Psychological Disorders

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CHAPTER 14

• Psychological Disorders
• Anxiety Disorders

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Anxiety Disorders

• Several kinds of anxiety disorders
• generalized anxiety disorder
• Panic disorders
• Agoraphobia
• Specific phobias
• Generalized anxiety Disorder
• feeling of stress and unease most of the time
• overreacts to stressful conditions.

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Anxiety Disorders

• Panic disorder
• sudden and intense attack of anxiety
• symptoms including rapid breathing, high heart
  rate
• feelings of impending disaster.
• Agoraphobia
• More a result of panic disorders and generalized
  anxiety disorder
• Becomes fearful of situations which elicit
  panic/anxiety
• Begin to avoid these areas
• But generalizes- soon afraid of everywhere!
• Phobias
• experiences fear or stress when confronted with a
  particular situation
• such as crowds, heights, enclosed spaces, open
  spaces, dogs, or snakes.

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Treatment of Anxiety Disorders

• Benzodiazepines
• most frequently used anxiolytic (antianxiety)
  drugs in the past.
• increase receptor sensitivity to the inhibitory
  transmitter GABA.
• Suggests deficit in benzodiazepine receptors may
  be one cause of anxiety disorder.
• Anxiety also appears to involve low activity at
  serotonin synapses.
• Antianxiety drugs
• initially suppress serotonin activity
• then produce a compensatory increase.

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Related Brain structures and Anxiety Disorders

• Number of brain structures activated in anxiety
• amygdala
• locus coeruleus.
• Both structures participate in more specific
  emotions, such as fear.
• Drugs which decrease action in the locus
  coeruleus are anxiolytic
• Drugs which increase its action increase anxiety.

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Obsessive compulsive disorders

• Obsessive-compulsive disorder (OCD)
• consists of two behaviors
• obsessions
• Compulsions
• Often occur in the same person.
• An obsession
• recurring and intrusive thought.
• A person may be annoyed by tune that mentally
  replays over and over,
• Plagued by troubling thoughts such as wishing
  harm to another person.
• Compulsive behavior
• Individual compelled to engage in ritualistic
  behavior
• touching a door frame three times before passing
  through
• endless hand washing
• Excessive checking to see if appliances are
  turned off.

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Brain changes in ocd

• PET studies
• OCD patients have increased activity in the
  orbital frontal cortex
• Also in part of the basal ganglia, the caudate
  nuclei.
• Helps explain motor component
• Excess activity decreases following
• drug treatment
• Also with behavior therapy.
• White matter abnormalities
• suggest defect in connections of the cingulate
  gyrus with a circuit involving the basal ganglia,
  thalamus, and cortex
• apparently results in a loss of impulse control.
• OCD patients show too high of serotonergic
  activity.
• only drugs that consistently improve OCD symptoms
  are antidepressants that inhibit serotonin
  reuptake.
• Make serotonin more available in synapse
• Alters production/reuptake
• Suggests it is the reuptake receptors that may be
  at fault

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Heritability of anxiety disorders

• Family and twin studies
• anxiety disorders appear to be genetically
  influenced,
• heritabilities ranging between .20 and .43,
  depending on the disorder.
• Why important to understanding the hereditary
  underpinnings of anxiety?
• significant genetic overlap with other disorders
• Dopaminergic or monoamine cluster disorders.
• Over 90 of individuals with anxiety disorders
  also have history of other psychiatric problems.
• Overlap with affective disorders is particularly
  strong.
• 50-60 of patients with major depression also
  have a history of one or more anxiety disorders
• panic disorder is found in 16 of bipolar
  patients.
• Family clusters
• Drug abuse/alcohol abuse
• ADHD
• Affective disorders
• OCD
• Schizophrenia