Anxiety Symptomatology Research Articles

B - 32 Grief in Neuropsychological Assessment among Culturally Diverse Middle-Old Older Adults.

Bereavement, exacerbated by losses stemming from the COVID-19 pandemic, contributes to high rates of grief and associated mood disturbances among older adults, potentially impacting neurocognition. Middle-old cohorts (ages 75-84) are particularly vulnerable, due to elevated levels of baseline depression, complicated grief, and perceived lower quality of life. The contributory role of grief and culturally-relevant manifestations of bereavement should be carefully considered as potential confounds or performance contributors. Four cases seen for neuropsychological assessment in the Department of Neurological Surgery: A 75-year-old bilingual (Russian, English) patient with a meningioma who noticed cognitive changes following spouse's death from COVID-19; A 77-year-old monolingual (English) patient with Parkinson's disease undergoing a pre-surgical work-up prior to Deep Brain Stimulator insertion. Mood reportedly worsened sharply since spouse's recent death; An 81-year-old monolingual (Cantonese) patient undergoing a pre-surgical work-up prior to DBS insertion. Shared grieving the recent death of younger sibling from COVID-19; An 84-year-old, monolingual (English) patient who was evaluated due to longstanding cognitive challenges in the context of cerebrovascular disease (monitored by Neurological Surgery). Cognitive deficits reportedly precipitously worsened following spouse's death. While levels of neurocognitive and adaptive dysfunction varied, mood disturbance and affective distress likely reduced engagement in the testing process. Reluctance to disclose depressive and anxious symptomatology on questionnaires as a function of culture was noted. Thorough, culturally-sensitive, clinical interviewing and metrics are needed to elicit nuanced information. Grief and associated mood disturbances are to be prioritized and carefully considered in the evaluation and treatment plan with middle-old older adults.

B - 62 The Clinical Utility of the BAI Compared to the GAI in Community Dwelling Older Adults.

Given the potential impact anxiety may have on cognitive performance, the current study explored the relationship of both the Beck Anxiety inventory (BAI) and the Geriatric Anxiety Inventory (GAI) to cognitive performance in community dwelling older adults. Specifically, the correlation of anxiety and depression symptomatology to performance on measures of executive functioning and processing speed was explored (Dorekamp & Vik, 2018; Najimi et al., 2015; Vytal et al., 2012). Archival data from a sample of 60 community dwelling older adult participants (female n = 54; White n = 52), with an average education of 13.83years and an average age of 76years were included. The BAI and GAI were used to determine anxiety levels. Processing speed and executive functioning were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Coding subtest and Trail Making Test B respectively. Data was analyzed using Pearson's R product moment correlations. Pearson's R product moment correlations were significant between the BAI and RBANS Coding (r = -0.328; p = 0.011), Trails B (r = 0.295; p = 0.023), and the GAI (r = 0.268; p = 0.04). However, the GAI was only significantly associated with the BAI. While both the BAI and GAI are well established measures of anxiety in older adults, the BAI appears to be more sensitive to the effects of anxiety on executive functioning and processing speed in community dwelling older adults. Future directions related to exploration of severity and potential cut scores will be discussed.

The Current Mental Health of Healthcare Workers 3 Years After the Start of the Pandemic: The Relationship Between Coping Strategies and Indices of Mental Health

Healthcare workers have been a vulnerable group during the pandemic. Even today, they continue to deal with the virus and its consequences. Such sustained stress over time has led to the development of mental health problems that may still be present in this population. These may be related to the coping strategies that are being implemented to manage this situation. This study aimed to examine the mental health of health professionals after the end of the acute phase of the pandemic and investigate which coping strategies predicted levels of stress, anxiety, depression, and burnout. A total of 285 healthcare workers were assessed. Descriptive and multiple regression analyses were performed. The result showed (a) levels of mild-to-moderate depressive symptomatology, moderate levels of stress and anxiety symptomatology, and a medium level of burnout; and (b) acceptance, behavioral disengagement, negation, substance use, and active coping as the strategies most implicated in this symptomatology. Interventions that help health professionals to develop adaptive coping strategies, thus avoiding or reducing the development of psychological symptoms, should be implemented.

Associations between elementary teachers’ mental health and students’ engagement across content areas

Teachers’ mental health has been recognized as relevant to teacher effectiveness, with past work identifying impacts of teachers’ mental health on teacher, classroom, and student outcomes. However, much still needs to be understood about the extent to which teachers’ mental health is associated with students’ learning experiences, including in which learning contexts and among which student groups effects might surface most pointedly. We investigated associations among fourth grade teachers’ (N = 65) self-reported depressive and anxious symptomatology and their students’ (N = 805) self-reported behavioral engagement in mathematics, science, and English language arts and whether these associations varied for students based on their enrollment status in a Free and Reduced Meal (FARM) program, a broad indicator of economic disadvantage. Multilevel modeling revealed interaction effects such that, among disadvantaged students, teachers’ depressive symptoms were associated with decreased mathematics and science engagement. Results highlight the importance of providing mental health support for teachers, as well highlight teachers’ well-being as relevant to issues of equity in elementary STEM education.

Validation of the Spanish version of the Perceived Control Scale: Perceived Constraints on Personal Control and Perceived Mastery

Objectives Perceived control is a relevant variable for understanding middle and older adults’ mental health. The Perceived Control Scale has two dimensions, Perceived Constraints on Personal Control and Perceived Mastery, and is a widely used instrument for assessing perceived control in adults. The aim of this study was to analyze the psychometric properties of the Spanish version of the Perceived Control Scale with data from two different studies. Method In Study 1, 348 older adults between 60 and 92 years old were assessed through face-to-face assessments. In Study 2, 334 adults between 40 and 90 years completed an online survey. Perceived control, self-perceptions of aging, and anxiety and depressive symptomatology were assessed. An exploratory (Study 1) and confirmatory (Study 2) factor analysis of the Perceived Control Scale were performed, and reliability and its relationship with the other assessed variables were evaluated. Results Results from parallel, exploratory, and confirmatory factor analyses suggested that the Spanish version of the Perceived Control Scale has a bidimensional structure: Perceived Constraints on Personal Control and Perceived Mastery. Good internal consistency was found for the scale in both samples. The results revealed negative and significant associations with negative self-perceptions of aging, and anxiety and depressive symptomatology. Conclusion The Spanish version of the Perceived Control Scale shows good psychometric properties which endorse its use with middle-aged and older adults assessed either face-to-face or through online surveys.

Impact of COVID-19 and emotional states of Filipino university students

<span lang="EN-US">The coronavirus disease (COVID-19) pandemic has extremely caused massive disruptions in the education sector, and this led to the adoption of full-distance learning modalities across different educational institutions worldwide. However, studies are still needed within the context of the Philippines in terms of the impact of the pandemic on university students in light of a gradual limited face-to-face transition. This study determined the Filipino college students’ perceived impact of the COVID-19 pandemic and the prevalence of depression, anxiety, and stress symptomatology (DASS) among them. This cross-sectional study surveyed Filipino university students from a public higher education institution in the Philippines via convenience sampling. A total of 3,718 students participated in the study. Analysis showed that despite the respondents’ level of DASS being roughly similar and normal, half of them is experiencing mild to extremely severe symptomatology. Further results indicated that there is a statistically significant difference in their DASS when grouped according to their gender and class level. The findings will be beneficial to multiple stakeholders in designing data-driven policies that would maximize the possibility of a safe resumption of limited, gradual, and eventually, full face-to-face modalities.</span>

Metacognitive interpersonal therapy-eating disorders versus cognitive behavioral therapy for eating disorders for non-underweight adults with eating disorders: study protocol for a pilot pre-registered randomized controlled trial.

Eating disorders (ED) are serious disorders characterized by an alteration of eating habits and excessive concern about weight and body shapes (Fairburn, 2002), accompanied by significant impairment inequality of life, high mortality rates and serious organic consequences (Jenkins et al., 2011; Treasure et al., 2015; 2020). Although evidence-based psychological therapies for nonunderweight ED presentations such as cognitive behavioral therapy for eating disorders (CBT-ED) are widely available, there is substantial scope for improvements, particularly in terms of efficacy and adherence. One option is to develop interventions to address elements of pathology not fully addressed by existing empirical supported treatments, such as incorporating techniques aimed at addressing interpersonal problems and personality disorder features into existing treatment delivery. We adapted Metacognitive Interpersonal Therapy, a psychological intervention supported by evidence for treating personality disorders and integrated it with existing CBT techniques for eating disorders (MIT-ED). MIT-ED targets aspects of ED that are not included in the transdiagnostic CBT-E model such as poor metacognition, or maladaptive interpersonal schemas. This is a pre-registered (Protocol number: 0000781) pilot randomized clinical trial aimed at assessing acceptability and feasibility of MIT-ED and establishing preliminary evidence of effectiveness for future larger studies. Twenty patients (10 in each arm) will be randomized to 20 sessions of individual psychotherapy, either MIT-ED or CBTE. Repeated follow-ups will be collected up to 24 months. Participants are recruited at a private outpatient clinic for ED treatment. Acceptability will be assessed via session attendance, completion rates and preliminary outcomes. The primary outcome is ED pathology assessed with the Eating Disorder Examination Questionnaire-6. Other ED outcomes assessed will be eating disorder attitudes, clinical impairment and binge eating pathology. Secondary treatment outcomes are anxiety, depression, and global symptomatology. We will also assess emotional awareness, emotion regulation and therapeutic alliance. Based on previous studies of MIT for personality disorders we hypothesize that MIT-ED will be acceptable to patients, evidenced by high treatment adherence and retention. We hypothesize that MIT-ED will be associated with reductions in eating disorder pathology, at least equivalent to CBT-E. Results will be used to inform the study design, sampling, likely effect sizes and choice of outcome measures for future larger trials of MIT-ED in ED samples.

The importance of the university of the third age to improved mental health and healthy aging of community-dwelling older adults

ABSTRACT The aim of this uncontrolled interventional study was to determine the effect of a yearly educational course within the University of the Third Age on quality of life, life satisfaction, sense of coherence, self-esteem, anxiety, depression, attitudes toward old age, and older people’s perception of social support. The population included 121 community-dwelling older people who had completed a yearly educational course within the University of the Third Age (three educational modules: 1. Cardiovascular Diseases, 2. Mental Health, and 3. Neurological Diseases; 16 lectures and two practical lessons for each module). Psychosocial factors were evaluated using the following tools: the Older People’s Quality of Life questionnaire (OPQOL_brief), the Life Satisfaction Index for the Third Age – Short Form (LSITA-SF), the Geriatric Depression Scale (GDS-15), the Geriatric Anxiety Inventory (GAI), the Attitudes to Aging Questionnaire (AAQ), the Sense of Coherence scale (SOC-13), the Rosenberg Self-Esteem Scale (RSES), and social support. After completing the yearly educational cycle, older people who had had lower scores for individual parameters at the beginning of the study were found to have a statistically significant improvement (p < .001) in anxiety, depression, quality of life, sense of coherence, life satisfaction, attitudes toward old age and aging, and perceptions of social support. To promote healthy aging, education at universities of the third age is recommended for lonely older people and older people with symptomatology of anxiety and depression.

The impact of prepartum pandemic-related perceived stress on anxiety symptoms in the postpartum: The role of perceived childbirth experiences

Postpartum anxiety is a significant component of postpartum maternal distress and is related to adverse outcomes for both the mother and the child. Although previous research reported higher anxiety symptoms in pregnant women during the Covid-19 pandemic, no studies evaluated the negative impact of pandemic-related perceived stress on postpartum anxiety symptomatology over time. This study aimed to examine the impact of prepartum pandemic-related stress on postpartum anxiety and to evaluate the role of subjective labor and delivery experiences on this relationship. A sample of 172 pregnant women completed an online questionnaire evaluating pandemic-related perceived stress and anxiety symptoms in the second or third trimester of pregnancy. In the postpartum, they completed a second questionnaire retrospectively evaluating their childbirth experience and assessing anxiety symptoms in the last two weeks. A mediation analysis was conducted. Prepartum pandemic-related perceived stress was significantly associated with postpartum anxiety symptoms. Moreover, childbirth experiences significantly and partially mediated this relationship. Findings highlighted the importance of evaluating perceived stress levels during pregnancy to prevent negative consequences on postpartum mental health. Clinicians need to foster better management of factors included in the childbirth experience that may potentially trigger or counteract anxiety risk.

Vitamin D levels and anxiety symptomatology in pregnancy and the postpartum.

Anxiety and vitamin D deficiency are both common in pregnancy, but research into the relationship between vitamin D levels and perinatal anxiety is sparse. We sought to examine whether an association exists and compare the distribution of vitamin D levels in women with and without anxiety symptoms. We analyzed 25-hydroxyvitamin D using ab213966 25(OH) vitamin D enzyme-linked immunosorbent assay in 54 women with and 47 women without anxiety symptoms at the first, second, and third trimesters and at 6 weeks postpartum. We conducted univariate and chi-square analyses to compare the frequencies of non-optimal and optimal vitamin D levels between the anxiety and non-anxiety groups at each timepoint. Overall, vitamin D levels were lower in the first and second trimesters than in the third trimester. In the first trimester only, the non-anxiety group had a marginally higher proportion of women with optimal vitamin D levels when compared to the anxiety group. Many pregnant women have insufficient or deficient levels of vitamin D, and our exploratory findings point to the need for further research into whether this differs between women with anxiety compared to healthy women.

The relationship between anxiety and irritable bowel syndrome symptoms among females: A cross-sectional study in Egypt.

There is a scarcity of studies focusing on irritable bowel syndrome (IBS) and anxiety in Egypt. Accordingly, our study aimed to assess the association between anxiety and IBS symptomatology among Egyptian females. Three hundred eighty-three females (145 IBS and 238 controls) were included in the study, and data were obtained using structured predesigned questionnaires. IBS and anxiety symptoms were assessed according to the Rome IV criteria and the Arabic version of the beck anxiety inventory, respectively. Both IBS and non-IBS groups showed increased anxiety during the pandemic, without a significant difference between both groups (P value = .657). Higher levels of education were significantly associated with severe anxiety (P value = .031). Multivariate analysis of IBS patients showed that intermediate education was significantly associated with 75% lower odds for increased IBS symptoms compared with illiterate or read-and-write IBS patients [odds ratio (OR): 0.25, 95% confidence interval (CI) 0.06-0.95, P value = .042]. Urban residence was significantly associated with 13.5 times greater odds of increased IBS symptoms, compared with rural residence (OR: 13.48, 95% CI 3.55-51.25, P value < .001). Moreover, patients who lost their job during the pandemic were 12.9 times more likely to have increased symptoms (OR: 12.89, 95% CI 1.84-90.15, P value = 0.01). A unit increase in patients age and beck anxiety inventory score was associated with 68% and 75% greater odds for increased IBS symptoms, respectively (OR: 1.68, 95% CI 1.12-2.53, P value = .012; OR: 1.75, 95% CI 1.08-2.84, P value = .024). Increasing anxiety is associated with increased IBS symptoms. Therefore, IBS patients should be screened for anxiety, and the role of psychiatric management of anxiety in the amelioration of IBS symptoms must be explored.

COVID-19 era-related e-learning: a cross-sectional web-scale study of cyberchondria, internet addiction and anxiety-related symptomatology among university nursing students

ObjectiveThe study assessed COVID-19 era-related e-learning cyberchondria, internet addiction and anxiety-related symptomatology among nursing students. The relationships, predictors and differences between the studied concepts were measured.DesignIn 2021, a quantitative cross‐sectional...

The relationship between subjective sleep disturbance and attenuated psychotic symptoms after accounting for anxiety and depressive symptoms.

Sleep disturbances are increasingly recognized as cooccurring with psychotic symptoms. The potential importance of this relationship is complicated when considering the effects of anxiety and depressive symptoms which commonly present in early-stage illness states. This study aimed to investigate the relationship between self-reported sleep disturbance on the development of attenuated psychotic symptoms (APS) cross-sectionally and longitudinally while adjusting for roles of anxiety and depressive symptoms. Eight-hundred and two help-seeking young people aged 12 to 25years who engaged with our Australian early intervention services were included in the study (the "Transitions" cohort). Cross sectional mediation and cross-lagged longitudinal (12-month) mediation models were developed with outcomes being different APS domains. Only baseline excessive daytime sleepiness predicted later APS when accounting for previous APS, anxiety and depressive symptomatology. Cross sectionally, self-reported sleep disturbance showed both direct and indirect predictive relationships with all APS domains. Partial mediation through anxiety and depression was shown for unusual thought content, perceptual abnormalities, and disorganised speech, while full mediation through depression was shown for non-bizarre ideas. The specificity of the relationship between self-reported sleep disturbance on APS highlights the potential for different roles in mechanistic models of psychotic symptom expression. This further indicates the need for further experimental research to illuminate potential causal pathways. Future research should continue to use continuous, symptom level approaches across a range of timeframes to more accurately model the complex dynamics present in the sleep-psychosis relationship.

In Between the Psychological and Physiological Self - The Impact of Covid-19 Pandemic on the Neuro-Socio-Ecological and Inflammatory Mind-Body-Brain System.

The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level.

COVID-19-Related Fear among Youth in Israel

The present study sought to expand the now expansive research on COVID-19 by examining COVID-19-related fear among adolescents in Israel, focusing on demographic variables, COVID-19-related variables (e.g., exposure and vaccination), psychosocial variables (e.g., adolescent wellbeing and perceived social support), and technology usage (e.g., amount of time spent on social media). Data from parents were also collected, reflecting parental attitudes toward the pandemic, anxiety and depression, and wellbeing. A total of 150 youth aged 12–18 and 150 parents participated in the study. Findings indicated that being a female, having a parent who knew someone who had died from COVID-19, and never having tested positive for COVID-19 were positively associated with increased fear of COVID-19. Increased fear of being infected with COVID-19 was also associated with high levels of anxiety and depressive symptomatology in both youth and parents and with low parent subjective wellbeing. Youth who used social media for sharing experiences and for politics also reported such fear. Youth whose parents reported that the media exaggerated COVID-19 risks were less likely to fear something bad would happen to them or to a loved one or fear another outbreak of the virus. Our findings call for paying further scholarly and professional attention to the role intrapsychological, interpersonal, and social aspects play in processes of increased fear and wellbeing in adolescents who constitute a particularly vulnerable group to the mental health consequences of the pandemic.

Forest bathing diminishes anxiety in undergraduate students: a pilot study in the Valdivian temperate rainforest

ABSTRACT Urban life has generally resulted in lifestyles characterised by high stress and anxiety, all which has increased the pervasiveness of mental disorders. University students, a group highly vulnerable to these problems, are likely to develop mental pathologies associated with anxiety and substance abuse. Forest bathing is one nature-oriented intervention aimed at improving physical as well as psychological well-being by reducing anxious symptomatology and stress. Here we evaluated the healing impact of forest bathing on the stress and anxiety of undergraduate students at one local university. We also included others key aspects of psychological mental health that have received scarce attention in forest bathing research like mindfulness, wellbeing and self-regulated learning. Twenty-one students belonging to the Universidad Austral de Chile were randomly assigned to the city or forest groups and took part in an intervention consisting in a low-impact 30 minute walk and a 15-minute contemplation afterwards. Five instruments to evaluate overall mental health (and blood pressure) were applied before and after the intervention. Our results showed that a rather short session of forest bathing is enough to reduce anxiety in undergraduate university students. The other measures of psychological or physiological health showed no statistical differences before and after the intervention (between city and forest) or time effects (within the forest or city treatment). A potential reason for this might be related to the short duration of the intervention itself. Our results are encouraging regarding mental health therapy, as this type of intervention could easily be implemented on campus.

Work Intensification and Its Effects on Mental Health: The Role of Workplace Curiosity

Work intensification is a psychosocial risk that has been increasing in recent decades and may have been accentuated after the COVID-19 pandemic. Its effects on health are negative, but they can be moderated by contextual and personal factors. The aim of this study was twofold: to analyze the effect of work intensification on workers’ stress, anxiety, and depression and to explore the role of workplace curiosity in these relationships. The study design was cross-sectional, and a total of 766 Spanish workers (58.9% female) with different occupations completed the survey. The results showed that work intensification was associated with the symptomatology of stress, anxiety, and depression, with a medium effect size. Women workers showed higher work intensification, but its association with mental health was equally strong for both genders. Workers with higher levels of the workplace curiosity dimension “stress tolerance” showed less impaired mental health in the presence of work intensification. However, workers with higher levels of the workplace curiosity dimension “deprivation sensitivity” showed more symptoms of stress, anxiety, and depression when faced with high work intensification. The results were discussed in terms of their contributions to the field of study of work intensification, the future research they could inspire, and the prevention and intervention measures they could motivate.

Validation of the Portuguese version of the Youth Anxiety Measure for DSM-5 (YAM-5-I)

Early intervention in anxiety symptomatology in school-aged children and adolescents is an effective way to prevent later psychopathology. Several measures have been developed to identify these symptoms although few of them rely on the latest criteria for anxiety disorders and, therefore, can be outdated. The Youth Anxiety Measure for DSM-5 (YAM-5) is a recently developed self-report instrument that assesses symptoms of the main anxiety disorders according to the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Already translated into several languages, this instrument has consistently revealed good psychometric properties. In this validation study, we translated and analyzed the psychometric properties of YAM-5-I in a Portuguese community sample including 300 participants. Data was collected using an online survey platform. Exploratory Factor Analysis and Parallel Analysis of data revealed a four-factor model accounting for 45% of the total variance in Part I of YAM-5, which included the scales of Separation Anxiety Disorder, Selective Mutism, Panic Disorder, and a fourth factor merging Social and Generalized Anxiety Disorders. This four-factor model was confirmed through Confirmatory Factor Analysis, revealing a better fit to the data than the original model. High internal consistency of the YAM-5-I was confirmed (ω = 0.88), as well as its convergent validity with similar symptomatology (correlations ranging from 0.38 to 0.74, except for the Selective Mutism Scale). The sample size can be a limitation of the present study, and cultural aspects could have influenced our results on the YAM-5-I four-factor model (different from the original version with five factors). Overall, our study supported the good psychometric properties of the Portuguese version of the YAM-5-I, therefore, consisting of a valid and updated tool for screening anxiety symptoms in children and adolescents.

Assessing the Effect of High-Density Housing on Mental Health of Urban Population. Case Study: Federal Territory of Kuala Lumpur

The increasing trends of urbanisation and the increasing prevalence of people having depression, anxiety, and stress worldwide are alarming. Urbanisation has exerted pressure on housing provision for urban dwellers, and more high-density housing is built to accommodate the migration of people to urban areas. This study aims to assess the effect of living in urban high-density residential on mental disorders of urban population. To understand the relationship between urban high-density living and mental disorders, a questionnaire survey was distributed to the dwellers of urban high-density residents in Federal Territory of Kuala Lumpur based on the characteristics of density, open spaces, and facilities provision. Responses are analysed using Spearman’s Correlation for the questionnaire. The questionnaire surveys show relatively high symptomatology of depression, anxiety and stress and a strong correlation value with high-density living. These results suggest that most people living in an urban high-density living may risk developing mental disorders. On this basis, mental health’s requisites should be considered when designing high-density housing and can support government policies such as in Sustainable Development Goals (SDG), in Ministry of Health policies, in PLANMalaysia development policies, State Structure Plans, District Local Plans, and others related organisation and research.

Neural representations of ambiguous affective stimuli and resilience to anxiety in emerging adults

The tendency to interpret ambiguous stimuli as threatening has been associated with a range of anxiety disorders. Responses to ambiguity may be particularly relevant to mental health during the transition from adolescence to adulthood (“emerging adulthood”), when individuals encounter unfamiliar challenges and navigate novel social situations. However, it remains unclear whether neural representations of ambiguity relate to risk for anxiety. The present study sought to examine whether multivariate representations of ambiguity — and their similarity to representations of threat — relate to appraisals of ambiguity or anxiety in a sample of emerging adults. Participants (N = 41) viewed threatening (angry), nonthreatening (happy), and ambiguous (surprised) facial stimuli while undergoing fMRI. Outside of the scanner, participants were presented with the same stimuli and categorized the ambiguous faces as positive or negative. Using representational similarity analyses (RSA), we investigated whether the degree of pattern similarity in responses to ambiguous, nonthreatening, and threatening faces within the amygdala related to appraisals of ambiguous stimuli and anxiety symptomatology. We found that individuals who evidenced greater similarity (i.e., less differentiation) in neural representations of ambiguous and nonthreatening faces within the left amygdala reported lower concurrent anxiety. Additionally, trial-level pattern similarity predicted subsequent appraisals of ambiguous stimuli. These findings provide insight into how neural representations of ambiguity relate to risk or resilience for the development of anxiety.