These characteristics are consistent with the biopsychol ogy theories previously described.
Fear and Anxiety 11
Carpenito (1997) and NANDA's (1996) nursing diag noses classification system were used to further
elaborate the antecedents of fear and anxiety. Table 2 reflects the rec onciliation of input from
the first two steps of the modified SCA and is considered stable, as it is consistent with the
current available neurobiological support that provided the basis for this model. Stability and
consistency are estab lished by consensus of experts within nursing and one external expert. While
larger peer review of this model will facilitate further critique and revision, changes should be
consistent with current anxiety and fear research.
Within the framework of theoretically driven defini tions and research, overlap and inconsistency
exists among antecedents of fear and anxiety. Most important, an antecedent to fear must include a
single event or salient stimulus that is dangerous or potentially threaten ing; results in a state
of fright or cardiac excitation; and a fight, flight, or freeze response. Yet, if removed, it
elimi nates the need for fear expression.