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Anxiety
A normal response to real or perceived dangerous situations.
Anxiety Disorder
Anxiety response to stimuli that do not objectively warrant such reactions and interfere with daily life.
Separation Anxiety Disorder
Fear or anxiety about separation from attachment figures.
Separation Anxiety Disorder Symptoms
Persistent fear of harm coming to attachment figures.
Separation Anxiety Disorder Symptoms
Reluctance to leave attachment figures.
Separation Anxiety Disorder Symptoms
Nightmares and physical distress (e.g., stomach aches).
Separation Anxiety Disorder Duration
4 weeks (childhood), 6 months (adulthood).
Selective Mutism
Failure to speak in social situations despite speaking in others.
Selective Mutism Cause
Not due to unfamiliarity with language.
Selective Mutism Duration
At least 1 month.
Specific Phobias
Intense fear/anxiety towards specific objects or situations.
Specific Phobias Characteristics
Fear is disproportionate to actual threat.
Specific Phobias Recognition
Recognized as excessive.
Specific Phobias Duration
At least 6 months.
Specific Phobias Subtypes
Animal, natural environment, blood-injection-injury, situational, and other phobias.
Social Anxiety Disorder
Fear of social interactions, scrutiny, or attention.
Social Anxiety Disorder Fear
Fear of negative judgment (embarrassment, humiliation, rejection).
Social Anxiety Disorder Symptoms
Symptoms include blushing, fear of vomiting, urgency to urinate/defecate.
Social Anxiety Disorder Duration
At least 6 months.
Panic Disorder
Recurrent unexpected panic attacks.
Panic Disorder Concerns
Worry about future panic attacks or behavior changes due to them.
Panic Disorder Duration
At least 1 month.
Panic Disorder Symptoms
Symptoms: Palpitations, sweating, trembling, shortness of breath, etc.
Agoraphobia
Fear/anxiety about public places, crowds, or being alone outside.
Agoraphobia Concerns
Concern that escape may be difficult or help unavailable.
Agoraphobia Characteristics
Fear is disproportionate to actual threat.
Agoraphobia Duration
At least 6 months.
Generalized Anxiety Disorder (GAD)
Persistent anxiety/worry about various aspects of life.
Generalized Anxiety Disorder (GAD) Control
Difficult to control.
Generalized Anxiety Disorder (GAD) Symptoms
Physical symptoms: Restlessness, fatigue, difficulty concentrating, muscle tension, sleep disturbance.
Generalized Anxiety Disorder (GAD) Duration
At least 6 months.
Obsessive-Compulsive Disorder (OCD)
Characterized by obsessions (intrusive, distressing thoughts) and/or compulsions (repetitive behaviors aimed at reducing anxiety).
Posttraumatic Stress Disorder (PTSD)
Re-experiencing a traumatic event, increased arousal, and avoidance of related stimuli.
Prevalence of Anxiety Disorders
Anxiety disorders affect ~40 million Americans.
Genetic Factors in Anxiety Disorders
30-40% of risk due to genetic variation.
Candidate Genes for Anxiety Disorders
CRHR1, COMT, 5-HTTLPR, HTR1A, MAOA.
Additional Genes Identified by GWAS
SATB1, ESR1, MAD1L1, OPRL1.
Environmental Factors in Anxiety Disorders
Contributing factors: Parental behavior modeling, overcontrol, substance abuse, poor health, negative life events, social media exposure.
Brain Regions Involved in Anxiety
Amygdala: Processes fear and anxiety.
Brain Regions Involved in Anxiety
Ventromedial Prefrontal Cortex (vmPFC): Regulates fear response.
Brain Regions Involved in Anxiety
Hippocampus: Contextualizes fear memories.
Brain Regions Involved in Anxiety
Insular Cortex: Assesses emotional valence.
Brain Regions Involved in Anxiety
Prefrontal Cortex: Involved in threat detection and behavioral control.
HPA Axis & Stress Response
Stress activates HPA axis -> CRH release -> ACTH release -> Cortisol release.
HPA Axis Overactivity
Overactive HPA axis contributes to prolonged anxiety responses.
Psychotherapy Treatment
Cognitive Behavioral Therapy (CBT): Focuses on restructuring negative thought patterns.
Exposure Therapy
Gradual exposure to feared stimuli.
Pharmacotherapy
Benzodiazepines: Enhance GABA function (short-term relief).
Pharmacotherapy
Selective Serotonin Reuptake Inhibitors (SSRIs): Increase serotonin levels (long-term treatment).
Pharmacotherapy
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Increase serotonin and norepinephrine levels.
Best Treatment Strategy
Combination of Psychotherapy & Pharmacotherapy provides the best outcomes.
