unaware of the distinction that the anxiety associated with an object and repressed unconscious and fear to an external object and known. The distinction may be difficult to do, that fear can also be due to an internal object, the unconscious, repressed projected onto another object in the world do outside.

Nevertheless, based on post-Freudian psychoanalytic formulations, the separation between fear and anxiety is justifiable from the psychological point of view. The main

. psychological difference between the emotional responses of fear is the acuity and chronicity of anxiety.

Charles Darwin pointed out that the word fear comes from words that indicate what is sudden and dangerous. The term also appears to be vital in neurophysiological phenomena of anxiety and fear.

In 1896, Darwin made the following description if a fear of acute psychophysiological finante with terror:

Fear is often preceded by astonishment, and so like this I mean that both the sense of sight and learning are immediately aroused. In both cases the eyes and mouth are wide open and eyebrows raised. The frightened man at first stands like a statue motionless holding his breath or lies down instinctively how to escape observation. The heart beats quickly and violently in order to beat or beating against my ribs, but it is very doubtful that it works more effectively than normal in order to send a larger amount of blood to all parts of the body because the skin becomes pale suddenly as for an impending loss of consciousness. Pal value, however, this surface is probably due, in large part or all of the fact that the vasomotor center is affected in such a way as to cause the contraction of small arteries skin. The fact that the skin is very interested in a great fear shown by the wonderful and inexplicable manner in which it occurs immediate ly sweating. This sweating is all the more remarkable because the skin surface in this case is cold, hence the term cold sweat, and sweat glands are nor mally induced action when the surface is hot. Even the hairs are erected and the superficial muscles shiver. In connection with the impaired action of the heart, the breathing is hurried. The salivary glands act imperfectly, the mouth becomes dry and is frequently opened and closed. I also noticed that due to a slight fear there is a strong tendency to yawn king. One of the most characteristic symptom is a tremor of the muscles of the body and this is often seen from his lips. Because of this and the dryness of the mouth, the voice becomes husky or indistinct, or may fail altogether ...
As the fear grows into terror you give us, as in all the violent emotions, different results. The CuO King beating in a violent way or causing a svenimen to be missing and there is a deathly pallor, breathing is labored, his nostrils are latate and there is a movement gasping and feverish lips, a tremor of the cheeks and continuous movements of swallowing, the eyes are not covered by the lids and rims shall be set to sull'ogget of terror, or they can rotate continuously from side to side. The pupils are said to be greatly expanded. All mu drains the body may become rigid or give rise to minds convulsive movements. The hands are alternately open and close, often with a contortion. The arms are outstretched, as if to avoid some terrible danger, or be troubled on his head ... In other cases there is a sudden and uncontrollable tendency to stampede, and this is so strong that more soldiers co raggiosi can be captured by sudden panic attacks.

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a deep thought and human resources, Pierpaolobasso that all Catholics should read!

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Appeals for the card. Bagnasco for a vote on abortion

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