Introduction to Anxiety

Brain circuits are shaped by

________environment.

Somatic symptoms of anxiety

________: muscle tension, restlessness, elevated heart rate.

Panic attack

________: abrupt experience of intense fear.

Cognitive symptoms of a panic attack

________: Fear of losing control, dying, or going crazy.

Physical symptoms of a panic attack

________: heart palpitations, chest pain, dizziness, sweating, chills or heat sensations, etc.

Two types of panic attacks

expected and unexpected

Classical and operant conditioning

symptoms are a result of learned associations

Suicide attempt rates are similar to

major depression

20% of panic patients

attempt suicide

Suicide increases for

all anxiety disorders

Anxiety disorders have high rates of

comorbidity

What are the comorbidity rates for anxiety disorders?

55%-76%

Commonalities between anxiety disorders and its comorbidities:

features and vulnerabilities

Anxiety disorders are linked with

physical disorders

Triple vulnerability

Generalized biological vulnerability

Generalized psychological vulnerability

Specific psychological vulnerability

Generalized biological vulnerability

diathesis

Generalized psychological vulnerability

Beliefs/perceptions

Specific psychological vulnerability

Learning/modeling

Biological vulnerabilities triggered by

stressful life events

Freud believed anxiety was a

psychic reaction to danger

Limbic system includes

Behavioral inhibition system (BIS) and Fight/flight (FFS) system

Behavioral inhibition system (BIS)

Received danger signals from:

• Brain stem

• Septal-hippocampal system

Fight/flight (FFS) system

• Panic circuit

• Alarm and escape response

Brain circuits and neurotransmitters

GABA

Noradrenergic

Serotonergic systems

The DSM – 5 diagnostic criteria for panic attack

4 (or more) of the following symptoms occur:


1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Feeling of choking
5. Chest pain or discomfort
6. Nausea or abdominal distress
7. Feeling dizzy, unsteady, light-headed or faint
8. Chills or heat sensations
9. Paresthesias
10. Derealization
11. Fear of losing control or going crazy
12. Fear of dying

Fear

Immediate, present-oriented

Sympathetic nervous system activation

Anxiety

Apprehensive, future-oriented