Term
| What is the definition of anxiety? |
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Definition
| An unpleasant state of anticipation, apprehension, fear, or dread |
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Term
| What are the psychological symptoms of anxiety? |
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Definition
Fear
Worry
Nervousness
Derealization
Depersonalization |
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Term
| What is the definition of derealization? |
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Definition
| The world seems distorted or unreal |
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Term
| What is the definition of depersonalization? |
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Definition
| The body feels unreal or disconnected...what's happening isn't happening to you |
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Term
| What is the definition of derealization? |
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Definition
You can't make sense of what you're seeing.
Example of Dr. Jibson with his psychiatry boards...not being able to read |
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Term
| What are the physiological symptoms of anxiety? |
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Definition
Sweating
Dizziness
Hyperreflexia
Hyperventilation
Palpitations
Butterflies
Just think of what it feels like to ask someone out on a date! |
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Term
| What are the differences between normal and abnormal anxiety? |
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Definition
Normal: adaptive for the situation
Abnormal: maladaptive
-Disproportioate response
-Symptoms interfere with adaptation, life functions
Criteria:
Real threat/stress?
Is the response adaptive?
Is there subjective distress? |
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Term
| What is the center in the brain that responds to fear? |
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Definition
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Term
| What are the neuronal pathways that feed into the amygdala? |
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Definition
Thalamus and sensory cortex: sensory information
Hippocampus: contextual memory
Medial prefrontal cortex: mediation of the response |
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Term
| What are the specific functions of the hippocampus in anxiety? |
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Definition
Interpretation of sensory input: what does it mean?
Emotional valence of memories: associating certain smells with memories |
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Term
| What are the specific functions of the medial prefrontal cortex in relation to fear/anxiety? |
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Definition
Interpretation of complex stimuli
Extinction of conditioned fear
Declarative memory
Conscious learning |
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Term
| Where do outputs from the amygdala go? |
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Definition
Brainstem (locus coeruleus, raphenuclei)
Hypothalamus/HPA axis
Motor cortex |
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Term
| What hormone is released from the HPA axis in response to frightening stimuli? |
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Definition
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Term
| What neurotransmitters are involved in the normal fear response? |
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Definition
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Term
| Where are neurons releasing NE found? Where do they project to? |
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Definition
Locus coeruleus in the brainstem
Go to:
Frontal cortex
Limbic system
Brainstem
Spinal cord |
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Term
| Where are neurons releasing serotonin found? Where do they project to? |
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Definition
Raphe nuclei in brainstem
Project to:
-Cortex
-Limbic system
-Hypothalamus |
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Term
| Where are neurons releasing GABA found? What is the function of GABA neurons? Where do they project to? |
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Definition
GABA interneurons are found throughout the whole brain!
They're inhbitory interneurons
They also project all over the place |
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Term
| Where are neurons releasing CRH found? Where do they project? |
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Definition
Amygdala, locus coeruleus
Go to:
Hypothalamus
Cerebral cortex |
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Term
| What is the effect of Cortisol and CRH on neuroplasticity? |
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Definition
They block neuroplasticity, leading to memories that cannot be forgotten
Think of Jibson's story about the neurosurgeon |
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Term
| What are the different ways that anxiety can be induced? |
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Definition
Classical conditioning: there's a certain stimulus that always induces fear
Inhibitory avoidance: if you're repeatedly exposed to fear inducing stimuli in a certain context, you'll have pervasive anxiety in that context
Sensitization: early trauma leads to anxiety problmes |
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Term
| What is reconsolidation? How can this be used to advantage in therapy? |
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Definition
Reactivation of neural pathways stregthens memories and anxiety responses. In this process, there's a temporary destabilization with each activation.
You can use this therapeutically by presenting an anxiety-invoking stimuli and then have nothing bad happen. |
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Term
| What is extinction? How does it relate to anxiety? |
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Definition
Learning new memories and responses via the medial prefrontal cortex and sensory cortex
You can learn new memories to associate previously anxiety inducing behaviors with positive associations |
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Term
| What is the effect of stress on the locus coeruleus? |
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Definition
| Increase in noradrenergic activity; NE levels increase |
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Term
| What is the effect of stress on serotonin receptorz? |
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Definition
Decrease the levels
If you have early-life stressors, you can have permanent reductions in these guys.
Also, you have a baseline amount. |
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Term
| What is the association between GABA and anxiety? |
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Definition
| Anxiety is associated with decreased GABA activity in the brain |
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Term
| What is the association between anxiety and CRH? |
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Definition
| Increased anxiety--> increased amygdala CRH activity |
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Term
| What is the definition of a panic activity? |
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Definition
| A discrete period of intense fear/distress, accompanied by specific physical and psychological symptoms |
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Term
| What is the onset of a panic attack? |
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Definition
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Term
| How long does it generally take for peak symptoms of a panic attack to be reached? |
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Definition
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Term
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Definition
Anxiety about situations in which escape might be difficult or in which help would be available:
-Outside the home by yourself
-Afraid of being in a crowd
-Afraid of being on a bridge
These people literally never leave the house. |
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Term
| What symptoms are concurrent with agoraphobia? |
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Definition
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Term
| What is the definition of panic disorder? |
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Definition
| Recurrent panic attacks accompanied by at least 1 month of persistent concern about having another attack, or a change in behavior due to the attacks |
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Term
| What is the treatment for agoraphobia? |
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Definition
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Term
| What kind of person is at greatest risk for panic disorder WITH agoraphobia? |
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Definition
Women (instead of men) in young adulthood
There IS a genetic componenet |
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Term
| What is the definition of social phobia? |
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Definition
| Marked or persistent fear of embarrassment in social or performance situations, which is recognized as being excessive,and which interferes with the person's function |
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Term
| What is the kind of person who will have social phobia? |
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Definition
Shy kid
Women (more common than men) that first shows it in adolescence |
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Term
| How can you tell if an infant is going to have social phobia? |
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Definition
Set the kid on the table and CLAP!
If they react very strongly, they're more likely to have a problem with anxiety/social phobia |
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Term
| What physiologic state is associated with phobias? |
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Definition
| High degrees of autonomic arousal |
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Term
| What is the treatment for social phobias? |
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Definition
B-blockers
Behaviora therapy
Benzodiazepines
MAOIs |
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Term
| Is there a biologic component to phobias? |
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Definition
Yes.
If a 1st degree relative has it, the person is also more likely to have it. |
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Term
| What is the treatment for specific phobias? |
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Definition
Behavioral therapy is the most effective
If there's going to be a scheduled exposure, give the person a benzodiazapine |
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Term
| What are the core anxiety disorders? |
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Definition
Generalized anxiety disorder
Panic disorders with or without agoraphobia
Social anxiety
Specific phobias |
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Term
| What is the definition of obsessive compulsive disorder? |
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Definition
| Recurrent and persistent thoughts or behaviors that are recognized as being excessive and unreasonable, and either cause marked distress, are time-consuming, or interfere with the person's function |
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Term
| What is the definition of an obsession? |
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Definition
Recurrent and persistent thoughts, impulses, or images that are intrusive and disturbing
Ex. My mom's back will break |
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Term
| What is the definition of a compulsion? |
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Definition
Repetitive behaviors that the person is driven to perform in response to an obsession in order to reduce distress or prevent a feared situation
Ex. I'm afraid that my mom's back will break, so I can't step on a crack in the sidewalk, ever. |
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Term
| What is the onset of OCD in men? Women? |
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Definition
Men: early teens
Females: mid-twenties |
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Term
| What is the course of OCD? |
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Definition
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Term
| Is there a genetic component to OCD? |
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Definition
YES!
Monozygotic twins: 75% |
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Term
| What is the treatment for OCD? |
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Definition
SSRI's
Clomipramine
Psychosurgery - WOW! |
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Term
| What are major comorbities for OCD? |
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Definition
Major depressive disorder
Eating disorders
Panic disorder |
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Term
| What are the criteria for PTSD? |
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Definition
Follows a severe traumatic event
The person re-experiences the trauma through flashbacks, nightmares, or disturbing memories
Conscious/unconscious avoidance of stimuli associated with the trauma
Increased arousal
Symptoms > 1 month
Symptoms significantly interfere with a person's function |
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Term
| What people are at especially increased risk for PTST? |
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Definition
Females more than males
War experiences, sexual assault |
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Term
| What is the onset of PTSD symptoms? |
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Definition
Immediate (within 6 months of the trauma)
Delayed (more than six months after the trauma) |
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Term
| What are the problems that can occur concurrently with PTSD? |
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Definition
Suicide
Major depressive disorder
Substance abuse
Think about veterans. |
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Term
| What is the treatment for PTSD? |
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Definition
Behavioral therapy
SSSRIS
Tricyclic antidepressants
MAOIs |
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Term
| What is acute stress disorder? How can you differentiate this from PTSD? |
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Definition
Onset is within 1 month of the event and the symptoms side within 1 month of the onset
PTSD lasts for much longer and can set in more than 6 months after the event |
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Term
| What is the definition of generalizedanxiety dirorder? |
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Definition
Excessive anxiety/worry about several events/icues
At least 3 somatic/psychological symptoms
Lasting at least 6 months
Lack of ability to function |
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Term
| What is adjustment disorder? |
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Definition
Significant anxiety, worry, or nervousneess arising in response to an identifiable psychosocial stressor
onset must be within 3 months of stress
Symptoms must resolve within 6 months of onset |
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Term
| What is substance induced anxiety disorder? |
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Definition
Anxiety, panic attac,s or OC symptoms resulting from a substance ingestion/withdrawal
Think of Jibson and how he had anxiety when drinking coffee |
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