18.4 - anxiety disorders

Question 1

what is anxiety

Answer 1

chronic fear that persists in the absence of direct threat

Question 2

what is anxiety a psychological correlate of

Answer 2

stress

Question 3

when is anxiety adaptive

Answer 3

if it motivates coping behaviours

Question 4

when do we say someone has an anxiety disorder

Answer 4

when feelings of anxiety become so severe that they disrupt normal functioning

Question 5

what’re all anxiety disorders associated with

Answer 5

1. feelings f anxiety like fear, worry

2. physiological stress reactions

Question 6

what are the examples of phsyiologcail responses associated with anxiety

Answer 6

1. tachycardia
2. hypertension (high BP)
3. nausea
4. breathing difficulties
5. sleep disturbances
6. high levels of glucocorticoids

Question 7

are anxiety disorders the most prevalent psychiatric disorders? what is the LTP?

Answer 7

Yes, between 14 and 34 percent

Question 8

are there gender diffexeneds in the prevalence of anxiety disrodrsd

Answer 8

yes, 2x female

Question 9

what is generalized anxiety disorder

Answer 9

characterized by stress responses and extreme feelings of anxiety and worry about a large number of different activities or events

Question 10

what are specific phobias

Answer 10

strong fear or anxiety about particular objects or situations - tend to try to avoid objects or situations they are phobic of

Question 11

what is agoraphobia

Answer 11

the pathological fear of public places and open spaces
- a specific phobia, but more incapacitating than most specific disorders phobias, and therefore has its own diagnostic category

Question 12

what is panic disorder

Answer 12

recurrent rapid onset attacks of extreme fear and severe symptoms of stress like choking, heart palpitations and shortness of breath

Question 13

which anxiety disorders do panic attacks occur in

Answer 13

panic disorder, GAD, specific phobias and agorpaphobia

Question 14

why is the role of experience in the onset of anxiety disorders typically so apparent

Answer 14

1. anx disorders are often triggered by identifiably stressful events
2. anx is often focused on particular objects or situations

Question 15

what is the heritability estimate of anx disorders

Answer 15

30-50% , higher concordance in monozygotic twins than dizygotic

Question 16

have we isolated any particular anxiety related genes

Answer 16

NOPE

Question 17

what are the three classes of drugs that are commonly prescribed for anxiety disorders

Answer 17

1. benzos
2. serotonin agonists
3. some antidepressants

Question 18

what are the two given examples of benzodiazepines

Answer 18

1. chlordiazepozide (librium)

2. diazepam (Valium)

Question 19

what other disorders are benzodiazepines prescribed for

Answer 19

1. insomnia disorders (as hypnotics)
2. anticonvulsants
3. muscle relaxants

Question 20

are benzodiazepines the most commonly prescribed psychoactive drug? what’s the % of American adults that take them?

Answer 20

Yes, around 10

Question 21

what are some of the adverse side effects of benzos?(6)

Answer 21

1. sedation
2. ataxia (disruption of motor activity)
3. tremor
4. naursua
5. withdrawal reaction that includes rebound anxiety
6. super addictive

Question 22

when should we prescribe benzos

Answer 22

only for short term use

Question 23

what is the mechanism of benzodiazepines

Answer 23

GABAa receptor agonists

Question 24

what serotonin agonist is used for the treatment of anx disorders, and what is its mechanism (including the specific receptor type)

Answer 24

buspirone - appears to have selective (SSRI) agonist effects at the 5-HT1A serotonin receptors

Question 25

what is the main advantage of buspirone over benzodiazepines

Answer 25

specificity - produces anxiolytic effects without producing ataxia, muscle relaxation, sedation and the other common side effects of benzos

Question 26

does buspirone have side effects

Answer 26

Yes, like dizziness, nausea, headache and insomnia

Question 27

wha is a major complication to studying anxiety disorders

Answer 27

the degree of comorbidity with other psychiatric disorders

Question 28

what is the comorbidity of anx for those with bipolar

Answer 28

47%

Question 29

what is the comorbidity of anx for those with MDD

Answer 29

53%

Question 30

what is consistent with the high comorbidity between anx and mood disorders (MDD)?

Answer 30

the fact that antidepressants like SSRIs and SNRIs are anxiolytic, and anxiolytic drugs are often effective against Clin depression

Question 31

what is consistent with the high comorbidity between anx and mood disorder (bipolar)

Answer 31

atypical antipsychotics and anticonvulsants which are often effective mood stabilizers are often used to treat anx disorders

Question 32

what is a weakness In animal models of anxiety disorder

Answer 32

they tend to involve animal defensive behaviours, implicitly assuming that defensive behaviours are motivated by fear and that fear and anxiety are similar affective states

Question 33

what are the three animal behaviours that model anxiety

Answer 33

1. elevated plus maze performance
2. defensive burying
3. risk assessment

Question 34

what is the elevated plus maze test

Answer 34

rats placed om a four armed plus sign shaped maze resting 50cm from the floor
two arms have sides, two have no side

• measure of anxiety is the proportion of time the rats spend in the enclosed arms rather than the open ones

Question 35

what its he defensive burying test

Answer 35

rats are shocked by a wired wrapped wooden dowel mounted on the wall of a familiar test chamber
- measure of anxiety - ammt of time the rats spend spraying bedding material from the floor of the chamber at the source of the shock with forward thhrusting movements of their head and forepaws

Question 36

what is the risk assessment test

Answer 36

after a single brief exposure to a cat on the surface of a lab burrow system, rats flee to their burrows and freeze, then engage in a bunch of a risk assessment behaviours, before their behaviour returns to normal
- measure of anxieyt- amount of time the rats spend in freezing and risk assessment respectively

Question 37

how have we validated the three animal models of anxiety

Answer 37

benzodiazepines reduce various indices of anxiety used in the test, while nonanxiolytic drugs fail to do so

Question 38

what is a potential problem with the ‘benzodiazepine reduces anxiety behaviours in animal models tf they have anxiety’ line of reasoning
what does this imply??

Answer 38

many cases of anxiety do not respond to benzodiazepiness, so these models may be models of benzodiazepine-sensitive anxiety, rather than anxiety proper
- models may not be sensitive the anxiolytic dugs that at by different (nonGABAnergic) mechanisms

Question 39

does buspirone have a reliable anxiolytic effect on the elevated plus maze tests? what does this seemingly support?

Answer 39

NOPE

- supports that animal models may not be sensitive the anxiolytic dugs that at by different (nonGABAnergic) mechanisms

Question 40

what do current theories of the neural basis of anxiety disorders rest on

Answer 40

the analysis of the therapeutic effects of drugs and their mechanisms

Question 41

what do we believe to be the neural mechanism of anxiety generally (at the synapse level)

Answer 41

deficits in GABAergicand serotonergic transmission

• ie, benzos (GABAa) = agonist
• buspirone, fluoxetine and paroxetine - serotonin agonist

Question 42

what other disorder has significant overlap of related brain structures with anxiety

• what are these areas (3)
• why is this overlap unsurprising (2)

Answer 42

MDD!

1. PFC
2. amygdala
3. hippo
4. comorbidity rates
5. mutual effectivity of treatments

Question 43

what is the main difference between the brain structure s involved in MDD and anxiety disorders

Answer 43

while they effect similar areas, MDD results in atrophy, while anxiety does not do so (only abnormal activity during emotional tasks).