Anxiety Disorders Flashcards
Describe the Yerkes-Dodson Curve for anxiety.
It’s the anxiety-performance curve that shows that some level of anxiety is required fo peak performance, but too much anxiety will cause performance to deteriorate
What are the three categories of anxiety-related disorders in the DSM?
anxiety disorders
obsessive compulsive and related disorders
trauma and stressor-related disorders
What are the major anxiety disorders from the DSM we dsicussed?
panic disorder agoraphobia specific phobias social anxiety disorder generalized anxiety disorder separation anxiety disorder substands or med-induced anxiety due to a medical condition
What must a person experience to be given the diagnosis of a panic disorder?
a panic attack
what does a panic attack entail?
a brief episode of intense fear accompanied by multiple physical symptoms that ocur repeatedly and unexpectedly in the absence of any external threat
What can we assume is the cause of panic attacks?
abnormal arousal of the fight or flight response
What other medical condition are panic attacks mot often confused for?
cardiac issues - heart attacks especially
What is agoraphobia?
it’s the anxiety of leaving the house and entering public places or feared situations
True or false, panic disorder is comorbid with all cases of agoraphobia.
false - they are separate disorders and can exist on their own, but it is ocmmon to see them together
What is the life prevalence rate for panic disorder? agoraphobia?
PD: 1.5%
AG: 2.7-5.8%
In what gender is panic disorder more comon?
women
What is the usual age of onset for PD?
late teens to early 30s, less prevalence in older people
What is social anxiety?
an intense fear of being humiliated in social situations - specifically with speaking in front of people
What is the lifetime prevalence of social phobia and when is the onset?
3-13% pretty high!
onset typically during childhood around 16 yrs
Although specific phobias can often lead to panic attacks, how are they different from panic diorder?
with phobias you know the trigger and with PD you don’t
A diagnosis of a phobia requires that the patient recognize the fear is…
excessive and unreasonable
In what gender are phobias more common? Prevalence rate?
women
5-12%
What is the obsessive part of OCD characterized by?
obsessive, disturbing thoughts, impulses, or images which cause an overwhelming anxiety (like contaminations, violent images, fear of harming oneself, sexual impulses, etc)
What characterizes the compulsion part of OCD?
actual behaviors - they are repetitive, ritualized acts that the person feels driven to perform to alleviate the anxiety caused by the obsessions
In addition to obsessions and compulsions, what must be present for a person to be diagnosed with OCD?
these have to be time consuming and\/or cause marked distress or impairment
plus th eperson has to recognize they’re unreasonable
What is the life prevalence of OCD? Onset?
2-3%
onset in childhood but treatment is usually sought later in life
What are the three general characteristics of PTSD?
re-experiencing the trauma
avoidance of things that remind of trauma
hyper-vigilance and exagerated startle response
WHat is the life prevalence rate for PTSD? How about in at risk individuals?
4%
at risk: 3-58% depending on proximity
What sort of conditioning is likely involved in development of PTSD?
operant conditioning (or TWO FACTOR LEARING THEORY)- a neutral stimulus gets tied to a negative stimulus causing a negative response
How is the avoidance behavior reinforced in PTSD?
avoiding the trigger is reinforced by the reduction of anxiety it yields - it’s negative reinforcement
How is the two stage operant conditioning model used in OCD?
the obsession causes the anxiety (the negative stimulus) and the compulsion is negatively reinforced by reducing the anxiety
How do the following neurochemistry systems affect anxiety - increase or decerease?
GABA, 5HT, NE, CRH, Adenosine, Neuropeptides, Lactate and CO2 (glucose met byproducts)
GABA - decrease
5HT - decrease
NE - increase
CRH - increase
adenosine - decrease (so don’t take caffeine)
neuropeptides - depends (opioids decrease)
glucose met - increase
How do the following neuroanatomical correlates affect anxiety?
amygdala, locus coeruleus, raphe, periaqueductal gray, hypothalamus, orbitofrontal cortex, hippocampus?
amygdala - icnrease
LC - NE release, so increase
Raphe- 5HT increase, so decrease
central gray - increase
hypothalamus - increase via ANS
orbitofrontal cortex - decides whether to panic
hippocampus - memories involved in anxiety
In what striatal nucleus is metabolic activity increased in OCD>
in the caudate nucleus and orbital gyrus (also frontal cortex in general)
What anatomical structure shrinks in PTSD?
hippocampus
What is the most effective treatment option for PTSD (and OCD, and phobias)?
exposure therapy
you expose them to the trigger and prevent the avoidance or compulsion
What is involved in CBT for anxiety disorders?
- identify triggers
- educate about triggers
- learn how to deal with triggers without safety behaviors
What pharmacological options are there for anxiety disorders?
benzodizaepines (barbs not used anymore), TCAs, SSRIs
