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Anxiety Disorder
Uni of Notts, Neurobiology of disease, second year, topic 5
| Term | Definition |
|---|---|
| Anxiety | Feelings of apprehension such as worry or fear, ranging from mild to severe |
| Anxiety disorder | Excessive, hard‑to‑control anxiety for most days over 6 months, causing distress & functional impairment, not due to exogenous chemicals |
| Generalised Anxiety Disorder (GAD) | Persistent anxiety about everyday situations with symptoms like cardiovascular changes, proprioceptive sensations, poor concentration, & sleep issues |
| Panic disorder | Sudden intense fear with rapid onset, lasting 5–20 minutes, occurring without clear triggers & overlapping with other conditions |
| OCD | Intrusive unwanted thoughts & cognitive distortions causing anxiety (obsessions), relieved by compulsive repetitive behaviours (compulsions) that impair daily functioning |
| PTSD | Trauma exposure plus re‑experiencing, avoidance, cognitive distortions, hyperarousal, >1 month duration, & functional impairment not caused by exogenous chemicals |
| Phobias | Debilitating irrational fears of animals, environments, situations, bodily stimuli, or complex fears like agoraphobia or social phobia |
| How persistent anxiety affects the PFC | Anxiety inhibits the PFC, reducing logical reasoning & top‑down emotional control |
| Role of the anterior cingulate cortex in anxiety | Amplifies fear signals from the amygdala, increasing emotional reactivity |
| Amygdala change in chronic anxiety | Persistent anxiety enlarges the amygdala & heightens fight‑or‑flight responses |
| What fMRI shows about anxiety disorder | Reduced functional connectivity between the amygdala & PFC on fMRI |
| Connectivity changes occur in chronic anxiety | Increased functional connectivity of the supramarginal gyrus with PFC, PCC, Insula, & medial temporal gyrus |
| Heritability of anxiety disorders | 30%, involving short SERT alleles, serotonin receptor dysfunction, MAO‑A efficiency, % reduced BDNF |
| Genetic variants increase anxiety risk after trauma | Neuropeptide Y variants in hurricane survivors & neuropeptide S receptor variants in stressful families |
| Neurotransmitter changes occuring in anxiety | Reduced GABAA receptors, altered serotonin signalling, and heightened sensitivity to (cholecystokinin) CCK hormone agonists but weren't improved by CCK antagonists |
| HPA axis & how GAD affects it | CRH → ACTH → cortisol/A/NA to inhibit CRH pathway; chronic stress disrupts cortisol negative feedback, keeping the system overactive |
| Factors guiding treatment decisions | Mental health history, stressors, medical/drug history, impairment level, & suicide risk. Patient will discuss with the doctor to decide whether or not medication is appropriate |
| First‑line treatments for anxiety | Self‑help, CBT, SSRIs, SNRIs, β‑blockers, atypical antipsychotics, & benzodiazepines |
| How benzodiazepines work | They act as GABAA positive allosteric modulators (PAM), binding between α and γ subunits to enhance GABA effects similar to barbituates, neurosteroids, & ethanol |
| Novel treatments in trial | Glutamatergics, neurosteroids, cannabinoids, MDMA analogues, & L‑DOPA |
Created by:
Denny12
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