User:Summer.pouliot/sandbox

Generalized Anxiety Disorder Article

Neurological Points//Notes/Suggestions:


 * Under Risk Factors the article discussed genetics. There is very little on the effects of genetics and GAD. So I think the article could benefit from more information on this. I feel that this is a place in the neurological section that is lacking. I definitely connected to this part of the article the most and felt that this would be cool to learn about and is definitely a needed area that requires more information.
 * The article also mentions the effects of smoking and how that is an increased risk for GAD due to neurotransmitter systems and stress. This might also be a section I could look into more and add more detail into this topic because there are only a few sentences.
 * Under Pathophysiology the article discussed ways parts of the brain like the amygdala, hypothalamus and cerebellum effect GAD. This section is pretty well written but maybe as I investigate more I could add or find somethings that need more content.
 * In the Treatment section it discusses medication sure as SSRI’s. At first I thought maybe this section could use more work but as I kept reading it actually held lots of information on many medications. So I think my contribution would be better somewhere else.
 * Maybe I could look more into the fear stimulus?

 Sources 

Source #1 - Clinical Review - Generalized Anxiety Disorder

Neurological:


 * Another overview of anxiety disorders but no concrete information on genetics.

Source #2  - Worry and Generalized Anxiety Disorder: A Review and Theoretical Synthesis of Evidence on Nature, Etiology, Mechanisms, and Treatment


 * women are more likely to become diagnosed with GAD. About 5.8% during their lifetime compared at 2.8%. Also White and Native American people seem to have a higher rate of GAD.


 * Major Depressive Disorder is highly associated with GAD. These two disorders are commonly seen together and have seen a genetic correlation.


 * Genetics and brain imaging has shown that individuals who suffer from GAD are more prone to negative emotional reactions. People who experience GAD tend to have stronger emotional reactions which are genetic.


 * Using magnetic resonance imaging studies have seen hyperresponsivity of the amygdala. The amygdala controls emotion and behavior. It also has a huge role in processing fear. Because of this stronger activity in the amygdala with individuals who have GAD they are seen to struggle with some emotions.


 * The amygdala also controls rapid responses and some stressors.


 * Individuals with GAD tend to struggle with social situations. Their brains cannot connect situations rapidly due to the amygdala so they might Disengage? (Check facts on this Pg.9)


 * Medications often used for GAD patients are selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) and if they have major depressive disorder they might use some antidepressants.

Source #3 - Genetics of generalized anxiety disorder and related traits


 * Two factors influence GAD. The first can be genetic factors and panic disorder. The second is environmental factors.


 * GAD can be linked to addictive disorders, social anxiety, stress disorders, and anorexia.


 * Twin studies have revealed that GAD and neuroticism have a high genetic correlation.


 * Some research has seen a connection with GAD and serotonergic and catecholaminergic systems. Also neurotrophic signaling. (pg.161)


 * Neuroimaging or imaging genetics is an amazing tool that is being used to study genetic correlations for GAD.


 * twin design study found increased amygdala right hippocampus glutamic acid/glutamine levels.” (pg.163) using magnetic resonance spectroscopy and diffusion tensor imaging.


 * GAD is being looked at with environmental interactions (gene-environment interactions). Some areas are childhood trauma and certain stressors.
 * When studies look at gene-environmental studies they look at individuals who suffered traumatic childhood experiences...then look at NT’s. Significant interactions have been found.


 * Research is also looking at other stressors like natural disasters and family situations. (pg.165) Some people experience GAD after a traumatic event like a huge hurricane.


 * “Low-warmth” family environment can possibly affect GAD


 * GAD is a heritable trait with a moderate genetic risk


 * chromosome 8 showed extended genetic correlations with an anxiety disorder


 * Gene-environment studies have been seeing the importance of early childhood development.

Source #4 - Biological markers of generalized anxiety disorder


 * People who suffer from GAD might use certain SSRIs or SNRIs


 * Neuroimaging in all different ways like MRI, DTI, and biochemical methods are finding all kinds of genetic correlations with GAD


 * Increased grey matter in the amygdala has been found with people who have GAD


 * Right Amygdala might have increased volume. Also  his might correlate with attention impairments. But this does not mean it depends on sex


 * Found greater volume of right amygdala with people who have suffered childhood maltreatment.


 * White matter volumes were lower with people who have GAD


 * More activity was presence with children who have GAD


 * Children with GAD have shown hyperactivity in the amygdala when shown negative faces.


 * GAD people had higher blood-oxygen levels when shown angry faces/triggers
 * Higher PFC activation with people who have GAD when shown angry faces


 * Resting state shows people with GAD have lower  prefrontal-limbic and higher perfontal hippocampus regions.


 * PET scan found lower basal ganglia rates  but increased gyrus  (Pg. 152)


 * 5-HT reuptake unchanged but dopamine-reuptake site was lower (pg 152)


 * (Pg. 153) - Types of genes with correlation.


 * HPA-axis activity (pg. 153) not affected much but look into more

Final Paragraphs for Group #5

Name: Summer Pouliot

Location of Paragraph: Under header titled "Risk Factors". Then under title "Genetics" after second sentence.

Perspective: Generalized Anxiety Disorder - Neurological

Neuroimaging, magnetic resonance imaging (MRI), direct tension indicator (DTI's), and biochemical methods have been used in studying individuals with GAD. Increased gray matter in the amygdala has been found in individuals who have been diagnosed with GAD. Grey matter is composed of cell bodies and dendrites and is involved with information processing. The amygdala plays a key part in emotion. Right amygdala shows larger volumes in patients with GAD who have suffered childhood trauma. Research is now looking at the effect of this trauma and how it relates to the environment. Gene-environment interactions are now being studied in individuals and twins. GAD does seem to have a genetic component but it is generally low risk.

Name: Jennina Esposito

Location of Paragraph: Under header titled "Risk Factors". Then under title "Genetics" after first paragraph. To be placed directly after paragraph above.

Perspective: Generalized Anxiety Disorder - Social

Generalized anxiety disorder, GAD, can affect many areas of an individual’s life. People with GAD often experience excessive, uncontrollable, and irrational worrying about events or activities within their lives. One of the areas most affected by GAD is one’s social life. Some emotional and behavioral symptoms include persistent fear of situations in which you may be judged, worrying about embarrassing or humiliating yourself, fear that others will notice that you look anxious, and even having anxiety in anticipation of a feared activity or event. Along with these emotional and behavioral symptoms, there are also several physical symptoms. Some of which include: fast heartbeat, trembling, sweating, upset stomach or nausea, difficulty breathing, dizziness, and muscle tension.

References for Jennina Esposito

Barrera, T. L., & Norton, P. J. (2009). Quality of life impairment in generalized anxiety disorder,

social phobia, and panic disorder. Journal of Anxiety Disorders, 23(8), 1086-1090. doi:10.1016/j.janxdis.2009.07.011

Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay, L. G. (2013).

Worry and Generalized Anxiety Disorder: A Review and Theoretical Synthesis of Evidence on Nature, Etiology, Mechanisms, and Treatment. Annual Review of Clinical Psychology, 9(1), 275-297. doi:10.1146/annurev-clinpsy-050212-185544

Social anxiety disorder (social phobia). (2017, August 29). Retrieved from

https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561