Stress, Anxiety, OCD, addiction Flashcards
Stress
Physiological reaction to aversive or threatening situations that mobilize the body for fight or flight.
Stress triggers ____ (axons off the brain and spinal cord synapse on the heart) and ____ (hormone release) responses
Autonomic and endocrine
Stress is adaptive on the ___short/long term
Short
Stress can lead to ____ (feelings of fear, worry, or unease),
Anxiety
True or false : anxiety can come without stress
True (stress is linked to EXTERNAL trigger)
Anxiety is characterized by a persistent feeling of…
Apprehension or dread in situations that are not actually threatening
Stress activates the _____sympathetic/parasympathetic branch of autonomic nervous system
Sympathetic
Stress activates the ___ axis
HPA (Hypothalamus-Pituitary-Adrenal gland)
Sympathetic autonomic nervous system activation leads the _____ glands to release ____ and _____
Adrenal glands, epinephrine and norepinephrine
ACTH causes the ____ gland to release glucocorticoids, primarily cortisol.
Adrenal
The HPA axis increases/decreases glucocorticoid signaling in the blood ?
Increases
The ______ releases CRH/CRF (corticotropin-releasing hormone/factor), starting a chain reaction
Hypothalamus
CRH causes the _____ to secrete ACTH (adrenocorticotropic hormone).
Pituitary
Cortisol is associated with ___ level : it fluctuates in quantity in the blood based on the acuity of the ____.
Stress
Autonomic and hormone responses work together to ____decrease/increase heart rate, blood pressure, and blood flow (fight or flight response)
Increase
Glucocorticoids
A group of hormones (including cortisol) that are essential for survival.
Acting on nearly every tissue and organ in the body, glucocorticoids function to maintain _______
Homeostasis
2 types of changes the glucocorticoids react to
Normal & in response to stress circadian changes in metabolism
Glucocorticoids are ultimately controlled by the _____
Hypothalamus
Functions of glucocorticoids
Cardiovascular function, immune function, skeletal growth, reproduction, and cognition
2 ways glucocorticoids prepare the body for immediate action
- Making glucose and fat available for immediate use (no matter what insulin is doing)
- Increasing blood flow and arousal.
Functions that get reduced by glucocorticoids
Growth hormone signaling, sex hormone signaling and immune function
Persistent glucocorticoid signaling can lead to increase symptom severity for a variety of ___ ___
Mental illnesses
How can permanent glucocorticoid signaling worsen cardiovascular health ?
Increase blood pressure, heart rate, heart disease, and heart palpitations
Digestive problems caused by glucocorticoids
Ulcers, irritable bowel syndrome, and weight gain/loss
Impact of permanent glucocorticoid on muscle health
Increase muscle tension and damage muscle tissue
Impact of permanent glucocorticoid on fertility
May cause infertility or stop menstruations
What is steroid diabetes, a possible consequence of glucocorticoid signaling, ?
Hormone-induced damage of the pancreas : it stops releasing insulin, causing diabetes
There is tons of glucocorticoids in this area of the brain
Hippocampus
Too much glucocorticoids signaling can cause __ death in the hippocampus, leading to ___ loss
Cell death and memory loss
Stress ____ the immune system and _____ the healing of flesh wounds.
Weakens and slows
Posttraumatic stress disorder (PTSD)
Mental disorder that can develop after a person is exposed to one or more traumatic events
Symptoms of PTSD
- vivid and intrusive memories of the traumatic event (“flashbacks”) as well as recurrent dreams about the traumatic event
- active avoidance of stimuli associated with the trauma, and pronounced mental or physical distress in response to these stimuli
- hyperarousal and hypervigilance
- Persistent negative moods and feelings of hopelessness are common
PTSD is no longer classified as an anxiety disorder since it entails multiple emotions outside the fear and anxiety spectrum, including ___, ___, and ____
Guilt, shame and anger
True or false : Most people who experience trauma do not develop PTSD
True
The likelihood of developing PTSD increases with the number of _____
Traumatic events
Traumatic events at this time in life are more likely to cause PTSD.
Childhood
Rate of PTSD
About 10% of women and 5% of men experience PTSD at some point.
Percentage of PTSD due to genetics variation
30%
Main treatments for PTSD are…
CBT, group therapy, and medication
Selective serotonin reuptake inhibitors (SSRIs) are the first-line medications and benefit about ___ of people with PTSD
Half
PTSD has been associated with abnormalities in the __ __
HPA axis
PTSD symptoms severity negatively correlates with size of the ____ and parts of the ____
Hippocampus and prefrontal cortex
Anxiety disorders
Variety of psychological disorders characterized by unrealistic and unfounded fear and anxiety.
Symptoms of anxiety disorders
Expectation of an impending disaster, muscle tension, over activity of the autonomic nervous system, and continuous vigilance for danger.
True or false : People often have only one type of anxiety disorder
False : People often have more than one type of anxiety disorder
Prevalence of anxiety disorders
About 12% of people are affected by an anxiety disorder each year. Twice as common in women.
Anxiety disorders usually begin before the age of ___
25
Prevalence of social anxiety and phobias
10 %
Environmental risk factors for anxiety
History of child abuse and poverty
Comorbidities of anxiety disorders
Major depressive disorder, personality disorder, substance use disorder, dementia
Treatment for anxiety disorders
Lifestyle changes, behavioural therapy, and medications.
Medication used as first line treatment for anxiety disorders
SSRIs
Benzodiazepines
Treat anxiety, particularly in emergency settings, because of their rapid onset
Generalized anxiety disorder
Disorder characterized by excessive anxiety and worry serious enough to cause disruption of daily life
Social anxiety disorder
Characterized by excessive fear of being exposed to the scrutiny of other people, leading to avoidance of social situations in which they may be called on to perform
Panic disorder
Characterized by episodic periods of severe and unremitting terror.
Symptoms of panic disorder
Shortness of breath, irregular heartbeat, and other autonomic symptoms, accompanied by intense fear
Anticipatory anxiety
Fear of having a panic attack promotes anticipatory anxiety that sometimes leads to the development of agoraphobia
Agoraphobia
Fear of being away from home or other protected places
Obsessive compulsive disorder (OCD)
– repeatedly having certain thoughts (“obsessions”)
– a need to repeatedly check things or perform certain routines (“compulsions” or “rituals”) to an extent that it causes distress & impairs general functioning.
4 groups of OCD symptoms
Symmetry, cleaning, hoarding, and forbidden thoughts.
Beliefs of imbalance in OCD
Belief that there is some imbalance in the world, something is out of
place, as well as the idea that life cannot proceed as normal while the imbalance remains.
Compulsions
performed to seek relief from obsession-related anxiety, out of fear that something bad will happen if the ritualistic behaviour is not done properly.
Prevalence of OCD
About 2% (2x more common in women)
The onset of OCD symptoms is
typically ___sooner/later in females
Later (late teens)
Symptoms of OCD usually start before age __in both sexes.
25
Genetic factors account for ~__% of the variability in OCD risk
50
Environmental risk factors of OCD
History of child abuse or other adverse events, infections late in life.
Sometimes symptoms emerge after brain damage, particularly to the ___ ganglia, ____ gyrus, or ____ cortex.
basal ganglia, cingulate gyrus, or prefrontal cortex.
fMRI studies have found increased activity in the ____ lobes and _____ in patients with OCD
Frontal lobe and striatum
cognitive behavioral therapy (CBT)
Treatment for OCD that includes increasing exposure to what causes the problems while not allowing the repetitive behavior to occur.
Medication to treat OCD
Selective serotonin reuptake inhibitors (SSRIs)
Cingulotomy
OCD treatment, cutting of a fiber bundle between PFC and anterior cingulate.
Deep brain stimulation within ____ ___ area could reduce OCD symptoms
Basal ganglia
Addictive substances
Alcohol, opiates, cocaine, meth, nicotine, barbiturates, and benzodiazepines.
Some gene predispose people to becoming addicted to a ____ drug
Specific
Other gene variants increase the risk of developing _____ in general.
Addiction
Genetic factors account for ___% of the risk factors for alcoholism.
40-60%
In the United States, ___percent of the people drink 50 percent of the alcohol.
10
Problems with alcohol abuse include :
- automobile accidents
- liver disease (cirrhosis of the liver)
- heart disease and strokes
- pancreatitis and diabetes
- fetal alcohol syndrome
- Korsakoff’s syndrome
Reinforcement learning
Reinforcement learning is driven by the consequences of one’s behaviour.
Addictive drugs ____ positively/negatively reinforcer behaviour.
Positively
Reinforcement is most effective when the consequences of an action are _____
Immediate
The speed by which the brain perceives reinforcement is thought to explain the relative addictive potential of different ____
Drugs
All reinforcers, natural or otherwise, elicit dopamine release in the ___
Striatum
Part of the striatum in which most dopamine release happens
Nucleus accumben
The most addictive drugs ____slowly/rapidly increase dopamine signaling.
Rapidly
Alcohol addiction ____decreases/increases with year
Increases
Dependence
Refers to the physical symptoms of tolerance and withdrawal.
Tolerance and withdrawal can occur independent of an _____
Addiction
True or false : not all addictive drugs produce noticeable tolerance and withdrawal.
True
Tolerance
When a drug effect gets smaller with repeated administration, increasingly larger doses are needed to achieve the desired effect.
Cause of tolerance
Compensatory mechanisms that oppose the effect of the drug.
Withdrawal
Appearance of symptoms opposite to those produced by drug when the drug is suddenly no longer taken
Cause of withdrawal
Presence of compensatory mechanisms (that relate to drug tolerance)
Negative reinforcement
When a behaviour is reinforced by the removal (or reduction) of an aversive stimulus.
Why do some say addiction is partially maintained by negative reinforcement ?
After tolerance develops, people sometimes continue to take drugs simply to prevent or reduce withdrawal symptoms.
Drug cravings and addictive behaviours far outlast any _____ symptoms.
Withdrawal
True or false : When withdrawal goes away, people are still addicted.
True
A ____ of all cigarettes were smoked by the 7% of the population that had some form of mental illness.
third
High comorbidity of drug addiction
Schizophrenia, and ADHD
___ schizophrenics smoke cigarettes and nearly half are addicted to other drugs.
Most
Abnormalities in the prefrontal cortex and its interactions with the striatum and ____ neurons may be a common factor in substance abuse disorders.
Dopamine
Drug addicts sometimes show deficits on tasks that involved the ____, similar to people that have brain damage in this area.
Prefrontal cortex
What may take over the role of the prefrontal cortex ?
Basal ganglia
True or false : if you never do a behavior in a context, you won’t have an urge to do it in this context.
True
Naltrexone is a high affinity, slow onset, long-acting opioid receptor _____agonist/antagonist that is prescribed to alcoholics and opiate addicts for daily use.
Antagonist
How does Naltrexone reduce the high produced by opiates ?
By outcompeting opiates for the receptor binding site
Side effects of Naltrexone
Seems to reduce cravings for food, alcohol, and other drugs in some people.
Naloxone (Narcan) is an extremely rapid (and short lived) opioid receptor _____ that reverses the effects of an opiate overdose.
Antagonist
During an overdose, people lose _____ and stop breathing.
Consciousness
A naloxone injection can ____ reverse overdose effects and even elicit withdrawal symptoms (but it is cleared away within an hour).
Immediately
Main difference between Naltrexone and Naloxone (Narcan)
Naltrexone is slow acting, Naloxene is instantaneous
Methadone Potent
Opiate that has a slower onset and offset than heroin does : harder to withdraw from. It is a substitute for heroin that allows people to live more functional lives.
Methadone maintenance programs require people come into a clinic each day and drink …
A liquid form of methadone
Main difference between Methadone Potent and Heroin
Methadone potent is slower than heroin and easier to withdraw from
Buprenorphine is a high affinity, partial opioid receptor (half activates the receptor) _____agonist/antagonist
Agonist
Buprenorphine is commonly prescribed to treat ____ addiction
Opiate
Buprenorphine strongly binds to ____ receptors but produces only a weak psychological effect
Opoid
Buprenorphine blocks the effects of other ____.
Opiate
To reduce the potential for abuse (and allow people to take home pills of it), buprenorphine is mixed with a little _____ (a short-lived opiate receptor antagonist), which eliminates the euphoric rush.
Naloxone
Varenicline is a partial ____antagonist/agonist at nicotinic (acetylcholine) receptors that is prescribed to treat nicotine addiction.
Agonist
Deep ___ stimulation could treat mental illnesses and drug addiction
Brain
Transcranial magnetic stimulation (TMS)
Non-invasive procedure that uses magnetic pulses to stimulate areas of the cerebral cortex.
Since some benefits of TMS have been reported for a variety of mental conditions, it has been approved for the treatment of …
Major depression, OCD, smoking, and migraines.
