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Neuroscience and Behaviour > Anxiety Disorder > Flashcards

Anxiety Disorder Flashcards

1
Q

what is anxiety?

A

Diffuse unpleasant vague sense of apprehension in anticipation of a future threat

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2
Q

what is fear?

A

is the emotional response to a real or perceived imminent threat

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3
Q

How to fear and anxiety overlap?

A

These two overlap, but they also differ. Fear is associated with surges in autonomic arousal (needed for fight or flight), whereas anxiety is associated with muscle tension and vigilance in preparation for future danger. Anxiety is also characterized by avoidance behaviours

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4
Q

what are some examples of anxiety disorders?

A
  • Specific phobia
  • Social anxiety disorder (social phobia)
  • Panic disorder (sometimes + agoraphobia)
  • Generalised anxiety disorder
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5
Q

Generalised anxiety disorder

A

symptoms:
- unrealistic, excessive and long-lasting worry, motor tension, relentlessness, irritability, difficulty sleeping, hypervigilance

  • 5% prevelence

Treatments:
- BZs, SSRIs, Venlafaxine, busprine, cognitive/behavioural therapy

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6
Q

social phobia

A

symptoms:
- aversion, fear, autonomic arousal in unfamiliar social settings

  • 13% prevelance

treatments:
- SSRis, cognitive/Behavioural therapy

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7
Q

Specific phobia

A

symptoms:
aversion, fear, autonomic arousal in specific situations (exposure to animals, blood etc.)

  • 11% prevelance

treatments
- Behavioural therapy

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8
Q

what is panic disorder?

A
  • breif, recurrent, unexpected episodes of terror, sympathetic cries, shortness of breath, fear of dying and losing control
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9
Q

what is PTSD?

A
  • following an extremely stressful event (involving actual injury, recurrent episodes of fear often triggered by reminders of initial trauma, autonomic arousal
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10
Q

what is OCD?

A

recurrent obsessions and compulsions: obsessions are persistent, intrusive or inappropriate thoughts that cause anxiety: compulsions are repetitive acts that sufferer feels driven to perform to alleviate anxiety

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11
Q

what are the core symptoms shared will illness-specific signs and cognitions?

A
  • physiological activation/arousal
  • escape
  • avoidance
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12
Q

what is the population prevalence for people with an anxiety disorder?

A

29%

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13
Q

First-degree relatives and anxiety? (Fyer et al 1995)

A
  • First-degree relatives are most likely to have the same anxiety disorder as the proband
  • but first-degree relatives are also at increased risk for other anxiety disorders
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14
Q

Gene-environment interactions (PTSD example)

A

-Genes can influence if you will get the disorder, i.e. give you a susceptibility for PSTD a larger hippocampus
- but need an environmental trigger for the disorder to develop for example combat experience
- if dont have the genetic component but high environmental risk could be protected from developing the disorder

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15
Q

classical (fear) conditioning in anxiety

A
  • process of pairing an US with a CS to produce a CR
  • can be used to condition fear/anxiety
  • for example Watson and Rayner (1920) fear conditioned little Albert to be scared of a white rat toy by pairing it with a loud bang
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16
Q

Avoidance learning

A
  • an avoidance response in a natural adaptive behaviour performed in response to danger
  • excessive avoidance has been suggested to contribute to anxiety disorders
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17
Q

Mowrer two-factor theory, Mowrer (1951)

A
  • Fear to a stimulus (or object, situation) is acquired through classical conditioning
  • Light – shock (CS-US) pairings. Presentation of the light, fear response
  • Instrumental conditioning (avoidance learning) allows animals to escape shock or postpone encountering the aversive stimulus.
  • CS+Response – No Shock (negative reinforcement)
  • Avoidance is critical in the maintenance of anxiety, because each time subjects encounter the CS, they emit a response to avoid the US (negative reinforcement). When avoidance is high, subjects never experience whether the CS is followed by the US.
18
Q

Fear and avoidance

A
  • A clear implication of two-factor theory is that
  • Fear → Avoidance
  • No Fear →no avoidance
  • Treatment thus has been oriented to attenuate fear
  • Newer conceptualizations (last decade) emphasize the bidirectional relationship between fear and avoidance
  • Fear → avoidance
  • Avoidance → Fear
19
Q

Neural system underlying fear and anxiety: amygdala

A
  • Amygdala is involved in the fear reaction to a threat (snake)
  • Prediction that amygdala is overactive in anxiety states
  • However, the current focus is on a “fear network” rather than a single structure (LeDoux, 2015)
20
Q

The Amygdala is the “hub in the wheel of fear”

A

gets input from:
- sensory thalamus (stimulus features)
- sensory cortex (objects)
- Rhinal (transition) Cortex (memories)
- Hippocampus (memories and cortex)
- Medial prefrontal Cortex (extinction)

amygdala output fear

21
Q

Amygdala activation by fearful faces and conditioned fear

A

show people fearful faces and there is some activity in the amygdala

22
Q

Emotional processing can be implicit;
these responses to fearful eyes are subliminal, Whalen et al (2004)

A
  • people can be trained with stimuli presented for a very brief period, so cannot verbalise response (17ms)
  • either shown wide eye whites (fear) of happy eye whites (no fear)
  • fear eye white (wide eyes) shows increased activity in amygdala
23
Q

Amygdala and PFC in extinction, Phelps et al., (2004)

A
  • pair a noise with a shock and fear is acquired
  • overtime if you stop pairing a shock and just present the noise fear can be extinct
  • fear response is inhibited
  • the more extinction occurs the more activity in the medial prefrontal cortex
  • activity in the prefrontal cortex inhibits the activity of the amygdala, so more medial prefrontal cortex activity the lower the amygdala activity
24
Q

Amygdala activation during avoidance, Prefrost et al., (2011)

A

reward learning
- money used to act as a reward, giving money = reward, taking money = punishment
- shown stimulus is give correct response money is given, if give incorrect response, money is not given

Avoidance learning
- no gain in money only take away money if incorrect answer given

  • In reward condition basolateral amygdala involved
  • in avoidance condition centro-medial amygdala activated
25
Q

Amygdala activation in high trait anxiety, Indovina et al (2011)

A
  • given a questionnaire and scored using STAI scale
  • correlational study
  • used brain scan to investigate activity in amygdala and looked at the relationship between brain activity and anxiety score
  • Individuals High in Trait Anxiety Showed Increased Amygdala Responsivity to Phasic Fear Cues
25
Q

vmPFC activation in high trait anxiety, Indovina, et al., 2011

A
  • same as previous correlation study but looking at the ventral medial prefrontal cortex
  • Individuals High in Trait Anxiety Showed Impoverished Pre-extinction
  • Ventral Prefrontal Cortical (vPFC) Activity
  • further shows idea the the vPFC inhibits amygdala activity
26
Q

Amygdala activation in phobics, Schienle et al., (2005)

A

Spider phobics show greater amygdala responses compared to controls, to phobic pictures as well as fear and disgust pictures.

27
Q

Amygdala activation in PTSD, Jacques et al (2011)

A
  • PTSD group showed greater recruitment right amygdala+ hippocampus during the construction of emotionally intense negative autobiographical memories
  • control group showed greater recruitment during construction of emotionally intense positive memories
28
Q

vmPFC activation in PTSD, St. Jacques et al. (2011)

A
  • PTSD group showed greater recruitment of the ventral medial PFC for negatively intense autobiographical memories
  • whereas the control group showed greater recruitment for positively intense memories
29
Q

OCD and reversal learning, Apergis-Schoute et al., 2017

A
  • Overactivation of PFC in OCD patients to safety signal (face not paired with shock)
  • Failure to reverse contingencies
  • Higher PFC activation predicted generalization during reversal
30
Q

OCD and reversal learning, Apergis-Schoute (2017)

A
  • Fear conditioning reversal learning
  • OCD patients learned the discrimination early on.
  • But failed to discriminate following reversal (early or late)
31
Q

Time course of effects of the three main classes of anxiolytic drugs

A
  • giving buspirone and antidepressants during treatment reduces anxiety and once stopped the withdrawal affect is low and anxiety remains low
  • benzodiazepine lowers anxiety during treatment but has a large withdrawla affect
32
Q

what are Benzodiazepines?

A
  • Anxiolytic drug used mainly to treat GAD and acute stress reactions
  • also used as anti-convulsants (e.g. alcohol withdrawal) and as hypnotics
  • they have a low toxicity
  • Disadvantage is the likelihood of dependence and associated with withdrawal symptoms, and the impariment of cognitive performance, e.g. can lead to anterograde amnesia
33
Q

BDZ distribution in the surface of the human brain, Nørgaard et al (2021)

A

-

34
Q

Serotonin pathways in the human brain

A
  • The 5-HT1A (serotonin receptor 1A)autoreceptor resides on the soma and dendrites of serotonin neurons in the raphe nuclei
  • where its activation hyperpolarizes and reduces the firing rate of these cells
  • thereby serotonin extracellular levels in its projection areas
  • 5-HT1A receptor
    agonists may act
    here to reduce 5-HT
    neuron activity
    (e.g. in the
    Amygdala)
  • 5-HT1A is a serotonin receptor associated with anxiety
35
Q

5-HT 1a Receptor distribution

A

High 5-HT1A
- hippocampus
- Medial temporal cortex

Medium 5-HT1A
- pre-frontal cortex

low 5-HT1A
- cerrebellum
- basal ganglia (caudate nucleus, putamen, globus pallidus and amygdala)

36
Q

Amygdala responses to fearful faces are linked to the serotonin system

A
  • Hariri et al (2002) = healthy volunteers with the short allele of the serotonin transporter (5HTTLPR) polymorphism show increased amygdala responses to fearful faces
  • Shienle et al (2001); Fu et al (2004): in patients with depression, the amygdala response to fearful faces is reduced by 8 week SSRI treatment (compared to placebo)
37
Q

Psychological treatments – CBT and Exposure therapy

A
  • Exposure based therapies and Cognitive Behavioural Therapy are the first line of treatment in the UK (and worldwide) for anxiety disorders
  • They work on the assumption that some fears (i.e., phobias) are learned and therefore presentation (and/or imagination) of stimuli associated with a feared outcome will extinguish the fear and anxiety.
38
Q

Psychological treatments – Enhancing Exposure therapy with drugs Walker et al., (2002)

A
  • Walker et al., (2002) tested the effect of DCS on fear extinction in rodents
  • Dose-dependent effect in facilitation of extinction
  • giving drugs produces a larger effect of instinction learned at a faster rate
39
Q

Psychological treatments – Enhancing Exposure therapy with drugs

A
40
Q
A

Neuroscience and Behaviour (27 decks)

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