Abstract
BackgroundResponses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression. Nonetheless, the relationship between subclinical stress and anxiety symptoms is still elusive.MethodsTo explore possible associations between stress and anxiety symptoms, patients with major depression (N = 77) and mentally healthy individuals of different age clusters and occupations (N = 412) were enrolled into the study. Stress was assessed with the new subclinical stress symptom questionnaire (SSQ-25). Anxiety was studied with the Beck Anxiety Inventory (BAI), mainly focusing on clinical anxiety, whilst anxiety as a personality trait was assessed with the trait aspect of the State Τrait Αnxiety Ιnventory Y (STAI Y). Statistical analyses included ANOVA, Scheffe test, linear regression models and a two-step cluster analysis using Log-Likelihood Distance measure and fixed number of two clusters.ResultsAge, stress symptoms and BAI scores differed significantly between among groups (P < 0.001), whilst STAI Y scores did not. Stress levels were found to be related to clinical anxiety (P < 0.001), while neither group identity nor age exerted any influence on anxiety levels (P > 0.05). The two Step Cluster analysis classified 76 out of 77 participants with milder stress (subclinical) symptoms into the cluster with moderate anxiety, as indicated by BAI scores, and all individuals with more severe stress into the severe anxiety cluster.ConclusionsThe observed associations between stress and anxiety shed light on the interrelations between even very mild (subclinical) stress and anxiety symptoms and may point to the potential of mild stress to serve as a target for early interventions aiming to prevent anxiety morbidity.
Highlights
Responses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression
That acute stress- and post-traumatic stress disorder, forming the one extreme of the spectrum of stress responses, are not classified as anxiety disorders any longer according to the diagnostic guidelines of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), despite the intuitive clinical relationship between stress and anxiety [7]
The aim of the present study was to shed light on potential associations between stress, grasped by an instrument sensitive to detect even subclinical stress, i.e. Stress Symptom Questionnaire25 (SSQ-25), and anxiety symptoms in mentally healthy individuals of different age groups and occupations, and in patients suffering from major depression
Summary
Responses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression. The new practical and easy-to-use Subclinical Stress Symptom Questionnaire (SSQ-25) enables a valid assessment and differentiation of even subclinical stress symptoms and their relevance in the study of psychopathological trajectories [6] It is noteworthy, that acute stress- and post-traumatic stress disorder, forming the one extreme of the spectrum of stress responses, are not classified as anxiety disorders any longer according to the diagnostic guidelines of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), despite the intuitive clinical relationship between stress and anxiety [7]. They are categorized into the new trauma- or stressor-related disorders, for the diagnosis of which the exposure to a traumatic event is required
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