Anxiety/Stress Disorders Flashcards
Define psychological disorder
A psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.
What is the manual grouping all psychological disorders?
Diagnostic and Statistical Manual of mental disorders (DSM-5): Manual published by the APA
Name the 3 potential areas of causes of psychological disorders
Genetic predisposition
Environmental factors
Psychological factors
Define genetic predispositions towards psychological disorder
decrease as the degree of relatedness does
• Identical twins (100% shared genes) - 48% of developing schizophrenia if one of the twins have it - because not one factor plays a role in disorders
• Varies from disease to disease: some are not genetically determined
Define environmental factors contributing towards psychological disorder
Life events, drugs, exposure, infections, family relations, etc
Name and define the 3 categories of psychological factors contributing towards psychological disorder
- Cognitive factors: how people think about themselves and the world, and life events
- Emotional factors: reactivity, ability to regulate emotions
- Behavioural factors: how people learn from the consequences of their actions and which behaviours people engage in depending on the life events they go through
Name the 5 types of studies observing the gene-environment interactions
Animal studies Family studies Adoption studies Twin Studies Molecular analysis
Define animal studies
expose animals of different genetic makeup to different environments
Define family studies
compare individuals at high risk for developing a disorder because they have a relative with the disorder, to people at low risk of developing the disorder. Also compares individuals who have moved to a new environment (immigrated) to those who haven’t
Define adoption studies
compare individuals who share the same parents but who were adopted in different families
Define twin studies
compare identical twins who have been reared in different environment in an effort to tease out the effects of genes versus those of the environment
Define molecular analysis
compare the effects of different environmental conditions across individuals with different genetic makeups
Define anxiety
An adaptive emotional state characterized by a feeling of worry or nervousness directed toward a future event, accompanied by a state of hyper vigilance.
• Source is often unknown
• Moderate amounts are adaptive/normal
Define fear
An adaptive emotional state triggered by an immediate and readily identifiable threat, which is associated with being startled, freezing, or escape.
• Source is clear
Define anxiety disorders
A group of psychological disorders whose symptoms include excessive anxiety, fear, and worry, which give rise to abnormally strong avoidance and escapist tendencies.
• Include phobias, panic disorder, and GAD
• Aware that their thoughts are irrational (did not lose touch with reality)
Describe the fear circuit and how it produces a fear response
amygdala is the center; involved in the learning and expression of fear
• Activates the HPA axis
○ Neurons in the hypothalamus secrete CRF (corticotropin-releasing factor), which binds to receptors in the pituitary gland
○ Results in the release of adrenocorticotropic hormone (ACTH) from the pituitary
○ ACTH binds on receptors on adrenal glands, which release cortisol and activate the fight/flight response
○ Hippocampus can reduce the response by inhibiting the release of CRH by the hypothalamus
How is the fear circuit impacted by anxiety disorders?
Amygdala’s response is exaggerated, and hippocampus fails to respond to the over activation of HPA axis
• Ex: social anxiety disorder: compared to a normal person, their amygdala will fire up a lot more than necessary when in front of social situations such as speaking up in class
Define the role and structure of the cingulo-opercular network in anxiety disorders
The cingulo-opercular network (anterior insula and dorsal anterior cingulate cortex (dACC))
• Involved in the detection of conflicts (ex: when a strong tendency to respond in a certain way is in opposition to performing a correct response)
Define the role and structure of the frontoparietal network in anxiety disorders
Frontoparietal network (anterior dorsolateral prefrontal cortex (aDLPFC) and medial cingulate cortex (MCC) and inferior parietal sulcus (IPS)) • Involved in cognitive control
Define the role and structure of the ventral attention network in anxiety disorders
Ventral attention network (ventrolateral prefrontal cortex (VLPFC) and tempoparietal junction (TPJ))
• Involved in stimulus-driven attention
Define the role and structure of the default mode network in anxiety disorders
Default-mode network (inferior-temporal cortex (IT), lateral parietal cortex (LP), posterior cingulate cortex (PCC), subgenular anterior cingulate cortex (sgACC), and medial prefrontal cortex (MPF)
• Active when a person’s mental activities are not focused on the external world (ex: when thinking about the past or planning for the future)
Name the 2 neurotransmitters involved in anxiety
GABA plays major role in anxiety
• Keeps in check the activity of the amygdala
• Benzodiazepines: GABA agonists - decrease anxiety
Serotonin also
• Target of many antidepressants
• Serotonin reuptake inhibitors (SSRIs) replaced benzos because they are less addictive
Define PTSD
A disorder observed in people having experienced a traumatic event that can be considered out of normal human experience.
Define intrusive syndrome
PTSD symptom consisting of intrusive thoughts (unwanted memories of the event), and nightmares
• Intense distress following these thoughts
How is PTSD impacting the prefrontal cortex?
Reduced activity in prefrontal cortex
• May account for cognitive symptoms (difficulties in concentration, attention and emotion regulation)
• May be responsible for intrusive syndrome
How is PTSD impacting the hippocampus?
Hippocampus may be reduced: role in the memory for contextual information is impaired
Circuit with hippocampus, locus coruleus, thalamus, medial prefrontal cortex is dysfunctional in PTSD
• Accounts for the reduced ability to process contextual info
How is PTSD impacting the amygdala?
Amygdala is of larger volume: overreaction in front of anxiety-inducing stimuli
How do people with PTSD differ in their levels of cortisol compared to people with anxiety disorders?
People with PTSD have no difference in levels of cortisol and in the functioning of the HPA axis
• In anxiety disorders, cortisol production from the adrenal glands during stress response is ultra sensitive
Which neurotransmitter do PTSD victims have more? Why?
Elevated levels of norepinephrine (which may be the result of amygdala over activity)
