Term
| ____________ is elicited by a threatening stimulus in the current environment. Onset is acute, duration limited by eliciting situation, and involves the activation of motoric escape / avoidance responses |
|
Definition
|
|
Term
| define anxiety. how does it differ from fear? |
|
Definition
| generally involves unpleasant anticipation of a future situation. More “mood like” than fear: Less acute, less focused, less discrete; and generally does not involve the activation of motoric escape / avoidance responses. |
|
|
Term
|
Definition
| is an intense, discrete episode of unpleasant physical symptoms typically accompanied by feelings of “fear.” Sometimes evoked an identifiable stimulus, sometimes spontaneous. |
|
|
Term
| what are the three types of panic attacks? |
|
Definition
| spontaneous (uncued), situationally-predisposed and situationally bound (cued) |
|
|
Term
| what is the essential feature of panic disorder? |
|
Definition
| the repeated occurrence of spontaneous panic attacks |
|
|
Term
| panic disorder is highly comorbid with __________ and ___________ |
|
Definition
| major depressive disorder and anxiety disorders |
|
|
Term
| what are some of the common symptoms of a panic attack? |
|
Definition
-dyspnea (trouble breathing)
-chest pains
-dimming of visual field
-heart palpitations, tachycardia (increased HR)
-lightheadedness
-dissociative symptoms (depersonalization, derealization)
-paresthesia (numbness, tingling) in lips and extremities
-thoughts of dying, going crazy or losing control |
|
|
Term
| what is the physiological cascade that occurs in hyperventilation? |
|
Definition
1) Hypocapnia: CO2 in the bloodstream falls
2) Respiratory alkalosis: Bloodstream pH increases
3) Hypoxia: The alkalosis triggers cerebral vasoconstriction, diminishing bloodflow to the brain and starving it of oxygen |
|
|
Term
| true or false: Hyperventilation plays a prominent role in several etiological theories of panic disorder |
|
Definition
|
|
Term
|
Definition
| Avoidance of places from which escape might be difficult or embarrassing or in which help might not readily be available in the event of panic sx. |
|
|
Term
| __________ is defined by anxiety or worry causing significant distress or impairment in social or instrumental role functioning, associated with: restlessness, muscle tension, impaired concentration, irritability and sleep disturbance |
|
Definition
| generalized anxiety disorder (GAD) |
|
|
Term
| what is the core symptom of GAD? |
|
Definition
| persistent rumination about multiple topics |
|
|
Term
| true or false: GAD is weakly comorbid with other anxiety disorders and mood disorders |
|
Definition
|
|
Term
| true or false: SNS arousal is present in GAD |
|
Definition
| false. one theory is that worry is actually an avoidance mechanism employed to prevent emotional processing of threatening images and the experience of SNS arousal |
|
|
Term
|
Definition
| Intense fear and avoidance of one or more specific social situations generally involving the possibility of being watched and evaluated and of doing something embarrassing |
|
|
Term
| ____________ is defined as persistent fear of a circumscribed object or situation other than fear of having a panic attack or of humiliation or embarrassment in certain social situations |
|
Definition
|
|
Term
| what are the 5 main types of specific phobias? |
|
Definition
1. Animal Type: Animals or insects
2. Natural Environment Type: Storms, heights, water, etc.
3. Blood-Injury-Injection Type
4. Situational Type: Public transportation, tunnels, bridges, elevators, flying, driving, enclosed spaces, etc.
5. Other Type: Choking, vomiting, falling, illness, loud sounds, clowns, etc. |
|
|
Term
| why does the BII (blood-injury-injection) type of specific phobia not exactly fit in with the rest? |
|
Definition
| because the physiological response is very different. people actually pass out upon sight of these things due to vagus nerve discharge when HR is high --> vasovagal syncope |
|
|
Term
| true or false: all phobias except BII are specifically heritable |
|
Definition
| false. most phobias tend to be heritable but not specific (ie if your mom has a phobia you are more likely to have a phobia but not necessarily the same one) but BII is specifically heritable |
|
|
Term
|
Definition
| Recurrent obsessions or compulsions severe enough to be time-consuming (>1 hr / day) or to cause significant distress or impairment. Insight (reality testing) is usually maintained, although it may fluctuate. |
|
|
Term
| ____________ are intrusive, recurrent, ego-dystonic ideas, thoughts, impulses, or images accompanied by feelings of tension and dread. |
|
Definition
|
|
Term
| what is though-action fusion? What disorder is this associated with? |
|
Definition
| The idea that thinking about some event increases the likelihood of its actual occurrence. Associated with OCD. |
|
|
Term
| ___________ are repetitive behaviors (overt or cognitive) designed to prevent or relieve distress. |
|
Definition
|
|
Term
| why are compulsions negatively reinforced in OCD patients? |
|
Definition
| because they lead to a temporary reduction of distress produced by obsessive thoughts |
|
|
Term
| what are some common obsessions? |
|
Definition
-contamination
-doubt
-harming people
-violating social taboos
-violent or disturbing thoughts or images |
|
|
Term
| what are some common compulsive rituals? |
|
Definition
-cleaning
-symmetry and orderliness
-repeating, checking, counting, touching
-confessing
-hoarding? may become separate in DSM 5, generally have poor insight |
|
|
Term
|
Definition
| Syndrome developing after a “traumatic event” which elicited intense fear, helplessness, or horror. Onset may be immediate or delayed. |
|
|
Term
| what are some of the main symptoms associated with PTSD? |
|
Definition
-re-experiencing the event in vivid dreams, flashbacks or intrusive thoughts
-avoiding stimuli associated with the event
-numbness of emotional responsiveness
-increased arousal |
|
|
Term
| why is PTSD unique in the DSM? |
|
Definition
| because it requires a specific etiology |
|
|
Term
| what are some major criticism of PTSD? |
|
Definition
difficult to define what constitutes a "trauma", this continues to broaden and change with time (bracket creep)
etiology should be specifically and strongly associated with the disorder, not the case. |
|
|
Term
| what is acute stress disorder? |
|
Definition
| Similar to PTSD with an emphasis on dissociative sx (derealization, depersonalization, memory difficulties). Sx develop and resolve within one month. (If sx persist, the dx is typically changed to PTSD). |
|
|
Term
| ______________ appears to be a strong predictor of later PTSD |
|
Definition
| peritraumatic dissociation |
|
|
Term
| true or false: all anxiety disorders display significant heritability and show little shared environment effect |
|
Definition
| true. GAD 38%, panic 32%, animal phobia 26%, social phobia 17%, OCD 25%-70% (wide range from different studies) |
|
|
Term
| In Ledoux's high-road, low-road theory the ______ road is quick and dirty (unconcious) and the ______ road is slow and detailed (concious) |
|
Definition
|
|
Term
| what are the three NT systems linked to anxiety and fear? |
|
Definition
| seratonin, norepinepherine and GABA |
|
|
Term
| the _________________ in the pons contains about 50% of the NE cell bodies in the brain |
|
Definition
|
|
Term
The LC is under strong inhibitory control from _____ receptors
|
|
Definition
|
|
Term
| Central NE activity enhances _____________, ________________ and _____________ |
|
Definition
vigilance,
attention, memory |
|
|
Term
| α2 antagonists (e.g., yohimbine) are ____________ in humans, while α2 agonists (e.g., clonidine) are ____________ |
|
Definition
|
|
Term
| Why are there implications for the treatment of traumatic memories with β-blockers (e.g. propranolol)? |
|
Definition
| Because central NE activity is necessary for the creation of emotional memories |
|
|
Term
SSRI’s (selective serotonin reuptake inhibitors), which block 5-HTT
(the serotonin reuptake transporter; a.k.a. SERT), are ______________
acutely but _____________ when administered chronically |
|
Definition
|
|
Term
| For which anxiety disorders are SSRIs widely prescribed? |
|
Definition
| OCD, PTSD, social phobia and panic disorder |
|
|
Term
SERT is encoded by a gene (SLC6A4) with a tandem repeat polymorphism in the
promoter region called ____________ and has 2 alleles, ____ and ____ |
|
Definition
| 5-HTTLPR(5-HTT-Linked Promoter Region), L (long) and S (short) |
|
|
Term
true or false: L carriers display greater amygdala activation to emotionally provocative
stimuli than S carriers |
|
Definition
| false. S carriers display greater amygdala activation even though the short allele is less active. |
|
|
Term
Developmental disruption from diminished 5-HTT activity is __________
, whereas chronic 5-HTT inhibition in adults is generally _____________ |
|
Definition
|
|
Term
| 5-HT1A (autoreceptor) agonists (e.g., buspirone) are (anxiolytic or anxiogenic)? |
|
Definition
| anxiolytic, meaning that inhibiting 5-HT release reduces anxiety |
|
|
Term
| How do benzodiazepine (BZD) ligands affect the release of GABA? |
|
Definition
because Ionotropic GABAA
receptor is structurally linked to a
benzodiazepine (BZD) binding site--a GABA-BZD receptor complex. GABA’s inhibitory effect is therefore modulated by the type of ligand present at the BZD
binding site |
|
|
Term
| What is the heritability rate of panic disorder? |
|
Definition
| 32-48% with the rest being accounted for by non-shared environmental influences (no environment or epistasis factors) |
|
|
Term
| what are some findings linking panic disorder and 5-HT? |
|
Definition
1. finding that there is a SNP in
SLC6A4 that is fairly strongly and specifically associated with panic disorder
2. finding that 5-HT1A reduced by
1/3 in anterior and posterior cingulate and by 41% in Raphé nucleus of panic
patients |
|
|
Term
| what is the hyperventilation theory of panic disorder? |
|
Definition
| that hyperventilation-induced hypocapnia (decreased levels of CO2 in the bloodstream) causes acute anxiety |
|
|
Term
| what is the suffocation false alarm theory of panic disorder? |
|
Definition
that panic patients suffer from an
overly sensitive suffocation detector (or asphyxiostat) which is triggered by trivial increases in bloodstream CO2 |
|
|
Term
| true or false: smoking increased risk for later development of panic disorder |
|
Definition
|
|
Term
|
Definition
| The expression of psychological distress in the form of physical symptoms. |
|
|
Term
| what are somatoform disorders? |
|
Definition
| a group of disorders in which no organic etiology can be determined for physical symptoms (disorders in which somatization plays a central role) |
|
|
Term
| ________________ is a somatoform disorder in which a pt has multiple, chronic, unexplained symptoms that begin before the age of 30 |
|
Definition
| somatization disorder or briquet's syndrome |
|
|
Term
| true or false: somatization disorder is highly comorbid with personality disorders (esp. histrionic, antisocial and borderline) |
|
Definition
|
|
Term
| _______________ is disorder in which the pt holds the obsessive belief that they have a serious disease due to misinterpretation of physical symptoms. this belief is not alleviated with medical assurance otherwise . |
|
Definition
|
|
Term
| ________________ is characterized by a preoccupation with pain in the absence of physical findings which account for its existence or its intensity |
|
Definition
|
|
Term
| what is undifferentiated somatoform disorder? |
|
Definition
Diagnosis given to medically4unexplained
physical sx conditions that do not meet the
full criteria for another somatoform disorder |
|
|
Term
| what is conversion disorder? |
|
Definition
A loss of, or deficit in, voluntary motor or sensory
function which cannot be accounted for by physical
findings |
|
|
Term
| what are common symptoms in conversion disorder? |
|
Definition
| paralysis, gait or coordination disturbances, anesthesias, partial or complete blindness, deafness, aphonia (inability to speak), convulsions |
|
|
Term
| _____________________ is characterized by an excessive anxious preoccupation with an imagined or trivial defect in appearance |
|
Definition
| body dysmorphic disorder (dysmorphophobia) |
|
|
Term
| what are some common symptoms related to body dysmorphic disorder? |
|
Definition
| covering of the problematic area, obessive grooming or mirror checking, multiple medical visits and procedures, social withdrawl |
|
|
Term
| what is facticious disorder (aslo called munchusens disorder)? |
|
Definition
| a disorder in which a person brings physical symptoms upon themselves and then procedes to feign illness. appears that the person does this attract wanted attention although person is thought to be concious only of mechanism and NOT of motivation |
|
|
Term
|
Definition
| a disorder very similar to that of facticious disorder but in which it is presumed that the person is aware of BOTH mechanism and motivation |
|
|
Term
| what are 3 etiological theories hypothesized for somatoform disorders? |
|
Definition
1. sick-role enactment
2. self-handicapping
3. perceptual augmentation/cognitive misinterpretation |
|
|
Term
| true or false: somatoform disorders are highly comorbid with depression and anxiety disorders |
|
Definition
|
|
Term
| what is the essential feature of dissociative disorders? |
|
Definition
: Disturbance in
the normally-integrated functions
of consciousness, memory,
identity, and perception of the
environment. |
|
|
Term
| true or false: dissociative disorder symptoms are always gradual and persistent |
|
Definition
| false. they can be gradual or sudden in onset and may be transient or persistent |
|
|
Term
_____________ is characterized by the inability to recall important personal information, usually of a traumatic or stressful nature, that is: a) too extensive to be explained as normal forgetting; and b) medically
unexplained |
|
Definition
|
|
Term
| what are the primary types of dissociative amnesia? |
|
Definition
1. Localized: Inability to recall specific periods, events, or parts of events
2. Generalized: Inability to recall entire life history, including identity. If
accompanied by sudden, unexpected travel, this type of amnesia is called fugue |
|
|
Term
| what is dissociative fugue? |
|
Definition
| similar to dissociative amnesia but characterized by sudden, unexpected travel paired with confusion about identity or assumption of a new identity |
|
|
Term
| what is depersonalization disorder? |
|
Definition
A disorder characterized by persistent or recurrent episodes of depersonalization or
derealization (i.e., a change in usual sense of reality about
one’s self or one’s environment). Reality testing remains
intact (i.e., the experience is “as if”). Onset is sudden. |
|
|
Term
| in what age group does depersonalization disorder usually occur? |
|
Definition
| adolescence or early adulthood |
|
|
Term
| depersonalization disorder patients show significantly higher metabolic activity in __________________ region associated with multimodal sensory integration |
|
Definition
| parietal-occipital-temporal junction |
|
|
Term
| what is dissociative identity disorder? |
|
Definition
| a disorder characterized by the presence of multiple personalities or personality states within one person accompanied by the inability to recall important personal information |
|
|
