FAMILIAL TRANSMISSION OF SIMPLE PHOBIAS AND FEARS

这项建议是由Dr. 巴洛和法耶谁提交了两个单独的，但类似的申请。 拟定研究的目的是进行一项盲态、对照、 DSM III R单纯恐怖症家庭直接访谈调查 它的家族传播，亚型的异质性（例如， 动物与情境性血液损伤），与"亚病症"的关系 非理性恐惧（即不符合障碍标准的非理性恐惧） 由于缺乏与恐惧相关的回避、损害或耐力） 以及其他DSM III R焦虑症。 精神障碍的风险和一级亲属的症状 将简单恐惧症先证者（SPD先证者，合并两个部位n = 120） 与从未接受过类似评估的一级亲属的风险相比， 精神病控制。 以确定是否有独立的家庭 血液/损伤、动物和情境亚型、先证者的聚集 将进行前瞻性分型，并对比各亚型的风险 由此产生的非控制不良先证者的亲属群体和亲属 （NCP）。 评估"亚障碍"非理性恐惧的家族聚集性 (SIF)以及它们与SPD的关系，包括SPD和NCP先证者组 将被至少一个简单无理数的存在或不存在所细分 恐惧（SIF）。 将对比SPD、SIF、两者或两者均不存在的风险 四个先证者组的亲属（无SPD/无SIF，仅SIF， 仅SPD和SPD + SIF）。 SPD患者亲属的家族性精神病理学研究 患者先证者也将与60岁以下的亲属进行比较。 未经治疗的"社区成员" SPD先证者。 我们最初的目标是用家庭研究的方法更清楚地 描述SPD和其他焦虑之间的病因有效界限 疾病以及DSM III R SPD类别本身。 我们漫长 长期目标包括这样一种可能性，即由于它们的离散性， 和常见的，仔细研究简单的恐惧症， “亚紊乱”的非理性恐惧可能导致一种独特的模式的发展， 来研究神经生理学 变异、主观情感和认知，以及正常和 心理病理学上的恐惧和回避行为

This proposal is one half of a jointly proposed multicenter study by Drs. Barlow and Fyer who are submitting two separate but similar applications. The objective of the proposed study is to conduct a blind, controlled, direct interview family of DSM III R simple phobic disorder to investigate its familial transmission, heterogeneity with respect to subtype (e.g. animal vs situational bs blood injury), relationship to "subdisorder" irrational fears (i.e. irrational fears which do not meet disorder criteria due to lack of associated avoidance, impairment or endurance with dread) and to other DSM III R anxiety disorders. Risk for psychiatric disorder and symptoms of first degree relatives of simple phobia probands (SPD probands, combined two site n=120) will be compared to risk among similarly evaluated first degree relatives of never mentally ill controls. To determine if there is independent familial aggregation of the blood/injury, animal and situational subtypes, probands will be prospectively subtyped and risk for each subtype contrasted across the resulting relative groups and relatives of not ill control probands (NCP). To assess familial aggregation of "subdisorder" irrational fears (SIF) and their relationship to SPD, both the SPD and NCP proband groups will be subdivided by presence or absence of at least one simple irrational fear (SIF). Risks for SPD, SIF, both or neither will be contrasted across relatives of the four resulting proband groups (No SPD/No SIF, SIF Only, SPD Only, and SPD+SIF). Familial psychopathology among relatives of SPD patient probands will also be compared to that of relatives of 60 untreated"community member" SPD probands. Our initial objective is to use the family study method to more clearly delineate etiologically valid boundaries both between SPD and other anxiety disorders as well as within the DSM III R SPD category itself. Our long term goals include the possibility that because of their discrete nature and common occurrence, careful study of simple phobic disorders and "subdisorder" irrational fears may lead to development of a unique model in which to investigate inter-relationships between neurophysiological variation, subjective affect and cognition, and development of normal and psychopathological fear and avoidance behavior.