anxietate

Question 1

What is anxiety?

Answer 1

Anxiety is the fear caused by anticipation of danger; threat is not actually present.

Question 2

What is fear?

Answer 2

An adaptive response to a realistic threat or potentially threatening stimulus.

Question 3

What is the DSM 5 diagnosis for anxiety?

Answer 3

Excessive worry or fear occurring more days than not, for at least 6 months

At least 3 symptoms or more:
- restlessness
- sleep disturbances
- muscle tension

Question 4

What are the commonalities among types of anxiety disorders?

Answer 4

There are different types of anxiety disorders such as PTSD and OCD.

They all share symptoms of fear and worry
They engage similar brain areas
They result in similar cognitive impairments
They can be treated with the same drug

Question 5

What are the symptoms of anxiety?

Answer 5

2 types: noticeable and hidden

eg:

Noticeable: mouth goes dry

Hidden: adrenaline produced for flight and fight

There are also other effects such as poor concentration, negative thinking

Question 6

what are the circuits in the brain that are related to anxiety

Answer 6

the shortcut
the high road

Question 7

1. What is the shortcut that anxiety takes in the brain?

Answer 7

stars off with info gathered from outside world- visual stimuli that enter eye and reach thalamus. from thalamus they go to amygdala

When startled, the brain activates the amygdala.
The amygdala alerts other brain structures.
The result is a fear response: sweaty palms

Question 8

2. What is the high road path that anxiety takes in the brain?

Answer 8

stimulus enters eye and reach thalamus, then processed through cortical areas that will then reach amygdala and from there we continue in a similar way to reach rest of body via the messages that are sent to the spinal cord

Sensory information reaches the thalamus.
The thalamus sends the information to the visual cortex.
The visual cortex analyses the raw data and decides whether they require a fear response.
If yes, the cortex signals the amygdala and the body stays on alert.

Question 9

1. How is anxiety induced by over-activation of shortcut?

Answer 9

short cut is over activated

Amygdala typically over-activated in response to stimuli if not regulated by GABA.

Question 10

what is evidence that amygdala is overactivated in people with anxiety

Answer 10

imaging studies
amygdala more activation in patients with anxiety when ppts are shown negative images as opposed to neutral images

Question 11

activity in the amygdala is not modulated by the intensity of the stimuli

Answer 11

Anxious patients do not distinguish between the intensity of fearful stimuli.

Non-anxious participants: more fearful stimuli = more activation of amygdala

Anxious participants: similar activation of amygdala regardless of the intensity of fearful stimuli.

Question 12

2. How is anxiety induced by under-activation of high-road?

Answer 12

high road less active

less able to make use of informed processes that allow to make more specific response to the extent to which a stimulus is really dangerous

diminished activation of regions that are part of high road - frontal regions

Activity in frontal areas is reduced in anxiety.
Therefore frontal regions do not downplay the amygdala which does not reduce the over-activation.

Less activity in frontal areas with increase of anxiety.
therefore more activity in amygdala with increase of anxiety

Question 13

What does anxiety do in the brain?

Answer 13

Increases amygdala activity and decreases prefrontal activity.

Question 14

What are the main neurotransmitters involved in anxiety?

Answer 14

Nerepinephrine
Serotonin
Dopamine
GABA

Question 15

What is the effect of anti-anxiety medications?

Answer 15

They promote GABA and serotonin effects so that amygdala is less activated and anxiety is reduced.

Question 16

What does GABA do?

Answer 16

inhibitory role

It controls the activity of the amygdala by inhibiting its reaction to potentially threatening stimuli

If GABA is deficient the amygdala is not downregulated and response to stimuli is amplified
If the process repeats, anxiety occurs

Question 17

How do anti-anxiety medications work for GABA?

Answer 17

They block the re-uptake of GABA. - blocks transporter

They increase GABA effect at receptors
So activity in brain areas controlled by the amygdala is normalised

Question 18

How do anti-anxiety medications work for serotonin?

Answer 18

Block serotonin re-uptake so serotonin can be present longer
So activity in brain areas controlled by the amygdala is normalised.

Question 19

How is anxiety maintained?

Answer 19

maintaining memories that are kinked to adverse event

• Amygdala is linked to the hippocampus (memory hub)
• Memory of stimuli associated with anxiety are stored in the hippocampus
• Info about anxiety-provoking memories is sent to the amygdala which is over-activated
• Anxiety reaction is consolidated

Question 20

What is the optimal performance for anxiety?

Answer 20

Too little or too much anxiety affects performance.
Middle ground is ideal for optimal performance.

Question 21

What cognitive abilities are impaired due to anxiety?

Answer 21

impaired cognitive abilities are likely to be those modulated by amygdala or frontal areas - since these areas are impaired in anxiety

Attention and focus
Learning and recall
Perception
Word finding

Question 22

cognitive performance and anxiety task - perception

Answer 22

emotional stroop task

ppts read word or colour of word

words either neutral or emotional

ppts with high anxiety might take longer or make more errors in processing words which have negative emotional valiance

ppts with high anxiety took longer to process negative stimuli as opposed to neutral ones

negative meaning of words can interfere with processing something like colour

Question 23

how does anxiety affect attention

Answer 23

attention based task
stimulus detection

how can emotional stimuli modulated attention in stimulus detection task

ppts presented with 2 words, 1 negative, 1 neutral

a probe was presented either where the negative word was or neutral

ppts detected position of probe as fast as they could

ppts took longer to detect the probe when it was on the same side as the negative key word

Question 24

why is memory retrieval reduced in anxious patients

Answer 24

brain areas responsible for memory formation - hippocampus

hippocampus is affected by anxiety

hippocampus is related to hypothalamus that is involved in releasing chemicals like cortisol

prolonged cortisol release associated with anxiety becomes toxic for the hippocampus

new memories are difficult to generate

Question 25

How is cognitive performance affected by anxiety?

Answer 25

Memory is poorer in anxious patients.
Memory is affected by emotional context at encoding.
E.g.: patients with high anxiety recalled more words when the words were presented on a negative background than on a neutral background.