Anxiety-related Symptoms Research Articles

Contamination-fear in subclinical obsessive-compulsive disorder: A further proof for no preferential processing of disorder-related stimuli

How do individuals with obsessive-compulsive disorder (OCD) process and respond to images of rotten food or dirty toilets? In contrast to other fear-related disorders, evidence for attentional biases and preferential processing of disorder-related stimuli in samples of OCD is mixed. To address methodological problems of previous studies and to increase validity, we used two independent samples of participants with contamination fear and two sets of standardized stimuli in an established experimental paradigm. In two experiments, we compared evaluation and visual processing of contamination-fear related (CFr) stimulus material in individuals with high (HCF) and low (LCF) contamination fear. In experiment 1, we selected CFr stimuli from a database with disgust-related images (DIRTI). Even though the HCF group rated CFr images as being more unpleasant, arousing, and disgusting, we found no indicators of preferential processing (larger priming effects or faster responses). In experiment 2, we selected CFr stimuli from a database with images specifically chosen to evoke symptom-related anxiety in OCD patients (BOCD-PS). Again, negative evaluations of stimuli did not transfer into enhanced information processing. We conclude that early information processing of CFr stimuli is fundamentally different to that of fear-related stimuli in anxiety disorders; probably because of the triggered disgust response.

Standard or individualized quality of life for larynx cancer patients?

Locally advanced larynx cancer benefits from curative surgery therapy. Clinical trials have been proposed for assessing the quality of life for patients with larynx malignant neoplasia who underwent radical surgery. The removal of the “voice box” is known to have great impact on the social reintegration of these patients as well as psychological distress. The presence of tracheostomy and voice impairment are two of the major issues that need to be thought of by patients that will have a total laryngectomy. The quality of life is a multi-dimensional subjective and personal concept which includes normal physical activity, looks, psychological status, somatic symptoms and, non the less, sexual activity. Cancer free survival intervals for patients with larynx cancer must be evaluated physical and psychological modifications with particular considerations to stress, anxiety and depression related symptoms and to functional rehabilitation adaptation regarding swallowing and speech. Oncology surgeons must consider that QoL is impaired in all patients with larynx cancer that benefit from total laryngectomy. However, there is evidence presented below that the difference in QoL parameters is small when comparing radical surgery, total laryngectomy, and larynx conservation by radio and chemotherapy.

Symptom clusters in chronic obstructive pulmonary disease: A systematic review

AimTo conduct a comprehensive literature review to identify symptom clusters commonly present in Chronic obstructive pulmonary disease (COPD) patients. BackgroundCOPD is the fourth leading cause of death worldwide. Substantial research has been studied regarding single symptoms that burden patients with this disease and the profound impacts that these symptoms can have on physical and psychological health. However, these symptoms rarely occur in isolation and limited research has been conducted identifying clinically significant relationships or clusters of symptoms associated with COPD afflicted patients. MethodsPubMed, Web of Science, and Embase databases were used to identify potential articles limited to records published between 2005 and 2018 with human-conducted trials on adults with COPD, examining symptom clusters in this population. Only 5 studies met inclusion criteria. ResultsAcross the five studies, 596 participants were included with a mean age of 70.49. Two themes emerged including psychological symptom clusters and respiratory-related symptom clusters. Anxiety-related symptoms appeared to be a common theme among psychological symptom clusters and varied greatly based on instrument selection. Inconsistent results were found in respiratory-related symptom clusters, but included difficulty breathing as a common symptom component. Only one study examined for stability of symptoms over time. ConclusionThere were inconsistent results across all studies which may be contributed to the heterogeneity amongst patients, instruments administered, and statistical approach. Future research should be conducted to further elucidate COPD related symptom clusters, their effects on somatic and cognitive health, and the stability of these symptom clusters over time.

The effects of environmental enrichment and social isolation and their reversion on anxiety and fear conditioning

Animal models of fear and anxiety provide important insight into anxiety-related symptoms in humans. Environmental physical conditions and social contact influence behavior and brain plasticity particularly at early developmental stages and have long lasting effects reaching even adulthood. The potential benefit that a later environmental enrichment may have on rats raised in isolation is however not fully understood. We aim to investigate the effects of housing conditions and their reversion on anxiety and fear-related behaviors in rats. In phase I, we compared the effects of different housing conditions (environmental enrichment, control and social isolation) on anxiety behaviors in the open field test, elevated plus maze and fear conditioning. We found stronger effects of housing on behavioral tests when induced at weaning (phase I), than later in development (phase II). After one month, EE rats showed lower anxiety related behaviors and more freezing in FC. In phase II, we evaluated the effects of the reversion of housing conditions on the same behavioral parameters. We observed a behavioral trend such that the groups started to behave similar to their new housing conditions in OFT mainly. These results suggest that housing conditions at weaning can have long-lasting effects on anxiety and fear-related behaviors. Because the behavioral changes observed after the housing reversal in adulthood were partial, we suggest that more time of social and physical enrichment could be necessary to promote major changes in behavior at this age.

Conversion and Anxiety: New Neuroimaging Evidence and Clinical Correlates

In this presentation, we will present data from the first-ever, case-controlled neuroimaging study of pediatric psychogenic nonepileptic seizures (PNES) and discuss associations between neuroimaging findings and psychopathology of youth with PNES, including the role of anxiety-related symptoms and neural circuits. We will also review evidence of links between anxiety and conversion symptoms and discuss potential mechanisms underlying these disorders. Finally, we will report our functional neuroimaging findings on cognitive networks involved in conflict processing in youth with anxiety disorders.

The effect of worrying on intolerance of uncertainty and positive and negative beliefs about worry

Background and objectivesThe effect of a worry manipulation on the clinical constructs intolerance of uncertainty (IU), negative beliefs about the consequences of worry (NCOW), positive beliefs about the consequences of worry (PCOW), in addition to the emotions anxiety and sadness, was examined. MethodsA non-clinical sample was split into two groups, a worry group (n = 29), who were asked to generate 20 potential worries about a hypothetical scenario, and a control group (n = 28), who were asked to generate 2 potential worries about the same scenario. Subsequently, participants were asked to complete measures of IU, NCOW, PCOW, sadness and anxiety. ResultsThe worry group scored significantly higher than the control group on measures of IU, NCOW and PCOW but not on measures of sadness and anxiety. LimitationsPossible limitations of the current study include the use of a student sample and the use of a hypothetical worry scenario. ConclusionsThe results suggest that engaging in worry can increase scores on measures of the beliefs and thought patterns often used to causally explain worry. The results are in line with recent research showing bidirectionality between anxiety related symptoms and their associated clinical constructs, and are consistent with an approach which sees anxiety symptoms as part of an evolved integrated threat management system that alerts the individual to threats to goals or challenges, and coordinates cognitive, behavioral, and affective reactions to enable effective responding to these threats and challenges.

Adolescent Nicotine Exposure Induces Dysregulation of Mesocorticolimbic Activity States and Depressive and Anxiety-like Prefrontal Cortical Molecular Phenotypes Persisting into Adulthood.

Considerable evidence demonstrates strong comorbidity between nicotine dependence and mood and anxiety disorders. Nevertheless, the neurobiological mechanisms linking adolescent nicotine exposure to mood and anxiety disorders are not known. Disturbances in the mesocorticolimbic dopamine (DA) system, comprising the prefrontal cortex (PFC), ventral tegmental area (VTA), and nucleus accumbens (NAc), are correlates of mood and anxiety-related symptoms and this circuitry is strongly influenced by acute or chronic nicotine exposure. Using a combination of behavioral pharmacology, in vivo neuronal electrophysiology and molecular analyses, we examined and compared the effects of chronic nicotine exposure in rats during adolescence versus adulthood to characterize the mechanisms by which adolescent nicotine may selectively confer increased risk of developing mood and anxiety-related symptoms in later life. We report that exposure to nicotine, selectively during adolescence, induces profound and long-lasting neuronal, molecular and behavioral disturbances involving PFC DA D1R and downstream extracellular-signal-related kinase 1-2 (ERK 1-2) signaling. Remarkably, adolescent nicotine induced a persistent state of hyperactive DA activity in the ventral tegmental area (VTA) concomitant with hyperactive neuronal activity states in the PFC. Our findings identify several unique neuronal and molecular biomarkers that may serve as functional risk mechanisms for the long-lasting neuropsychiatric effects of adolescent smoking behaviors.

Progressive muscle relaxation technique on anxiety and depression among persons affected by leprosy.

Anxiety and depression have been found to be increasing among people with leprosy and it may lead to decreased social participation. The progressive muscle relaxation technique (PMRT) is widely used today in choice of treatment for reducing the anxiety and depression. This study aimed to assess the effectiveness of PMRT in reducing anxiety and depression among the hospitalized leprosy affected person in a tertiary care centre. This study is a case series of 50 leprosy affected people aged between 18–60 years who were admitted for leprosy complications in tertiary leprosy referral hospital. The Anxiety-Depression scale was developed and validated by the investigators and administered before intervention of PMRT and after 2 weeks. The follow-up assessment was done at 6 weeks after the initial intervention. The finding shows that a statistically significant difference was observed on anxiety domain before and after application of PMRT. The anxiety means score showed steady decline from 6.76 at pretest to 3.0 (t=25.068, P≤0.001) at post test and 1.12 (t=22.679, P≤0.001) at follow-up. In depression domain, a statistically significant difference was seen in before and after application of PMRT. The depression means score showed steady decline from 6.92 at pre test to 3.28 (t=16.082, P≤0.001) at post test and to 1.16 (t=18.918, P≤0.001) at follow-up. This study proved that the PMRT as a valid treatment option for hospitalized person with leprosy in minimizing the anxiety and depression related symptoms and to benefit the psychosocial wellbeing of leprosy affected patients.

17 β-Estradiol exacerbates methamphetamine-induced anxiety-like behavior in female mice

The present experiment investigated the effect of 17 β-estradiol (E2) on anxiety-like behavior following methamphetamine administration in female, Swiss-Webster mice. Mice underwent bilateral ovariectomy (OVX) followed by a subcutaneous implantation of a Silastic capsule containing either sesame oil (OVX + Oil) or E2 (36 μg/ml; OVX + E2). One week later, mice were placed in an open-field chamber for an 8-h session. During the first 3 h of the session, mice were permitted to run in the absence of any drug (baseline). Then, mice were injected intraperitoneally with methamphetamine (0.25, 0.5 or 1.0 mg/kg) or vehicle (physiological saline) and returned to the open-field chamber for the remaining five hours of the session. Mice were injected with vehicle or a different methamphetamine dose once a week for 4 weeks. Four measures of anxiety were assessed: distanced traveled, vertical counts, time in the center, and time resting in the perimeter of the chamber. OVX + E2 were less active and spent less time in the center than OVX + Oil mice during Hour 1 at certain doses, but not during remaining baseline hours (Hours 2–3). Furthermore, group differences were not observed during the Stimulant Phase (Hour 4) following injection of any methamphetamine dose (0.25, 0.5 or 1.0 mg/kg) or the vehicle. However, OVX + E2 mice were less active, spent less time in the center, and spent more time resting in the perimeter of the chamber compared to OVX + Oil mice during certain hours of the Clearance Phase (Hours 5–8) following injection of the high (1.0 mg/kg), but not the low (0.25 mg/kg) or moderate (0.5 mg/kg), methamphetamine doses. These results suggest that E2 exacerbates anxiety-like behavior during acute clearance from a high methamphetamine dose in OVX female mice, perhaps indicating that E2 contributes to drug relapse in women by worsening anxiety-related withdrawal symptoms.

Hyperglycemia elicits anxiety-like behaviors in zebrafish: Protective role of dietary diphenyl diselenide

Diabetes mellitus (DM) is a chronic metabolic disease that may comorbid with various psychiatric disorders, such as anxiety and depression. The search for effective therapeutics to alleviate hyperglycemia and complications resulting from DM is continuous. Here we investigate the effects of diphenyl diselenide (DD), an organoselenium compound with several pharmacological properties, in a zebrafish model of hyperglycemia. Fish were fed for 74 days with a diet containing 3 mg/Kg DD, a concentration chosen after experiments based in a dose-response curve (DD 1, 2 and 3 mg/Kg) that did not cause overt toxicity (mortality, weight loss and neurobehavioral deficits). In the last 14 days of the experimental period, fish were concomitantly exposed to a glucose solution (111 mM). Afterwards, blood glucose levels, brain selenium (Se) content, and behavioral analysis aiming to assess anxiety-like behaviors and locomotor/exploratory activities were performed. In the novel tank diving test, glucose decreased vertical exploration and fish spent less time in the lit area when tested in the light-dark test, suggesting increased anxiety-like behavior. Moreover, DD decreased blood glucose levels in hyperglycemic fish as well as prevented the development of anxiety-related symptoms. DD diet alone did not change glycemia and behavioral parameters, but increased Se levels in the brain without affecting the cellular viability. Collectively, our findings highlight the growing utility of this zebrafish hyperglycemia model as a valuable strategy for further research in DM field and neuroprotective approaches.

Characterizing anxiety subtypes and the relationship to behavioral phenotyping in major depression: Results from the EMBARC study

The current study aimed to characterize the multifaceted nature of anxiety in patients with major depression by evaluating distinct anxiety factors. We then related these derived anxiety factors to performance on a Flanker Task of cognitive control, in order to further validate these factors. Data were collected from 195 patients with nonpsychotic chronic or recurrent major depression or dysthymic disorder. At baseline, participants completed self-report measures of anxiety, depression, and other related symptoms (mania, suicidality) and clinicians administered a structured diagnostic interview and the Hamilton Rating Scale for Depression, including anxiety/somatization items. Four discrete factors (State Anxiety, Panic, Neuroticism/Worry, and Restlessness/Agitation) emerged, with high degrees of internal consistency. Discriminant and convergent validity analyses also yielded findings in the expected direction. Furthermore, the neuroticism/worry factor was associated with Flanker Task interference, such that individuals higher on neuroticism/worry responded more incorrectly (yet faster) to incongruent vs. congruent trials whereas individuals higher on the fear/panic factor responded more slowly, with no accuracy effect, to the Flanker Task stimuli. These results parse anxiety into four distinct factors that encompass physiological, psychological, and cognitive components of anxiety. While state anxiety, panic and neuroticism/worry are related to existing measures of anxiety, the Restlessness/Agitation factor appears to be a unique measure of general anxious arousal. Furthermore, two factors were independently validated through the Flanker Task. These results suggest that these anxiety domains have distinct behavioral profiles and could have differential responses to distinct treatments.

A Critical Outlook on Combat-Related PTSD: Review and Case Reports of Guilt and Shame as Drivers for Moral Injury

ABSTRACTThe model of posttraumatic stress disorder (PTSD) that has been dominant for many years has focused on fear conditioning and anxiety-related symptoms as main drivers of the pathology. Yet, the fear based conceptualization fails to consider the rules of modern combat, the culture of combatants, operational stressors and the moral dimension. Recently there is renewed interest in moral distress and moral injury with a focus on guilt, shame, and anger. Accumulating evidence suggests a link between transgression of moral values and symptoms of guilt and shame, anger, suicidal ideation, and PTSD in military servicemen and veterans. Although proper assessment is still in its infancy, there is a need to better understand how moral decisions can affect the mental health of military personnel at any point during their careers, including postrelease. The authors illustrate this with three clinical case reports. They conclude with a call for attention to the relation between the incurrence of moral injurious distress, and the role of guilt and shame as drivers for chronicity of PTSD. Identifying and addressing these issues can contribute to therapy adherence, facilitate successful progression, and contribute to healing and moral repair and reduce overall symptoms of PTSD.

ATP-sensitive potassium-channel inhibitor glibenclamide attenuates HPA axis hyperactivity, depression- and anxiety-related symptoms in a rat model of Alzheimer's disease

Affective disorders including depression and anxiety are among the most prevalent behavioral abnormalities in patients with Alzheimer's disease (AD), which affect the quality of life and progression of the disease. Dysregulation of the hypothalamic-pituitary-adrenal-(HPA) axis has been reported in affective disorders and AD. Recent studies revealed that current antidepressant drugs are not completely effective for treating anxiety- and depression-related disorders in people with dementia. ATP-sensitive-potassium-(KATP) channels are well-known to be involved in AD pathophysiology, HPA axis function and the pathogenesis of depression and anxiety-related behaviors. Thus, targeting of KATP channel may be a potential therapeutic strategy in AD. Hence, we investigated the effects of intracerebroventricular injection of Aβ25-35 alone or in combination with glibenclamide, KATP channel inhibitor on depression- and anxiety-related behaviors as well as HPA axis response to stress in rats. To do this, non-Aβ25-35- and Aβ25-35-treated rats were orally treated with glibenclamide, then the behavioral consequences were assessed using sucrose preference, forced swim, light-dark box and plus maze tests. Stress-induced corticosterone levels following forced swim and plus maze tests were also evaluated as indicative of abnormal HPA-axis-function. Aβ25-35 induced HPA axis hyperreactivity and increased depression- and anxiety-related symptoms in rats. Our results showed that blockade of KATP channels with glibenclamide decreased depression- and anxiety-related behaviors by normalizing HPA axis activity in Aβ25-35-treated rats. This study provides additional evidence that Aβ administration can induce depression- and anxiety-like symptoms in rodents, and suggests that KATP channel inhibitors may be a plausible therapeutic strategy for treating affective disorders in AD patients.

Tianeptine: An Atypical Antidepressant with Multimodal Pharmacology

Background: Tianeptine is an atypical antidepressant marketed as Stablon since the late 1980's. While chemically very similar to tricyclic antidepressants, tianeptine was thought to have the apparently paradoxical mechanism of action of enhancing serotonin reuptake. However, recent data highlight a multimodal pharmacology for tianeptine including actions at glutamatergic synapses (inhibiting NMDA receptors and an indirect effect on AMPA receptors) coupled with agonist effects at mu opioid receptors (µ-receptors). Objective: We have reviewed clinical and preclinical data for tianeptine to provide a comprehensive study of its pharmacology. Results: Clinical trials show that tianeptine is at least as efficacious as first-line antidepressant treatments, with improved tolerability as it is significantly less prone to disrupting the patient's normal functionality. Tianeptine appears more efficacious in males than females, although these gender-specific differences may be accounted for by pharmacokinetics. Preclinical data suggest that the ability to stabilise glutamatergic neurotransmission may underlie tianeptine's ability to improve cognitive function and anxiety-related symptoms. Alternatively, µ-receptor activation of the mTOR signalling pathway could lead tianeptine to be a fastacting antidepressant. Agonist actions at µ-receptors could also explain the potential abuse liability and dependence issues seen with high dose tianeptine. Conclusion: Tianeptine itself is off patent, but it still holds much promise as an experimental tool yielding valuable insights into the molecular mechanisms underlying depression. Keywords: Depression, anxiety, serotonin, glutamate, µ-opioid receptor, gender, mTOR.

Hypothalamic-pituitary-adrenal axis variants and childhood trauma influence anxiety sensitivity in South African adolescents.

Anxiety sensitivity (AS) is characterised by the fear of anxiety-related symptoms and is a risk factor for the development of anxiety-related disorders. We examined whether genetic variation in three stress response genes, CRHR1, NR3C1, and FKBP5, interact with childhood trauma (CT) to predict AS in South African adolescents. Xhosa (n=634) and Coloured (n=317) students completed self-report measures of AS and CT, and a total of eighteen polymorphisms within CRHR1, NR3C1, and FKBP5 were genotyped. Differences in AS based on genetic variation and CT were analysed within population and gender groups using multiple linear regression. Associations were found between AS and FKBP5 rs9296158 (p=0.025) and rs737054 (p=0.045) in Coloured males. Analysis of gene x CT interactions indicated that NR3C1 rs190488 CC-genotype, NR3C1 rs10482605 G-allele addition, and FKBP5 rs3800373 C-allele addition protect against AS with increasing CT in Xhosa females (p=0.009), Xhosa males (p=0.036) and Coloured males (p=0.049), respectively. We identified two different protective single nucleotide polymorphism (SNP) combinations in a four-SNP CRHR1 haplotype in Coloured males. An analysis of the interaction between CT and a six-SNP FKBP5 haplotype in Coloured males revealed both protective and risk allelic combinations. Our results provide evidence for the influence of both genetic variation in CRHR1, NR3C1 and FKBP5, as well as CT x SNP interactions, on AS in South African adolescents. This study reinforces the importance of examining the influence of gene-environment (G X E) interactions within gender and population groups.

Hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders. A systematic review.

Depression has repeatedly been linked to subclinical hypothyroidism, and thyroid hormones have successfully been used to augment antidepressant treatment. By contrast, the extent of thyroid dysfunction in anxiety disorders remains less clear. This is surprising, given that anxiety-related symptoms (e.g., nervousness, palpitations, increased perspiration) are highly prevalent in hyperthyroidism. The present study was undertaken to synthesize the literature on hypothalamic-pituitary-thyroid (HPT) axis functioning in anxiety disorders. The PubMed and PsycINFO databases were systematically searched. Three types of studies were included: (1) "comorbidity studies" assessing the prevalence of thyroid disorders in individuals with anxiety disorders, (2) "case-control studies" comparing HPT parameters between patients and controls, and (3) "correlational studies" assessing self-reported anxiety levels and HPT parameters. Risk of bias was assessed via a standardized quality rating. Twenty studies were eligible. Nearly all found the comorbidity between anxiety and thyroid disorders was significant. Half of the studies additionally supported the notion of subtle thyroid dysfunction in that thyroid-stimulating hormone (TSH) responses to the administration of thyrotropin-releasing hormone (TRH) were blunted and an inverse relationship was observed between self-reported anxiety levels and TSH. Overall, HPT assessments were well conducted, but several studies failed to adjust their analyses for smoking, body mass index (BMI), and depression. The findings resonate well with clinical recommendations to routinely screen for thyroid disorders in patients with anxiety disorders, and with what is known from basic research about thyroid-brain interactions. The results of the risk of bias assessment underscore the importance of further high-quality experimental and longitudinal epidemiological research.

Interpersonal Subtypes Within Social Anxiety: The Identification of Distinct Social Features

ABSTRACTAlthough social anxiety disorder is defined by anxiety-related symptoms, little research has focused on the interpersonal features of social anxiety. Prior studies (Cain, Pincus, & Grosse Holtforth, 2010; Kachin, Newman, & Pincus, 2001) identified distinct subgroups of socially anxious individuals' interpersonal circumplex problems that were blends of agency and communion, and yet inconsistencies remain. We predicted 2 distinct interpersonal subtypes would exist for individuals with high social anxiety, and that these social anxiety subtypes would differ on empathetic concern, paranoia, received peer victimization, perspective taking, and emotional suppression. From a sample of 175 undergraduate participants, 51 participants with high social anxiety were selected as above a clinical cutoff on the social phobia scale. Cluster analyses identified 2 interpersonal subtypes of socially anxious individuals: low hostility–high submissiveness (Cluster 1) and high hostility–high submissiveness (Cluster 2). Cluster 1 reported higher levels of empathetic concern, lower paranoia, less peer victimization, and lower emotional suppression compared to Cluster 2. There were no differences between subtypes on perspective taking or cognitive reappraisal. Findings are consistent with an interpersonal conceptualization of social anxiety, and provide evidence of distinct social features between these subtypes. Findings have implications for the etiology, classification, and treatment of social anxiety.

The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: A randomized controlled trial

Evidence supports exercise as an intervention for many mental health concerns; however, randomized controlled investigations of the efficacy of different exercise modalities and predictors of change are lacking. The purposes of the current trial were to: (1) quantify the effects of aerobic exercise and resistance training on anxiety-related disorder (including anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder) status, symptoms, and constructs, (2) evaluate whether both modalities of exercise were equivalent, and (3) to determine whether exercise enjoyment and physical fitness are associated with symptom reduction. A total of 48 individuals with anxiety-related disorders were randomized to aerobic exercise, resistance training, or a waitlist. Symptoms of anxiety-related disorders, related constructs, and exercise enjoyment were assessed at pre-intervention and weekly during the 4-week intervention. Participants were further assessed 1-week and 1-month post-intervention. Both exercise modalities were efficacious in improving disorder status. As well, aerobic exercise improved general psychological distress and anxiety, while resistance training improved disorder-specific symptoms, anxiety sensitivity, distress tolerance, and intolerance of uncertainty. Physical fitness predicted reductions in general psychological distress for both types of exercise and reductions in stress for aerobic exercise. Results highlight the efficacy of different exercise modalities in uniquely addressing anxiety-related disorder symptoms and constructs.

Prayer, Meditation, and Anxiety: Durkheim Revisited

Durkheim argued that religion’s emphasis on the supernatural combined with its unique ability to foster strong collective bonds lent it power to confer distinctive social benefits. Subsequent research has confirmed these propositions with respect to religion and mental health. At the same time, meditation has been linked to mental health benefits in intervention-based studies. Our investigation offers a unique test of two comparable inhibitors of anxiety-related symptoms in the general population, namely, prayer versus meditation. Using data from the 2010 wave of the Baylor Religion Survey, we find that frequent communal prayer is correlated with an increased incidence of anxiety-related symptoms whereas worship service attendance is negatively associated with reported anxiety. Attendance also combines with communal prayer to yield anxiety-reducing benefits. Meditation, measured as a dichotomous indicator, is unrelated to reported anxiety in our sample of American adults. Our study underscores the selective efficacy of collective forms of religious expression, and points to several promising directions for future research.

Efficacy of Using Heart Rate Measurements as an Indicator to Monitor Anxiety Disorders: A Scoping Literature Review

Post-traumatic stress disorder (PTSD) is a prevalent disorder affecting veterans, first responders, children and others who have experienced traumatic events. Heart rate measures like resting heart rates along with heart rate accelerations are important measures to monitor the changes in the state of PTSD and other related disorders. A scoping review was conducted to investigate the efficacy of using heart rate (HR) measurements as reliable indicator for assessment of PTSD and other anxiety-related disorders. Findings show that while Heart Rate Variability (HRV) may provide a more robust measurement of PTSD and other anxiety-related symptoms, heart rate accelerations in response to traumatic reminders are reliable indicators. Changes in resting or basal heart rates show promise in long-term monitoring of PTSD symptoms.