Anxiety Disorders

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Questions and Answers

How does intermittent negative reinforcement affect the behavior of individuals with Generalized Anxiety Disorder?

It reinforces the avoidance behavior associated with their fears. (correct)

It decreases their anxiety levels over time.

It leads to an increase in their social interactions.

It eliminates the triggers of their anxiety.

Which neurotransmitter is decreased in activity in individuals with anxiety disorders?

Adrenaline

Dopamine

Norepinephrine

Serotonin (correct)

What physiological changes occur due to the release of epinephrine during the fight-or-flight response?

Decreased heart rate and lowered blood pressure

Slowed breathing rate and increased energy storage

Heightened immune response and increased digestion

Increased heart rate and elevated blood pressure (correct)

What role does the amygdala play in the stress response?

It processes emotional responses to stimuli. Signup and view all the answers

During a prolonged stress situation, which system is activated after the hypothalamus initiates the initial stress response?

HPA axis Signup and view all the answers

What is a common cognitive misinterpretation associated with panic disorders?

Believing every sensation is a sign of extreme danger Signup and view all the answers

What happens to cortisol levels once the threat of stress subsides?

They drop, allowing the body to calm down. Signup and view all the answers

Which symptom distinguishes anxiety disorders from normal anxiety?

Intensity of the emotional response Signup and view all the answers

What type of strategy should be used to diagnose anxiety disorders?

A thorough assessment including history and mental status examination Signup and view all the answers

Which of the following is NOT a somatic symptom associated with anxiety?

Increased appetite Signup and view all the answers

How do somatic symptoms in anxiety sometimes present?

Resembling genuine physiological abnormalities across various systems Signup and view all the answers

In individuals with anxiety, what is the effect of feedback loops of heightened arousal?

They create an ongoing cycle of anxious thoughts and symptoms Signup and view all the answers

Which of the following describes the fight-or-flight response in relation to anxiety?

Sympathetic and autonomic arousal triggered by normal sensations Signup and view all the answers

What distinguishes primary anxiety disorders from secondary anxiety disorders?

Primary disorders are idiopathic while secondary are linked to other conditions Signup and view all the answers

Which symptom is associated with the gastrointestinal aspect of anxiety?

Dyspepsia Signup and view all the answers

What is a common physiological response during an anxiety episode?

Rapid heartbeat and diaphoresis Signup and view all the answers

Which of the following is a characteristic of specific phobia?

Significant distress or impairment in various areas of life Signup and view all the answers

What is a common physiological response experienced by individuals with specific phobia?

Sympathetic nervous system arousal Signup and view all the answers

At what age does the onset of specific phobias typically occur?

In early childhood, often before age 10 Signup and view all the answers

Which type of phobia tends to onset later than others?

Situational phobias Signup and view all the answers

What role does selective mutism play in individuals with anxiety?

It may function as a coping mechanism for anxiety. Signup and view all the answers

Which of the following triggers can lead to the development of specific phobias?

Past traumatic events Signup and view all the answers

What distinguishes a panic attack from other anxiety symptoms?

Sudden onset of intense fear or discomfort Signup and view all the answers

What brain regions are associated with specific phobia pathology?

Amygdala, anterior cingulate cortex, thalamus, and insula Signup and view all the answers

Study Notes

Generalized Anxiety Disorder

In Generalized Anxiety Disorder, worry and fear are learned and repeated to avoid negative reinforcement
Experiencing successful avoidance of a negative outcome makes the behavior more likely to be repeated in future situations.
For example, reading about an air disaster might increase an individual's fear of air travel
This is known as negative reinforcement.

Anxiety and The Fight-or-Flight Response

Anxiety disorders are characterized by excessive or persistent anxiety beyond what is typical for a person's age.
They are sometimes considered an inappropriate activation of the stress response system (known as “fight-or-flight”)
The fight-or-flight response is triggered by the amygdala, which signals distress to the hypothalamus
The hypothalamus releases epinephrine (adrenaline) from the adrenal glands, triggering physiological changes such as increased heart rate, blood pressure, and breathing rate
If the perceived threat continues, the hypothalamus also activates the HPA axis, which releases hormones like CRH, ACTH, and cortisol, sustaining alertness and energy levels
Once the threat subsides, the parasympathetic nervous system helps the body calm down, reducing the fight-or-flight response
For individuals with anxiety disorders, the parasympathetic system may not be effective at reducing the stress response, leading to persistent anxiety.

Neurotransmitters Involved in Anxiety

Increased activity of adrenaline and noradrenaline is associated with anxiety
Decreased activity of serotonin and GABA are associated with anxiety.

Catastrophic Misinterpretations

Many anxiety disorders, particularly panic disorders, may be caused by catastrophic misinterpretations of normal bodily sensations.
Vulnerable individuals may experience heightened alarm responses to normal or slightly abnormal sensations, leading to sympathetic and autonomic arousal.
This heightened arousal then generates more bodily sensations (like rapid heartbeat or sweating), creating a feedback loop of anxious thoughts and physical symptoms, perpetuating the cycle of anxiety.

Clinical Features of Anxiety

Many individuals with anxiety experience both psychological anxiety and somatic (bodily) symptoms.
Somatic symptoms may resemble those of genuine physical abnormalities, affecting various organ systems.
Common somatic symptoms include:
- Neurological/Autonomic: Diaphoresis (sweating), warm/cold flushes, dizziness or fainting, headache, tingling in extremities, numbness around the mouth, mydriasis (pupil dilation)
- Gastrointestinal: Sensation of choking, dyspepsia (indigestion), nausea, diarrhea, abdominal bloating or pain
- Cardiorespiratory: Palpitations (subjective experience of tachycardia), chest pain, dyspnea (difficulty breathing) or sensation of being smothered
- Genitourinary: Urinary frequency or urgency.

Diagnosing Anxiety Disorders

Diagnosing anxiety disorders requires a comprehensive assessment, including both etiologic (cause) and syndromic (syndrome) perspectives.
It is essential to ascertain whether the anxiety disorder is primary (idiopathic) or secondary to factors such as systemic or neurological conditions, drug intoxication, or withdrawal.
This assessment involves physical examinations, laboratory tests, and a detailed review of the patient's history and mental status.

Specific Phobias

Specific phobias are characterized by:
- Intense and persistent fear of a specific environmental stimulus
- Pathological anxiety response when exposed to the stimulus
- Avoidance of the stimulus or distress when forced to endure it
Specific phobias can be triggered by traumatic events, panic attacks, or exposure through media, but often the cause is unknown.
The onset typically occurs in early childhood, usually before the age of 10.
Specific phobias are categorized according to the type of stimulus that elicits the phobic response.

Specific Phobia: Key Features

Persistent and intense fear, anxiety, or avoidance lasting at least six months, leading to significant distress or impairment in various areas of life.
Individuals with specific phobia experience heightened physiological arousal when exposed to their phobic object or situation.
Physiological responses can include sympathetic nervous system arousal or a vasovagal fainting response.
Abnormal brain activity in areas such as the amygdala, anterior cingulate cortex, thalamus, and insula is associated with specific phobia.
Situational phobias tend to onset later than other types of phobias.
Childhood phobias may fluctuate over time but often persist into adulthood.

Panic Attacks

Many anxiety disorders involve sudden, intense episodes of symptoms called panic attacks.
The typical age of onset for panic attacks in the United States is around 22-23 years among adults.

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Description

This quiz covers the key concepts of Generalized Anxiety Disorder, including the role of negative reinforcement in anxiety and the fight-or-flight response. Explore how anxiety is processed in the brain and the physiological reactions that occur during stressful situations.