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How does intermittent negative reinforcement affect the behavior of individuals with Generalized Anxiety Disorder?
Which neurotransmitter is decreased in activity in individuals with anxiety disorders?
What physiological changes occur due to the release of epinephrine during the fight-or-flight response?
What role does the amygdala play in the stress response?
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During a prolonged stress situation, which system is activated after the hypothalamus initiates the initial stress response?
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What is a common cognitive misinterpretation associated with panic disorders?
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What happens to cortisol levels once the threat of stress subsides?
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Which symptom distinguishes anxiety disorders from normal anxiety?
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What type of strategy should be used to diagnose anxiety disorders?
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Which of the following is NOT a somatic symptom associated with anxiety?
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How do somatic symptoms in anxiety sometimes present?
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In individuals with anxiety, what is the effect of feedback loops of heightened arousal?
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Which of the following describes the fight-or-flight response in relation to anxiety?
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What distinguishes primary anxiety disorders from secondary anxiety disorders?
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Which symptom is associated with the gastrointestinal aspect of anxiety?
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What is a common physiological response during an anxiety episode?
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Which of the following is a characteristic of specific phobia?
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What is a common physiological response experienced by individuals with specific phobia?
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At what age does the onset of specific phobias typically occur?
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Which type of phobia tends to onset later than others?
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What role does selective mutism play in individuals with anxiety?
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Which of the following triggers can lead to the development of specific phobias?
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What distinguishes a panic attack from other anxiety symptoms?
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What brain regions are associated with specific phobia pathology?
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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.
