Anxiety Disorders Review

This flashcard set covers the definitions, neurobiology, diagnostic criteria, and pharmacotherapy of various anxiety disorders as discussed in the lecture notes.

Anxiety

A future-oriented emotional state characterized by excessive worry, apprehension, anticipation of threat, and physiologic arousal.

Fear

An emotional response to an immediate threat occurring in the present moment.

Generalized Anxiety Disorder (GAD) Diagnostic Duration

Excessive anxiety and worry occurring more days than not for at least six months.

GAD-7 Scale

A screening tool used to assess anxiety; scores of 5-9 indicate mild, 10-14 moderate, and 15-21 severe anxiety.

Amygdala

The brain region responsible for threat detection and serving as the fear center.

Prefrontal Cortex

The brain region responsible for emotional regulation.

Hippocampus

The brain region involved in memory and context.

Catastrophizing

A cognitive distortion involving the overestimation of danger or assuming the worst possible outcome.

High Neuroticism

A personality trait identified as a common psychological contributor to anxiety disorders.

ACES

Adverse Childhood Experiences, which serve as environmental risk factors for developing anxiety.

Hyperthyroidism

A medical condition that must be ruled out by testing $TSH$ and $T4$ levels during the diagnosis of anxiety.

Social Anxiety Disorder First-Line Treatment

Treatment consisting of SSRIs, SNRIs, or Cognitive Behavioral Therapy (CBT).

Panic Disorder

A disorder characterized by recurring panic attacks followed by at least one month of persistent concern about more attacks or maladaptive behavior changes.

Agoraphobia

Marked fear or anxiety about situations where escape might be difficult, such as using public transportation or being in open spaces.

Separation Anxiety Disorder Adult Criteria

Persistent and excessive fear concerning separation typically lasting six months or more in adults.

Specific Phobia

Marked fear or anxiety about a specific object or situation, lasting six months or more and causing significant impairment.

Exposure and Response Prevention (ERP)

A specific type of therapy preferred for treating agoraphobia and phobias.

Selective Mutism

Consistent failure to speak in specific social situations where there is an expectation for speaking, despite speaking in other situations.

SSRI/SNRI Onset of Action

A period typically lasting $4 \times 6$ weeks before the full therapeutic effect is observed.

Hydroxyzine (Vistaril/Atarax)

An $H_1$ histamine receptor antagonist used for sedation and subjective calming, often as a non-addictive alternative for patients with substance abuse history.

Propranolol (Inderal)

A non-selective beta-1 and beta-2 adrenergic receptor antagonist used off-label for performance anxiety.

Gabapentin (Neurontin) Mechanism

Blocks voltage-dependent $Ca$ channels to reduce excitatory neurotransmitter release.

Pregabalin (Lyrica)

A Schedule V controlled substance that blocks voltage-dependent $Ca$ channels; it has a higher potential for abuse and recreational use than Gabapentin.

GABA

The main inhibitory neurotransmitter in the Central Nervous System ($CNS$).

Benzodiazepines Mechanism

Allosterically bind to $GABA_{A}$ receptors to increase the affinity of $GABA$ to the receptors, enhancing inhibitory effects.

Benzodiazepine Tapering

The safest strategy for discontinuing long-term therapy by gradually reducing the dose over weeks to months to avoid fatal seizures or withdrawal.