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Chapter 17

PSYC 211 Chapter Notes - Chapter 17: Palpitations, Mirror Neuron, Desipramine

Course Code
PSYC 211
Yogita Chudasama

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!Anxiety is an affective state characterised by:
- cognitive expectations of a diffuse and certain danger.
- an internal physiological preparedness to deal with the
threat (e.g. increased heart rate) and an external
physiological sign of anxiety (e.g. pale skin, trembling)
- an emotional sense of dread, fear, panic or worry.
- behaviours directed at escaping or avoiding the source of
!Anxiety is adaptive if it motivates effective behaviours, but if
the behavioural component becomes maladaptive, it is
referred to as an anxiety disorder.
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Five Classes of Anxiety Disorders
1.Generalised anxiety disorders occur in the absence of any
precipitating stimulus.
2.Phobia anxiety disorders are triggered by exposure to
particular objects or situations.
3.Panic disorders are rapid-onset attacks of extreme fear and
severe stress symptoms (e.g. choking, heart palpitations).
4.Obsessive-compulsive disorders are characterised by
frequently recurring, uncontrollable anxiety producing
thoughts (obsessions) and impulses (compulsions).
5.Posttraumatic stress disorder is an ongoing emotional
reaction to an extreme psychological trauma.
Panic Disorder
!People with panic disorder suffer from episodes of acute and
unremitting terror characterised by recurring panic attacks.
!Symptoms of panic attacks are universal .
!Physical symptoms of panic attacks include shortness of
breath, perspiration, irregularities in heartbeat, dizziness and
!The victim of a panic attack thinks he/she is going to die.
!Between panic attacks, the person will experience
anticipatory anxiety: the fear that another panic attack will
" Agoraphobia (fear of open spaces) prevents the person
venturing outside the house.
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What Causes Physical Symptoms of Panic Attacks?
!Lactic acid (a by product of muscular activity) and breathing
air with elevated levels of CO2
- increase heart and rate of respiration
!Yohimbine (an !2 adrenergic receptor antagonist) and
- have direct pharmacological effects on the nervous
-People with panic disorder have a family history of anxiety
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Pharmacological Treatment: Benzodiazepines
!Clinically used benzodiazepines such as diazepam (i.e. valium) are
full agonists at the benzodiazepine receptor.
!The benzodiazepine receptor forms part of the GABAA receptor
!Benzodiazepine agonists increase sensitivity of the GABA binding
site " anxiolytic effect
!Benzodiazepine antagonists occupy the receptor thereby reducing
sensitivity of GABA binding site " anxiogenic effect.
!Treatment of flumazenil (a benzodiazepine antagonists) produces
panic in patients with panic disorder, not controls (Nutt et al.,
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