Anxiety-related Scales Research Articles

Uncovering the correlation between neurotransmitter-specific functional connectivity and multidimensional anxiety in a non-clinical cohort.

Research on anxiety faces challenges due to the wide range of symptoms, making it difficult to determine if different aspects of anxiety are linked to distinct neurobiological processes. Both alterations in functional brain connectivity (FC) and monoaminergic neurotransmitter systems are implicated as potential neural bases of anxiety. We aimed to investigate whole-brain FC involving monoaminergic nuclei and its association with anxiety dimensions in 178 non-clinical participants. Nine anxiety-related scales were used, encompassing trait and state anxiety scores, along with measures of cost-probability, hypervigilance, reward-punishment sensitivity, uncertainty, and trait worry. Resting-state functional magnetic resonance imaging data were acquired, focusing on seven brainstem regions representing serotonergic, dopaminergic, and noradrenergic nuclei, with their FC patterns voxel-wise correlated with the scales. All models underwent family-wise-error correction for multiple comparisons. We observed intriguing relationships: trait and state anxiety scores exhibited opposing correlations in FC between the dorsal raphe nucleus and the paracingulate gyrus. Additionally, we identified shared neural correlates, such as a negative correlation between the locus coeruleus and the frontal pole. This connection was significantly associated with scores on measures of probability, hypervigilance, reward sensitivity, and trait worry. These findings underscore the intricate interplay between anxiety dimensions and subcortico-cortical FC patterns, shedding light on the underlying neural mechanisms governing anxiety.

What do Anxiety Scales Really Measure? An Item Content Analysis of Self-Report Measures of Anxiety

Anxiety is a common experience and component of the human condition, but as a construct it is difficult to define and anxiety scales vary in which aspects are emphasized. In the present study, we analyzed and quantified the content overlap of self-report instruments used to measure non-specific or global anxiety. Categorization of the 313 items across thirteen commonly used anxiety scales resulted in 60 disparate categories that spanned a wide variety of symptoms. Mean overlap between all of the selected scales was generally low. On average, only 30.9.% of all symptoms were captured by any given measure. Results indicate that the scales are heterogenous in the content that they measure. Therefore, anxiety-related scales should not be assumed to be interchangeable and careful consideration should be taken when selecting measures.

Mitochondrial modulators for obsessive–compulsive and related disorders: a systematic review and meta-analysis

It remains unclear whether mitochondrial modulators (MMs) are beneficial in the treatment of obsessive–compulsive and related disorders. Thus, in an attempt to answer this clinical question, we performed a systematic review and a random-effects meta-analysis of double-blind, randomized, placebo-controlled trials. The primary outcome was change in overall symptoms as measured using standardized rating scales. Other outcomes were response to treatment; improvement in anxiety-related scales scores, depression-related scale scores, Clinical Global Impression Severity Scale (CGI-S) scores, and Sheehan Disability Scale (SDS) scores; all-cause discontinuation; and individual adverse events. We calculated the standardized mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. We reviewed 17 studies (n = 629, 72.62% female; duration = 2–20 weeks; mean age = 30.47 years) of MMs: eicosapentaenoic acid (K = 1), folic acid (K = 1), lithium (K = 1), N-acetylcysteine (K = 10), inositol (K = 3), and silymarin (K = 1). MMs outperformed placebo in overall improvement in symptoms (p < 0.01) and in improving anxiety-related scale scores (p = 0.05). Subgroup analysis of individual MMs revealed that although overall symptoms were better improved by N-acetylcysteine (p < 0.01) and lithium (p = 0.04), no MMs outperformed placebo in terms of improving anxiety-related scale scores. Neither pooled nor individual MMs outperformed placebo in improving response to treatment, depression-related scale scores, CGI-S scores, SDS scores, or all-cause discontinuation. N-acetylcysteine was no more associated with a higher incidence of individual adverse events including gastrointestinal symptoms, than placebo. In conclusion, N-acetylcysteine was beneficial in the treatment of obsessive–compulsive and related disorders. However, further study with larger samples is necessary to confirm this finding.

Pilot Study of a Virtual Reality Educational Intervention for Radiotherapy Patients Prior to Initiating Treatment.

Virtual reality (VR) presents opportunities for innovative patient educational methods. This study used a combination of subjective questionnaires and objective physiological measures to investigate the impact of a VR radiotherapy (RT) educational system on patients' understanding and anxiety prior to commencing RT. Sixty patients were randomized to control (n = 30) and intervention (n = 30) groups prior to initiating RT. The control group received the standard nursing care process. The intervention group additionally participated in a detailed introduction to RT positioning, procedures, treatments, and other RT-related information via VR education. All patients completed a data collection from pre- and postintervention, which included questions on RT comprehension, anxiety-related scales, and objective physiological data reflecting the patient's psychological state, such as blood pressure, heart rate, and respiration. Both groups had high anxiety levels before the intervention, and there was no significant difference between the questionnaire and physiological data of the two groups. Following the intervention, anxiety scores (state-trait anxiety scale and visual analog scale) of the intervention group decreased significantly compared with those of the control group, and there was a significant decrease in systolic blood pressure (p < 0.05) and increase in cognitive score (p < 0.05). This study reports the positive impact of a virtual reality radiotherapy (VRRT) patient educational system on increasing patient RT comprehension and reducing anxiety. Further work is needed to improve the acceptability of the system to patients and to explore further the impact of VR education on patients' psychological and physical needs.

Karolinska Scales of Personality, cognition and psychotic symptoms in patients with schizophrenia and healthy controls

Background: Studies on both personality dimensions and cognition in schizophrenia are scarce. The objective of the present study was to examine personality traits and the relation to cognitive function and psychotic symptoms in a sample of patients with schizophrenia and healthy controls. Method: In total 23 patients with schizophrenia and 14 controls were assessed with the Karolinska Scales of Personality (KSP). A broad cognitive test programme was used, including the Wechsler Adult Intelligence Scales, the Finger-Tapping Test, the Trail Making Test, the Verbal Fluency Test, the Benton Visual Retention Test, the Wisconsin Card Sorting Test and Rey Auditory Verbal Learning Test . Results: Compared with controls, the patients exhibited prominent elevations on KSP scales measuring anxiety proneness and neuroticism (P = 0.000005–0.0001), on the Detachment scale (P < 0.00009) and lower value on the Socialization scale (P < 0.0002). The patients also scored higher on the Inhibition of Aggression, Suspicion, Guilt and Irritability scales (P = 0.002–0.03) while the remaining five scales did not differ between patients and controls. KSP anxiety-related scales correlated with the Positive and Negative Symptoms Scale (PANSS) general psychopathology subscale. Cognitive test results were uniformly lower in the patient group and correlated with PANSS negative symptoms subscale. There was no association between KSP scale scores and PANSS positive or negative symptoms. Conclusion: The patients revealed a highly discriminative KSP test profile with elevated scores in neuroticism- and psychoticism-related scales as compared to controls. Results support previous findings utilizing other personality inventories in patients with schizophrenia. Cognitive test performance correlated inversely with negative symptoms.

Age and Temperament Differences in Mental Illness: Results From Three Studies

Objective Temperament and mental illnesses are considered to be varying degrees along the same continuum of neurotransmitter imbalance in neurophysiological systems of behavioural regulation. Three studies investigated relationships between temperament traits and clinical scales measuring five groups of symptoms of mental illness: Depression, Anxiety, Antisocial behaviour, Dominance-Mania and Borderline/Schizophrenia. Method The intake records of 395 (Study 1), 331 (Study 2), and 214 (Study 3) clients of a private psychological practice were examined, including their scores on the Structure of Temperament Questionnaire (STQ-77); Study 3 used the Personality Assessment Inventory (PAI). The sample was divided into four age groups (17-24, 25-45, 46-65, and 66-84). Results Study 1 and 2 found changes in the dynamical aspects of behaviour, such as endurance, plasticity and impulsivity in patients suffering from anxiety and depression. Study 3: Scores on the Depression- and Anxiety-related scales of PAI correlated with temperament scales of the STQ in a pattern similar to Studies 1 and 2. Anti-social scales of PAI correlated positively with Sensation Seeking and Impulsivity of the STQ-77. Higher Anxiety and Anti-social symptoms appeared to be more prominent in the younger age (unlike Depression symptoms), and declined with age. Dominance-Mania scores of PAI correlated positively with the Social-verbal Endurance and Tempo, Empathy and Self-confidence. Conclusions The analysis of age differences in association between temperament and mental illness showed age-sensitive patterns. Strong concurrent validity between the STQ-77 and the PAI scales suggests links between temperament traits and disposition for the main group of mental illness.

Pilot Study of Personality Traits Assessed by the Karolinska Scales of Personality (KSP) in Asthma, Atopy, and Rhinitis

Asthma and atopy are common diseases. To study associations between personality and asthma, atopy, rhinitis, and personality traits were measured on the Karolinska Scales of Personality for 193 persons working in 19 buildings with suspected indoor air problems. In addition, information on history of atopy, asthma, and rhinitis was collected by postal questionnaire. In analyses, asthma was associated with higher impulsiveness scores, and atopy in non-asthmatics was associated with higher social desirability scores and lower irritability, guilt, and impulsiveness scores. Non-atopic rhinitis was associated with scores on several anxiety-related scales, while atopic rhinitis was not associated with scores on the Karolinska Scales of Personality. This exploration implies that asthma, atopy, and rhinitis may be associated with various but different personality trait scores. The finding of such personality trait associations in persons with non-asthmatic atopy raises the question of a potential role of an emotional conflict in atopy and the role of personality in asthma, atopy, and rhinitis.

Depression, Anxiety, and the MCMI–III: Construct Validity and Diagnostic Efficiency

This study aimed to enhance knowledge of the construct validity and diagnostic efficiency of the depression- and anxiety-related scales of the MCMI–III (Millon, 1994). The MCMI–III, various concurrent depression and anxiety measures, and an Axis I structured diagnostic interview were administered in a total sample of 696 outpatients with depressive disorders, anxiety disorders, or both. Sound construct validity was found for the Dysthymia and Major Depression clinical syndrome scales and the Avoidant and Depressive personality disorder scales. The validity of the Anxiety scale was poor, showing moderate convergence with panic and worry-related anxiety measures, but problems discriminating from depression. Operating characteristics for discriminating depressed patients from anxious patients were fair for the Major Depression scale, but poor for the Anxiety and Dysthymia scales.

The long-term stability of temperament traits measured after a suicide attempt. A 5-year follow-up of ratings of Karolinska Scales of Personality (KSP)

The main aim of the present study was to investigate whether or not temperament dimensions are stable over time. Twenty-six patients (21 women and five men) filled in the Karolinska Scales of Personality (KSP) both at admission after a suicide attempt (index) and at follow-up 5 years later. KSP changes were significantly associated with low severity of psychiatric symptoms and no reported reattempts at follow up. There were significant changes of all five groups of KSP, most prominently in anxiety-related scales. At index, KSP scores did not differ between those who later would repeat a suicide attempt (repeaters) and not, but repeaters more often tended to have a personality disorder and their 24-h urinary cortisol tended to be lower. In this limited sample, repeaters seem to have a protracted high anxiety level as mirrored by high and stable KSP scores over time.

Karolinska Scales of Personality in a forensic psychiatric population: Stability over time and between situations

Assessment of personality traits by means of the Karolinska Scales of Personality (KSP) was made in connection with a forensic psychiatric investigation and at follow-up after 2 years. For some subjects, major life events had occurred between the assessments - in some cases positive events such as marriage, having children, starting regular studies or employment, or receiving psychotherapeutic treatment. In many cases. however, the events or circumstances during the 2-year interval were negative, such as relapse in criminality, incarceration in prison for the whole period between the ratings, or development of a schizophrenic disorder. Moreover, the second assessments were performed in various settings. No significant differences between the two ratings were found in the traits Impulsiveness, Monotony avoidance, or Socialization. Measures of Indirect and Verbal aggression and Irritability also remained stable, as did measures of Guilt and Social desirability. Thus. KSP personality traits related to psychopathy and aggressiveness proved to be stable over time independent of life events. Moderate to high correlations between scores obtained on the two occasions were found for most scales. However, scores of all anxiety-related scales were lower at the second assessments, as in other disordered populations.