Chapter 17 - Anxiety Disorders, Autistic Disorder, Attention-Deficit/Hyperactivity Disorder, and Stress Disorders

Question 1

chronic fear that persists in the absence of any direct threat

Answer 1

anxiety

Question 2

when anxiety interferes with normal functioning

Answer 2

anxiety disorder

Question 3

Most prevalent of all psychiatric disorders

Answer 3

anxiety disorder

Question 4

Episodic periods of symptoms such as shortness of breath, irregularities in heartbeat, and other autonomic symptoms, accompanied by intense fear

Answer 4

panic disorder

Question 5

– a fear of having a panic attack; may lead to the development of agoraphobia.

Answer 5

anticipatory anxiety

Question 6

Excessive anxiety and worry serious enough to cause disruption in one’s life

Answer 6

generalized anxiety disorder

Question 7

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

Answer 7

social anxiety disorder

Question 8

possible cause of anxiety disorders: Variations in the BDNF

Answer 8

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).

Question 9

Prescribed for anxiety, hypnotics, anticonvulsants, muscle relaxants

Answer 9

benzodiazepines

Question 10

BDZs are GABA agonists:

Answer 10

• bind to GABAA receptor at a different site than GABA (unknown)
• increase action of GABA (inhibition)
• Amygdala contains high concentration of GABAA receptors

Question 11

GABAA receptors:

Answer 11

• 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

Question 12

selective agonist at 5-HT1A receptor

o Produces anxiolytic effects without producing ataxia, muscle relaxation, & sedation

Answer 12

Buspirone

Question 13

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

Answer 13

D-cycloserine

Question 14

A mental disorder characterized by obsessions and compulsions.

Answer 14

OCD

Question 15

• 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

Answer 15

obsession

Question 16

– feel that one is obliged to perform a behavior, even if one prefers not to do so
- 4 categories: counting, checking, cleaning, avoidance

Answer 16

compulsions

Question 17

Neurological disorder characterized by tics and involuntary vocalizations and sometimes by compulsive uttering of obscenities and repetition of the utterances of others

Answer 17

Tourette’s syndrome

Question 18

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

Answer 18

Cingulotomy

Question 19

destroys fiber bundle (internal capsule) that connects the caudate with the mPFC

Answer 19

Capsulotomy

Question 20

Genetic neurological syndrome in girls (arrest of normal brain development)

Answer 20

Rett syndrome

Question 21

Speech is not delayed and IQ is at least 70

Answer 21

Asperger syndrome

Question 22

Normal intelligence and social behavior, then sever regression into autism (around ages 2-10 years)

Answer 22

Childhood disintegrative disorder

Question 23

diagnosed if a child has some symptoms of PPD but not enough to meet specific criteria of ASD.

Answer 23

PDD not otherwise specified (PDD-NOS).

Question 24

intellectually handicapped individuals who display specific cognitive or artistic abilities

Answer 24

savants

Question 25

extracellular binding protein

Answer 25

NRXN1

Question 26

an intracellular scaffolding protein that binds indirectly to NLGNs through PSD95

Answer 26

SHANK3

Question 27

a frequent occurrence that shows autistic features that have been correlated with the absence of SHANK3, which is normally localized to this chromosome.

Answer 27

Terminal 22q deletion syndrome

Question 28

Neuroligin and Animal Model

Answer 28

-NL3 Human mutation knock-in mouse
o Selective deficit in social interaction

-NL4 knockout mice
o Selective deficit in social interaction

Question 29

Mutation in the sequence of a single gene can cause Rett syndrome. (MeCP2)

Answer 29

Rett syndrome

Question 30

Prenatal exposure to: (causes of autism)

Answer 30

-	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

Question 31

Postnatal exposure to MMR: (causes of autism)

Answer 31

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)

Question 32

Potential causes of ASD – Environment:

Answer 32

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

Question 33

peptide that serves as a hormone and neuromodulator, facilitates pair bonding and increases trust and closeness to others

Answer 33

oxytocin