Lecture 50: Overview of Anxiety Disorders Flashcards
What are types of anxiety disorders?
PTSD OCD Specific phobia Social phobia (Social anxiety disorder, SAD) Panic disorder Generalized anxiety disorder (GAD)
How can you use neuroimaging to diagnose anxiety disorders?
Current technology is useful for identifying average neural differences between groups of individuals with specific disorder without that disorder
What are specific phobias?
Being afraid of a certain thing
What are risk factors for specific phobias?
- Environmental risk factors (traumatic experience with stimulus)
- Genetic risk factors: Heritability = 43%
- Preparedness and the nonrandom distribution of fears and phobia
What are brain areas implicated in anxiety disorders?
Amygdala, insula, ACC
Where do neural changes occur in patients with specific phobia?
Left insula (more activity = more phobia) Anterior Cingulate Cortex (ACC)
What is the treatment for specific phobia?
One-session treatment (developed by Ost lollllllll)
- rapid and effective (mean treatment is 2.1 hr) - durable (after 4 years, much improved or recovered
What are the general characteristics of Social Phobia?
Fear of being in social situations in which one will be embarrassed or humiliated
What are the risk factors for Social Phobia?
Interaction of psychosocial and biological causal factors
a. temperamental factors (shy/timid) b. Genetic factors c. social fears/phobias in evolutionary context (don’t want to be ostracized from group or else you will die) d. cognitive variables - blushing
What are the areas of the brain implicated in SAD?
- decreased levels of insula, middle frontal gyrus, aCC, hippocampus (kind of counterintuitivie)
- Increases in dorsolateral/medial Prefrontal cortex, dorsal ACC
What is Nefazadone?
An SSRI
Used to treat SAD
-increases insula, middle frontal gyrus, ACC and hippocampus activity
-decreases dorsolateral medial PFC and dorsal ACC
What is agoraphobia?
Fear of crowded spaces or enclosed public places
What are the general characteristics of Panic Disorder (with, w/o agoraphobia)?
- persistent unexpected panic attacks
- fear of other attacks and/or concern about implications
- agoraphobia
What are the risk factors for panic disorder?
Genetic factors (heritability = 30-40%)
-heritability of agoraphobia = 67%
Interoceptive fears
-greater “fear of fear”
What is the cognitive theory of panic disorder?
- Trigger/stimulus
- Perceived threat
- Apprehension or worry
- Body sesnations
- Interpretation of sensations as catastrophic
- Perceived threat (circular)
What neural areas are implicated in panic disorder?
- Insula
- Anterior cingulate (detection of interoceptive stimuli)
- Periaqueductal gray matter
What is interoceptive stimuli?
Relating to stimuli produced within an organism
How do you treat panic disorder/agoraphobia?
- SSRIs, SNRIs, TCAs, benzodiazepines
- CBT
What does CBT do for panic disorder?
Decreased activity in hippocampus, ACC, cerebellum and pons (all connected to the amygdala)
Increased activity in medial PFC
What are the general characteristics of Generalized Anxiety Disorder (GAD)?
Excessive and uncontrollable worry for OVER 6 months
Additional symptoms like muscle tension, concentration problems, sleep problems
What are the risk factors for GAD?
- Genetic factors (neuroticism and depression)
- A functional deficiency of GABA
- Neurobiological differences between anxiety and panic
What is purpose of GAD?
Cognitive strategy go damapen emotional experience
Anxiety used to not feel emotion?
What are the neural correlates of GAD?
-dampened connectivity between amygdala subregions ACC/insula
-greater connectivity between amygdala and DLPFC
PFC implicated in GAD
