Anxiety‐related disorders: An overview

Riordan, Denise; Singhal, Deepa

doi:10.1111/jpc.14167

Cited by 11 publications

(10 citation statements)

References 32 publications

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“…Anxiety disorders are the most prevalent mental disorders and are associated with immense social health care costs 21 . A central symptom is avoidance behavior, which also acts as a reinforcer of the anxious state 24, 38 . It is vital then to understand the underlying cellular and circuitry mechanisms underpinning this type of avoidance behavior, which could result in new methods to break the cycle of anxiety-avoidance.…”

Section: Discussionmentioning

confidence: 99%

“…One possibility is PV GABAergic interneurons, which comprise only 3-4% of all neurons in the NAc 19, 20 . In other brain regions, these neuron regulate fear response 21 , anxiolysis 22 , alcohol addiction 23 , and reward seeking 3, 24 . However, we know less about the function of accumbal PV neurons and the inputs they receive, and nothing about any possible role in anxiety related behavior.…”

Section: Introductionmentioning

confidence: 99%

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A new GABAergic projection from the BNST onto accumbal parvalbumin neurons controls anxiety

Xiao

Zhou

Wei

et al. 2019

Preprint

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1The prevailing view is that parvalbumin (PV) interneurons play modulatory 2 roles in emotional response through local medium spiny projection neurons 3 (MSNs). Here, we show that PV activity within the nucleus accumbens shell 4 (sNAc) is required for producing anxiety-related avoidance when mice are 5 under anxiogenic situations; sNAc PV neurons exhibited high excitability in 6 chronically stressed mice model, which generated excessive maladaptive 7 avoidance behavior in an anxiogenic context. We also discovered a novel 8 GABAergic projections from the anterior dorsal bed nuclei of stria terminalis 9 (adBNST) to sNAc PV neurons; optogenetic activation of these afferent 10 terminals in sNAc produced an anxiolytic effect via GABA transmission. Next, 11 we further demonstrated that chronic stressors attenuated the inhibitory 12 synaptic transmission at adBNST GABA sNAc PV synapses, which in turn 13 explains the hyperexcitability of sNAc PV neurons on stressed models; therefore, 14 activation of these GABAergic afferents in sNAc rescued the excessive 15 avoidance behavior related to anxious state. 16Our findings reveal the coordination between BNST and NAc through an 17 inhibitory architecture in controlling of anxiety-related response and provide a 18 neurobiological basis for therapeutic interventions in pathological anxiety. 19 Introduction 1 Stressors and stress responses are critical for guiding both approach and 2 avoidance behaviors in animals and humans. Exposure to chronic, 3 unpredictable stressors leads to increased anxiety responses, including 4 excessive avoidance behavior, and this exposure has been adopted to study 5 anxious state-related behaviors 1, 2 . The bed nucleus of the stria terminalis 6 (BNST), a subregion of the extended amygdala, is a critical node in the stress 7 response 3, 4 . Recent work on human drug addiction has also demonstrated a 8 role of BNST in withdrawal-related anxiety and relapse, indicating an intrinsic 9 link between this stress response region and the reward system. The nucleus 10 accumbens (NAc) is a vital component in the reward circuitry 5-7 , which 11 responds to stress signals 8, 9 and has a dominant effect on anxiety regulation 10 . 12 However, with the exception of one 15-year-old anatomical observation 11 , the 13 connectivity between NAc and BNST, and whether it is necessary in producing 14 anxiety-related behavior, remains unexplored. Furthermore, GABAergic 15 efferents originating from the BNST are predominantly sent downstream 12, 13 ; 16 however, the nature and function of any GABAergic input to NAc is unknown.17 Medium spiny neurons that express dopamine 1 and 2 receptors (D1-and 18 D2-MSNs) are the predominant neural population in the NAc . Regarding 19 anxiety regulation, it is accepted that D1-MSNs are not involved in 20 anxiety-related behavior, but play roles in modulating reward-related 21 responses 14, 15 whereas D2-MSNs may regulate anxiety-related aversion or avoidance behavior 16 . However, the role of D2-MSNs are not entirely clear 1 because ot...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A new GABAergic projection from the BNST onto accumbal parvalbumin neurons controls anxiety

Xiao

Zhou

Wei

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…For moderate to severe ADHD, depression and any psychosis, medication should be considered a first‐line intervention in combination with psychosocial management. Pharmacotherapy is indicated for anxiety where psychosocial interventions have been ineffective …”

Section: Management Of Aggression In Childrenmentioning

confidence: 99%

“…Pharmacotherapy is indicated for anxiety where psychosocial interventions have been ineffective. 30,31 For the management of aggression, studies have shown that atypical antipsychotics (risperidone and aripiprazole), α-2 adrenergic agonists (clonidine and guanficine) and mood stabilisers (lithium and valproate) are all more effective than placebo for reducing aggression in children with conduct disorder. 30 However, all of these medications carry considerable early and later adverse effects.…”

Section: Management Of Aggression In Childrenmentioning

confidence: 99%

The aggressive child

Scott

Tunbridge

Stathis

2018

J Paediatrics Child Health

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Aggression in children is a common transdiagnostic symptom associated with a wide range of developmental and mental health problems. It emerges early and without intervention, may increase in severity as the child grows stronger. Aggressive children are more likely to experience physical and mental illness, unemployment, poverty and forensic problems as adults. Strategies to prevent aggression must address risk factors: low maternal education, adolescent pregnancy, in utero exposure to tobacco and alcohol, poverty, coercive parenting, childhood maltreatment and bullying victimisation. The aggressive child requires a comprehensive assessment to identify and manage underlying or comorbid problems, to understand the reasons for the aggressive behaviour and to detect modifiable factors that exacerbate or perpetuate the aggression. Psychosocial interventions include parenting skills training and child‐directed cognitive behavioural therapy, whereas pharmacotherapy may be used to treat underlying developmental or mental health problems or to manage the aggression.

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“…Comorbidities may affect treatment response and should be actively co-managed. There are documented increases in the incidence of separation anxiety, specific phobias, generalised anxiety 24 , attention-deficit hyperactivity disorder 25 and oppositional defiant disorder in children with soiling. 26 The Avon longitudinal study has been helpful in identifying trajectories and associations with soiling, albeit with the bias associated with relying on maternal report.…”

Section: Treatment Resistance and Comorbiditiesmentioning

confidence: 99%

Children who soil: A review of the assessment and management of faecal incontinence

Trajanovska

King

Gibb

et al. 2018

J Paediatrics Child Health

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Soiling is a common and distressing condition affecting children. In the vast majority of patients, it is associated with constipation. Most constipation is functional and is best thought of as difficulty achieving adequate bowel emptying. In a small minority of patients, there is no associated constipation, so‐called non‐retentive faecal incontinence. The aetiology of this latter condition in children remains unclear. The mainstay of management in all cases is a regular toileting programme, together with laxatives as required. This must be individualised considering the diagnosis, the age of the child and the psychosocial factors affecting the child and family. The diagnosis is made with a thorough history and examination, supplemented in some cases with targeted investigations. Engaging the child and family in a long‐term treatment programme (at least 6 months to 2 years) is essential for treatment success. The following clinical practice guideline and algorithm for the assessment and management of children who soil represents consensus opinion using available evidence.

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Anxiety‐related disorders: An overview

Cited by 11 publications

References 32 publications

A new GABAergic projection from the BNST onto accumbal parvalbumin neurons controls anxiety

A new GABAergic projection from the BNST onto accumbal parvalbumin neurons controls anxiety

The aggressive child

Children who soil: A review of the assessment and management of faecal incontinence

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