Anxiety Flashcards
Name one difference between fear and anxiety:
Fear is a response to an imminent threat
Anxiety is the anticipation in preparation for a future threat
Name some of the Anxiety disorders:
- Specific phobia
towards a situation or object due to past bad experience with thing - Social anxiety disorder (social phobia)
Avoid all social situations - Panic disorder (sometimes + agoraphobia)
Brief moments of hyperventilation (im gonna die)
Places are avoided where painc happens - Generalised anxiety disorder
Obsessive-compulsive and related disorders
- Obsessive-compulsive disorder (OCD)
Trauma- and stressor-related disorders
- Posttraumatic stress disorder (PTSD)
For each anxiety disorder name the treatment:
Fear and avoidance and the 2 core symptoms of anxiety disorders
Whether genetic or environmental factors influence on human psychiatric disorders is of course a question of relevance.
First-degree relatives are most likely to have the same anxiety disorder as the proband (Fyer et al 1995), but first-degree relatives are also at increased risk for other anxiety disorders
What else is critical?
The environment
Gene-environment interactions:
If Twin A has a smaller hippocampus and has a bad experience in the army, do they have a high or low chance of developing PTSD?
High chance of developing PTSD
If Twin B has a normal hippocampus and has a bad experience in the army, do they have a high or low chance of developing PTSD?
Low chance of developing PTSD as their hippocampus is a normal size so they are not genetically pre-disposed.
If Twin B has a smaller hippocampus and has not had experiences in the army, do they have a high or low chance of developing PTSD?
Low chance of developing PTSD as there is not an environmental stressor triggering the disorder.
What type of conditioning is used to measure anxiety?
Classical fear conditioning
Phenomena: phobia, exposure therapy, desensitization
Which learning process involves a person/animal learning behaviour or response to avoid a negative or unpleasant stimulus?
Avoidance learning
- Reinforcement for the behaviour is the absence or removal of the stimulus.
(eg. how cows may learn to avoid an electric fence by walking around it to get to their food)
Explain Mowrers two-factor theory:
Fear to a stimulus (or object, situation) is acquired through classical conditioning
Dog – bite (CS-US) pairings. Presentation of the dog, fear response
Instrumental conditioning (avoidance learning) allows animals to escape bite or postpone encountering the aversive stimulus (dog).
CS+Response – No Shock (negative reinforcement)
Mowrer two-factor theory:
Why is Avoidance critical in the maintenance of anxiety?
Because each time subjects encounter the Conditioned Stimulus,
the thing that produces a fear response automatically,
they emit a response to avoid the Unconditioned Stimulus
(negative reinforcement).
When avoidance is high, subjects never experience whether the Conditioned Stimulus is followed by the Unconditioned Stimulus.
Which brain region is involved in the fear reaction to a threat (snake)?
Amygdala
- overactive in anxiety states
- heavily involved in extinction learning
However, current focus = “fear network” rather than a single structure
Humans can be measured by showing people
fearful faces and conditioned fear. We can measure this activity on a brain scan which shows which region has high activation?
High activation in amygdula
Which 2 brain areas are important for the extinction of fear?
Amygdula and Medial Frontal Cortex
What are the roles of the Amygdula and Medial Frontal Cortex in relation to fear extinction?
vmPFC Signal is increased as extinction progresses
while
Signal in amygdala reduces over extinction
Individuals High in Trait Anxiety Showed Increased Amygdala responsivity to which type of Cues?
Phasic Fear Cues
Also showed impoverished Pre-extinction
Ventral Prefrontal Cortical (vPFC) Activity
What is a visual stimulus paired with an electric shock called?
A Phasic Fear Cues
eg. sound or rat paired with electric shock
OCD patients failed to do what during reversal learning?
they failed to relearn new pairings of stimuli
(discriminate the following reversal)
But this was due to OVER activation of their PFC which was unlike other anxiety disorders that have hypoactivation (under) in the PFC
Overactivation of PFC in OCD patients to the safety signal presented (face not paired with shock)
Failure to reverse these contingencies
Name some of the types of pharmacological drugs used to treat anxiety:
Which drug prescribed for Anxiety induces independence and results in very bad withdrawal symptoms?
Benzodiazepines
- A sedative introduced in the 1960’s
- Acute treatment
- GABA receptor in brain
Which 2 drugs are non-sedative and are classed as uptake blockers?
SSRI’s and SNRI’s
- Both block the reuptake of Noradrenaline or Serotonin
- Neurochemicals are left in synaptic cleft for post synaptic neuron to carry on
Which drug is an anti-anxiety medicine (not an anti-psychotic medication) that treats symptoms of anxiety?
Buspirone
Which brain areas will result in anxiolytic drug effects of:
Drowsiness
Sedation
Confusion
Dependence and withdrawal symptoms
Stomach upset when given Benzos?
Activity in limbic cortex:
Amygdula, PFC and Hippocampus
Which health problem produces drug effects of:
Poor coordination
Walking unsteadily
Poor balance
Trouble with fine motor tasks when given Benzos?
Ataxia
Which brain areas will result in appetite-stimulant drug effects when given Benzos?
Ventromedial Hypothalamus
Serotonin pathways in the human brain:
Stems from the brain stem to the Amygdala and PFC
5-HT1A receptor
agonists may act to reduce what?
(e.g. in the Amygdala)
To reduce the 5-HT neuron activity
The imbalance in the 5-HT1A receptor is thought to contribute to anxiety symptoms.
Raphe nuclei are where its activation hyperpolarizes and reduces the firing rate of these cells, and thereby serotonin extracellular levels in its projection areas
Healthy volunteers with the short allele of the serotonin transporter (5HTTLPR) polymorphism show increased or decreased amygdala responses to fearful faces?
Short allele = show increased amygdala responses to fearful faces
In patients with depression, the amygdala response to fearful faces is reduced by which 8 week treatment (compared to placebo)?
8 week SSRI treatment
Which treatment works on the assumption that some fears (phobias)
are learned and therefore presentation (and/or imagination) of stimuli associated with a feared outcome will extinguish the fear and anxiety?
Psychological treatments – CBT and Exposure therapy
Which drugs enhance extinction in social, panic disorders, and acrophobia?
DCS
Explain Novel experimental treatments – Amnesia following memory retrieval:
Patient recalls the traumatic event in the lab
given a drug inducing amnesia
dampen the subsequent expression of that memory
preventing the memory from being restored in the brain
Novel experimental treatments – Amnesia following memory retrieval in PTSD
In PTSD, the strength of trauma can be considered as the result of overconsolidation of the memory for the traumatic event due to the action of stress hormones.
People who previously took the amnesia drug showed higher or lower heart rate and skin conducting autonomic responses?
Showed lowered heart rate and skin conducting autonomic responses
The blockade of these soon after the traumatic event (consolidation) decreases the likelihood of developing PTSD in the following 3 months
In the clinical literature, avoidance behaviours are called “safety behaviors”
What is the term used to describe a technique that is being trialed to diminish safety behaviours?
Safety behavior (SB) fading
