Anticipatory Stressors Research Articles

State Trait Anxiety in the Emergency Department

To determine the relationship between stress indicators and state anxiety among pediatric emergency department (ED) patients, as a background to develop appropriate psychoeducational and behavioral interventions. Patients with nonchronic conditions aged 10 to 18 years completed questionnaires assessing demographics; (8) life stressors (LSs), such as death in family and marital separation/divorce; (10) anticipatory stressors (ASs) such as fear of needles, blood, or undressing; and the State Trait Anxiety Inventory for Children (a 20-item validated tool). One hundred patients completed the study: the mean age was 13.3 years; 56% were female; and 90% were Latino patients. Notable life stressors (mean, 1.83) included: change in school location (24%), change in school performance (29%), death in family (33%), and marital separation/divorce (48%). Common AS (mean, 4.76) included worry about shots (33%), strangers (41%), talking about personal problems (44%), separation from parents (51%), undressing (56%), hospitalization (57%), and pain (73%). Significant correlations were found between age and state anxiety (r, -0.21; P < 0.05), age and AS (r, -0.38; P < 0.001), and AS and state anxiety (r, 0.20; P < 0.05). Patients with clinical state anxiety (36%) were more likely to be in the ED with a complaint of pain and/or trauma, had significantly more AS (t, 2.1; P < 0.05), and worry about parental separation (χ, 5.5; P < 0.05) and blood tests (χ, 4.9; P < 0.05) than patients with subclinical state anxiety. The ED experience produces fear/anxiety, particularly in younger patients with a chief complaint of pain and/or trauma. Findings may lead to the development of psychoeducational and behavioral interventions that focus on anxiety reduction.

Anticipating loss and other temporal stressors predict traumatic stress symptoms among partners of metastatic/recurrent breast cancer patients

This study examined pre- and post-loss levels of posttraumatic stress symptoms (intrusion and avoidance) in partners of metastatic/recurrent breast cancer patients, and the relationship of these symptoms to past, current, and anticipatory stressors. The results indicate that 34% (17/50) of the partners experienced clinically significant symptom levels prior to the patients' deaths. Prior to loss, partners' symptoms were positively associated with their current level of perceived stress and anticipated impact of the loss; whereas following loss, partners' symptoms were predicted by higher pre-loss levels of symptoms, past family deaths, and anticipated impact of the loss. Limitations and treatment implications of the present research and directions for future research are discussed.

The effects of anticipatory stress on heart rate and T-wave amplitude

The purpose of the present study was to examine the effects of an anticipatory stressor on three measures of cardiovascular activity: heart rate (HR), T-wave amplitude (TWA) and blood pressure (BP). Twenty-eight males were assigned to either a stress or no-stress group. All subjects reviewed a brief section of prose and then read it aloud during two sessions. The stress group was told that the reading task was a speech and that their performance would be evaluated. The no-stress group was told that the reading task was a part of the readability evaluation of the text material. Reliable increases in HR were observed during both sessions with the stress group exhibiting greater accelerations than the no-stress group. Though TWA and BP varied with periods, no reliable group differences were observed. Degree of threat or aversiveness appears to be indexed more reliably by HR changes than by changes in TWA.