Flores anxiety Flashcards
Prevalence decreases with increased socioeconomic status
anxiety disorders
3 major neurotransmitters associated with anxiety disorders (which ones increase and which ones decrease)
(increase) noraderanaline,
(increase) serotonin
(decrease) GABA
what drugs increase noraderenaline and provoke frequent severe panic attacks?
beta adrenergic receptor agonists –> isoproterenol
alpha 2 adrenergic receptor antagonists –> yohibine
(Clonidine –> alpha 2 adrenergic receptor agonist so reduces anxiety)
acute stress causes an increase in serotonin in what areas of brain
prefrontal cortex, nucleus accumbens, amygdala, lateral hypothalamus
what drugs increase serotonin effects causing anxiety
McPP and fenfluaramine
also hallucinogens and stimulants like LSD and MDMA are associated with development of anxiety
what drug enhances the efficacy of GABA decreasing anxiety
benzos
at type A receptor
in the fear network : Viscerosensory info is conveyed to the ________ by the _____ and the ______
amygdala by the thalamus and primary viscerosensory cortices
In the fear network: contextual info is stored in the ________ and conveyed directly to the ______
hippocampus to the amygdala
Efferent pathways of amygdala relevant to anxiety , What brain regions causes:
physio and behavior arousal
locus cereleus by increasing NA
Efferent pathways of amygdala relevant to anxiety , What brain regions causes:
defensive behavior and postural freezing
periaqueductal gray regions
Efferent pathways of amygdala relevant to anxiety , What brain regions causes:
Activation of pHA (i think HPA), releasing adrenocorticoids
hypothalmic paraventricular nucleus
Efferent pathways of amygdala relevant to anxiety , What brain regions causes:
activation of sympathetic nerv system
lateral hypothalamic nucleus
Efferent pathways of amygdala relevant to anxiety , What brain regions causes:
influences in resp. rate and timing
parabrachial nucleus
the HPA axis physiological stress increases synthesis and release of ____
cortisol
what is the role of cortisol in stress
mobilizes and replenishes energy stores and contributes to increased arousal, vigilance, focused attn, and memory formation
the social learning model is part of the ________ theory and for what disorder?
behavioral
anxiety
GAD must have sever anxiety and worry about several events or activities for most days/ for how long?
at least a 6 month period
I GAD is associated with somatic symptoms how many needed? examples of symptoms
3 or more
muscle tension, irritability, difficulty sleeping, restlessness, easy fatigue, difficulty concentrating
waxing and waning is what prevents this illness from recovery
GAD
harboring panic disorder or major depressive disorder= =
GAD
GAD treatment:
psychotherapy
Pharm.
cognitive and existential
first line –> SSRIs
Benzos (short term)
Buspirone ***
Second line –> sedating antihistamines, betaadrenergic blocks, clonidine
Panic attack peaks within ____ min and lasts ______ needs ______ or more of specified symptoms
10 min
20-30 min/ >60 rare
4 or more
panic attacks vs panic disorder
panic disorder are recurrent unexpected panic attacks worry more than a month
________ patients have highest us of ERs of any psychiatric population
panic disorder
increase financial dependency because 70% quit or lose job/ many unable to drive further than 3 miles
panic disorder
Panic disorder treatment
first line: SSRIs
benzos + antidepressants
cognitive –> identify cognitive distortions and modify
and or
behavioral –> modify responses through exposure
1/3 of panic disorder patients also have
agoraphobia
patients with social phobia may release more __________ or ________ both centrally and peripherally than nonphobic or may be more sensitive to normal levels of them
norepinephrine and epinephrine
treatment for agoraphobia
first line SSRI
benzos
exposure therapy
treatment for specific phobia
exposure therapy
treatment for social phobia
first line: SSRI;s (paroxetine)
SNRI (venlafaxine), benzos, beta blockers, buspirone
exposure therapy
