ReviewThe default response to uncertainty and the importance of perceived safety in anxiety and stress: An evolution-theoretical perspective
Section snippets
How does it start and why respond to neutral (‘uncertain’) situations?
Chronic anxiety, including disorders such as generalized anxiety disorder (GAD), panic disorder (PD) and social anxiety disorder (SAD), but also nonclinical anxiety and ‘just’ habitual worrying are responsible for a considerable part of mental suffering and also form a major risk factor for somatic disease. For example, most types of chronic anxiety are associated with a two to seven-fold risk for cardiovascular disease (Kubzansky and Kawachi, 2000; Roest, Martens, de Jonge, & Denollet, 2010;
Reformulating the question: generalized unsafety theory of stress (GUTS)
We propose that the solution lies in the fact that the way in which the question is formulated is wrong. Available neurobiological evidence and evolutionary logic imply that the stress response, and thus the anxiety response, is a default response of the organism, and that it is the response the organism automatically falls back upon when no other information is available. So, the problem should not be phrased as: “what causes chronic stress responses?” but as “what mechanism allows the default
When life’s uncertainty turns into unsafety: compromised life domains
We will now point out what we mean with each compromised domain and why we hypothesize that the chronic physiological responses associated with them are due to GU.
Summary and conclusion
In this paper we proposed an entirely new theoretical perspective on chronic anxiety and stress, based on evolution-theoretical reasoning and neglected or forgotten neurobiological principles from Hughlings Jackson (1884) and Julius (1995): the generalized unsafety theory of stress (GUTS). The two core ideas of GUTS are that: (1) the stress response is a default response that is normally under tonic inhibition; (2) when no safety is perceived, the default response remains uninhibited. We argued
Acknowledgements
This work was supported byZON-MW (Netherlands Organisation for Health Research and Development); TOP Grant no. 40-00812-98-11029.
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