Commentary on Part II The Inhibited Child “Syndrome”: Thoughts on Its Potential Pathogenesis and Sequelae

This chapter describes fear and its neuroendocrine regulation. It specifically highlights the role of elevated cortisol and corticotropin-releasing hormone (CRH) in the regulation of fear responses, placing a particular emphasis on the central nucleus of the amygdala and the bed nucleus of the stria terminalis. It starts with a discussion of the central motive state of fear and its biological basis. It then discusses the neural circuitry that underlies the perception of fearful events and fear-related behaviors. Next, it presents a description of the neuroendocrine basis of fear and a discussion of glucocorticoids and CRH in sustaining fear-related behaviors. Moreover, it evaluates the role of norepinephrine and epinephrine in facilitating responses to and memory of aversive events. It is showed that neuropeptides such as CRH chemically code the sense of fear that is sustained by elevated cortisol and that may underlie the excessively shy, fearful child's hyperexcitable central state.