Disorders Pt. 4

Question 1

Generalized Anxiety Disorders (GAD)

Answer 1

Where a person for no obvious reason is tense and uneasy.
- Jittery, on edge, sleep deprived
- Fixate on potential threats
- Concentration suffers
- Constant ANS arousal
- Must persist for 6 months or more
- Two-thirds of women affected; one-
third of men affected

Question 2

Panic Disorder

Answer 2

Involves the experience of panic attacks, or sudden episodes of intense dread, and fears about the next episode’s unpredictable onset
- Frequently accompanied by
feeling flushed, irregular
heartbeat, chest pains, shortness
of breath
- 3% experience recurrent panic
attacks
- Ironically, anxiety about having a
panic attack can cause panic
attack
- Comorbid with agoraphobia

Question 3

Phobias

Answer 3

When a person is intensely or irrationally afraid of something
-Common phobias: Particular
animals, insects, heights, blood, or
closed spaces
- Most deal with phobia by avoiding
triggers

Question 4

Anxiety Disorder Treatments

Answer 4

• Psychotherapy, typically cognitive
  behavioral therapy (CBT)
• Exposure therapy
• Medication (SSRIs)
• Benzodiazepines (but not
  recommended for routine use)
• Aerobic exercise
• Hypnosis
• Biofeedback
• Acupuncture
• Self-help groups

Question 5

Post Traumatic Stress Disorder (PTSD)

Answer 5

• PTSD can develop after a terrifying
  event that involves physical harm or
  the threat of physical harm (e.g. war,
  assault, accident, disaster)
• Stress-related reactions linger for 4
  weeks or longer, don’t improve over
  time (or get worse), and interfere
  with daily life
• Victims and witnesses can develop
  PTSD
  
  • CLEAR environmental
    cause/factor
  • Genetic/other factors unknown

Question 6

PTSD & Memory

Answer 6

• People with PTSD continue to feel terrified & stressed long after they are no longer in danger

PRIMARY THEORY: overlearning of
fearful events by
amygdala

• Correlated with a smaller hippocampus

Question 7

PTSD Treatment

Answer 7

• CBT
• Prolonged exposure
• Cognitive processing therapy
• Medications can also be helpful, typically SSRIs
  
  • Sometimes beta-blockers or
    benzodiazepines may be
    prescribed for acute situations as
    well
  • For treatment-resistant PTSD use
    of MDMA in phase 3 clinical trials,
    to be completed in 2022

Question 8

OCD

Answer 8

Affects 2-3% of the population
OBSESSIONS: intrusive & distressing
thoughts
- Contamination/cleanliness
- Perfectionism (e.g. need for
symmetry)
- Fear of harm to self or others
- Hoarders
COMPULSIONS: stereotyped &
ritualistic behaviors
- Washing/cleaning
- Checking
- Repeating
- Two main peaks in the age of onset
- In childhood ~ 11 years
- In early adulthood ~ 23 years
- The cause of OCD is unclear,
however, it appears to be
correlated with abnormal
functioning of the basal ganglia
along two main pathways

Question 9

Treatments for OCD

Answer 9

• Only 10-15% recover on their own
• Therapy is most effective, especially
  cognitive-behavioral therapy (CBT)
• Medication can help (e.g. SSRIs)
• Cingulotomy for severe treatment-
  resistant OCD (lesion to part of
  anterior cingulate cortex
• Deep Brain Stimulation (DBS)

Question 10

Tics, Twitches, & Snorts: Tourettes’s

Answer 10

• Often combined with OCD, and both
  involve abnormalities of the basal
  ganglia
  
  • Patients may fling arms, kick, or
    make violent movements
• Patients have heightened sensitivity to tactile, auditory, and visual stimuli
  
  • Diagnosed early at 6-7 years
  • Often comorbid with ADHD
• In twin studies, the affected twin has
  more dopamine receptors in the
  the caudate nucleus of the basal
  ganglia