Chapter 17 - Anxiety Disorders, Autistic Disorder, Attention-Deficit/Hyperactivity Disorder, and Stress Disorders Flashcards
chronic fear that persists in the absence of any direct threat
anxiety
when anxiety interferes with normal functioning
anxiety disorder
Most prevalent of all psychiatric disorders
anxiety disorder
Episodic periods of symptoms such as shortness of breath, irregularities in heartbeat, and other autonomic symptoms, accompanied by intense fear
panic disorder
– a fear of having a panic attack; may lead to the development of agoraphobia.
anticipatory anxiety
Excessive anxiety and worry serious enough to cause disruption in one’s life
generalized anxiety disorder
Excessive fear of being exposed to the scrutiny of other people that leads to avoidance of social situations in which the person is called upon to perform
social anxiety disorder
possible cause of anxiety disorders: Variations in the BDNF
Val66Met allele of the BDNF gene impairs extinction of conditioned fear in animals and humans, atypical activity of frontal cortex-amygdala circuitry (decreased activity of vmPFC during extinction).
Prescribed for anxiety, hypnotics, anticonvulsants, muscle relaxants
benzodiazepines
BDZs are GABA agonists:
- bind to GABAA receptor at a different site than GABA (unknown)
- increase action of GABA (inhibition)
- Amygdala contains high concentration of GABAA receptors
GABAA receptors:
- Chemicals that active one of the known sites (neurosteroid site) also increase GABAA activity.
- During anxiety attacks synthesis of neurosteroids (& activity of GABAA receptor is suppressed).
- XBD173 (drug that increases neurosteroids) and thus, activity of GABAA receptor
- Reduces panic, no sedation or withdrawal
selective agonist at 5-HT1A receptor
o Produces anxiolytic effects without producing ataxia, muscle relaxation, & sedation
Buspirone
indirect NMDA agonist
- In conjunction with cognitive behavioral therapy
- Facilitated treatment of acrophobia, social anxiety, panic disorder
- Augments the ability of cognitive behavior therapy to extinguish fear responses
D-cycloserine
A mental disorder characterized by obsessions and compulsions.
OCD
- unwanted thought or idea with which a person is preoccupied
- Concern or disgust with bodily secretions, dirt, germs, etc, fear that something terrible might happen, need for symmetry, order, or exactness
obsession
– feel that one is obliged to perform a behavior, even if one prefers not to do so
- 4 categories: counting, checking, cleaning, avoidance
compulsions
Neurological disorder characterized by tics and involuntary vocalizations and sometimes by compulsive uttering of obscenities and repetition of the utterances of others
Tourette’s syndrome
surgical destruction of specific fiber bundles in the subcortical frontal lobe, including the cingulum bundle (PFC with limbic cortex) and a region that contains fibers that connect the BG with PFC
Cingulotomy
destroys fiber bundle (internal capsule) that connects the caudate with the mPFC
Capsulotomy
Genetic neurological syndrome in girls (arrest of normal brain development)
Rett syndrome
Speech is not delayed and IQ is at least 70
Asperger syndrome
Normal intelligence and social behavior, then sever regression into autism (around ages 2-10 years)
Childhood disintegrative disorder
diagnosed if a child has some symptoms of PPD but not enough to meet specific criteria of ASD.
PDD not otherwise specified (PDD-NOS).
intellectually handicapped individuals who display specific cognitive or artistic abilities
savants
extracellular binding protein
NRXN1
an intracellular scaffolding protein that binds indirectly to NLGNs through PSD95
SHANK3
a frequent occurrence that shows autistic features that have been correlated with the absence of SHANK3, which is normally localized to this chromosome.
Terminal 22q deletion syndrome
Neuroligin and Animal Model
-NL3 Human mutation knock-in mouse
o Selective deficit in social interaction
-NL4 knockout mice
o Selective deficit in social interaction
Mutation in the sequence of a single gene can cause Rett syndrome. (MeCP2)
Rett syndrome
Prenatal exposure to: (causes of autism)
- Prenatal exposure to: o thalidomide (morning sickness), o valproic acid (anticonvulsant) or o rubella infection in the mother o these mainly act in 1st 8 wks
Postnatal exposure to MMR: (causes of autism)
o Parents often first become aware of autistic symptoms around the time of vaccinations (MMR) and so a great deal of speculation surrounded thiomersal (preservative having mercury) as causative in ASD. However, overwhelming evidence of properly controlled studies found no connection. Authors of paper were found guilty of dishonesty by UK General Medical Council, journal retracted claims (The Lancet)
Potential causes of ASD – Environment:
Thalidomide – given early in pregnancy – increases chance of autism
o Indicates neurodevelopmental error occurs within 1st few weeks of pregnancy when motor neurons of the cranial nerves are developing
o Consistent with observed deficits in face, mouth, and eye control
- Anomalies in ear structure indicate damage occurs between 20 and 24 days after conception
peptide that serves as a hormone and neuromodulator, facilitates pair bonding and increases trust and closeness to others
oxytocin
