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While all psychiatric disorders can benefit from psychotherapy which disorders may be
especially effectively treated with psychotherapy?
anxiety and traumatic disorders
Anxiety disorders have considerable symptom overlap with major depression particularly what
symptoms?
particularly sleep disturbance, problems concentrating, fatigue, and psychomotor/arousal
symptoms
Anxiety disorders are are extensively comorbid, not only with major depression but especially
with what other disorders?
substance abuse, ADHD, bipolar disorder, pain disorders, sleep disorders, and more
From a therapeutic point of view, it may matter little what the specific diagnosis is; what is the
primary objective of psychopharmacological treatments?
The emphasis is increasingly to take a symptom-based therapeutic strategy for patients with
psychiatric disorders.
PTSD is now categorized as a stress-related disorder rather than what type of disorder?
an anxiety disorder, and is considered a disorder of hyperarousal
All anxiety disorders have overlapping symptoms of what?
Anxiety/fear coupled with worry
Worry is the second core symptom shared across the spectrum of anxiety disorders. This
symptom is hypothetically linked to what?
Linked to the functioning of cortico-striato-thalamo-cortical (CSTC)loops
What differentiates one anxiety disorder from another may not be the anatomical location or the
neurotransmitters regulating fear and worry in each of these disorders but what?
The specific nature of malfunctioning within these same circuits in various disorders
Where is the amygdala located?
near the hippocampus and has an important anatomical connections that allow it to integrate
sensory and cognitive information, and then determine whether there will be a fear response
, What regulates the affect or feelings of fear?
They may be regulated via reciprocal connections the amygdala shares with the prefrontal cortex
that regulates emotions, namely the orbitofrontal cortex and the anterior cingulate cortex
Motor responses of fear are regulated in part by connections between the amygdala and what?
The periaqueductal gray area of the brainstem
There are also endocrine reactions that accompany fear in part due to connections between the
amygdala and the hypothalamus which causes what?
causes changes in the HPA (hypothalamic-pituitary-adrenal) axis, and thus of cortisol levels
Chronic and persistant activation of the HPA axis of the fear response can lead to wht
comorbidity?
increased medical comorbidity including rates of coronary artery disease, type 2 diabetes, and
stroke along with hippocampal atrophy
An adaptive response to fear is to accelerate respiratory rate when having a fight or flight
reaction to enhance survival, but when in excess what can this lead to?
unwanted symptoms of shortness of breath, exacerbation of asthma, or a false sense of being
smothered, all symptoms common during anxiety and especially during attacks of anxiety such
as panic attacks
The autonomic nervous system is attuned to fear and is able to trigger responces from the
cardiovascular system such as what?
increased pulse and blood pressure for fight/flight reactions and survival during real threats
Autonomic and cardiovascular responses are mediated by connections between what?
between the amygdala and the locus coeruleus, home if the noradrenergic cell bodies
When autonomic responses are repetitive, inappropriately, or chronically triggered as part of an
anxiety disorder, this can lead to what?
increases in atherosclerosis, cardiac ischemia, hypertension, myocardial infarction, and even
sudden death
Anxiety can be triggered internally from traumatic memories stored in the hippocampus and
activated by what?
the connections with amygdala, especially in conditions such as PTSD
The known neurobiological regulators of the amygdala, including what neurotransmitters?
GABA, serotonin, and norepinephrine, and the voltage-gated calcium channels