Anxiety Disorders

Question 1

Describe the Yerkes-Dodson Curve for anxiety.

Answer 1

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

Question 2

What are the three categories of anxiety-related disorders in the DSM?

Answer 2

anxiety disorders
obsessive compulsive and related disorders
trauma and stressor-related disorders

Question 3

What are the major anxiety disorders from the DSM we dsicussed?

Answer 3

panic disorder
agoraphobia
specific phobias
social anxiety disorder
generalized anxiety disorder
separation anxiety disorder
substands or med-induced
anxiety due to a medical condition

Question 4

What must a person experience to be given the diagnosis of a panic disorder?

Answer 4

a panic attack

Question 5

what does a panic attack entail?

Answer 5

a brief episode of intense fear accompanied by multiple physical symptoms that ocur repeatedly and unexpectedly in the absence of any external threat

Question 6

What can we assume is the cause of panic attacks?

Answer 6

abnormal arousal of the fight or flight response

Question 7

What other medical condition are panic attacks mot often confused for?

Answer 7

cardiac issues - heart attacks especially

Question 8

What is agoraphobia?

Answer 8

it’s the anxiety of leaving the house and entering public places or feared situations

Question 9

True or false, panic disorder is comorbid with all cases of agoraphobia.

Answer 9

false - they are separate disorders and can exist on their own, but it is ocmmon to see them together

Question 10

What is the life prevalence rate for panic disorder? agoraphobia?

Answer 10

PD: 1.5%
AG: 2.7-5.8%

Question 11

In what gender is panic disorder more comon?

Answer 11

women

Question 12

What is the usual age of onset for PD?

Answer 12

late teens to early 30s, less prevalence in older people

Question 13

What is social anxiety?

Answer 13

an intense fear of being humiliated in social situations - specifically with speaking in front of people

Question 14

What is the lifetime prevalence of social phobia and when is the onset?

Answer 14

3-13% pretty high!

onset typically during childhood around 16 yrs

Question 15

Although specific phobias can often lead to panic attacks, how are they different from panic diorder?

Answer 15

with phobias you know the trigger and with PD you don’t

Question 16

A diagnosis of a phobia requires that the patient recognize the fear is…

Answer 16

excessive and unreasonable

Question 17

In what gender are phobias more common? Prevalence rate?

Answer 17

women

5-12%

Question 18

What is the obsessive part of OCD characterized by?

Answer 18

obsessive, disturbing thoughts, impulses, or images which cause an overwhelming anxiety (like contaminations, violent images, fear of harming oneself, sexual impulses, etc)

Question 19

What characterizes the compulsion part of OCD?

Answer 19

actual behaviors - they are repetitive, ritualized acts that the person feels driven to perform to alleviate the anxiety caused by the obsessions

Question 20

In addition to obsessions and compulsions, what must be present for a person to be diagnosed with OCD?

Answer 20

these have to be time consuming and\/or cause marked distress or impairment
plus th eperson has to recognize they’re unreasonable

Question 21

What is the life prevalence of OCD? Onset?

Answer 21

2-3%

onset in childhood but treatment is usually sought later in life

Question 22

What are the three general characteristics of PTSD?

Answer 22

re-experiencing the trauma
avoidance of things that remind of trauma
hyper-vigilance and exagerated startle response

Question 23

WHat is the life prevalence rate for PTSD? How about in at risk individuals?

Answer 23

4%

at risk: 3-58% depending on proximity

Question 24

What sort of conditioning is likely involved in development of PTSD?

Answer 24

operant conditioning (or TWO FACTOR LEARING THEORY)- a neutral stimulus gets tied to a negative stimulus causing a negative response

Question 25

How is the avoidance behavior reinforced in PTSD?

Answer 25

avoiding the trigger is reinforced by the reduction of anxiety it yields - it’s negative reinforcement

Question 26

How is the two stage operant conditioning model used in OCD?

Answer 26

the obsession causes the anxiety (the negative stimulus) and the compulsion is negatively reinforced by reducing the anxiety

Question 27

How do the following neurochemistry systems affect anxiety - increase or decerease?
GABA, 5HT, NE, CRH, Adenosine, Neuropeptides, Lactate and CO2 (glucose met byproducts)

Answer 27

GABA - decrease
5HT - decrease
NE - increase
CRH - increase
adenosine - decrease (so don’t take caffeine)
neuropeptides - depends (opioids decrease)
glucose met - increase

Question 28

How do the following neuroanatomical correlates affect anxiety?
amygdala, locus coeruleus, raphe, periaqueductal gray, hypothalamus, orbitofrontal cortex, hippocampus?

Answer 28

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

Question 29

In what striatal nucleus is metabolic activity increased in OCD>

Answer 29

in the caudate nucleus and orbital gyrus (also frontal cortex in general)

Question 30

What anatomical structure shrinks in PTSD?

Answer 30

hippocampus

Question 31

What is the most effective treatment option for PTSD (and OCD, and phobias)?

Answer 31

exposure therapy

you expose them to the trigger and prevent the avoidance or compulsion

Question 32

What is involved in CBT for anxiety disorders?

Answer 32

1. identify triggers
2. educate about triggers
3. learn how to deal with triggers without safety behaviors

Question 33

What pharmacological options are there for anxiety disorders?

Answer 33

benzodizaepines (barbs not used anymore), TCAs, SSRIs