Week 4 Flashcards
What is fear ?
The emotion we experience in response to concrete danger
What is anxiety ?
Complex feelings of uneasiness to possible impending threats
How are fear and anxiety linked ?
Both are related to the FoF response
What are anxiety disorders linked to ?
- Exposure to a truamatic event increases risk of developing an anxiety disorder
- Anxiety disorder may also be secondary to a chronic illness
- If anxiety is excessive and disabling and there is lack of a physical cause, a person may be diagnosed with an axiety disorder
What are the types of anxiety disorders ?
- GAD
- Panic Disorder
- Phobic Disorder
What disorders fall under Trauma and Stressor-Related disorders ?
- OCD
- PTSD
What is GAD ?
- Excessive uncontrollable and unrealistic anxiety and worry
- Common co-morbidity with depression
- Women over men; Onset often begins in childhood or adolesence
What is Panic disorder ?
- Characterized by repeated and unexpected panic attacks, typically accompanied by worry about future attacks
- Symptoms are similar to those of a heart attack
- Panicked person has intense fear; anxiety sensitivity; interoceptive sensitivity (awareness to what’s going on in the body)
What are phobias ?
An unreasonable or excessive fear of an object, situation, or activity
What are the 3 broad catgories of phobias ?
- Agoraphobia
- Social phobia
- Specific phobias
What is agoraphobia?
fearful of a public palce or being outside of the home to the extent that a panic attack or extreme embarassment is possible
What is Social phobia ?
a fear of social activity, especially of being scrutinized and embarassed
What are specific phobias ?
exaggerated fear of specific objects/situations not covered by the other two
How does anxiety look like in the brain ?
- Increased activation of amygdala and decreased activation of prefrontal cortex (PFC) while viewing negative stimuli
- The ability of the PFC to inhibit activation of amygdala is not present in personas with anxiety disorder
- High levels of anxiety correlate with increased activation of the amygdala and **decreased ventral anteriros cingulate cortex (vACC) activation
What are obsessions ?
Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress
What are compulsions ?
Ritualistic repetitive behaviours or mental acts that are designed to neutralize anxiety and negative affect
What occurs in OCD ?
- Decreased inhibitory control, evidence by increased impulsivity and compulsivity
- Impariment in goal-directed behaviour leading to overreliance on maladaptive, habitual behaviours and contributing to the formation of compulsions
How does OCD affect the brain ?
- Dysregulation of the cortico-basal-ganglia-thalamo-cortical (CBGTC) loop conceptualized in symptom provacation
- Hyperactivity of the dorsal anterior cingulate cortex (dACC) results in overestimation of threat and creates a disbalance b/w habit formation and goal-directed networks (impaired goal-directed behaviour)
What is the relationship b/w stress and OCD ?
- 25-67% of OCD patients report significant life events in relation to the onset of their OCD
- exposure to traumatic events in childhood are 5-9x more likely to meet criteria for OCD in adulthood
- high school and middle school students who reported stressful life events were 21% more likely to go on to meet the criteria for OCD 12 months later
What can excessive stress cause in relation to OCD ?
- Result in atrophy (shrinkage) of the frontal cortices and caudaute nucleus, which impairs goal-directed behaviours
- Executive dysfunction is key factor in OCD (rather than emotion dysregulation)
What is the relationship b/w anxiety and PTSD ?
Reaction to traumatic stressors that results in
* Reliving the event - flashbacks, reactivity to reminders, nightmares
* Avoidance - emotional numbing, detached, repression
* Arousal - poor concentration, exaggerated stratle, hyperbigilance, irritable
What emotions are included in PTSD ?
PTSD includes emotions of guilt, shame and anger, moving beyond the fear/anxiety specturm
What did the Web-based epidemiological study find ?
- 2 months after 9/11, persons living in closer proximity to the WTC were more likely to report PTSD symptoms
- Prevalence of probably PTSD was higher in NYC metropolitan area than the rest of the country
How does PTSD affect the brain ?
- Increased activation of amygdala and decreased activaation of PFC to fearful faces
- Atrophy of hippocampus
What did Gilbertson et al. 2002 find ?
- Hippocampal volume and PTSD in patient and unexposed twin pair
- smaller hippocampal volume -> increased risk of PTSD
What treatments are used for anxiety disorders ?
- Pharmacological - SSR’s. anxiolytics, Propranolol (PTSD)
- Behavioural - systematic desensitization, response prevention
- CBT
- Preventive - integrate the strategies that work best into daily routine
What disorders “fall under” depression ?
- MDD - Unremitting depression
- BD - Cyclical period of mania and depression
What does a person with depression have to experience ?
Person experiences at least one major depressive epsiode that lasts 2 weeks or more
What is the Diathesis-Stress Model of Depression?
Stress leads to depression in vulnerable individuals
How does depression affect the hippocampus ?
- Smaller volume
- lower neurogenesis
- Glucocoticoid Cascade Hypothesis: Excessive secretion of GC cross the blood brain barrier and impose neurotoxic effects on the HC over time
How does depression affect the amygdala ?
- 50-70% increased blood flow and metabolism in amygdala
- amygdala activity correlated with severity symptoms
- faulty amygdala-PFC coupling
How does depression affect the subgenual anterior cingulate cortex ?
- Smaller volume in MDD
- Increased activity
How does depression affect HPA activity ?
- HPA dysregulation
- higher secretion of cortisol (hypercortisolimia)
What treatments are used for depression ?
- Lifestlye behaviours
- Pharmacological treatments - SSRIs
- Therapy treatments - Behaviour therapy, interpersonal psychotherapy, CBT, MBCT
What is involved in anger ?
- Anger primes us to fight as in the FoF response
- Anxiety can supersese or accompany anger
- Several reasons for feeling anger: a demeaning offense, frusturation, competitiveness, need to control/dominate
- All of these reasons are based on perception
What is anger-in ?
anger directed towards the self
What is anger-out ?
directed to someone else
What is intermittent explosive disorder (IED) ?
A psychiatric disorder characterized by episodes of extreme anger and acting out through assaults or property damage
What is catharsis theory ?
If anger is not expressed, it will build up until a person “explodes”
What is stress inoculation ?
Builds coping strategies to use in stressful situations
