W12L2 - Anxiety and Decisions

Question 1

Define Anxiety and how it is different from fear

Answer 1

Share many common physiological features

• Anxiety
  
  • Sustained state of fear
  • Experienced in absense of direct physical threat and persist over longer period of time (6 months)
• Fear
  
  • Fear response elicited by specific stimuli and short-lived
  • Fear response decreases when threat is removed

Question 2

What are some DSM diagnostics of GAD

Answer 2

• Sustained
  
  • 6 Months
• Physiological Responses
  
  • Restlessness
  • Fatigure
  • Sleep Disturbances
  • Muscle tension

Question 3

How is conditioned fear diminshed. When can we classify “Treatment Success”.

Answer 3

Graded Desensitization Training

• Based on exctinction principles
  
  • Replace anxiety or fear response with relaxation response through classical conditioning
• Gradually associate, through repeated pairings, a fear-arousing stimulus with a state of relaxation, in a series of graded steps.
  
  • Treatment success is defined when phobia is not hindering daily life

Question 4

Can fear disappear after successful training? What are the 3 effect to describe this?

What is it interpreted as…?

Answer 4

Fear can return AFTER successful extinction training

• Time
  
  • Spontaneous recovery
• Context
  
  • Renewal effect
• Stress
  
  • Reinstatement effect

During extinction, “Fear memory” is interpreted as

• Not deleted/erased; but
• Inhibited

Question 5

Define “active coping”. What does “active coping” involve?

Answer 5

Definition

Actions that result in positive emotional outcomes and as a result, avoid negative consequence of fear

Involves:

• Awareness of stressor
• Attempt to reduce negative outcome

Question 6

What is reconsolidation?

How does it diminish conditioned fear expressions?

Answer 6

Alteration of original CS-US association stored in lateral amygdala

Consolidation

• Actively seek to disrupt formation of memory

Post-Consolidation

• Modify/inhibit (not eliminate) memory by actively retrieving
  
  • Reconsolidation period​: Act of retrieval makes the underlying memory trace fragile again, which provides another opportunity to disrupt memory, potentially allowing to block the memory completely

Question 7

What did animal studies demonstrate in regard to consolidation

Answer 7

• Blocking reconsolidation period with protein synthesis inhibitors
  
  • Specifically blocked reactivation of fear memories
  • While leaving other memories intact
• Fear memories did not return with time, context, or stress

Question 8

What did human studies demonstrate in regard to consolidation

Answer 8

• No safe drug (protein synthesis inhibitors) to block human reconsolidation
• Propanalol was the first drug used for experimental reconsolidation blocker
  
  • Unclear mechanisms
  • Most studies failed to show clear beneficial effecs in human studies

Question 9

What is suggested to be underlying Anxiety Disorder. And what are the brain parts implicated?

What else does anxiety impair?

Answer 9

Dysregulation of neurocircuitry of conditioned fear

• Heightened amygdala activation
• PFC control of amygdala disrupted

What else

• Anxiety also impairs extinction learning and retention, as well as the regulation of emotional responses via cognitive strategies
  
  • e.g. anxious patients exhibit reduced PFC during or before fear extinction, and require heightened PFC to successfully reduce negative emotion with cognitive reappraisal

Question 10

What are the two key cognitive information processing bias, charactersitics of people with anxiety.

Answer 10

1. Bias to threat-related information
2. Bias to negative interpretation of ambiguous stimului

Question 11

1: Bias to threat-related information

Answer 11

Selective Attention Task:

• Hyperactive Amygdala
• Reduced PF control over amygdala response
  
  • Remember, training was clinically non-significant

Question 12

2: Bias to negative interpretation of ambiguous stimuli (what are some stimulis)

Answer 12

Stimulus: Not specific

• Faces
• Face-Voice Pairings
• Verbal Homophones
  
  • Dye/Die
• When evaluating future life events, anxiety overestimate the likelihood of negative outcomes

Question 13

What are the nerual mechanisms underlying cognitive biases of anxiety

Answer 13

• Amygdala hyperactivity while attending and evaluating negative stimuli
  
  • Heightened cognitive and affective responses to potential threats
• Prefrontally mediated cognitive and affective regulation processes also appear to be impaired in anxiety, reducing the ability to modulate these pre-existing tendencies

(Both Amygdala and PFC)

Question 14

What is uncertainity and how does it relate to anxiety. What is the study

Answer 14

​Uncertainity

• Elicits greater anxiety
• People with anxiety show threat-related information processing bias, altering their decision-making

Task: Risk (Dohnmen, 2011)

• Anxiety correlated with greater risk aversion/avoidance for themselves.
  
  • When evaluation of a response includes increase in physiological response (BP, HR), anxious pariticpants are even more risk averse
• When anxious participants made choice for another, they are less risk averse

Question 15

In Dohmen’s risk study, he examined gender, height, age, and parental academic achivement. What is the association with risk?

Answer 15

Gender

• Women less risky

Height

• Taller more risky

Age

• Older less risky

Parental Academic Achivement

• Having a mother, and lesser extent father, with academic achivement more risky

Question 16

What is ambiguity and how does it relate to anxiety?

Answer 16

Ambiguity

• Ambiguity elicits greater anxiety
• People with anxiety will show greater avoidance of ambiguous decisions
  
  • Overestimate probabiity of negative outcomes and their subjective cost
    
    • Car vs Train (Will choose car, even though car is more risky)
    • Visible and Opaque Urn

Question 17

What are the neural systems involved in decision making biases (In relation to anxiety)

Answer 17

• Insula cortex
  
  • Detect own physiological response arousal
  • Insula:
    
    • Increased loss aversion (Physiological arousal heightened = Scared)
    • Leision impaired risk decision performance on tasks such as the Balloon Analogue Response Task
• Prefrontal cortex (Dorsolateral and Ventromedial)
  
  • TMS stimulation will also stimulate this pattern of risky decision making

Question 18

What is framing effect and what does it relate to? How does anxiety fit into it?

Answer 18

Framing

• Anxiety associated with greater framing effects because they are driven by loss aversion
  
  • e.g. Keep 20/50 or lose 30/50

Loss Aversion

• Degree to which avoiding losses is priortised to achieving equivalent gains
• Anxious associated with increased loss aversion
  
  • Increased sensitivty to loss
  • Avoid responses where there is a greater risk
  • Increasing risk taking behaviour