State Anxiety Research Articles

Brain electrical activity in Newly diagnosed Generalized Anxiety Disorder: A Quantitative EEG analysis

Background: Generalized Anxiety Disorder (GAD) is one of the most common global mental disorders with negative impact on social life. Quantitative EEG can objectively estimate the anxiety status. Relatively increase beta activity along with decrease alpha activity is associated with GAD. Objectives:To evaluate power of all brain waves in female patients with GAD. Methods:This observational study was conducted on 20 female patients with GAD (age 20-40 years),For comparison, 20 healthy female volunteers of same age were enrolled as control. In this study, EEG was recorded for 3 minutes by placing electrodes on scalp according to 10-20 system. To assess brain electrical activities, the band power of delta, theta, alpha and beta brainwave was recorded from an EEG data acquisition device, EEG Traveler Brain Tech 32+ CMEEG -01, India. Power spectral analysis of EEG data was done by BT40 analysis software. Data were expressed as median (Inter Quartile Range). Statistical analysis was done by Mann-Whitney U test.Results: The significantly higher absolute power of beta was found in most of the electrodes of prefrontal, frontal and temporal region as well as significantly lower power of alpha, theta and delta werefound in all cortical regions in female GAD patients compared to healthy controls at baseline. Conclusion: This study concluded that GAD patients had high excitable state in most of cortical region associated with lack of relaxing ability. J Bangladesh Soc Physiol 2023;18(2): 78-88

Relationship Between Mobile Phone Addiction and State Anxiety of College Students: The Mediating Effect of Psychological Craving for Mobile Phones

With the widespread use of mobile phones, college students addicted to mobile phones cause anxiety. In order to explore the relationship between mobile phone addiction and state anxiety among college students, whether there is a mediating role in mobile phone psychological desire. The questionnaire method was used to investigate the state anxiety, mobile phone addiction and mobile phone psychological desire of 589 students from 3 universities in Hebei Province.The result shows that State of anxiety and mobile phone craving were positively correlated with mobile phone addiction (r =0.25, P<0.01; r =0.74, P <0.01).State of anxiety was positively correlated with phone craving (r =0.16, P <0.01), and the mediating effect was 0.28.We can see that State of anxiety can promote mobile phone addiction directly or indirectly by increasing psychological craving for mobile phone.

Construction and evaluation of two nomograms for screening major depressive disorder and subthreshold depression individuals based on anxiety, depression, and sleep items

BackgroundCurrent evidence is insufficient to support specific tools for screening Major Depressive Disorder (MDD). Early detection of subthreshold depression (SD) is crucial in preventing its progression to MDD. This study aims to develop nomograms that visualize the weights of predictors to improve the performance of screening tools. MethodsParticipants were recruited from Peking University Sixth Hospital and Beijing Physical Examination Center between October 2022 and April 2024. The Mini-International Neuropsychiatric Interview (MINI) 5.0.0 was employed as the diagnostic gold standard, and Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI) were employed to assess anxiety, depression, and sleep state. The nomograms were constructed by incorporating optimal predictors, selected through the Least Absolute Shrinkage and Selection Operator (LASSO), into a multivariate logistic regression model to estimate the probability of MDD and SD. ResultsAfter matching age and education, 164 participants were included in each group for analysis. Both nomograms demonstrated superior discrimination, calibration, and clinical applicability compared to PHQ-9. Anxiety emerged as a most significant predictor for SD, while sleep problems exhibited high rankings for both SD and MDD. The two predictors subsequently affect concentration and daytime functioning. LimitationsWith a lack of external validation data, the performance of nomograms may be overestimated. ConclusionsThis study is the first attempt to develop a nomogram for predicting SD, while also providing a nomogram for MDD. The crucial predictors offer valuable insights into potential variables for clinical intervention.

Allostatic Load as a Mediator and Perceived Chronic Stress as a Moderator in the Association between Maternal Mental Health and Preterm Birth: A Prospective Cohort Study of Pregnant Women in Pakistan

Introduction: The complex biopsychosocial pathways linking maternal mental health with preterm birth (PTB) are not well understood. This study aimed to explore allostatic load (AL) as a mediator and perceived chronic stress as a moderator in the pathway linking maternal mental health and PTB. Methods: A cohort study of pregnant women (n = 1,567) recruited at clinic visits within 10–19 weeks of gestation was assessed for maternal mental health (i.e., pregnancy-related anxiety, state anxiety, depressive symptoms) and perceived chronic stress. Blood pressure and levels of cortisol, total cholesterol, C-reactive protein, and glycosylated hemoglobin were used to create a composite measure of AL. Results: AL had the most significant effect on PTB (odds ratio (OR) = 1.84, 95% CI = 1.26–12.67, p = 0.001), while systolic blood pressure emerged as the only significant individual marker using variable selection (OR = 22%, 95% CI = 1.06–1.40, p < 0.001) in multiple logistic regression analysis. A mediation analysis revealed that maternal mental health did not have a significant direct effect on PTB (p = 0.824), but its indirect effect mediated by AL was significant (z = 2.33, p < 0.020). Low and high levels of perceived chronic stress, relative to the mean, moderated this indirect effect (z = 3.66, p < 0.001). Conclusions: AL has a significant direct influence on PTB and mediates the effect of maternal mental health on PTB; however, the indirect effect of AL is indistinguishable between women with higher or lower levels of perceived chronic stress than normal.

The effect of assessor visibility on student stress and anxiety in emergency care simulation assessments

BackgroundSimulation assessment can result in anxiety for students. These assessments involve being observed by assessors, so there is a significant socio-evaluative stress component which may cause greater anxiety if assessors are visible to students during assessments. The aim of this study was to determine the effect of assessor visibility on biological and physiological markers of stress and levels of anxiety experienced by pre-hospital emergency care students in a simulation assessment environment.MethodsA paired comparison, pre-post test research design was used with two conditions; an assessor visible condition with simulation assessors visible to students in the room and an assessor not visible condition with assessors not in the room but connected via video link. With a sample of 29 emergency care students anxiety was measured with the State-Trait Anxiety Inventory and stress was measured with salivary cortisol and heart rate variability (HRV).ResultsDifferences in state anxiety scores, HRV variables and salivary cortisol suggested lower stress and anxiety in the assessor visible group. Only heart rate was significantly different between the groups (p = 0.016), with a higher heart rate in the assessor not visible group.ConclusionsGreater stress and anxiety may be experienced by students during emergency care simulation assessments when assessors are not visible to students.

Mechanistic insights into Suanzaoren Decoction's improvement of cardiac contractile function in anxiety-induced cardiac insufficiency

Ethnopharmacological relevanceAccording to traditional Chinese medicine, Anxiety-induced cardiac blood insufficiency leads to palpitations and restlessness. Suanzaoren Decoction (SD) is effective in replenishing blood and promoting blood circulation. Clinical practice has shown that it has a better therapeutic effect on cardiac insufficiency. However, its mechanism of action is still unclear. Aim of the studyThe study aims to determine the mechanism by which SD treats chronic restraint stress (CRS)-induced anxiety-induced cardiac insufficiency (ACI). Materials and methodsSD was orally administered to mice with CRS-induced ACI. Firstly, we constructed an anxiety model in mice by CRS. Subsequently, SD was investigated to assess cardiac function and pathological changes through echocardiography, H&E staining, and Masson staining. Thirdly, the function of sympathetic and parasympathetic nerves was evaluated using enzyme-linked immunosorbent assay (ELISA) and enzyme activity assays. Network pharmacology and molecular docking were employed to predict potential targets for SD treatment of cardiac insufficiency. CaMKII expression was scrutinized utilizing publicly accessible databases. CaMKII was identified as a target through immunohistochemistry and Western Blot analysis in mouse hearts. Finally, the therapeutic mechanism of SD was confirmed in injured cardiomyocytes via Western Blot and quantitative PCR. ResultsSD exerted anxiolytic effects by increasing the frequency of entries into and the duration spent in open arms while reducing the time spent in the light chamber and increasing the number of transitions between light and dark chambers. Additionally, it mitigated cardiac insufficiency, as evidenced by the enhancement of left ventricular ejection fraction (LVEF) and attenuation of cardiomyocyte damage and inflammatory infiltration.However, SD did not alleviate the elevated norepinephrine (NE) and decreased Acetylcholine (Ach) in anxiety states. To investigate the mechanism of action of SD, we constructed a Drug-Component-Target-Disease network, identifying 13 potential active compounds. Additionally, leveraging bioinformatics analysis and molecular docking targeting heart diseases characterized by clinical left ventricular ejection fraction (LVEF), we focused on the CaMKII target. The ability of SD to modulate CaMKII expression and phosphorylation in the mouse heart was investigated using immunohistochemistry and Western blotting. SD was found to alleviate NE-injured cardiomyocytes by modulating the Ca2+/CaMKII/MEF2 and GATA4 pathways. ConclusionSD is a potential formula for the treatment of chronic restraint stress (CRS)-induced ACI that ameliorates cardiomyocyte injury and improves cardiac function. Its efficacy is associated with the inhibition of the Ca2+/CaMKII/MEF2 and GATA4 signaling pathways.

A Parallel-Group, Randomized Trial Examining Impact of Colposcopy Results Delivery by a Nurse Liaison on Patient-Reported Outcomes and Adherence

ObjectivesCervical cancer is on the rise in Canada. Addressing patient anxiety and improving patient understanding of colposcopy and results may improve adherence. This randomized controlled trial examined the impact of colposcopy results delivery by a Nurse Liaison versus the referring primary care provider (PCP) on patient anxiety, and secondary outcomes including patient satisfaction, knowledge of diagnosis, and 9-month adherence to follow-up. MethodsPatients ≥18 years old presenting for initial appointment at the study colposcopy clinic were randomized 1:1 to an intervention group (Nurse Liaison) versus a control group (PCP). After receiving colposcopy results, participants completed online measures of anxiety (State-Trait Anxiety Inventory), health care satisfaction scales (Patient Satisfaction Questionnaire-18, Health Anxiety Inventory, Visit-Specific Satisfaction Questionnaire-9), self-reported colposcopy diagnosis, and demographics. Chart review at 9 months assessed adherence to recommended colposcopy follow-up. Groups were compared on continuous and categorical variables, controlling for diagnosis severity and trait anxiety. ResultsThe intervention group had significantly lower state anxiety with State-Trait Anxiety Inventory-state mean scores of 37.3 versus 40.7 in controls (P = 0.03). Intervention group participants were more likely to correctly report their diagnosis (84% vs. 66.3%, P = 0.003). Questionnaire responders were more likely to be in the intervention group and had a higher proportion of cervical intraepithelial neoplasia 2+ pathology. There were no differences in demographics, patient satisfaction, or adherence to follow-up between groups. ConclusionsDirect delivery of colposcopy results by a trained Nurse Liaison was associated with decreased patient anxiety around colposcopy results, and increased patient knowledge regarding diagnosis. This model may be considered to improve patient-centred care.

Effect of a controlled diaphragmatic breathing session on perceived pain and state anxiety in people with chronic pain

Chronic pain conditions are frequently comorbid with anxiety problems. The controlled diaphragmatic breathing technique has been applied in both conditions. However, few studies have examined its efficacy in reducing perceived pain and state anxiety in the population with both pathologies. Thus, the study objective was to investigate the immediate effects of a single-session diaphragmatic breathing intervention on perceived pain and state anxiety in a group of people with chronic pain. We analyzed the influence of sociodemographic variables, dispositional anxiety, average pain during the last week, respiratory rate, and inhalation/exhalation ratio. The sample comprised 169 people with chronic pain from Spain and Poland who were evaluated before and after performing an online controlled diaphragmatic breathing task. The Wilcoxon test showed significant decreases in state anxiety and perceived pain. Linear regression analyses revealed an association between dispositional anxiety and pretest/posttest differences in state anxiety, as well as an association between both average pain in the last week and nationality and pretest/posttest differences in perceived pain. We conducted an exploratory analysis of the differences between both countries in the study variables. We discuss the results and the relevance of further studies on the efficacy of this technique in reducing perceived pain and state anxiety.

Turkish adaptation of the state-trait anxiety inventory short version (STAIS-5, STAIT-5).

This study examines the validity and reliability of a Turkish version of the State-Trait Anxiety Inventory Short Version. The sample consisted of 306 people between the ages of 18-59 who agreed to participate in the study and met the inclusion criteria. Data were collected with the demographic questionnaire, State-Trait Anxiety Inventory Short Version, State-Trait Anxiety Inventory and Brief Fear of Negative Evaluation Scale. All factor loadings of the State Anxiety Inventory Short Version were between 0.706 and 0.835, and those of the Trait Anxiety Inventory Short Version were between 0.694 and 0.810. The Cronbach alpha coefficients of the State and Trait Anxiety Inventory Short Version were calculated as 0.838 and 0.837, respectively. There was a significant difference between the first-test and retest values of the State Anxiety Inventory Short Version (p = 0.033) and no difference in the Trait Anxiety Inventory Short Version (p = 0.145). The Turkish-adapted State-Trait Anxiety Inventory Short Version is a valid and reliable measurement tool to determine the anxiety levels of individuals aged 18-59.

Quality of life and psychological distress in end-stage renal disease patients undergoing hemodialysis and transplantation.

Among diverse profound impacts on patients' quality of life (QoL), end-stage renal disease (ESRD) frequently results in increased levels of depression, anxiety, and stress. Renal replacement therapies such as hemodialysis (HD) and transplantation (TX) are intended to enhance QoL, although their ability to alleviate psychological distress remains uncertain. This research posits the existence of a significant correlation between negative emotional states and QoL among ESRD patients, with varying effects observed in HD and TX patients. To examine the relationship between QoL and negative emotional states (depression, anxiety, and stress) and predicted QoL in various end-stage renal replacement therapy patients with ESRD. This cross-sectional study included HD or TX patients in the Eastern Region of Saudi Arabia. The 36-item Short Form Survey and Depression Anxiety Stress Scale (DASS) was used for data collection, and correlation and regression analyses were performed. The HD and TX transplantation groups showed statistically significant inverse relationships between QoL and DASS scores. HD patients with high anxiety levels and less education scored low on the physical component summary (PCS). In addition, the results of the mental component summary (MCS) were associated with reduced depression. Compared with older transplant patients, TX patients' PCS scores were lower, and depression, stress, and negative working conditions were highly correlated with MCS scores. The findings of this study revealed notable connections between well-being and mental turmoil experienced by individuals undergoing HD and TX. The PCS of HD patients is affected by heightened levels of anxiety and lower educational attainment, while the MCS of transplant patients is influenced by advancing age and elevated stress levels. These insights will contribute to a more comprehensive understanding of patient support.

A novel analysis of interoceptive underpinnings of anxious psychopathology in COVID-19 survivors

IntroductionSARS-CoV-2 affects brain, body, and their interchange. We investigated interoceptive mechanisms in COVID-19 survivors focusing on their potential link with psychopathology and inflammatory biomarkers. MethodsWe assessed interoceptive accuracy (IAc) and time-perceiving (TA) skills of 57 COVID-19 survivors one month after hospital discharge through, respectively, a heartbeats perception task and a time duration task. Each participant was assessed about his interoceptive awareness (IAw) through Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA) and then, screened for post-traumatic (Impact of Events Scale – IES-R), anxious (State-Trait Anxiety Inventory – STAI-Y1) and depressive (Zung Self-Rating Depression Scale - ZSDS; Beck Depression Inventory - BDI-13) symptoms.Biomarkers of inflammation (platelet count, PC; mean platelet volume, MPV and systemic immune-inflammation index, SII) were obtained in a subsample of 40 survivors by a blood sampling conducted at admission and discharge time from the hospital. Correlational, GLM, GLMZ, and mediation analyses were performed. ResultsIAc did not correlate with TA confirming the reliability of interoceptive measure. IAc positively predicts MAIA’s Trusting subscale and negatively predicts anxious psychopathology which fully mediates the effect of IAc on Trusting.PC at hospital admission predicts anxiety at one month after recovery. Again, a higher decrease of SII during hospitalization predicts higher IAc skill and lower anxiety state at one month. The link between SII change and anxiety is fully mediated by IAc. ConclusionsOur results unveil a potential key role of interoception and brain-body interchange in the exacerbation and maintenance of anxiety psychopathology in COVID-19 survivors.

Impact of Public Health and Social Measures on Cosmetic Treatments in the COVID-19 Pandemic: A Retrospective Multi-Center Study Combined With a Questionnaire-Based Cross-Sectional Study.

Public health and social measures (PHSMs) are considered the most effective approaches for controlling epidemic diseases. This study aimed to explore variations in the time-dependent characteristics of and public preferences for cosmetic treatments during and after the implementation of PHSMs during the COVID-19 pandemic. Medical records from six medical institutions were extracted retrospectively. Time-series analyses were conducted to reveal the variations in characteristics in volume and proportion of cosmetic treatments according to PHSMs. A cross-sectional study was conducted with online questionnaire designed for the general population during and after the implementation of PHSMs. A total of 141 033 records were included in this retrospective study. The implementation of PHSMs led to extremely low treatment volumes; compared with the increases in private hospitals, the treatment volumes in public hospitals exhibited earlier and more significant increases, even higher than pre-PHSM levels (p < 0.05), which mainly contributed to the increase in plastic surgery volumes during and after the implementation of PHSMs. The differences in the anxiety state, self-perceived appearance, and cosmetic treatment intentions of the participants were illustrated during and after PHSMs. We further demonstrated the participants' decisions on cosmetic treatments after the implementation of PHSMs during the COVID-19 pandemic. The immediate effects and aftereffects of PHSMs on cosmetic treatments were different in public and private hospitals. Furthermore, as PHSMs guided the adjustment of cosmetic treatments in the post-COVID-19 era, the intention to undergo cosmetic treatment during PHSMs was associated with the anxiety states and preferences of the population.

Neural correlates of prospective memory in college students with anxiety.

Prospective memory (PM) is the ability to create and execute future tasks. It is comprised of two components: cue detection and intention retrieval. PM is essential for performing high-level goals, a proficiency extremely important in college populations. Anxiety is a prevalent psychological experience in college populations that may be associated with impairments in PM. The present study examined PM performance and anxiety in college students, using neurophysiology to measure the mechanism of impairment. After self-reporting anxiety levels, 80 participants completed an event-based, focal PM task while two event-related potentials were recorded from an electroencephalogram: the N300 to assess cue detection, and the prospective positivity to assess intention retrieval. The results demonstrated that, when controlling for age and gender, higher state anxiety was significantly associated with lower PM accuracy (β = -0.27, p = 0.020) and lower prospective positivity amplitude (β = -0.04, p = 0.021). Lower prospective positivity amplitude was significantly associated with lower PM accuracy (β = 0.27, p = 0.015). Higher state anxiety was significantly indirectly associated with lower PM accuracy mediated by lower prospective positivity amplitude (ab = -0.11, p = 0.047). These findings suggest intention retrieval could be a key component in supporting PM for college students with high state anxiety.

Exploring the characteristics changes of cardiopulmonary exercise testing in patients with acute coronary syndrome after PCI before and during the COVID-19 pandemic

Objective: To investigate the changes in cardiopulmonary exercise testing (CPET) characteristics before and after the outbreak of COVID-19 in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Methods: This is a cross-sectional study that included ACS patients who underwent PCI at the General Hospital of the Northern Theater Command from July 2018 to February 2023. Based on the timeline of the COVID-19 pandemic, patients were divided into two groups: the pre-pandemic group and the during-pandemic group, with January 2020 as the dividing line. Clinical data were collected from both groups, and a comparative analysis was performed on their postoperative CPET outcomes, including peak oxygen uptake (peak VO2), peak metabolic equivalents (peak MET), and other indicators. Weber's classification was used to assess cardiac function. In addition, the 7-tiem generalized anxiety disorder scale (GAD-7) and the patient health questionnaire-9 (PHQ-9) were used to assess the patients' psychological anxiety and depression states, respectively. Multivariate logistic regression was used to analyze the influencing factors of CPET after PCI. Results: A total of 4 310 post-PCI ACS patients were included, with an average age of (58.7±9.1) years, and 3 464 (80.37%) were male. There were 1 698 patients in the pre-pandemic group and 2 612 patients in the during-pandemic group. The main indicator of the CPET, peak VO2 (15.04±3.93) ml·min-1·kg-1 in the during-pandemic group, was lower than that in the pre-pandemic group (15.52±3.68) ml·min-1·kg-1, and the difference was statistically significant (P<0.001). Multivariate logistic regression analysis showed that advanced age, female gender, high body mass index, elevated high-sensitivity C-reactive protein, reduced high-density lipoprotein cholesterol, smoking history, history of myocardial infarction, more severe ACS classification, and mild to moderate degree of depression were related to poor cardiopulmonary outcomes (P<0.05). Conclusion: The COVID-19 pandemic had a negative impact on the cardiopulmonary outcomes of ACS patients after PCI. Reduced physical activity, and increased psychological stress should be given consideration and attention regarding their impact on patients' cardiopulmonary function.

An Intelligent System for Determining Driver Anxiety Level: A Comparison Study of Two Fuzzy-Based Models

While driving, stress and frustration can affect safe driving and pose the risk of causing traffic accidents. Therefore, it is important to control the driver’s anxiety level in order to improve the driving experience. In this paper, we propose and implement an intelligent system based on fuzzy logic (FL) for deciding the driver’s anxiety level (DAL). In order to investigate the effects of the considered parameters and compare the evaluation results, we implement two models: DAL Model 1 (DALM1) and DAL Model 2 (DALM2). The input parameters of DALM1 include driving experience (DE), in-car environment conditions (IECs), and driver age (DA), while for DALM2, we add a new parameter called the accident anxiety state (AAS). For both models, the output parameter is DAL. We carried out many simulations and compared the results of DALM1 and DALM2. The evaluation results show that the DAL is very good for drivers’ ages between 30 to 50 years old. However, when the driver’s age is below 30 or above 50, DAL tends to decline. With an increase in DE and IECs, the DAL value is decreased. But when the AAS is increased, the DAL is increased. DALM2 is more complex because the rule base is larger than DALM1, but it makes a better decision of DAL value.

Comparison of State-Trait Anxiety and Fear of Childbirth According to Attachment Styles of Pregnant Women.

Fear of childbirth (FoC) and its extreme form, tokophobia, is a clinical condition that can lead to many negative consequences, and its importance is increasingly understood. This article aims to assess the severity of FoC and anxiety levels according to different attachment styles and to investigate the relationships between these factors. A cross-sectional study was conducted in a state hospital in the largest city in Turkey. Three hundred pregnant women attending the Antenatal Outpatient Clinic were included. A sociodemographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire-version-A (W-DEQ), Spielberger State-Trait Anxiety Inventory and Adult Attachment Style Scale were administered. 8.1% of participants had tokophobia (W-DEQ sum score ≥85). FoC was significantly higher in pregnant women who had a history of pregnancy loss and past psychiatric history. For multiparous women, adverse birth outcomes were also associated with higher FoC. State and trait anxiety were positively correlated with FoC levels. Regarding the attachment patterns, pregnant women with avoidant attachment styles presented with higher levels of FoC than those with secure attachment styles. In logistic regression analysis, higher anxiety levels, adverse birth outcomes, and insecure attachment styles were found to predict severe and clinical FoC. FoC has a considerable effect on pregnant women, albeit at different clinical levels. Adverse birth outcomes, high anxiety levels, and insecure attachment styles were associated with higher FoC. Therefore, antenatal patients with adverse birth outcomes and higher anxiety levels, which are risk factors for FoC, should be carefully evaluated in terms of tokophobia and referred to mental health professionals when necessary.

Focused Ultrasound Combined With Microbubbles Attenuate Symptoms in Heroin-Addicted Mice

ObjectiveTo explore the efficacy and mechanisms of stimulating the nucleus accumbens (NAc) in heroin-addicted mice using focused ultrasound and microbubbles (MBs). MethodsThe conditioned place preference (CPP) method was employed to establish a heroin-addicted mice model. Mice were randomized into control (C), heroin (H), heroin + ultrasound (H + U) and H + U + MBs. Ultrasound (2 MHz fundamental frequency, 1.34 MPa peak-negative pressure, 1 MHz pulse repetition frequency, 5% duty cycle, 15 min/d, over 2 d) was applied to stimulate the NAc in the latter 2 groups. Whereas H + U + MBs received an injection of sulfur hexafluoride MBs during the stimulation. Subsequently, CPP scores, open-field test (OFT), and elevated plus-maze test (EPMT) were conducted to assess behavioral changes in addiction memory, anxiety and exercise status. HE staining was performed to detect pathological structures. Neurotransmitters such as dopamine (DA), serotonin (5-HT) and glutamate (Glu) were detected using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Transmission electron microscopy (TEM) was used to observe ultrastructural changes of synapses in NAc. Immunohistochemistry (IHC) was utilized to detect Cleaved Caspase-3 in the NAc region. Western blotting (WB) was used to detect the protein expression of Cleaved Caspase-3, Bax and Bcl-2 in NAc. ResultsHE staining showed small patches of erythrocyte exudation were observed in the NAc and adjacent areas in H + U + MBs. The CPP scores of H + U + MBs were lower (p < 0.05) than H. After ultrasound treatment, all indices of the OFT and EPMT in H + U + MBs were significantly higher than H (p < 0.05). UPLC-MS/MS revealed that the levels of DA, 5-HT and Glu in H + U + MBs were lower than H (p < 0.01). TEM showed decrease the number of synapses (p < 0.05), and noticeable swelling of mitochondria, membrane damage, as well as damage to the cristae. Further detection by IHC and WB showed that the pro-apoptotic proteins Cleaved Caspase-3 and Bax increased and Bcl-2 decreased as anti-apoptotic proteins after ultrasound combined with MBs (p < 0.05). ConclusionFocused ultrasound combined with MBs stimulate the NAc can weaken the addictive memory and improve anxiety of heroin-related mice. The mechanical effect of ultrasound combined with the cavitation effect may be a potential treatment for addiction.

Testing theoretical processes that maintain paediatric social anxiety: A comparison between children and adolescents with social anxiety disorder, other mental disorders, and non-clinical controls

BackgroundPaediatric social anxiety disorder (SoAD) responds poorly to treatment. Improved understanding of potential psychological maintaining processes may indicate fruitful directions to improve treatment outcomes. The current study compared self-reported psychological processes and state anxiety in response to two social tasks experienced by children and adolescents with SoAD against comparison samples. Methods641 children and adolescents aged 6–17 years (Mage = 9.45 yr; 47.6% girls) engaged in a brief, impromptu speech and a social discussion with a confederate. Participants included 307 with SoAD, 285 with other mental disorders, and 49 non-clinical controls. Participants who completed each task self-reported their anticipated probability and cost of negative evaluation, self-focused attention, personal evaluation of social performance, and engagement in post-event rumination (assessed 1 h later). Independent raters also scored their social performance. Relationships between the variables were tested through path analysis. ResultsParticipants with SoAD were more likely to avoid and reported significantly greater state anxiety than both comparison groups. They also reported higher levels of each of the putative maintaining processes than either comparison group. In contrast, independent observers did not discriminate between groups on their overt social performance. Path analyses demonstrated good fit of a priori models to the data for both social tasks. ConclusionsPaediatric SoAD is associated with strong expectation of the probability and cost of negative evaluation, excess self-focused attention, and more negative evaluation of one's own social performance. In turn, these putative processes are strong predictors of state anxiety and post-event processing in response to both a speech and social interaction.

Understanding internal dynamics of state anxiety during COVID-19 pandemic: Seven-wave longitudinal findings via panel network analysis.

Research on state anxiety has long been dominated by the traditional psychometric approach that assumes anxiety symptoms have a common cause. Yet state anxiety can be conceptualized as a network system. In this study, we utilized data from the COVID-Dynamic dataset from waves 7 to 13, collected at three-week intervals from June 6, 2020, to October 13, 2020, and included 1,042 valid participants to characterize the internal dynamics of state anxiety. Using the Gaussian graphical model along with strength centrality, we estimated three network models of state anxiety. The between-subjects and contemporaneous network showed numerous positive relations between items and some unexpected negative relations. Three communities were identified in the between-subjects network, and two communities were identified in the contemporaneous network. The temporal network showed the coexistence of positive and negative predictions between items after three weeks. Several items exhibited significant positive autocorrelations after three weeks. These findings have implications for anxiety theory and clinical interventions at between-subjects and within-subjects levels.

Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL)

BackgroundMaintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function.MethodsIn this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up.DiscussionThis study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022.