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NPP > Chapter 17: Disorders of Anxiety and Impulsivity & Drugs Used for Treatment > Flashcards

Chapter 17: Disorders of Anxiety and Impulsivity & Drugs Used for Treatment Flashcards

1
Q

DSM-5 has reclassified the anxiety disorders into what 3 major categories?

A
  1. anxiety
  2. OCD and related disorders
  3. trauma related disorders (PTSD)
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2
Q

T/F: Anxiety is important for survival.

A

true; evolutionarily speaking, it warns us for possible danger and activates the fight-or-flight response, enabling us to cope with our environment

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3
Q

What percent of US adults suffer from anxiety? What is the female to male ratios?

A

19%

2:1

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4
Q

T/F: Anxiety is one of the most prevalent mental disorders.

A

true

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5
Q

What are some of the ways that anxiety can manifest?

A
  1. panic episodes
  2. phobia of specific stimuli
  3. excessive avoidance
  4. compulsive behavior (OCD)
  5. intrusive thoughts
  6. negative thinking patterns
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6
Q

What are symptoms of anxiety?

A

mental: excessive worrying, agitation, irritability, lack of concentration, sleep disturbances
physical: muscle tension, restlessness, increased heart rate, sweating
stress: fight or flight responses
physical: muscle tension, restlessness

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7
Q

Anxiety is usually […] with other psychopathologies, typically […]. This is due to […].

A

comorbid; clinical depression, overlapping symptoms

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8
Q

Anxiety responses could lead to pathological interactions among the following components in an escalating manner. Such as…

A

bodily responses, upsetting thoughts, ineffective behavior

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9
Q

Fear:

A

emotional response to clear or current danger

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10
Q

Anxiety:

A

apprehension (worry/nervousness) about possible future negative events or misfortune, and our ability to deal with them

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11
Q

Research on which neural mechanisms provided crucial insights on anxiety disorders mechanisms?

A

fear learning

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12
Q

Where in the brain is fear elicited?

A

amygdala

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13
Q

Urbach-Wiethe disease causes…

A

damage to the focal bilateral amygdala

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14
Q

The […] gets activated during fearful stimuli, and shows hyperreactivity in […] disorders such as […].

A

amygdala; fear-related; PTSD

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15
Q

Amygdala:

A

receives highly processed sensory and cognitive information from many other brain areas

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16
Q

What brain areas send information to the amygdala?

A
  1. sensory thalamus
  2. sensory and association cortical regions
  3. hippocampus
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17
Q

What part of the amygdala are inputs of information sent to?

A

lateral nucleus of the amygdala (LA)

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18
Q

Amygdala outputs that elicit emotional responses: List the brain areas.

A
  1. lateral hypothalamus
  2. dorsal motor nucleus of vagus
  3. parabrachial nucleus
  4. VTA, LC, PPN
  5. nucleus reticularis
  6. periaqueductal gray
  7. trigeminal and facial nuclei
  8. paraventricular nucleus of hypothalamus
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19
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the lateral hypothalamus.

A

sympathetic activation

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20
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the dorsal motor nucleus of vagus.

A

parasympathetic activation

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21
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the parabrachial nucleus.

A

increased respiration

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22
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the VTA, LC, PPN.

A

activation of DA, NE, and ACh

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23
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the nucleus reticularis.

A

increased reflexes

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24
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the periaqueductal gray area.

A

cessation of behavior

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25
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the paraventricular nucleus of hypothalamus.

A

ACTH release

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26
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the lateral hypothalamus.

A

increased heart rate, blood pressure, paleness, pupil dialation

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27
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the dorsal motor nucleus of vagus.

A

ulcers, urination, defecation

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28
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the parabrachial nucleus.

A

panting and gaping for breath

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29
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the VTA, LC, PPN.

A

behavioral arousal and increased vigilance

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30
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the nucleus reticularis.

A

increased startle response

31
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the periaqueductal gray area.

32
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the trigeminal and facial nuclei.

A

facial fear expression

33
Q

Amygdala outputs that elicit emotional responses: Component of emotional response of the paraventricular nucleus of hypothalamus.

A

glucocorticoid release (stress response)

34
Q

Amygdala outputs that elicit emotional responses: Physiological effect of the trigeminal and facial nuclei.

A

mouth open and jaw movements

35
Q

What are some fear responses?

A
  1. emotional response to sudden aversive events
  2. require activation of the lateral (LA) and basolateral (BLA) amygdala
  3. mediated via outputs from the central nucleus of the amygdala (CeA)
36
Q

What are some anxiety responses:

A
  1. emotional response when stimuli are less precise predictors of potential danger
  2. produces a state of sustained preparedness for an unclear danger and prolonged anticipation of unpleasantness
  3. LA and BLA activation still play fundamental roles of anxiety
    Mediated via the bed nucleus of the stria teminalis (BNST)
37
Q

[…] and […] share output to elicit fear/axiety responses. There are also connections between them that get altered in […].

A

CeA; BNST; anxiety disorders

38
Q

How long does it take for anxiolytics to take effect?

A

several weeks or months

39
Q

T/F: Antidepressants be used as anxiolytics.

A

true; there are shared symptoms in anxiety and depression

40
Q

Corticotropin-releasing factor (CRF) is released from the […] in response to […].

A

hypothalamus; stress

41
Q

What does the CRF activate?

A

rest of the HPA axis

42
Q

HPA axis stands for…

A

hypothalamus-pituitary-adrenals

43
Q

Noradrenergic involves which catecholamines?

A

epinephrine and norepinephrine

44
Q

Adrenals release […] which activates the […] in the brain.

A

epinephrine; locus coeruleus

45
Q

After activated by epinephrine. Locus coeruleus release […] into the […].

A

norepinephrine; amygdala

46
Q

Infusion into LC of the […] yohimbine produces arousal and fear responses in rats. This is because there is a […] of NE release into the […].

A

alpha2-autoreceptor antagonist; increase; amygdala

47
Q

Yohimbine can also produce […] in patients with panic disorder or […].

A

panic attacks; PTSD

48
Q

Veterans with PTSD have higher than normal…

A

circulating NE

49
Q

Beta-adrenergic receptors (postsynaptic):

A
  1. play roles in the formation of emotional memories
  2. by blocking postsynaptic beta-receptors in the amygdala right after emotional trauma, it may be possible to block the formation of traumatic memories
  3. beta-adrenergic antagonists are also being tested to disrupt already consolidated traumatic memories in PTSD patients
50
Q

Beta-blocker medication:

A

propanolol

51
Q

Propranolol:

A
  1. impairs consolidation of emotional memories

2. used to treat PTSD after car accidents

52
Q

Benzodiazepines are also known as…

53
Q

Benzodiazepines:

A
  1. psychoactive drugs that depress neural activity via GABA-A receptors
  2. inhibit neural firing in LC, thus reducing NE release, which could then reduce amygdala activity
  3. mechanism responsible for some anxiolytic effects of benzos
54
Q

Tricyclic antidepressants:

A
  1. act of several NT mechanisms
  2. can inhibit reuptake of NE
  3. can inhibit monoamine oxidation (MAOIs)
  4. effects enhance activation of presynaptic alpha-2 autoreceptors and eventually reduce NE release
55
Q

Administration of GABA of the GABA agonists […] into the amygdala has […] effects in animal tests of […].

A

muscimol; anxiolytic; anxiety

56
Q

Effect of GABA or GABA agonist administration can be reversed by…

A
  1. benzodiazepine (BDZ) binding site antagonist flumazenil

2. coadministration of the GABA antagonist bicuculline

57
Q

5-HT1a agonists: […] effects via […] actions.

A

anxiolytic; postsynaptic

58
Q

5-HT1a antagonists: […] effects via […] actions.

A

anxiogenic; postsynaptic

59
Q

SSRIs:

A
  1. first line of treatment for anxiety
  2. inhibits 5-HT reuptake, prolonging 5-HT effects
  3. reduce LC neural firing, this decreasing NE release and anxiety
  4. SSRIs are “tricky” because it can initially increase anxiety in the early phase of treatment for some
  5. long-term neuronal adaptations beyond the acute increase in 5-HT function are required for SSRIs’ effectiveness to reduce anxiety
60
Q

Benzodiazepines trade name:

A

valium or xanax

61
Q

Benzodiazepines treat which disorders?

A
  1. GAD
  2. panic disorder
  3. OCD
  4. social phobia
  5. alcohol withdrawal
  6. acute situational anxiety
62
Q

Trade name for tricyclic antidepressants:

A

tofranil and aventil

63
Q

What are tricyclic antidepressants used to treat?

A
  1. panic disorders
  2. GAD
  3. OCD
  4. PTSD
64
Q

Monoamine oxidase inhibitors trade name:

A

nardil and parnate

65
Q

MAOI are used to treat:

A
  1. social phobia

2. panic disorder

66
Q

SSRI tradename:

A

prozac, zoloft, paxil

67
Q

SSRIs are used to treat…

A
  1. social phobia
  2. panic disorders
  3. OCD
  4. PTSD
68
Q

Buspirone trade name:

69
Q

Anxiety disorders treated by busiprone:

A
  1. GAD

2. panic disorders

70
Q

Models of anxiety and PTSD:

A
  1. wet bedding
  2. flooded cage
  3. mild shocks
71
Q

Models of anxiety and PTSD: Stress = immobilization in […].

A

plastic cones

72
Q

Chronic stress transforms […] in many brain regions. There’s a […] in HPC and […] in amygdala.

A

dendritic arborizations; shrinkage; growth

73
Q

Stress produces a persistent enhancement in […].

A

fear conditioning

74
Q

Stress augments neural activity and fear-related signaling in the […].

NPP (9 decks)

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