The Human AmygdalaNagy A. Youssef, MD
Duke University, Durham, NC, USA
Edited by Paul J. Whalen and Elizabeth A. Phelps. New York, NY: The Guilford Press; 2009; ISBN 978-1-606-230336; pp 429; $66.66 (hardcover).
This book presents a great review of the state of knowledge and recent literature on the amygdala. Some may think the amygdala is totally irrelevant to clinicians. However, I would argue that the more one starts learning about the amygdala, the more one starts noticing its clinical effects and that of the limbic system in general. These effects were described by Dr. George Murray in a chapter from another clinically focused book as the “limbic music.”1
This book can be helpful to both researchers and clinicians. Researchers may further appreciate the limbic music in studying normal differences among individuals, as well as in studying psychopathology. Clinicians may become more in tune to listening to limbic music in their patients by detecting a wide range of symptoms and signs that the amygdala dysfunction may be implicated in, and orchestrate the needed pharmacological or psychotherapeutic interventions. Also, psychoeducation about the role of the amygdala is an integral part of cognitive- and exposure-based psychotherapies. It teaches patients how amygdala dysfunction can color their view of the world and that therapy can help in developing alternate adaptive and healthy ways of viewing the world.
The book consists of 18 chapters and is divided into 3 main parts: Part I (chapters 1-4) bridges the gap and discusses the knowledge from animal models to function of the amygdala in humans. Part II (chapters 5-13) focuses on the function of the human amygdala from the developmental perspective to its function in the fear conditioning, control of fear, social functioning, and individual differences in amygdala functioning, and even in perception. Part III (chapters 14-18) discusses human amygdala dysfunction. This includes amygdala dysfunction in disorders such as anxiety disorders, schizophrenia, and autism. It also includes an interesting chapter on the genetic basis of amygdala reactivity that links the fields of molecular genetics and neuroimaging in studying the amygdala, and “shedding light on the mechanisms giving rise to individual differences in complex behavior and related psychiatric disorders.” Imaging genetic studies are helping towards the understanding “of the pathways and mechanism through which the dynamic interplay of genes, brain, and environment shapes variability in behavior” and “inform risks and resiliency.” These risks and resilience issues can help further our understanding not only in anxiety disorders such as posttraumatic stress disorder, but also in mood disorders, as individual differences in “trait negative affect are important predictors of vulnerability for a wide spectrum of health-related disorders including depression, anxiety, and cardiovascular disease.” This also includes the implication of important neurotransmitters in the risk and resilience paradigm including the implications of serotonin, brain-derived neurotropic factor, and neuropeptide Y among others. At the end of each chapter, a nice, brief section entitled “What We Think” provides the author’s take on and a summary of the literature in the specific area discussed.
In summary, this book provides a nice review of the literature from great leaders in the field. It provides an in-depth understanding for both scientists and clinicians interested to learn more about the amygdalar world, and the amygdalar view of the world.
- Murray G. Limbic music. In: Stern T, Fricchione G, Cassem N, et al, eds. Massachusetts General Hospital handbook of general hospital psychiatry. Philadelphia, PA: Mosby, Inc.; 2004:21-28.
Annals of Clinical Psychiatry ©2012 Quadrant HealthCom Inc.