Deck 16: Disorders of Anxiety and Impulsivity and the Drugs Used to Treat These Disorders

Question 1

Acute anxiety can be most effectively treated with

A) tricyclic antidepressants.
B) cognitive behavior therapy.
C) benzodiazepine medications.
D) barbiturates.

Answer 1

benzodiazepine medications.

Question 2

Which statement about CRF is false?

A) CRF acts as both a hormone and a neurotransmitter.
B) Hormonal CRF activates the pituitary glands during stress.
C) CRF antagonists that reduce stress or anxiety have not yet been discovered.
D) High levels of CRF receptors are found in brain regions involved in anxiety.

Answer 2

CRF antagonists that reduce stress or anxiety have not yet been discovered.

Question 3

Which statement about the role of norepinephrine in anxiety is false?

A) Inhibition of the locus coeruleus can elicit alerting and fear responses in animals.
B) Abnormal sympathetic nervous system activation is a common feature of anxiety disorders.
C) Excess norepinephrine activity can contribute to the formation of trauma memories in PTSD.
D) Some anxiety-reducing drugs work by inhibiting norepinephrine pathways.

Answer 3

Inhibition of the locus coeruleus can elicit alerting and fear responses in animals.

Question 4

Which of the following is not an effect of anxiety-reducing drugs on locus coeruleus (LC) cell firing?

A) TCAs enhance norepinephrine action at inhibitory autoreceptors to reduce LC firing.
B) Benzodiazepines increase the inhibitory effects of GABA on the cells in the LC.
C) SSRIs increase serotonin, which inhibits LC firing.
D) Yohimbine increases serotonin and norepinephrine, resulting in a decrease in LC firing.

Question 5

Which statement regarding the role of GABA in anxiety is false?

A) The GABA drug muscimol causes anxiety.
B) Intracranial injections of benzodiazepines reduce anxiety in operant conflict tasks.
C) Bicuculline blocks benzodiazepine-enhancement of behavior in the social interaction test in animals.
D) Benzodiazepine injections into the amygdala increase the number of light-dark crossings in animals.

Question 6

Which statement about adult mice exposed to early prenatal stress is false?

A) They show enhanced HPA axis activity in response to stress.
B) They show disrupted negative feedback of the HPA axis.
C) They have increased numbers of glucocorticoid receptors.
D) They show increased expression of CRF in the amygdala.

Question 7

Which of the following has not been implicated as a risk factor or triggers in panic disorder?

A) Genetic predisposition for panic
B) Breathing air with decreased amounts of carbon dioxide
C) Injection with lactic acid
D) Yohimbine injection

Question 8

Which statement about phobias is false?

A) They involve fears that the person recognizes as extreme or irrational.
B) They are in part determined by culture; for example the Chinese often fear the cold and loss of body heat.
C) They are effectively treated by having the person relax while presenting the feared stimulus in gradually increasing intensities.
D) They are rarely so severe that they affect the quality of a person's life.

Question 9

Which statement about post-traumatic stress disorder (PTSD) is false?

A) It has been diagnosed in very few soldiers returning from the wars in Iraq and Afghanistan.
B) It occurs in people who have experienced or witnessed traumatic events, such as the 9/11 terrorist attacks.
C) It is characterized by nightmares and flashbacks in which people relive the traumatic event.
D) It is associated with increased physiological and psychological reactivity to events that are related to the trauma.

Question 10

Which of the following is not a reliable symptom or characteristic of PTSD?

A) Sleep disturbances
B) Numbing of emotional responses
C) High cortisol levels
D) High incidence of substance abuse

Question 11

Which statement about OCD is false?

A) It is characterized by obsessions and compulsions.
B) It is now considered to be the most common anxiety disorder.
C) It creates great anxiety for patients if they are unable to carry out their rituals.
D) It is considered by some researchers to be a motor disorder.

Question 12

All of the following brain areas have been implicated in the neurobiological model of OCD except for the

A) amygdala.
B) basal ganglia.
C) thalamus.
D) anterior cingulate cortex.

Question 13

Drugs that relieve anxiety are

A) anxiolytics.
B) sedatives.
C) CNS depressants.
D) All of the above

Question 14

Which of the following is not a way that benzodiazepines affect GABA at the synapse?

A) They act as GABA antagonists and produce inhibitory effects.
B) They cause an IPSP.
C) They result in a local hyperpolarization.
D) They cause the chloride ion channel to open more frequently.

Question 15

While barbiturates are probably the oldest of the sedative hynotics, they are not currently used for anxiety/insomnia because

A) sodium amytal was the only barbiturate available.
B) barbiturates only came in short-acting forms.
C) barbiturates can be lethal, while benzodiazepenes are much safer.
D) barbiturates do not help with insomnia.

Question 16

Which of the following is not a side effect of the barbiturates?

A) Tolerance to the sedative effects of the drug
B) REM rebound after withdrawal from the medication
C) Cognitive deficits
D) Tolerance to the respiratory effects of the drug

Question 17

The duration of action of benzodiazepines

A) is fairly constant, ranging from 10-20 hours.
B) is longer for drugs like Valium and Librium that have active metabolites.
C) depends partly on whether drugs are redistributed to fat and muscle depots.
D) is equal to the length of time it takes for phase I metabolism to occur.

Question 18

Which of the following is not an advantage that the benzodiazepines have over the barbiturates?

A) There is more metabolic tolerance with the benzodiazepines than the barbiturates.
B) The benzodiazepines have a higher therapeutic index.
C) There is an antagonist drug available to reverse the effects of benzodiazepine overdose but not barbiturate overdose.
D) The withdrawal syndrome following use of benzodiazepines is milder than that of the barbiturates, and it is not life-threatening.

Question 19

Which of the following is not a reason BuSpar has limitations as a clinically effective drug?

A) It takes too long to work; hence it cannot be used for situational anxiety.
B) It shows no cross-tolerance with other sedative-hypnotics and hence cannot be used to substitute for these drugs during withdrawal.
C) It is not useful as a treatment for insomnia.
D) It produces a severe withdrawal syndrome.

Question 20

Which of the following is not a reason that antidepressants are used to treat anxiety disorders?

A) Depression and anxiety often occur together in the same person.
B) The side effects of the SSRIs are more tolerable than those of the anxiolytic drugs.
C) The antidepressant desipramine is particularly effective in treating all forms of anxiety and depression.
D) Some people with anxiety disorders are prone to drug abuse and should not take the traditional anxiolytics; antidepressants are another option.

Question 21

One significant problem with using antidepressants to relieve anxiety is that antidepressants

A) like SSRIs can take 4-6 weeks to work.
B) like SSRIs have more significant side effect profiles than all other anxiolytic drugs.
C) like barbiturates do not relieve anxiety.
D) do not work on anxiety.