Dental Anxiety - Guillot Flashcards
Defensive behavior and physiological responses (defensive survival circuit) that you can’t control is what system
subcortical
Emotional fear/anxiety response (conscious feelings) that involves learning/working memory and motivates future behavior/survival is what system
cortical
Present-oriented state that’s
responding to an immediate threat
Fear
Future-oriented state that’s
responding to an anticipated threat
Anxiety
Fear and anxiety are both largely mediated by what nervous system
sympathetic
Frontal lobe located anterior to the cortical motor areas (“everything in the frontal lobe, except motor areas”)
PFC
what are the 4 regions of the PFC
dorsolateral PFC
ventromedial PFC
lateral OFC
medial OFC (part of limbic cortex)
What part of the PFC are these associated with:
Higher-order intellectual traits and behaviors (executive functions)
Analytical ability, problem solving, and mathematical ability, abstractions
Goal-directed behaviors, delaying gratification, planning
Rejection of inappropriate alternatives based on past experience (judgment,
foresight, decision making)
Regulatory role for pts to decide to engage in dental care, despite negative emotions
Conscious awareness of emotions
Dorsolateral PFC
What part of the PFC are these associated with:
Site of safety learning/fear extinction: turns OFF the amygdala with cognitive training (can inhibit fear response)
Closely linked to emotional behavior and basic drive states (personality, appropriate social conduct and emotional responses, motivation and drive)
Ventromedial PFC
what 2 regions of the PFC can down regulate the amygdala
dorsolateral and ventromedial PFC
Training or therapy to reduce the fear response:
Increases activity in the ______PFC and _______ PFC
Reduces activity in the _______
dorsolateral ; ventromedial
amygdala
Which region of the OFC preferentially activates with POSITIVE affect (deficient in anxiety disorders = fewer cells or less activity)
Medial
Which region of the OFC preferentially activates with NEGATIVE affect (excess in anxiety disorders)
lateral
Group of cortical and subcortical structures is what system
Limbic system
Limbic system regulates HOME, what is this?
Homeostasis: autonomics/ neuro-endocrine control (hypothalamus)
Olfaction (olfactory cortex)
Memory (hippocampus)
Emotion and drives (amygdala)
What gyrus modulates sensory perceptions related to emotional, motivational, and attentional changes
Anterior Cingulate Gyrus (ACC)
What anterior portion is part of the limbic system and is associated with the following:
Conscious experience of somatic sensations (interoceptive stimuli) aka being aware of your heart pounding as you sit down to take a big exam
Decision making integrates sensory inputs, emotions, interoceptive stimuli
Insula
The insula integrates sensory inputs, emotions, interoceptive stimuli with connections to the ________ and _________ PFC
ACC ; dorsolateral
The insula is often co-activated with _______ during emotional processing
amygdala
The hippocampal formation (HF) is located in the
medial temporal lobe
What is associated with memory and is crucial of making new memories
Hippocampal Formation (HF)
Memory is not stored in the _____ , it is process in the ______ , and then sent back to its specific area for _______
HF ; HF ; storage
Group of cells also located in the anteromedial temporal lobe, anterior to the HF is the
amgydala
What helps associate stimuli with emotional states
amygdala
Emotion + associated physiologic (autonomic, endocrine, and skeletomotor) responses
Emotional State
The amygdala/emotional states are mediated by what 3 things
limbic cortices
diverse cortical & subcortical connections
Associated with amygdala output to nucleus accumbens is related to _______ emotional responses
positive
The _________ is important in how we expecience fear
amygdala
Associated with amygdala
output to multiple areas and epileptiform discharges from
amygdala produce feelings
of fear or dread is related to _________ emotional responses
Negative/stressful (like fear)
Plays a key role in processing threats
Amygdala
_____ and ________ process potential threats and produce anxiety
ACC ; insular cortex
Plays a key role in “learned
helplessness”
Amygdala
Emotional states influence memory and learning; memories stir emotions of their original event
Amygdala
Collection of subcortical “ganglia” (misnomer because it’s in the CNS and should be called nuclei)
5 fundamental components that
modulate movement + nucleus
accumbens
Some of the 5 movement
nuclei are also associated
with emotional regulation
Basal ganglia
Hypnosis limits ______ processing
sensory
