ANXIETY D/Os Flashcards
Earliest lvl of anxiety
Disintegration anxiety
- fear that the self will fragment because others are not responding with needed affirmation and validation
perception that the self is being invaded and annihilated by an outside malevolent force
Persecutory anxiety
linked to the oedipal phase
father, may damage the little boy’s genitals or otherwise cause bodily harm
Castration anxiety
guilt feelings about not living up to internalized standards of moral behavior derived from the parents
superego anxiety
no specifically identifiable stimulus exists for a chronically anxious feeling
generalized anxiety
persons experience feelings of living in a purposeless universe
Existential Theories
Chronic sx (panic attacks, insomnia, startle, autonomic hyperarousal)
NOREPINEPHRINE
Stimulation of this area in the brain causes fear response
Locus ceruleus (in the rostral pons)
B-adrenergic receptor agonists and a2-adrenergic receptor antagonists
provoke severe panic attacks
clonidine (Catapres), an a2-receptor agonist
reduce anxiety sx
increased from psychological stress
mobilize and replenish energy stores and contributes to increased arousal, vigilance, focused attention, and memory formation
inhibition of the growth and reproductive system; and containment of the immune response
Cortisol
Alterations in ____ function have been demonstrated in PTSD.
HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS
blunted adrenocorticoid hormone (ACTH) responses to corticotropin-releasing factor (CRF) found in px with?
Panic DO
One of the most important mediators of the stress response
CORTICOTROPIN-RELEASING HORMONE (CRH)
coordinates the adaptive behavioral and physiological changes that occur during stress
CORTICOTROPIN-RELEASING HORMONE (CRH)
Hypothalamic levels of ___ are increased by stress, resulting in activation of the HPA axis and increased release of cortisol and dehydroepiandrosterone (DHEA)
CORTICOTROPIN-RELEASING HORMONE (CRH)
inhibits a variety of neurovegetative functions, such as food intake, sexual activity, and endocrine programs for growth and reproduction
CORTICOTROPIN-RELEASING HORMONE (CRH)
Different types of acute stress result in increased ____ turnover
no clear pattern of abnormality of this in panic disorder
5-hydroxytryptamine (5-HT)
cell bodies of most serotonergic neurons are located in?
Raphe nuclei (in the rostral brainstem)
Role in anxiety disorders is most strongly supported by the undisputed efficacy of benzodiazepines
GABA
enhance the activity of GABA at the GABA type A (GABAA ) receptor, in the treatment of some types of anxiety disorders
benzodiazepines
low-potency benzodiazepines are most effective for __ while high-potency benzodiazepines are for __
GAD
Panic DO
autonomic nervous system symptoms of anxiety disorders are induced when __ is administered
also causes anxiety in normal control volunteers
B-carboline-3-carboxylic acid (BCCE)
a neurotrans model based on a sea snail that reacts to danger
when classically conditioned, shows measurable changes in presynaptic facilitation = the release of increased amounts of neurotransmitter
Aplysia
a highly conserved 36-amino acid peptide, which is among the most abundant peptides found in mammalian brain.
Neuropeptide y (NPY)
has counterregulatory effects on corticotropin-releasing hormone (CRH) and LC-NE systems at brain sites that are important in the expression of anxiety, fear, and depression
Neuropeptide y (NPY)
Evidence suggesting the involvement of the ___ in the anxiolytic effects of NPY, occuring via the NPY-Yl receptor
Amygdala
Preliminary studies in special operations soldiers under extreme training stress indicate that high levels of this are associated with better performance
Neuropeptide y (NPY)
a peptide involved in a number of physiological and behavioral functions, including learning and memory, pain control, food intake, neuroendocrine control, cardiovascular regulation, and, most recently, anxiety
Galanin
Studies in rats have shown that ___ administered centrally modulates anxiety-related behaviors.
Galanin
These 2 may be novel targets for antianxiety drug development
Galanin and NPY receptor agonists
Brain Imaging Studies - structural studies i.e. CT and MRI - show increase in size of ___ among anxiety DOs
cerebral ventricles
lobe affected in patients with panic disorder.
right temporal lobe
fMRI (PET, SPECT, EEG) - show abnormalities in these brain regions of px w/ anxiety DO
For panic DO, at:
frontal cortex; the occipital and temporal areas
Parahippocampal gyrus
Involved in pathophysio of OCD
caudate nucleus
Involved in pathophysio of PTSD and assoc w/ FEAR
amygdala
recognized as a predisposing factor in the development of anxiety disorders
Heredity
project primarily to the limbic system and the cerebral cortex
become the focus of hypothesis-forming about the neuroanatomical substrates of anxiety disorders
locus ceruleus and the raphe nuclei
increased activity of this in the limbic sys. may lead to anxiety
septohippocampal pathway
part of the limbic sys implicated particularly in the pathophysiology of OCD
cingulate gyrus
Frontal cerebral cortex is connected with (3) and thus may be involved in the production of anxiety disorders
parahippocampal region, the cingulate gyrus, and the hypothalamus
temporal lobe epilepsy assoc with
OCD
