Lecture 4 - Panic Disorder & Generalised Anxiety Disorder (GAD)

Question 1

Agoraphobia

Answer 1

Fear of leaving familiar surroundings due to the possibility of having a panic attack in public.

Question 2

Amygdala

Answer 2

Brain structure involved in the emotional processing of threats.

Question 3

Anxiety Sensitivity

Answer 3

Fear of anxiety symptoms and related sensations.

Question 4

Benzodiazepines

Answer 4

Class of drugs that slow down the CNS, used for short-term anxiety relief.

Question 5

Catastrophic Misinterpretations

Answer 5

Interpreting bodily sensations or events as far worse than they actually are.

Question 6

CBT (Cognitive Behavioural Therapy)

Answer 6

A type of therapy that helps individuals identify and change negative thought patterns and behaviours.

Question 7

CRH (Corticotropin-Releasing Hormone)

Answer 7

Hormone released by the hypothalamus that stimulates cortisol release.

Question 8

GABA (Gamma-aminobutyric acid)

Answer 8

The main inhibitory neurotransmitter in the brain.

Question 9

Hippocampus

Answer 9

Brain structure involved in learning emotional responses and forming memories.

Question 10

Interoceptive Conditioning

Answer 10

Classical conditioning of a panic response to internal bodily sensations.

Question 11

Locus Ceruleus

Answer 11

Major source of norepinephrine in the brain.

Question 12

Panic Attack

Answer 12

Sudden onset of intense panic with multiple physical symptoms of stress.

Question 13

Panic Disorder

Answer 13

A disorder characterized by recurrent, unexpected panic attacks and subsequent fear of further attacks.

Question 14

Safety Behaviours

Answer 14

Actions taken to avoid a perceived catastrophic outcome, often maintaining anxiety.

Question 15

Stimulus Control Treatment

Answer 15

A behavioural intervention for GAD that involves controlling the contexts in which worrying occurs.

Question 16

Tricyclic Antidepressants

Answer 16

Class of drugs that increase serotonin and norepinephrine levels, used to treat depression and anxiety.

Question 17

Differentiate between a panic attack and panic disorder.

Answer 17

A panic attack is a sudden onset of intense panic with multiple physical symptoms of stress, often accompanied by feelings of impending doom. Panic disorder is diagnosed when panic attacks occur frequently enough to cause significant difficulty in adjusting to daily life.

Question 18

Describe the role of the amygdala and hippocampus in the aetiology of panic disorder.

Answer 18

The amygdala is responsible for the emotional processing of threats, while the hippocampus plays a role in learning emotional responses and forming memories of panic attacks, contributing to anticipatory anxiety.

Question 19

Explain the concept of interoceptive conditioning and how it contributes to panic disorder.

Answer 19

Interoceptive conditioning is the classical conditioning of a panic response to internal bodily sensations (interoceptive cues). This can lead to agoraphobic avoidance as individuals attempt to prevent triggering these sensations. Safety behaviours, actions taken to avoid a perceived catastrophic outcome, can maintain this conditioning.

Question 20

What did Ohst & Tuschen-Caffier (2020) discover about catastrophic misinterpretations in panic disorder?

Answer 20

Ohst & Tuschen-Caffier (2020) found that patients with panic disorder exhibited significantly more catastrophic misinterpretations than those with other anxiety disorders or healthy controls, but only after physiological arousal was induced by watching a suspenseful film.

Question 21

Outline two different pharmacological approaches to treating panic disorder, including their potential side effects.

Answer 21

Tricyclic antidepressants increase serotonin and norepinephrine levels, potentially causing drowsiness, dry mouth, and blurred vision. Benzodiazepines slow down the CNS, offering short-term anxiety relief but with potential side effects like mild psychomotor and cognitive impairments, and a risk of addiction.

Question 22

What is the cardinal diagnostic feature of generalised anxiety disorder (GAD)?

Answer 22

Pathological worrying, perceived as uncontrollable and closely associated with catastrophising (magnification), is the cardinal diagnostic feature of GAD.

Question 23

Explain the roles of GABA and CRH in the neurochemical understanding of GAD.

Answer 23

GABA, the main inhibitory neurotransmitter, calms the nervous system and inhibits amygdala activity. Low GABA levels are implicated in GAD. CRH stimulates cortisol release, increasing alertness. Elevated CRH contributes to the heightened stress response in GAD.

Question 24

Describe how attentional bias modification is used in the treatment of GAD.

Answer 24

Attentional bias modification uses a modified dot-probe task where the probe consistently appears in the same position as a neutral word. This trains the individual to attend more rapidly to neutral stimuli, reducing the attentional bias towards threat and subsequently decreasing negative intrusive thoughts and worry.

Question 25

What is stimulus control treatment and how is it applied to GAD?

Answer 25

Stimulus control treatment is a behavioural intervention for GAD that involves controlling the contexts in which worrying occurs. Individuals learn to identify and differentiate worrisome thoughts from necessary or pleasant thoughts related to the present moment, thereby limiting worry to specific times and places.

Question 26

Briefly discuss the combined approach to treating GAD.

Answer 26

A combined approach using both pharmacological and CBT interventions is often recommended for treating GAD. Medication, such as SSRIs, may provide immediate management of symptoms, while CBT and self-help programmes offer long-term coping strategies. The specific approach depends on the severity of the case.