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Anxiety Disorders (Diagnostic Criteria DSM V (Panic attack (abrupt surges…
Anxiety Disorders
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Neurobiology
most research on the role of amygdala, reciprocal connections between amygdala & PFC, alterations in interoceptive processing by the anterior insula
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amygdala
coordinates automatic threat response, integrating information from sensory features, context & prior learning via cortical/subcortical inputs
modulated by top down medial PFC (OFC, ACC, hippocampus) --> context & memory info, conscious self-regulation to influence threat responding
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anterior insula integrates info from the amygdala, nucleus accumbens, OFC --> generates prediction/anticipation signal representing the difference between the current body state and the predicted future state (current state vs. possible future options)
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also altered insular function in OCD, PTSD, GAD, SAD
Neurochemistry
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release of CRF by hypothalamus --> pituitary releases adrenocorticotropin-releasing hormone (ACTH) into bloodstream --> ACTH is detected and facilitates release of glucocorticoids eg. cortisol
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Neuropeptides
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eg. substance P, Neuropeptide Y, Oxytocin, Orexin, Galanin
Course Manual Figure
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Amygdala: integrates info from all the different levels, mediates appropriate response, coordination of automatic response to the threat
Thalamus: involved in relaying the CS information, all sensory information goes through its nuclei
Hypothalamus: respiration, body temperature, HPA axis to stimulate hormone production
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Fear vs. Anxiety
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if disorder: fear/anxiety are excessive, persisting
fear & anxiety should generate different sets of behaviors, they are distinguishable in terms of cause and effect
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Le Doux:
more subjective definition of fear, no one-to-one mapping
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Treatment
Pharmacology
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blockade of glucocorticoids & noradrenaline for trauma-related anxiety (because those stress hormones have memory-enhancing effects)
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