Structural anxiety – biological features and contemporary cultural imprints

Affectivity – alongside instinctual life – represents the energetic and motivational support that dynamically drives personal life. The most important experiences and events in life carry primarily emotional weight. Emotions and feelings that accompany us throughout life alternate or interfere with each other and can be intensified both consciously and unconsciously. The association of individual emotional states has been named by Saint Augustine as interiority, being the most faithful expression of human subjectivity. Emotional experiences have various ways of expression, but in order to fulfill their main purpose – that of opening us up and bringing us closer to the world around us –, they need to be legitimized in front of reason. Thus, they become the major support of knowledge strategies that ensure adaptive behavior and provide coherence and depth to individual identity⁽³⁾. However, there is also an emotional logic in which reasoning lacks logic, ideational associations are superficial – through similarity and contiguity –, synthesis is used and little or no analysis, and the dominant motivation is personal desire or belief. This form of logic can be useful when the individual cannot or does not want to appeal to reason. A particular form is represented by pure affective logic, according to which an emotion or a feeling evokes similar ones. Thus, a moment of joy evokes benevolence, and a moment of tenderness can bring compassion to the forefront⁽⁸⁾. This logical variant represents a primary interpersonal bond, and it is found in the territory of virtues.

The description of anxiety and the perspectives from which it can be understood confirm the affective foundation of individual personality. Emotional life – which integrates the adaptive variants of anxiety – diversifies, deepens, and nuances correspondingly to the stages of personogenesis and integration into life roles. There is an underlying emotional state – mood or endotimia – that is independent of external stimuli, as well as emotional experiences triggered by stimuli or exotimic reactions. They include, alongside reactive anxious experiences, structural anxiety, as a variant of negative hyperthymias.

From the perspective of biological conditioning, there are known structures of the central nervous system that initiate and shape the anxious response of fight or flight, as well as the inhibitory response. Thus, the prefrontal cortex and the anterior cingulate cortex participate in the awareness of emotions, and the temporal cortex is involved in paroxysmal anxiety^(5,8). The hippocampus is linked to emotional memory, and the hypothalamus is involved in vegetative anxiety. In the same context, the hyperfunction of the central amygdala nucleus is responsible for all forms of anxiety, except for that associated with obsessive-compulsive disorder, and avoidance behavior is centered in the nucleus accumbens⁽⁷⁾. Overall, anxiety control is difficult because in the feedback loop, the amygdala – prefrontal cortex inhibitory loop is dominant, explaining why irrational phobias escape the voluntary control.

According to the neurotransmitters involved, norepinephrine and dopamine are anxiogenic, while GABA, CRH and testosterone reduce anxiety. Additionally, cholecystokinin and serotonin induce and mitigate panic attacks, respectively. Genetic factors are primarily involved in panic attacks through hyperdopaminergia, with confirmation of their increased incidence in families with paroxysmal anxiety and in monozygotic twins compared to dizygotic twins^(2,6,11).

In generalized or diffuse anxiety, hyperdopaminergia is implicated in the described comorbid conditions, with an equal rate of concordance between monozygotic and dizygotic twins, the role of genetic factors being insignificant⁽¹³⁾. Corresponding to individual personality, Cloninger’s psychobiological dimensional model – with four temperamental and three character dimensions – is involved in structural anxiety. The first ones are correlated with brain neurotransmission – novelty seeking with serotonergic transmission, harm avoidance with dopaminergic transmission, reward dependence with noradrenergic transmission, and persistence with glutamate-mediated neurotransmission. High scores of novelty seeking, harm avoidance and reward dependence correlate with increased levels of structural anxiety, including in obsessive-compulsive personality disorder. On the other hand, the described model allows for flexible adjustment to normally structured personalities, although in adaptive or physiological anxiety, with a mobilizing role in behavior^(9,15).

In the sociofamilial conditioning of structural anxiety, a variety of factors are involved, such as the severity of education and parental aggression, distorted or devaluing affective messages, simultaneous overprotection and depreciation, structural instability of families, and the prevalence of single-parent families. Additionally, the disruption of family life rhythms with the disregard of stable and protective traditional values, sedentary lifestyles, and the replacement of personal skills cultivation with technological substitutes are associated with structural anxiety⁽¹⁰⁾. Differential and sometimes conditioned access to material values, as well as the discrepancy between individual abilities and existential offerings are also evident. Rituals in initiation or transitioning from one age to another, with a maturing and self-transcendent capacity-enhancing role, are occasionally evoked⁽¹⁾.

From a cultural perspective, the conditioning of structural anxiety involves the ignorance or mystification of old traditions and customs, the diversion of traditional values’ meanings, and their alignment with the false myth of immediate happiness. It also includes the unconscious exploitation of the talents and abilities of the younger population. In the same context, the disregard of beliefs and religions and their messages, or their transformation into show variants, as well as the promotion of classical cultural values for commercial or entertainment purposes, and the dismantling or distortion of intergenerational relationships and their meanings become more widespread⁽³⁾.

Structural anxiety is a personal attribute associated with a fragile self, with deficient defense mechanisms and coping strategies, and a low tolerance for minor life events, intricately linked to self-esteem. It is fueled by feelings of unfulfillment and persistent dissatisfaction, and it is exacerbated by the contradiction between the vulnerable self and the Super Ego, which is unwilling to compromise. Structural anxiety can play an adaptive role in normal personalities and a maladaptive one in pathological personalities and related comorbid conditions^(4,12).

From a categorical perspective, in the case of the avoidant pathological personality, structural anxiety is favored by a devaluing and overprotective parental style, the induced belief that others can provide care and protection, and the subsequent atrophy of personal reality in relation to the external one. Social phobias are constant and social isolation is experienced shamefully, due to the belief that rejection from the social circle is deserved.

In the case of the dependent pathological personality, the structuring of anxiety is facilitated by the same parental style described earlier, which cultivates the belief that the only way to survive depends on others. The hypertrophied mental representation of others and the tendency to approach and not be abandoned sustain the ideo-affective and attitudinal ambivalence, as well as hypersensitivity to criticism.

The structuring of anxiety in the case of obsessive-compulsive personality involves the dominant and distant attitude of parental figures, inducing the child’s feeling that he/she is neither valued nor loved. It is also associated with the feeling of incompleteness, according to which the child can never do enough to earn the appreciation and love of the parents. Anxiety is directed towards the parents and, along with the fear of losing self-control, maintains the need to control others. In the same context, the hidden desire to meet the expectations of the parents promotes overinvolvement in the role and performance anxiety, along with insecurity and a low level of spontaneity. The dimensional perspective on structural anxiety involves the two models, the Big Seven factors and the Big Five factors⁽¹⁶⁾.

In the case of the first mentioned dimensional model of avoidant personality, there are low values of novelty seeking and high values of reward dependence and harm avoidance. Also, characteristic are the low values of self-determination, cooperativeness, and self-transcendence.

For dependent personality, specific are the high values of novelty seeking, reward dependence, and harm avoidance, as well as cooperativeness, and the low values of self-determination and self-transcendence.

For obsessive-compulsive personality, there are low values of reward dependence and harm avoidance, and high/low values of novelty seeking, along with high values of persistence. There are also high values of self-determination and low values of cooperativeness and self-transcendence⁽¹⁴⁾.

According to the Big Five model, in the case of avoidant personality, there are high values of neuroticism and low values of extraversion and agreeableness. For dependent personality, there are high values of neuroticism and agreeableness, and low values of extraversion. The structural complexity of obsessive-compulsive personality combines high values of neuroticism, cooperativeness and conscientiousness, and low values of extraversion and agreeableness. The discussed dimensions of the Big Five model are predominantly genetically conditioned, and agreeableness and conscientiousness have a major effect on adaptive capacities, interpersonal relationships and longevity.

In anxious personalities, the subjective well-being is particularly fragile in dependent and paranoid personality disorders, and is also vulnerable in obsessive-compulsive personality disorder, but with intermittent amplification of the cognitive component through the contribution of the Super Ego. Involvement in family and social roles is minimal in avoidant personality disorder, corresponding to social phobias, increased self-criticism, and depersonalization states. In the case of dependent personality disorder, involvement is difficult and insecure in duration due to the submissive style and fear of abandonment. The subjective well-being of obsessive-compulsive personality is well defined, but lacking in emotional messages, dominated by monotony, authoritarianism, rigidity, the need for confirmation of self-attributed moral altitude, and always marked by hypercriticism.

The involvement in professional roles for dependent personality is extremely difficult due to self-devaluing scenarios or constantly maintaining a subordinate attitude. Dependent disorder involves itself in the professional role in relation to the person or group to which the subject is attached and always displays anticipatory anxiety. Obsessive-compulsive personality disorder assumes an early and stable professional role, internalizes the dominant values of the profession, and has a complex hyperinvolved attitude. The relationship with the profession is vulnerable due to the rigidity of attitude, the sense of omnipotence, the contempt for the inferior, difficulty adapting to new things, and a selfish interpretation of justice⁽¹⁷⁾.

Access to material values, which are always at the forefront of contemporary daily life, is difficult or constantly conditioned in avoidant and dependent personality disorders. Obsessive-compulsive personality disorder is involved in acquiring and promoting material values, except for the use of relaxation and leisure activities. Existential values that should dominate today’s world – such as traditions, customs, beliefs, solidarity and common sense – have a different position corresponding to the structural dominants of anxious personalities. In the case of avoidant and dependent personality disorders, their involvement is dominant and affected by personal inferiority and shame, corresponding to the inability to integrate into common activities and relationships with others, which are now mystified by mass media. Due to the protection of the Super Ego in obsessive-compulsive personality disorder, access to the mentioned values is less disadvantaged.

In avoidant, dependent, and obsessive-compulsive personality disorders, there is a high vulnerability to mental illnesses. The most commonly involved are different forms of depression with or without associated suicidal behavior. True suicide, with a staged progression between the idea of self-suppression and the actual act, is encountered primarily in avoidant and obsessive-compulsive personality disorders, but also in dependent personality disorder, where it can sometimes have a demonstrative parasuicidal character. A common frequent complication is toxic behavior towards alcohol, drugs, as well as anxiolytic and/or mood-stabilizing medication⁽¹⁵⁾.

Contemporary Western socioculture continues to promote material and biological components of life over the cultural and spiritual aspects necessary for controlling and transcending anxious experiences. A major anxiolytic role can be played by openness to spiritual values, which always modify subjective well-being and individual self-esteem. The same contribution is made by increasing harmony and cohesion in social roles, motivated by profession, hobbies, leisure activities, promoting individual talents, as well as religious practices.

“To love is to rejoice” (Aristotle), but the path to love and the authentic ability to be fulfilled with oneself remain an anthropological aspiration when the inner world of the human being and the external world meet in the territory of anxiety.  

Corresponding author: Prof. Dr. Aurel Nireştean E-mail: aurelnirestean @yahoo.com

CONFLICT OF INTEREST: none declared.

FINANCIAL SUPPORT: none declared.

This work is permanently accessible online free of charge and published under the CC-BY.