Health Scan: Understanding anxiety

New research shows anxiety may not come from hypersensitivity; help with potentially leaky implants; pharmacy licenses.

Brain 311 T (photo credit: Thinkstock/Imagebank)
Brain 311 T
(photo credit: Thinkstock/Imagebank)
Anxious people have long been classified as “hypersensitive” for their tendency to be more fearful and feel threatened more easily than their non-anxious counterparts. But new research from Tel Aviv University shows that anxiety may not come from hypersensitivity; in fact, just the opposite, says Dr. Tahl Frenkel, a doctoral candidate from the school of psychological sciences and the Adler Center for Research in Child Developmental and Psychopathology, working with her supervisor Prof. Yair Bar-Haim.
As part of a study on how the brain processes fear in anxious and non-anxious individuals, the researchers looked at brain activity as study participants were shown fear-inducing stimuli. Using an electroencephalograph, which measures electrical activity on the scalp caused by activity of the neurons, the researchers discovered that the anxious group was actually less stimulated than the non-anxious group. The results of the study were recently published in the journalBiological Psychology.
This results show that the anxious participants weren’t as sensitive to subtle changes in their environment, explains Frenkel. Anxious individuals could have a deficit in their threat evaluation capabilities, necessary for effective decision making and regulating fear responses – leading to an over-reaction to subtle threatening stimuli.
Non-anxious individuals seem to have a subconscious “early warning system” that allows them to prepare for evolving threats. Essentially, anxious people are “surprised” by fearful stimuli that non-anxious individuals have already subconsciously noticed, analyzed and categorized properly by level of threat, she adds.
Anxious people process stimuli with a lot of bias, says Frenkel. They will categorize things as threatening that non-anxious people can process automatically and then dismiss as non-harmful.
A non-anxious person has forewarning when they are confronted with stimuli, having subconsciously noticed the subtle changes in the environment before conscious recognition of the threat. Without such preparation, anxious individuals often react more strongly, as though the threat is creeping up behind them.
“What looks like hypersensitivity on a behavioral level is in fact, when you look at the results of the EEG, the anxious person’s attempt to compensate for a deficit in the sensitivity of their perception,” she explains.
The Health Ministry has set a precedent by instructing the four health funds to pay for the surgical removal and replacement in any public hospital of breast implants for esthetic surgery if the patient’s doctor believes she is at risk for the first one to leak and pose a cancer risk. The patient would pay for a new implant, but the insurer would cover the costs of surgery and hospitalization.
The unusual decision followed the discovery than an implant called PIP, manufactured in France, apparently was at higher risk to leak silicone into the body due to manufacturing defects. Although none of the PIP implants had been approved by the Health Ministry during the last two years after the first warnings were issued abroad, some 850 had apparently been in storage and implanted, most of them by surgeons at private hospitals. The ministry is investigating how they were used at all without approval.
The ministry said that the exceptional decision is unusual because rules prohibit patients for paying for medical devices approved by its legal department.
The decision will be in effect not only for the PIP implants but for whenever a qualified doctor fears a breast implant is leaking or at risk of doing so.
Until now, purely esthetic surgery has not been included in the basket of health service.
American manufacturers of other silicone implants (not the PIP kind) recommend replacing them every 10 years, while American societies for plastic and esthetic surgery say they should be replaced only if there is concern about leakage. Their Israeli counterparts differ on the subject and do not have a uniform recommendation.
In about a year, anyone who graduated from a local school of pharmacy and wants to become a licensed pharmacist must pass a government exam. The change, according to its initiator MK Arye Eldad, means that unlike other medical professions, passing such a test was not mandatory, even though the Health Ministry had the power to demand it. Until now, it used its authority only to demand adequate test marks from people who studied at schools of pharmacy abroad.
Now graduates of Israeli schools will have to do so. There was no opposition in the Knesset to this change.