VC - Anxiety Flashcards
What are the biological pathways associated with Depression and Anxiety?
Depression: Mood pathway
Anxiety: Fear pathway
What is the definition focus for Depression vs. Anxiety?
Depression: Symptoms and duration of time are reported
Anxiety: Symptom classification and self-reporting
What brain pathways are involved in Depression and Anxiety?
Depression: Circuit level connectivity
Anxiety: Circuit level connectivity (including the amygdala)
What is the primary transmitter pathway associated with Depression and Anxiety?
Depression: Monoamines
Anxiety: GABA
What is the molecular target in the treatment of Depression and Anxiety?
Depression: Transmitter transporter
Anxiety: Inhibitory GABA receptor
What are the clinical confounds associated with treating Depression vs. Anxiety?
Depression: Side effects
Anxiety: Withdrawal and addiction
How is fear (3) distinguished from anxiety (3)?
Fear
- Physiological response
- Adaptive survival mechanism
- Context-appropriate
Anxiety
- Pathological
- Maladaptive response
- Context-inapproriate; responds to neutral/ambiguous cues
What is the physiological response in fear (5)?
- Hyper-arousal
- Increased heart rate
- Heightened sensory awareness
- Fight-or-flight response
- Enhanced metabolic readiness
What are the symptoms of anxiety as a pathophysiological state (6)?
- Increased heart rate
- Decreased salivation
- GI disturbances
- Hypervigilance
- Heightened startle response
- Autonomic symptoms
What are the similarities between fear and anxiety (5)?
- Both involve learning mechanisms and can be acquired through direct experience or observational learning.
- Each uses neuromodulatory pathways and involves cognitive processing.
- Both activate the autonomic nervous system, leading to physiological responses like increased heart rate and heightened alertness.
- Memory systems influence both, affecting how past experiences shape responses.
- Can lead to behavioral modification as individuals adapt or avoid perceived threats.
What are examples of anxiety disorders (9)?
- Panic attack
- Agoraphobia
- Specific phobia
- Social phobia
- Panic disorder
- Acute stress disorder
- Generalised anxiety disorder
- OCD
- PTSD
What are animal models used for in fear/anxiety research?
Fear Conditioning: Context and signal-based fear responses (e.g., freezing, heart rate measurement)
Purpose: To mimic human responses and assess fear circuits via contextual and sensory cues
Explain context conditioning in fear response.
Unsignaled Conditioning: An animal is placed in a blue box and receives an electric shock, causing a fear response. When placed in a different (purple) cage, no fear response occurs.
Signaled Conditioning: A bell rings right before an electric shock, creating an association between the sound and the shock. Later, even in a cage without shocks, the bell alone triggers a fear response.
How does the amygdala contribute to fear response (4)?
- Integrates information to create emotional response
- Links with hypothalamus, hippocampus, orbital cortex, etc
- Supports associative learning in fear circuitry
- There are both negative and positive modulations of the core fear centre
What roles do the Orbital cortex, Hippocampus, Central amygdala and Striatum play in fear and anxiety responses?
- Orbital Cortex: Involved in choice behavior and emotional memory
- Hippocampus: Responsible for learning and spatial memory
- Central Amygdala and Bed Nucleus of the Stria Terminalis: Controls autonomic responses and attention
- Striatum: Associated with avoidance behavior
What is the preferred treatment order for anxiety (5)?
- SSRIs (increase serotonin)
- Tricyclic antidepressants (increase serotonin, noradrenaline)
- Benzodiazepines (GABA potentiation)
- Anticonvulsants (e.g., valproate)
- Monoamine oxidase inhibitors (increase serotonin; less favored)
Drug treatment now commonly supported by Cognitive Behavioural Therapies encompassing relaxation approaches.
How do benzodiazepines function (5)?
- Act on GABA receptors as allosteric modulators
- Increase chloride influx, causing membrane hyperpolarization
- Affect GABA channels only when GABA is bound
- Agonists increase flux (anxiolytic)
- Inverse agonists decrease flux (anxiogenic)
What are the successes (4) and limitations (3) of benzodiazepines (BZ)?
Successes:
- Rapid-acting: Provides quick relief, unlike SSRIs which take 8-12 weeks.
- Broad receptor expression: Affects GABA receptors throughout the brain, including in the amygdala.
- Acts as an anxiolytic, sedative, hypnotic, and muscle relaxant through different GABA receptor types.
- High efficacy with limited toxicity compared to barbiturates.
Limitations:
- Can cause amnesia with prolonged use.
- Tolerance and withdrawal issues, leading to dependence.
- Primarily used for short-term or acute treatment.
Often tapered off gradually and combined with SSRIs for long-term management.
What are some non-drug therapies for anxiety (4)?
Psychoanalysis: Explores unconscious mind (mixed evidence)
Mindfulness: Focus on present; meditation affects brain state (mixed outcomes)
Cognitive Behavioral Therapy: Organizes thought processes (evidence of brain activity changes)
Family Therapy: Addresses life events and social context (variable outcomes)
