Baseline Trait Anxiety Research Articles

Trait-based Anxiety Symptoms are Associated with Higher Incidence of Nightmare Frequency in the Wisconsin Sleep Cohort

ABSTRACT Objectives Nightmares affect up to 12% of the population and are often comorbid with psychiatric disorders like anxiety and depression. Limited research has examined their influence on nightmare frequency. This study investigates the relationship between depression and trait-anxiety symptoms on incident nightmare frequency at follow-up. Method Cross-sectional and longitudinal analyses were conducted on 758 Wisconsin Sleep Cohort participants. Trait anxiety and depression symptom severity were measured using the State Trait Anxiety Inventory and Zung Depression Scale. Ordinal regression determined nightmare frequency cutoffs based on anxiety and depression severity. Cross-sectional associations were assessed with Spearman and Kruskal–Wallis tests. Longitudinal associations were analyzed using adjusted binomial regression of binary nightmare frequency (low: <4/month, high: >5/month) against clinical cutoffs of trait anxiety and depression. Results Adjusted models indicated a small correlation between baseline nightmare frequency and trait anxiety (β = 0.01, p = .010) and depression symptoms (β = 0.01, p = .005). High baseline trait-anxiety symptoms were associated with frequent nightmares at follow-up (OR = 3.75, CI95% [1.306,10.793], p < .014), but depression symptoms were not (OR = 1.35, CI95%[0.399, 4.587], p = .627). Conclusions Our findings suggest that high trait-anxiety symptoms are associated with increased incident nightmare frequency, when adjusted for depression. However, high depression symptoms were not associated with an increase in nightmare frequency when adjusted for trait-anxiety.

The effectiveness of Chinese instrumental music embedded with binaural beats in relieving anxiety related to academic stress among undergraduates: A randomized controlled trial

The study aimed to determine the effectiveness of binaural beat (BB) Chinese music, with dynamic theta- to delta-frequency progression, in relieving anxiety among Singapore undergraduates. It also examined whether the binaural effects differ between students with high and normal trait anxiety. This was a randomized controlled trial with 151 undergraduates assigned to listen to a single 30 min episode of BB Chinese music, Chinese music, or audiobook. The Perceived Stress Scale (PSS) measured stress, while the state subscale of the State-Trait Anxiety Inventory (STAI-S) and root mean square of successive R–R interval differences (RMSSD) were outcome measures for anxiety. Results indicated that mean STAI-S and PSS reductions were not statistically significant between groups. No significant difference in mean change of RMSSD was detected when the BB Chinese music group was compared with the Chinese music or audiobook groups. However, students with high baseline trait anxiety experienced a greater, marginally significant reduction in STAI-S scores and an increase in RMSSD than those with normal trait anxiety after BB exposure. BB Chinese instrumental music may not have anxiolytic effects on healthy undergraduate populations, as evidence for an anxiolytic effect was observed only among students with high baseline trait anxiety, warranting further research on this population.

Is everything really okay?: Using ecological momentary assessment to evaluate daily co-fluctuations in anxiety and reassurance seeking

ObjectiveReassurance seeking, a behavior prominent in anxiety disorders and depression, is associated with poorer quality of interpersonal relationships and acts as a mechanism of stress generation. However, little research has elucidated momentary associations between state anxiety and reassurance seeking behaviors. MethodIn a sample of 104 university-affiliated young adults, we sought to replicate cross-sectional associations of reassurance seeking with trait anxiety (Aim 1) and intolerance of uncertainty (Aim 2). We then used ecological momentary assessment (EMA) to evaluate concurrent fluctuations in daily anxiety and reassurance seeking across 14 consecutive days (Aim 3). Hierarchical multi-level models for intensive longitudinal data were used to evaluate the relationship between state anxiety and daily reassurance seeking. ResultsIn baseline analyses, trait anxiety and intolerance of uncertainty were significantly associated with greater trait reassurance seeking, controlling for depression. Analyses of the EMA data showed that daily reassurance seeking behaviors fluctuated concurrently with daily anxiety during the 14 days, while controlling for trait anxiety and depression. ConclusionGiven evidence of concurrent fluctuations between state anxiety and reassurance seeking, the behavior should be considered as a potential target in treatment for anxiety disorders.

Preliminary data that psychological treatment and baseline anxiety are associated with a decrease in postprandial fullness and early satiation for individuals with bulimia nervosa and related other specified feeding or eating disorder.

Gastrointestinal symptoms, particularly postprandial fullness, are frequently reported in eating disorders. Limited data exist evaluating how these symptoms change in response to outpatient psychological treatment. The current study sought to describe the course of postprandial fullness and early satiation across psychological treatment for adults with bulimia nervosa and related other specified feeding or eating disorders and to test if anxiety moderates treatment response. Secondary data analysis was conducted on questionnaire data provided by 30 individuals (80% white, M(SD)age = 31.43(13.44) years; 90% female) throughout treatment and six-month follow-up in a pilot trial comparing mindfulness and acceptance-based treatment with cognitive-behavioral therapy for bulimia nervosa. Participants completed items from the Rome IV Diagnostic Questionnaire for Adult Functional Gastrointestinal Disorders and the State Trait Anxiety Inventory. Postprandial fullness and early satiation both significantly decreased over time (ds = 1.23-1.54; p's < .001). Baseline trait anxiety moderated this outcome, such that greater decreases were observed for those with higher baseline anxiety (p = .02). Results extend prior work in inpatient samples by providing preliminary data that postprandial fullness and early satiation decrease with outpatient psychological treatment for bulimia nervosa. Baseline anxiety moderated this effect for postprandial fullness. Future work should replicate findings in a larger sample and test anxiety as a mechanism underlying postprandial fullness in eating disorders. The current study found that common gastrointestinal symptoms (postprandial fullness and early satiation) decrease over the course of outpatient psychotherapy for adults with full and subthreshold bulimia nervosa. Postprandial fullness decreased more across time for those high in anxiety.

The Impact of Self-Directed Arthrocentesis Model Practice on Student Stress and Procedural Performance of Live Donkey Arthrocentesis

Arthrocentesis is an essential procedure for diagnosing and treating equine lameness. However, veterinary students may receive insufficient practice on live equids, and cadaver training is suboptimal due to difficulty procuring cadavers, autolysis, and inability to use cadavers repetitively. We evaluated the impact of third year students’ equine model arthrocentesis practice on their performance of arthrocentesis on a live donkey. After baseline salivary cortisol and trait anxiety testing, students received didactic training on arthrocentesis. The model-trained group performed self-directed tibiotarsal arthrocentesis on an equine hindlimb model using a needle and syringe that emitted an auditory stimulus when the joint space was entered. All students (model group and control group) subsequently performed arthrocentesis on a live donkey. Immediately before and after arthrocentesis on the model and donkey, students’ salivary cortisol and situational and trait anxiety were measured. Groups did not differ in number of attempts, time, or performance score on the donkey. Students’ cortisol levels were highest at baseline and lowest immediately prior to live arthrocentesis, suggesting that veterinary students have a high baseline level of stress and that focusing on performing a single procedure may have a paradoxical stress-reducing effect. Students’ situational anxiety was highest immediately after performing live arthrocentesis, suggesting that they reflected on their performance with self-criticism. One short session of self-directed model training was not effective at improving students’ performance or reducing their stress levels associated with performing arthrocentesis on a donkey.

Unexpected Death of a Mannequin: A Mixed Methods Pilot Study on Relationships of Stress, Anxiety, and Resilience on Learning Outcomes

BackgroundAlthough simulation increases competencies in end of life care, unexpected death simulations are often avoided due to student stress and anxiety. This pilot study aimed to determine a protocol for studying relationships of stress, anxiety, and resilience on student learning outcomes during an unexpected death simulation. MethodA mixed methods design used demographics, resilience scores, anxiety scores, competency measurements, and one-on-one interviews to study the variables. ResultsPaired samples t-test of state anxiety scores showed a statistically significant increase from the baseline measurement to immediately after the simulated death. Large negative correlations were found between baseline resilience and state anxiety scores, and between baseline resilience and trait anxiety scores. Interview responses indicated that multiple factors lead to students experiencing stress and anxiety. ConclusionThe procedures and methods were appropriate for studying the variables. Correlations between resilience and anxiety scores indicated that maximum sampling variation may be beneficial when choosing interview participants.

Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety.

To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre–post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (β = −8.24 [95%CI −15.39; −1.09], p = 0.02) and WEMWBS (β = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.

State and trait anxiety in children with incontinence and their parents.

Maternal anxiety increases the risk for incontinence in children. The aim was to analyze anxiety in children with incontinence and their parents before (t1) and after 6months of incontinence treatment (t2). 40 children with incontinence and 40 controls completed the State-trait Anxiety Inventory for Children, their parents the Child Behavior Checklist (CBCL) and the State-trait Anxiety Inventory at baseline (t1) and 6months later (follow-up, t2). Psychiatric disorders were assessed by a standardized parental diagnostic interview (Kinder-DIPS), IQ was tested by a one-dimensional test. All children were neurologically examined. Children with incontinence underwent a guideline-based treatment during the 6months. At baseline, child and parental state and trait anxiety scores, as well as all CBCL scores were significantly higher in the patient group compared to the control group. At t2, parental anxiety, CBCL scores, and child trait anxiety were significantly higher in patients versus controls, whereas child state anxiety decreased, and parental state anxiety increased from t1 to t2. Incontinence and anxiety are associated. While state anxiety decreases, trait anxiety can remain stable over time. Higher levels of anxiety can influence incontinence treatment and should be assessed in every patient.

P.329 State anxiety induced by THC and CBD does not change after correcting for baseline anxiety levels

Background: In the last decade, the psychoactive substance delta-9-tetrahydrocannabinol (THC) in cannabis products has risen considerably, which has been associated with increased anxiety [1]. The non-psychoactive cannabis compound cannabidiol (CBD) is suggested to counteract THC-induced anxiety to some extent [2,3], however, these effects are mild [3]. Trait anxiety has been suggested to moderate cannabis-induced anxiety [4]. The present study aimed to examine whether the CBD effects on THC-induced anxiety can be explained by baseline state anxiety levels and/or trait anxiety levels in healthy volunteers. Methods: A placebo-controlled, randomized within-subjects study including 26 healthy recreational cannabis users was set up to test the effects of vaporized cannabis containing THC (11% THC, <1% CBD), CBD (<1% THC, 11% CBD), THC/CBD (11% THC, 11% CBD), and placebo cannabis (<1% THC, <1% CBD) on anxiety measures. Participant ratings of subjective state anxiety using Visual Analogue Scales (VAS) and State-Trait Anxiety Inventory (STAI)-state served as a measure of explicit anxiety, and a computer-based emotional Stroop task was used to assess implicit anxiety. Subjective anxiety state was scored repeatedly over 6 hours, while the STAI-state and emotional Stroop task were administered directly after drug inhalation. Trait anxiety levels (STAI) were measured once prior to the test days and baseline state anxiety level were measured once prior to each drug inhalation. All data were analysed with Linear Mixed Models (LMMs); the VAS ratings of state anxiety were analysed with unstructured covariance structure, and the STAI-state and emotional Stoop data were analysed with compound symmetry as covariance structure. The STAI-trait and anxiety state baseline scores were added as covariates. When a covariate was non-significant, it was removed from the model. In the case of a main Drug effect, planned Bonferonni-corrected pairwise comparisons were performed. Results: There was a main effect of the covariate baseline state anxiety (p< 0.01), a drug by trait anxiety interaction (p= 0.02) and a main Drug effect (p< 0.01) on the subjective state rating of anxiety (VAS). Participants felt more anxious during THC (p< 0.01; 95% CI [-2.02, -0.80]) and THC/CBD (p< 0.05; 95% CI [-1.46, -0.23]) compared to placebo. Both covariates did not show a significant effect on the STAI-state and emotional Stroop and thereby removed from further analyses. There was a main Drug effect on the STAI-state; (p< 0.01) both THC (p< 0.01; 95% CI [-17.20, -9.30]) and THC/CBD (p= 0.03; 95% CI [-10.89, -2.76]) increased state anxiety compared to placebo, however anxiety induced by THC/CBD was less compared to the THC condition (p= 0.02; 95% CI [2.30, 10.54]). There were no significant Drug effect on the emotional Stroop task. Conclusion: The present study shows that trait anxiety partly predicts cannabis induced increments in state anxiety. However, cannabis effects on anxiety are robust as they do not change after correcting for baseline differences in state anxiery. While baseline levels and trait anxiety are both subjective measures, future studies might also include pharmacokinetics and pharmacodynamics modelling in order to include individual differences in metabolism which might explain the cannabis-induced anxiety.

Apathy and Anxiety in De Novo Parkinson's Disease Predict the Severity of Motor Complications.

Neuropsychiatric and affective symptoms are prevalent in prodromal and clinical Parkinson's disease (PD). Some evidence suggests that they may also signify risk for motor complications (motor fluctuations and dyskinesias) of dopamine replacement therapy (DRT). To determine whether neuropsychiatric symptoms present in de novo PD (ie, before DRT initiation) predict the severity of eventual motor complications of DRT. We used clinical, demographic, neurobehavioral, and neuroimaging data from the Parkinson's Progression Markers Initiative (PPMI), a multicenter observational PD study. Participants were unmedicated at enrollment and 361 initiated DRT during PPMI follow-up. We used Cox proportional hazard and multivariate ordinal mixed-effects regression models to evaluate the relationship between baseline neuropsychiatric symptoms and motor complications as measured by the Movement Disorders Society-revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The cumulative incidences of dyskinesias and motor fluctuations during follow-up (6.0 ± 1.5 years) were 34.3% and 59.9%, respectively. Both apathy and high trait-anxiety (top quartile) conveyed over two-fold increases in hazard for dyskinesia onset and for adverse impact on activities of daily living caused by both dyskinesias and motor fluctuations. The longitudinal severity of motor fluctuations and dyskinesias was significantly predicted by baseline trait-anxiety and apathy, but not depression. Models were adjusted for dimensionally related symptoms (eg autonomic dysfunction) and potential confounding variables (eg DRT dose). Apathy and anxiety levels in de novo PD may be neuropsychiatric biomarkers of vulnerability to earlier and more disabling motor complications of DRT.

Use of an estradiol-based combined oral contraceptives has no influence on attentional bias or depressive symptoms in healthy women

Combined oral contraceptive (COC) use is associated with small, albeit significant, increases in mental symptom scores, predominantly irritability, depressed mood, and anxiety. Yet, randomized prospective trials are needed to better characterize the women at risk for COC-induced negative mood change. Thus, the primary aim of this sub-study to a placebo-controlled randomized trial was to determine whether COC use influences emotional interference by negative and positive stimuli. Secondly, we wanted to evaluate what factors would predict depressive symptoms at the end of the trial, taking personality factors, history of mental disorders and other demographic factors into account. Sixty-nine women were included, randomized to three cycles of treatment with a COC (1.5 mg estradiol and 2.5 mg nomegestrolacetate) or placebo. An emotional verbal Stroop task was used to measure interference of emotional stimuli, in which participants were asked to only name the color of a presented word, while ignoring the meaning of the word. Four different word categories were used; neutral, positive, depression, and anxiety. For the second aim of the study, rating on the Montgomery-Åsberg Depression Rating Scale during the final days of the trial was used as outcome.We found no interaction between emotional verbal Stroop word category and treatment, indicating that COC treatment did not evoke any differences in emotional interference to the three word categories. Significant predictors for depressive symptoms at the end of the trial were trait anxiety at baseline and prior adverse mood effects by hormonal contraceptive use. Treatment (i.e. whether women had been treated with the COC or placebo) did not play a role in predicting depression scores at the end of the trial. In conclusion, we found no evidence that combined oral contraceptive use is associated with impaired cognitive-emotional processing. Instead, the main predictors of self-rated depression at the end of the trial were baseline trait anxiety and previous mental symptoms during hormonal contraceptive use.

ANXIETY, NEUROTICISM AND LATE-LIFE DEPRESSION

Introduction Late-life depression (LLD) is associated with psychiatric comorbidities that may worsen mood outcomes in older adults, yet these comorbid conditions remain underdiagnosed and understudied in LLD. Anxiety and neuroticism have been independently associated with depression, but the interplay between these traits in older adults is uncertain and may be key to understanding the development and important mood and cognitive outcomes of LLD. In this study, we analyzed the relationship between neuroticism, anxiety and depression in older adults and hypothesized that higher anxiety measures would be associated with: (1) higher depression severity, (2) higher neuroticism, (3) lower cognitive scores at baseline, and (4) cognitive decline. Methods Older non-demented adults who were either depressed or never depressed (controls) were recruited. Anxiety, neuroticism, depression and cognition were assessed using the State-Trait Anxiety Inventory (STAI), NEO Personality Inventory (NEO PI), Montgomery-Asberg Depression Rating Scale (MADRS) and the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) cognitive battery, respectively. A study psychiatrist confirmed or ruled out diagnosis of depression for depressed and control subjects. The psychiatrist followed a guided treatment algorithm in which sertraline was initially offered to all subjects at baseline. A sub-group analysis was performed on sertraline intention to treat (ITT) subjects. Subjects in the depression group were followed every two weeks by the psychiatrist, who made dosing adjustments and administered the MADRS. Results Baseline study results were obtained from a sample of 121 older depressed subjects and 39 never depressed controls. Longitudinal results were obtained from a sample of 93 depressed subjects for 3-month outcomes (3M), and 57 subjects for 12-month outcomes (12M). The sub-group sertraline-ITT analysis was performed for 51 subjects for 3M and 36 subjects for 12M. At baseline, state and trait anxiety scores were highly associated with depression scores in both study groups. Higher state and trait anxiety scores were associated with lower baseline cognition scores in the control group, and significantly less so in the depressed group. Baseline total neuroticism was associated with higher state and trait anxiety, and with higher depression scores in both groups. At baseline, total neuroticism was not significantly associated with lower cognition scores. For longitudinal results, we found that baseline trait anxiety was a predictor of 3M and 12M depression scores in the depressed group, but not a predictor of change from baseline. Trait anxiety and total neuroticism were predictors of 3M depression scores in the ITT sub-group. We also found that the anxiety, depression and stress vulnerability domains of neuroticism were predictors of 3M depression scores, for both the depressed group and the ITT sub-group. The impulsiveness facet of neuroticism was a predictor of 12M depression in both group and sub-group analyses. The only significant predictor of 12M cognitive score was baseline state anxiety. Conclusions Anxiety and neuroticism in late life are highly prevalent among older depressed individuals. We found that anxiety measures correlated with depression measures in older adults, regardless of clinical diagnosis as depressed or non-depressed. Interestingly, anxiety correlated with lower cognitive performance only in the non-depressed individuals. These results highlight a differential effect of anxiety on cognition between non-depressed older adults and those adults suffering from LLD. Several baseline neuroticism and anxiety traits were found to predict depression scores, but none was found to correlate with significant changes in depression and cognition in this 12-month analysis. There is a complex interplay between mood and personality traits in older adults, and studies that include a longer follow-up are needed to identify important predictors of mood and cognitive outcomes in LLD. This research was funded by The Leo and Anne Albert Charitable Trust National Institute of Mental Health Grant R01 MH108578

Metacognitive Beliefs Predict Greater Mental Contamination Severity After an Evoking Source.

Mental contamination occurs when individuals experience feelings of internal dirtiness and distress in the absence of physical contact with a contaminant. Women who experience sexual trauma frequently report mental contamination. The self-regulatory executive function (S-REF) model proposes that metacognitive beliefs contribute to the appraisal and regulation of thinking, leading to expectations that metacognitive beliefs would predict greater mental contamination severity following an evoking source. Women who reported directly experiencing sexual trauma (N = 102) completed self-report measures of metacognitive beliefs and covariates during an online study session, and subsequently completed a task that evoked mental contamination during a follow-up in-person study session. Metacognitive beliefs surrounding the uncontrollability and danger of thoughts, cognitive confidence, and the need to control thoughts positively correlated with mental contamination severity following the evoking source. Metacognitive beliefs surrounding the uncontrollability and danger of thoughts predicted greater mental contamination severity following the evoking source in multivariate analyses that statistically controlled for baseline mental contamination severity, trait anxiety, and overlap among the metacognitive beliefs. The present results provide preliminary support for the S-REF model as a potential framework for conceptualizing mental contamination.

Effects of lorazepam on saccadic eye movements: the role of sex, task characteristics and baseline traits.

Saccadic eye movements are controlled by a network of parietal, frontal, striatal, cerebellar and brainstem regions. The saccadic peak velocity is an established biomarker of benzodiazepine effects, with benzodiazepines reliably reducing the peak velocity. In this study, we aimed to replicate the effects of benzodiazepines on peak velocity and we investigated effects on previously less studied measures of saccades. We also explored the roles of sex, task characteristics and the baseline variables age, intelligence and trait anxiety in these effects. Healthy adults ( N = 34) performed a horizontal step prosaccade task under 1 mg lorazepam, 2 mg lorazepam and placebo in a double-blind, within-subjects design. We replicated the dose-dependent reduction in peak velocity with lorazepam and showed that this effect is stronger for saccades to targets at smaller eccentricities. We also demonstrated that this effect is independent of sex and other baseline variables. Lorazepam effects were widespread, however, occurring on mean and variability measures of most saccadic variables. Additionally, there were sex-dependent lorazepam effects on spatial consistency of saccades, indicating more adverse effects in females. We conclude that saccadic peak velocity is a sensitive and robust biomarker of benzodiazepine effects. However, lorazepam has pronounced effects also on other parameters of horizontal saccades. Sex-dependent drug effects on spatial consistency may reflect cerebellar mechanisms, given the role of the cerebellum in saccadic spatial accuracy.

Comparison of the effect of lavender and bitter orange on anxiety in postmenopausal women: A triple-blind, randomized, controlled clinical trial

IntroductionThis trial compared the effects of lavender and bitter orange on anxiety in postmenopausal women. MethodsThis trial was conducted in 2015. Eligible postmenopausal women were allocated into one of two intervention groups or a control group (n = 52 per group) in a 1:1:1 ratio using a randomized block design. Intervention groups received 500 mg capsules containing only bitter orange or lavender flower powder, and the control group received 500 mg capsules containing starch. The Spielberger's State -Trait Anxiety Inventory (STAI) was used before and eight weeks after starting the intervention. Data analyses were based on intention to treat. ResultsA one-way ANOVA showed no significant difference in mean state anxiety (P = 0.254) and trait anxiety (p = 0.972) score among the three groups before the intervention. The general linear model, adjusted for baseline state and trait anxiety scores and confounding factors, showed significant differences among the groups in the mean state anxiety (P = 0.010) and trait anxiety (p = 0.041) score after eight weeks of treatment. Bitter orange significantly reduced the mean state-anxiety scores compared with the control group [Adjusted Mean Difference (aMD): −1.99 (95% Confidence Interval, −3.64 to −0.34)]. Lavender significantly reduced the mean state-anxiety scores compared with the control group as well [aMD: −2.45 (95% CI -4.13 to −0.77)] and Bitter orange significantly reduced the mean trait-anxiety scores compared with the control group [aMD: −1.76 (95% CI -3.45 to −0.06)]. Lavender significantly reduced the mean trait-anxiety scores compared with the control group as well [aMD: −2.05 (95% CI -3.76 to −0.33)]. There was no significant difference between bitter orange and lavender groups after intervention in the mean trait-anxiety (p = 0.731) or state-anxiety (p = 0.578) scores. ConclusionThe positive effect of bitter orange and lavender on anxiety in postmenopausal women suggests that they can be used to decrease anxiety in such women.

Abstract P5-19-04: Psychosocial impact of a multi-modality surveillance program for women at high-risk for breast cancer

Abstract Purpose: To evaluate the psychosocial impact of semi-annual dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) screening in women at high-risk for breast cancer. Background: For women with BRCA1 and BRCA2 mutations and/or a personal or family history of breast cancer, annual breast MRI has shown improved sensitivity and cancer detection compared to mammography. However, MRI's heightened sensitivity may lead to increased: false positives requiring additional follow-up biopsy/imaging; iatrogenic risk; and psychosocial distress, which all may negatively impact women's overall health-related quality of life. Methods: Between 2004 and 2016, we assembled a prospective cohort of high-risk women undergoing semi-annual DCE-MRI and annual mammography. We reviewed a subset of this group. Participants completed psychosocial assessments at baseline and 6-month visits using the following measures: coping (MBSS); state/trait anxiety (STAI-S/T); depression (BDI-II); risk perception; and mental health (SF-36). Participants were classified according to Monitor or Blunter coping style. Mixed-effects logistic regressions models examined effects of demographics on psychosocial changes over time. Results: 295 women were recruited to the study; 44% of the study participants had pathogenic mutations in BRCA1 or BRCA2 genes. 232 of 295 enrolled participants (78.6%) completed psychosocial assessments. For the total population: median age 44y (range: 21-73), 71% ≥college/post-graduate education; 84% Caucasian; 8% African American; 2% Latino; 99% with health insurance; 72% annual income of &amp;gt;$60,000. One third of women had a personal cancer history. Participants were evenly split between baseline Monitoring and Blunting coping style (49% and 51%, respectively). No significant differences were found between demographics (age, race, income, mutation, cancer type, cancer history) or psychosocial factors (baseline trait anxiety (p =0.64), depression (p =0.65), SF36 global health (p=0.66). After adjusting for education, race, cancer history and coping, women with ≥$60,000 income had lower trait anxiety (p&amp;lt;0.000) and greater mental health (p&amp;lt;0.001) than those with &amp;lt;$60,000 income. Over time, change in trait anxiety varied by coping (p=0.0006): Blunters did not experience significant changes in trait anxiety (p=0.072) while Monitors had significant diminished trait anxiety over time (p&amp;lt;0.001). For depression, women with ≥$60,000 income and college educated had lower BDI-II depression (p&amp;lt;0.000). Yet, women with a cancer history had significantly greater BDH-II depression (p= 0.048). Mental health over time varied by race as non-whites had greater gains in mental health (p=0.001) over time than whites (p=0.03). Conclusion: Semi-annual DCE-MRI did not cause a significantly elevated state anxiety or depression, nor was there a significant decline in mental health over time for groups regardless of cancer history and genetic mutation status. Coping style may have an impact on psychosocial outcomes for those undergoing heightened surveillance over time. Citation Format: Amico AL, Fang R, Raoul A, Wroblewski K, Nielsen S, Weipert C, Abe H, Sheth D, Romero I, Kulkarni K, Schacht D, Patrick-Miller L, Verp M, Bradbury AR, Hlubocky F, Olopade OI. Psychosocial impact of a multi-modality surveillance program for women at high-risk for breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-19-04.

Оценка психоэмоционального состояния больных с последствиями повреждения спинного мозга

Introduction Assessment of patients' psychoemotional condition (PEC) is a standard aspect of clinical care within traumatic spinal cord injury (SCI) rehabilitation. Materials and methods The evaluation was performed for 40 patients with SCI aged more than one year and ASIA grades B, C, D. HAM (Health, Activity, Mood) tests, the Beck Depression Inventory (BDI) and the Spielberger-Khanin Anxiety Scale were used to assess psychoemotional conditions in the patients. Results Patients with traumatic SCI did not reveal high level of state anxiety and depression at a long-term follow-up with evidently limited motor function (ASIA grades B, C). Even the presence of baseline trait anxiety did not result in severe psychoemotional disorders like depression. This can be described as a regulating effect of the autonomic nervous system through both recovery and compensation of autonomic dysfunctions employing reparative and adjustment mechanisms including coping efforts. Conclusions The majority of the patients could successfully cope with consequences of SCI at mid- and long-term follow-up. Most of them were able to adapt to the circumstances, learn to live with a new status, and successfully overcome SCI related physical, psychological and social difficulties.

Excess weight gain prevention in adolescents: Three-year outcome following a randomized controlled trial.

Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge-eating-disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health education (HE) to prevent excess weight gain at 1-year follow-up in 113 adolescent girls at high-risk for excess weight gain because of loss-of-control eating and high body mass index (BMI; kg/m2; Tanofsky-Kraff et al., 2014). Participants from the original trial were recontacted 3 years later for assessment. At baseline, adolescent- and parent-reported social-adjustment problems and trait anxiety were evaluated. At baseline and follow-ups, BMIz and adiposity by dual-energy x-ray absorptiometry were obtained. Nearly 60% were reassessed at 3 years, with no group differences in participation (ps ≥ .70). Consistent with 1 year, there was no main effect of group on change in BMIz/adiposity (ps ≥ .18). In exploratory analyses, baseline social-adjustment problems and trait-anxiety moderated outcome (ps < .01). Among girls with high self-reported baseline social-adjustment problems or anxiety, IPT, compared to HE, was associated with the steepest declines in BMIz (p < .001). For adiposity, girls with high or low anxiety in HE and girls with low anxiety in IPT experienced gains (ps ≤ .03), while girls in IPT with high anxiety stabilized. Parent-reports yielded complementary findings. In obesity-prone adolescent girls, IPT was not superior to HE in preventing excess weight gain at 3 years. Consistent with theory, exploratory analyses suggested that IPT was associated with improvements in BMIz over 3 years among youth with high social-adjustment problems or trait anxiety. Future studies should test the efficacy of IPT for obesity prevention among at-risk girls with social-adjustment problems and/or anxiety. (PsycINFO Database Record

Altered Insula Connectivity under MDMA.

Recent work with noninvasive human brain imaging has started to investigate the effects of 3,4-methylenedioxymethamphetamine (MDMA) on large-scale patterns of brain activity. MDMA, a potent monoamine-releaser with particularly pronounced serotonin- releasing properties, has unique subjective effects that include: marked positive mood, pleasant/unusual bodily sensations and pro-social, empathic feelings. However, the neurobiological basis for these effects is not properly understood, and the present analysis sought to address this knowledge gap. To do this, we administered MDMA-HCl (100 mg p.o.) and, separately, placebo (ascorbic acid) in a randomized, double-blind, repeated-measures design with twenty-five healthy volunteers undergoing fMRI scanning. We then employed a measure of global resting-state functional brain connectivity and follow-up seed-to-voxel analysis to the fMRI data we acquired. Results revealed decreased right insula/salience network functional connectivity under MDMA. Furthermore, these decreases in right insula/salience network connectivity correlated with baseline trait anxiety and acute experiences of altered bodily sensations under MDMA. The present findings highlight insular disintegration (ie, compromised salience network membership) as a neurobiological signature of the MDMA experience, and relate this brain effect to trait anxiety and acutely altered bodily sensations-both of which are known to be associated with insular functioning.

Is State Anxiety, Trait Anxiety, or Anxiety Sensitivity a Clinical Predictor of Symptoms in Those Presenting With Mild Traumatic Brain Injury or Concussion?

Is state anxiety, trait anxiety, or anxiety sensitivity a clinical predictor of symptoms in those presenting with mild traumatic brain injury or concussion? Summary of Key Findings: A literature search returned 3 possible studies; 3 studies met inclusion criteria and included. One study reported in athletes that greater social support was associated with decreased state-anxiety, lower state anxiety post-concussion was associated with increased social support, and that those with greater social support may experience reduced anxiety, regardless of injury type sustained. One study reported baseline trait anxiety in athletes was not significantly associated with post-concussion state anxiety, but that symptoms of depression at baseline was the strongest predictor for post-concussion state anxiety. Three studies reported that state and trait anxiety are not related to increased post-concussion symptom scores. One study reported that greater anxiety sensitivity is related to higher reported post-concussion symptom scores, which may manifest as somatic symptoms following concussion, and revealed that anxiety sensitivity may be a risk factor symptom development. Clinical Bottom Line: There is low-level to moderate evidence to support that anxiety sensitivity is linked to post-concussion symptoms. State and trait anxiety do not appear to be related to post-concussion symptoms alone. Post-concussion state anxiety may occur if post-concussion symptoms of depression are present or if baseline symptoms of depression are present. Better social support may improve state anxiety post-concussion. Strength of Recommendation: There is grade B evidence to support that state and trait anxiety are not risk factors for post-concussion symptom development. There is grade C evidence to support anxiety sensitivity as a risk factor for developing post-concussion symptoms.