Beck Anxiety Inventory Total Scores Research Articles

Gray matter substrates of depressive and anxiety symptoms in idiopathic REM sleep behavior disorder

IntroductionIdiopathic rapid eye movement sleep behavior disorder (iRBD) is a prodromal stage of Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Depressive and anxiety symptoms are frequent features of PD, DLB and iRBD, and some studies suggest that depressive symptoms are a marker for neurodegeneration in iRBD. However, the pathophysiology of depressive and anxiety symptoms in iRBD is still unclear. This study aimed to investigate cortical and subcortical gray matter (GM) volume substrates of depressive and anxiety symptoms in iRBD patients. MethodsForty-six polysomnography-confirmed iRBD patients and 31 healthy controls (HC) without cognitive or mood impairment were recruited. All participants underwent 3-T magnetic resonance imaging and completed the Beck Depression Inventory Second Edition (BDI-II) and Beck Anxiety Inventory (BAI) questionnaires. Voxel-based morphometry analysis was performed to assess GM volume in cortical and subcortical structures. Between-group comparisons and regressions were performed. ResultsiRBD patients with depressive symptoms (BDI-II score > 13 or the use of antidepressants to treat depression) showed reduced GM volume in the caudate nucleus compared to HC and iRBD patients without depressive symptoms. Moreover, iRBD patients with anxiety symptoms (BAI score > 9 or the use of anxiolytics to treat anxiety) showed reduced GM volume in the left amygdala extending to the hippocampus compared to HC and iRBD patients without anxiety symptoms. In iRBD patients, higher BDI-II and BAI total scores were associated with lower GM volumes in these regions respectively. ConclusionDepressive and anxiety symptoms in iRBD patients are related to patterns of cortical and subcortical GM volume loss.

The impact of motor symptoms on self-reported anxiety in Parkinson's disease

ObjectiveAnxiety is commonly endorsed in Parkinson's disease (PD) and significantly affects quality of life. The Beck Anxiety Inventory (BAI) is often used but contains items that overlap with common PD motor symptoms (e.g., “hands trembling”). Because of these overlapping items, we hypothesized that PD motor symptoms would significantly affect BAI scores. MethodsOne hundred non-demented individuals with PD and 74 healthy control participants completed the BAI. PD motor symptoms were assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). Factor analysis of the BAI assessed for a PD motor factor, and further analyses assessed how this factor affected BAI scores. ResultsBAI scores were significantly higher for PD than NC. A five-item PD motor factor correlated with UPDRS observer-rated motor severity and mediated the PD-control difference on BAI total scores. An interaction occurred, whereby removal of the PD motor factor resulted in a significant reduction in BAI scores for PD relative to NC. The correlation between the BAI and UPDRS significantly declined when controlling for the PD motor factor. ConclusionsThe results indicate that commonly endorsed BAI items may reflect motor symptoms such as tremor instead of, or in addition to, genuine mood symptoms. These findings highlight the importance of considering motor symptoms in the assessment of anxiety in PD and point to the need for selecting anxiety measures that are less subject to contamination by the motor effects of movement disorders.

A Breathing-Based Meditation Intervention for Patients With Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study.

To evaluate feasibility, efficacy, and tolerability of Sudarshan Kriya yoga (SKY) as an adjunctive intervention in patients with major depressive disorder (MDD) with inadequate response to antidepressant treatment. Patients with MDD (defined by DSM-IV-TR) who were depressed despite ≥ 8 weeks of antidepressant treatment were randomized to SKY or a waitlist control (delayed yoga) arm for 8 weeks. The primary efficacy end point was change in 17-item Hamilton Depression Rating Scale (HDRS-17) total score from baseline to 2 months. The key secondary efficacy end points were change in Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) total scores. Analyses of the intent-to-treat (ITT) and completer sample were performed. The study was conducted at the University of Pennsylvania between October 2014 and December 2015. In the ITT sample (n = 25), the SKY arm (n = 13) showed a greater improvement in HDRS-17 total score compared to waitlist control (n = 12) (-9.77 vs 0.50, P = .0032). SKY also showed greater reduction in BDI total score versus waitlist control (-17.23 vs -1.75, P = .0101). Mean changes in BAI total score from baseline were significantly greater for SKY than waitlist (ITT mean difference: -5.19; 95% CI, -0.93 to -9.34; P = .0097; completer mean difference: -6.23; 95% CI, -1.39 to -11.07; P = .0005). No adverse events were reported. Results of this randomized, waitlist-controlled pilot study suggest the feasibility and promise of an adjunctive SKY-based intervention for patients with MDD who have not responded to antidepressants. ClinicalTrials.gov identifier: NCT02616549.

Psychometric properties and measurement equivalence of the English and Chinese versions of the Beck Anxiety Inventory in patients with breast cancer.

There is a lack of psychometric data for both the English and Chinese versions of Beck Anxiety Inventory (BAI) to support its usage among breast cancer patients. This study examined the psychometric properties and measurement equivalence of the English and Chinese versions of BAI among breast cancer patients in Singapore. Patients were recruited from two major cancer centers in Singapore. The criterion and construct validity of BAI was assessed by its correlation strength with (1) the emotional functioning subdomain of EORTC QLQ-C30 and (2) constructs related to anxiety, namely fatigue, dyspnea, and quality of life. The known-group validity was assessed according to the patients' breast cancer stage, religious beliefs, and emotional functioning levels. The internal consistency of the BAI domains was evaluated using Cronbach's alpha coefficient. Regression analysis was performed to compare the BAI total and domain scores between the two language versions. Data from 244 patients (144 English-speaking and 100 Chinese-speaking) were analyzed. For both language versions, the BAI total scores correlated moderately with the EORTC QLQ-C30 emotional functioning subdomain (r=-0.655 and -0.601). Correlations with fatigue, quality of life, and dyspnea were moderate (|r|=0.456-0.606). Patients with poorer emotional functioning reported higher anxiety levels, establishing known-group validity. All BAI domains demonstrated satisfactory internal consistencies (α=0.74-0.87), except for the panic domain (α=0.57-0.61). Possible measurement equivalence between the language versions was established. Both English and Chinese versions of BAI are valid, reliable, and possibly equivalent for future use.

Sex Differences in the Effects of Anxiety and Anxiety Sensitivity on Visual Perception

Objective: Most previous studies investigating the relationship between visual perception and anxiety have found that anxiety-provoking stimuli are perceived as relatively larger in size. Thus, the present study used neutral stimuli to investigate the relationships among anxiety, anxiety sensitivity (AS), and visual perception in a group of male and female university students. Methods: The Visual Size Perception Assessment Test (V-SPAT), which requires subjects to define a neutral figure in a dichotomous manner (i.e., tall/short, large/small, wide/ narrow, crowded/deserted) was administered to all participants (n:76). Additionally, the anxiety level and AS of each participant was determined using the Beck Anxiety Inventory (BAI) and the Anxiety Sensitivity Index-3 (ASI-3), respectively. Results: The BAI and ASI-3 total and cognitive scores of female participants were correlated with perceptions of “deserted”, whereas their ASI-3 social scores were correlated with perceptions of “short”. The ASI-3 cognitive scores of male participants were correlated with perceptions of “crowded”, and their ASI-3 physical scores were correlated with perceptions of “tall”. The present findings indicate that the visual per ception of neutral objects is correlated with anxiety and AS. Conclusion: Furthermore, these data revealed sex differences in the relationship between AS and visual perception in that males perceived the objects as larger and females perceived them as smaller.

Psychological Predictors of Neurobehavioral Symptoms in a Polytrauma Veteran Sample

ABSTRACTGiven the high prevalence of comorbid conditions found in polytrauma settings, effective screening measures are needed. Several screening tools are commonly used in polytrauma clinics within the Department of Veterans Affairs (VA). This study examined the use of three screening measures—the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and PTSD Checklist–Civilian Version (PCL-C)—to predict scores on the Neurobehavioral Symptom Inventory (NSI). Research suggests that the presence of mental health conditions, such as PTSD, shares a significant amount of variance with postconcussive symptoms. The investigators hypothesized that the PCL-C would be the best predictor of scores on the NSI. All subjects were administered the screening measures as part of an evaluation in an outpatient Level III polytrauma clinic. Regression analysis was used to determine which instrument might serve as the best predictor of NSI total scores. Regression analysis revealed that BAI, BDI-II, and PCL-C total scores were good predictors of NSI total scores, with the BAI accounting for the majority of the variance. Mental health conditions can account for higher scores on the NSI, and screening of other mental health conditions should be taken into account when reviewing the NSI for individuals in polytrauma settings.

The Impact of Anxiety and Anxiety Sensitivity On Visual Perception; Differences Between Two Genders

Objective Most previous studies investigating the relationship between visual perception and anxiety have found that anxiety-provoking stimuli are perceived as relatively larger in size. Thus, the present study used neutral stimuli to investigate the relationships among anxiety, anxiety sensitivity (AS), and visual perception in a group of male and female university students. Methods The Visual Size Perception Assessment Test (V-SPAT), which requires subjects to define a neutral figure in a dichotomous manner (i.e., tall/short, large/small, wide/narrow, crowded/deserted) was administered to all participants ( n = 76). Additionally, the anxiety level and AS of each participant was determined using the Beck Anxiety Inventory (BAI) and the Anxiety Sensitivity Index-3 (ASI-3), respectively. Results The BAI and ASI-3 total and cognitive scores of female participants were correlated with perceptions of 'deserted”, whereas their ASI-3 social scores were correlated with perceptions of 'short”. The ASI-3 cognitive scores of male participants were correlated with perceptions of 'crowded”, and their ASI-3 physical scores were correlated with perceptions of 'tall”. Conclusions The present findings indicate that the visual perception of neutral objects is correlated with anxiety and AS. Furthermore, these data revealed sex differences in the relationship between AS and visual perception in that males perceived the objects as larger and females perceived them as smaller.

Association between joint hypermobility and anxiety in Brazilian university students: Gender-related differences

IntroductionAnxiety disorders may be associated with several non-psychiatric disorders. Current literature has been investigating the association between anxiety and joint hypermobility (JHM), with special interest in non-articular symptoms that may be related to autonomic dysfunction. This study investigated the association between anxiety and JHM in a sample of Brazilian university students. MethodsData were cross-sectionally collected in two Brazilian universities (N=2600). Participants completed three validated self-rating anxiety scales: Beck Anxiety Inventory (BAI), Social Phobia Inventory (SPIN) and the brief-version of SPIN (Mini-SPIN). They also answered the self-rating screening questionnaire for JHM: the Five-part Questionnaire for Identifying Hypermobility. ResultsHypermobile women showed significantly higher scores in all the anxiety scales, when compared with men: BAI total score (t=3.77; p<0.001), its four subscales, SPIN score (t=2.71; p<0.007) and Mini-SPIN (t=2.58; p<0.01). Among BAI subscales, the autonomic subscale was shown to be more significantly (t=3.89; p<0.001) associated with joint hypermobility in women. ConclusionsThe results of the present study support earlier evidence on the relationship between anxiety and JHM in women, showing specific gender-related features in this field. It also directs attention to non-articular symptoms that may be enrolled in this association.

Exploring clinical determinants and anxiety symptom domains among Asian breast cancer patients

Psychological distress, such as anxiety, is commonly experienced by breast cancer patients. This study was designed to evaluate the presentation of anxiety symptom domains among Asian breast cancer patients and to identify clinical factors that were associated with occurrence of anxiety. An observational study was conducted between August 2009 and January 2012. Breast cancer patients (stages I to III) with different chemotherapy treatment status completed the Beck Anxiety Inventory (BAI) to evaluate the prevalence and severity of their anxiety symptoms. Demographical and clinical data were collected. Multiple linear regression was conducted to delineate clinical factors associated with anxiety. A total of 319 patients were recruited (age: 51 ± 9 years; 80.9 % Chinese; 69.6 % stage I/II). The median BAI total score was 8 (IQR, 4-14). Anxiety severities varied greatly across patients with different chemotherapy treatment status: patients who were receiving concurrent chemotherapy at the point of assessment (n = 161) experienced more severe anxiety symptoms, as compared to pre-chemotherapy receiving (n = 78) patients and post-chemotherapy (n = 88) patients (29.8 % vs. 9.0 % vs. 20 %, respectively; p = 0.021). Regression model identified fatigue (p < 0.001) and the concurrent receipt of chemotherapy (p < 0.001) as the strongest factors associated with anxiety. Concomitant neuropsychiatric medicines (antidepressants, anxiolytics, and hypnotics) were moderately associated with anxiety occurrence. This is the largest series to date to evaluate anxiety symptom domains among Asian breast cancer patients. Results suggest that toxicities of chemotherapy may have contributed to the presentation of anxiety symptoms.

Diabetes Diagnosis is related to Anxiety Among Mexican Americans But Not non-Hispanic Adults: A Project FRONTER study

This study examined the link between diabetes and specific anxiety symptoms among Mexican Americans in comparison with non-Hispanics in a rural sample. The prevalence of Hispanic, and more specifically, Mexican American individuals with diabetes, is larger than their white, non-Hispanic counterparts. Adults with diabetes also experience psychological dysfunction, particularly an elevation in anxiety symptoms. Both non-Hispanic and Hispanic individuals have been found to experience co-occurring anxiety disorders and diabetes. Hispanic individuals have a higher prevalence of both anxiety and diabetes than non-Hispanic individuals. Cross-sectional data were analyzed from 582 rural dwelling individuals from an ongoing rural health study, Project FRONTIER. The Beck Anxiety Inventory (BAI) and the factor scores previously derived by the test’s authors (i.e., Subjective, Neurophysiological, Autonomic, and Panic) were entered as predictor variables into regression models with Diabetes diagnosis as the outcome variable. Among Mexican Americans, diabetes diagnosis was significantly related to BAI total score. The diagnoses were significantly related to all of the BAI factor scores. Specifically, Panic, Autonomic, Neurophysiological, and Subjective factor scores. Diabetes diagnosis was not related to BAI total or factor scores among non-Hispanics. Research and clinical implications are discussed.

Psychometric Properties of a Spanish Version of the Beck Anxiety Inventory (BAI) in General Population

This is the first study that provides normative, reliability, factor validity and discriminant validity data of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in the Spanish general population, Sanz and Navarro's (2003) Spanish version of the BAI was administered to 249 adults. Factor analyses suggested that the BAI taps a general anxiety dimension comprising two related factors (somatic and affective-cognitive symptoms), but these factors hardly explained any additional variance and, therefore, little information is lost in considering only full-scale scores. Internal consistency estimate for the BAI was high (alpha = .93). The BAI was correlated .63 with the BDI-II and .32 with the Trait-Anger scale of the STAXI 2, but a factor analysis of their items revealed three factors, suggesting that the correlations between the instruments may be better accounted for by relationships between anxiety, depression, and anger, than by problems of discriminant validity. The mean BAI total score and the distribution of BAI scores were similar to those found in other countries. BAI norm scores for the community sample were provided from the total sample and from the male and female subsamples, as females scored higher than males. The utility of these scores for assessing clinical significance of treatment outcomes for anxiety is discussed.

The clinical significance of amenorrhea as a diagnostic criterion for anorexia nervosa

Amenorrhea is a DSM-IV criterion for the diagnosis of anorexia nervosa (AN). Several studies have reported few differences between patients who meet the full DSM-IV criteria for AN and those who meet all but the amenorrhea criterion. Although this suggests that the absence of menses does not provide critical diagnostic information, many of these studies are limited by small sample sizes. This study aims to examine the clinical utility of amenorrhea as a criterion for the diagnosis of AN. A chart review was conducted of 240 consecutive patients admitted for inpatient treatment at the NY State Psychiatric Institute from 1993 to 2006. Menstrual data were collected from the Eating Disorder Examination conducted upon admission. Independent samples t-tests were performed to evaluate differences in clinical variables, including age, lifetime lowest body mass index (BMI), admission and discharge BMI, previous number of hospitalizations, duration of illness, Beck Depression Inventory total score, Beck Anxiety Inventory total score, and Eating Disorder Examination subscale scores. The amenorrheic and menstruating groups differed significantly only on lowest lifetime BMI and admission BMI, with individuals with amenorrhea having lower BMIs on both measures. These results indicate that amenorrhea does not distinguish between groups on a number of important measures of clinical severity. It may be that amenorrhea reflects weight and nutritional status, rather than providing useful diagnostic information. Future studies are needed to examine the potential prognostic value of menstrual status.

Factor structure, reliability, and validity of the Beck Anxiety Inventory in adolescent psychiatric inpatients

The purpose of this study was to examine further the factor structure, reliability, and validity of the Beck Anxiety Inventory (BAI) in samples of adolescents, ages 14 to 18 years. The BAI is a 21-item self-report measure of anxiety severity. The BAI total score differentiated between the inpatient and high-school adolescents. In the psychiatric inpatient sample, girls obtained higher anxiety-severity scores than boys; no gender differences were obtained for the BAI total score in the high-school sample. Confirmatory factor analyses did not provide adequate fit for the two- factor oblique BAI models to the separate male and female psychiatric inpatient data. Principal axes with varimax and promax rotations initially identified a four-factor solution in the separate male and female inpatient participants. However, second-order analyses of the primary factors provided stronger support for a single-factor structure in each sample. Estimates of reliability for the BAI were adequate in samples of psychiatric inpatient and high-school adolescents. Evidence for convergent and discriminant validity of the BAI was investigated separately in the male and female inpatient samples. Overall, the BAI showed acceptable psychometric properties in these populations.

The beck anxiety inventory: Psychometric properties in a community population

This study presents data on the norms and psychometric properties of the Beck Anxiety Inventory (BAI), using a sample of 225 community adult volunteers. Maximum-likelihood confirmatory factor analyses of previously published models of the BAI: a two-factor model and a five-factor model, showed that the fit of each model was unacceptable. Also, the fit of the single-factor model was poor. Exploratory principal-components analyses with varimax and oblique rotations suggested four BAI components within this sample. Satisfactory levels of reliability were established for the BAI subscales. Finally, the relations between the BAI total and subscale scores and a related measure of anxiety and with another self-report measure of psychological distress were examined.