Lecture 50: Overview of Anxiety Disorders

Question 1

What are types of anxiety disorders?

Answer 1

PTSD
OCD
Specific phobia
Social phobia (Social anxiety disorder, SAD)
Panic disorder
Generalized anxiety disorder (GAD)

Question 2

How can you use neuroimaging to diagnose anxiety disorders?

Answer 2

Current technology is useful for identifying average neural differences between groups of individuals with specific disorder without that disorder

Question 3

What are specific phobias?

Answer 3

Being afraid of a certain thing

Question 4

What are risk factors for specific phobias?

Answer 4

1. Environmental risk factors (traumatic experience with stimulus)
2. Genetic risk factors: Heritability = 43%
3. Preparedness and the nonrandom distribution of fears and phobia

Question 5

What are brain areas implicated in anxiety disorders?

Answer 5

Amygdala, insula, ACC

Question 6

Where do neural changes occur in patients with specific phobia?

Answer 6

Left insula (more activity = more phobia)
Anterior Cingulate Cortex (ACC)

Question 7

What is the treatment for specific phobia?

Answer 7

One-session treatment (developed by Ost lollllllll)

- rapid and effective (mean treatment is 2.1 hr)
- durable (after 4 years, much improved or recovered

Question 8

What are the general characteristics of Social Phobia?

Answer 8

Fear of being in social situations in which one will be embarrassed or humiliated

Question 9

What are the risk factors for Social Phobia?

Answer 9

Interaction of psychosocial and biological causal factors

a. temperamental factors (shy/timid)
b. Genetic factors
c. social fears/phobias in evolutionary context (don’t want to be ostracized from group or else you will die)
d. cognitive variables
	- blushing

Question 10

What are the areas of the brain implicated in SAD?

Answer 10

1. decreased levels of insula, middle frontal gyrus, aCC, hippocampus (kind of counterintuitivie)
2. Increases in dorsolateral/medial Prefrontal cortex, dorsal ACC

Question 11

What is Nefazadone?

Answer 11

An SSRI
Used to treat SAD
-increases insula, middle frontal gyrus, ACC and hippocampus activity
-decreases dorsolateral medial PFC and dorsal ACC

Question 12

What is agoraphobia?

Answer 12

Fear of crowded spaces or enclosed public places

Question 13

What are the general characteristics of Panic Disorder (with, w/o agoraphobia)?

Answer 13

• persistent unexpected panic attacks
• fear of other attacks and/or concern about implications
• agoraphobia

Question 14

What are the risk factors for panic disorder?

Answer 14

Genetic factors (heritability = 30-40%)
-heritability of agoraphobia = 67%
Interoceptive fears
-greater “fear of fear”

Question 15

What is the cognitive theory of panic disorder?

Answer 15

1. Trigger/stimulus
2. Perceived threat
3. Apprehension or worry
4. Body sesnations
5. Interpretation of sensations as catastrophic
6. Perceived threat (circular)

Question 16

What neural areas are implicated in panic disorder?

Answer 16

1. Insula
2. Anterior cingulate (detection of interoceptive stimuli)
3. Periaqueductal gray matter

Question 17

What is interoceptive stimuli?

Answer 17

Relating to stimuli produced within an organism

Question 18

How do you treat panic disorder/agoraphobia?

Answer 18

• SSRIs, SNRIs, TCAs, benzodiazepines

- CBT

Question 19

What does CBT do for panic disorder?

Answer 19

Decreased activity in hippocampus, ACC, cerebellum and pons (all connected to the amygdala)
Increased activity in medial PFC

Question 20

What are the general characteristics of Generalized Anxiety Disorder (GAD)?

Answer 20

Excessive and uncontrollable worry for OVER 6 months

Additional symptoms like muscle tension, concentration problems, sleep problems

Question 21

What are the risk factors for GAD?

Answer 21

1. Genetic factors (neuroticism and depression)
2. A functional deficiency of GABA
3. Neurobiological differences between anxiety and panic

Question 22

What is purpose of GAD?

Answer 22

Cognitive strategy go damapen emotional experience

Anxiety used to not feel emotion?

Question 23

What are the neural correlates of GAD?

Answer 23

-dampened connectivity between amygdala subregions ACC/insula
-greater connectivity between amygdala and DLPFC
PFC implicated in GAD