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Chapter 17

PSYC 211 Chapter Notes - Chapter 17: Posterior Parietal Cortex, Capsulotomy, Encephalitis


Department
Psychology
Course Code
PSYC 211
Professor
Yogita Chudasama
Chapter
17

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Chapter 17: Anxiety Disorders, Autistic Disorder, Attention-
Deficit/Hyperactivity Disorder, and Stress disorders
Notes taken by: Ashley Brown
Contact for mistakes: Ashley.brown@mail.mcgill.ca
Anxiety Disorders
Anxiety disorder: a psychological disorder characterized by tension, overactivity of the
autonomic nervous system, expectation of an impended disaster and continuous vigilance
for danger
- Panic disorder, generalized anxiety disorder, and social anxiety disorder are
three types that appear to have a biological cause
- OCD is classified as an anxiety disorder but is really different (diff symptoms
and diff brain regions)
Panic Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder
Description
Panic disorder: a disorder characterized by episodic periods of symptoms such as
shortness of breath, irregularities in heartbeat, and other autonomic symptoms,
accompanied by intense fear
- women twice as likely to suffer from panic disorder
- characterized by panic attacks which have physical symptoms such as shortness
of breath, clammy sweat, irregularities in heartbeat, dizziness, faintness and
feelings of unreality
o often feel they are going to die
- in between panic attacks many suffer from anticipatory anxiety which is a fear
of having panic attacks that can lead to the development of agoraphobia
o agoraphobia: a fear of being away from home or other protected places
Generalized anxiety disorder: a disorder characterized by excessive anxiety and worry
serious enough to cause disruption to one’s life
- also two times more likely in women than in men
Social anxiety disorder: a disorder characterized by excessive fear of being exposed to
the scrutiny of other people that leads to avoidance of social situations in which the
person is called on to perform
- equally likely in men and women
- if situations where they have to like speak in public or something are
unavoidable they experience anxiety and distress
Possible Causes
All those three have a hereditary component

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The short allele of the 5-HT transporter is also associated with higher levels of anxiety
- blushing is more prevalent in people with social anxiety disorder whose
chromosomes contain one or two short alleles of the 5-HTT promoter gene
Amygdala + the cingulate, prefrontal, and insular cortices are involved in anxiety
disorders
Panic attack decreased activity in right orbitofrontal cortex and anterior cingulate
cortex, increased activity in the amygdala
Activity of the amygdala when looking at angry/disgusted/fearful faces is correlated with
severity of people with social anxiety disorder’s symptoms
- in healthy people ventrolateral prefrontal cortex suppresses this activity
o not activated in people with social anxiety disorder
students with high levels of anxiety but not a diagnosed disorder show increased
activation of the amygdala and insular cortex, both were correlated with severity of their
anxiety
Treatment
Anxiety disorders are sometimes treated with benzodiazepines
- because the amygdala has a lot of GABAA receptors, these drugs (which target
that particular receptor) decrease the activity of both the amygdala and the
insula while looking at emotional faces
- administering flumazenil (a benzodiazepine antagonist) produces panic in
patients with panic disorder, but not controls
Serotonin appears to play a role in anxiety disorders as well as depression
- SSRIs (which are potent serotonin agonist) are used to treat OCD and very
effective in treating panic attacks
- Related to the 5-HT1A receptor
Something about glycine and D-Cycloserine in conjunction with cognitive behaviour
therapy to treat patients with anxiety disorders. Gets rid of maladaptive conditioned
emotional reponses
Obsessive-Compulsive Disorder
Description
Obsessive-compulsive disorder (OCD): a mental disorder characterized by obsessions
and compulsions
- obsession: an unwanted thought or idea with which a person is preoccupied
o incl. concern or disgust with bodily secretions, dirt, germs or a fear that
something might happen, and a need for symmetry, order or exactness
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- compulsion: the feeling that one is obliged to perform a behaviour: even if one
prefers not to do so
o four categories: counting, checking, cleaning, and avoidance
o believed to be species-type behaviour released from normal control
mechanisms by a brain dysfunction
Obsessions are also seen in schizophrenia but people with OCD recognize that their
thoughts and behaviours are senseless and desperately wish that they would go away,
especially as compulsions become more and more demanding
OCD seems to be an exaggeration of natural human tendencies
Possible Causes
OCD is at least partially hereditary
- greater concordance in MZ twins than DZ twins
OCD is associated with a neurological disorder that appears in childhood called
Tourette’s syndrome
- characterized by tics and involuntary vocalizations and sometimes by
compulsive uttering of obscenities and repetition of the utterances of others
- people with OCD show tics, the similarities of symptoms suggest an underlying
genotype
- studies have found a family association between OCD and tic disorders
Not all cases of OCD have genetic origin, sometimes occur after brain damage caused by
various means (birth trauma, encephalitis, and head trauma)
- in particular symptoms appear to be associated with damage/dysfunction of the
basal ganglia, cingulate gyrus, and the prefrontal cortex
o Tic disorders (incl. OCD) can be caused by a group A β-hemolytic
streptococcal infections which causes several autoimmune diseases
attacking several places including the tissue of the basal ganglia (in
addition to the valves of the heart and the kidneys)
Evidence of increased activity in the frontal lobes (especially the orbitofrontal cortex) and
caudate nucleus of the basal ganglia in people with OCD
- reducing the activity in these regions alleviates the symptoms
Treatment
Some patients with OCD have been successfully treated with cingulotomy or surgical
destruction of specific fibre bundles in the subcortical frontal lobe called the cingulum
bundle that connects the limbic structures of the temporal lobe with the frontal lobe
- considered a last resort when conventional treatments fail to work
o adverse side effects: problems of planning apathy, or difficulty
inhibiting socially inappropriate behaviour
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