Flashcards in Overview of Anxiety Disorders Deck (22):
5-6 disorders within the realm of "Anxiety Disorders"?
PTSD - won't be called anxiety disorder in DSM V, though.
Social Phobia (aka. SAD)
Generalized Anxiety Disorder (GAD)
Does people's to phobias always correspond to their genuine perceived threat from the object/situation?
How is blood/injection/injury phobia unique among phobias?
People pass out after getting revved up. (and that's generally not considered an evolutionarily favorable response to threatening stimuli)
5 categories of specific phobias?
Natural environment type
How heritable is having a specific phobia?
What does "preparedness and the non-randrom distribution of fears and phobias" refer to?
People are more likely to develop phobias of things... that you can make an evolutionary argument for being afraid of: E.g. snakes, spiders, heights, social exclusion.
What's the preferred treatment for specific phobia? How effective is it?
Very effective: over 90% report "much improved or completely recovered" after 4yrs.
What 2 areas of the brain are most overactive in specific phobias?
Left insula and ACC.
What are 4 causal factors for social phobia?
Temperamental factors (higher risk for inhibited kids).
Evolutionary context (instinctual fear of social isolation).
Cognitive variables (risk and cost of feared outcomes such as blushing).
Overactive areas of brain in social phobia?
Bilateral amygdala, insula, etc. etc. etc.
What effect does nefazodone (an SRI) have on brain activity in patients with SAD: What increases in activity? What decreases?
Increased: insula, middle frontal gyrus, ACC, hippocampus, etc. (somewhat unexpectedly)
Decreases: dorsolateral and medial PFC, and dorsal ACC (areas for "cognitive control and self-reference)
I think the notes might be wrong - from the original article: Nefazodone treatment was associated with marked clinical improvement. Comparison of social anxiety-related neural activations prior to and after nefazodone administration indicated greater activity in the precentral gyrus, insula, midbrain/hypothalamus, and middle frontal and anterior cingulate gyrus prior to treatment, and greater activity in the left middle occipital and bilateral lingual gyri, postcentral gyrus, gyrus rectus, and hippocampus after treatment.
What differentiates panic from anxiety?
Panic is acute - peaks at 10 minutes, typically lasts 15 or less.
What are the 2 central features (not diagnostic criteria) of panic disorder?
Persistent, recurrent panic attacks.
Fear of future attacks.
How heritable is panic disorder?
A little less than some: 30-40%.
(agoraphobia is more heritable)
What is an "interoceptive fear"?
Fear of fear. Much of panic disorder illness is driven by avoiding situations that will precipitate panic attacks.
3 areas of brain implicated in panic disorder?
Insula, ACC, periaqueductal gray matter.
Do CBT and medications work synergistically for panic disorder?
Actually, no. CBT seems to have longer-lasting effects without medication.
(recall the woman drinking caffeine before exposure therapy to actually increase anxiety/panic)
What medications can be used for Panic Disorder and Agoraphobia?
SSRIs, SNRIs, TCAs, and benzos.
(Recall discussion in psych small group about the utility of benzos for panic disorder.)
How does CBT for panic disorder affect the brain: What 4 areas have decreased activity? Which area has increased activity? (vs. pre-treatment)
Decreased: hippocampus, ACC, cerebellum, & pons (less contextual fear)
Increased: mPFC (more emotional control)
What must the duration be to diagnose generalized anxiety disorder (GAD)?
Excessive and uncontrollable worry for >6 mos.
What additional symptoms does GAD have?
Sleep problems, muscle tension, concentration problems.