Differences In Anxiety Symptoms Research Articles

Analysis of the influencing factors of increasing farmers’ income, urban-rural income gap, and anxiety disorder

BackgroundWith the rapid changes in the urban and rural economic structure, the issue of increasing farmers’ income and the income gap between urban and rural residents are continuously expanding. With the rapid changes in both, farmers’ anxiety is becoming increasingly severe. With the advancement of rural land transfer and agricultural modernization, there have been fundamental changes in farmers’ production patterns and lifestyles, which have had a profound impact on their mental health.Subjects and MethodsThis article selects 156 farmers from a village and randomly divides them into an experimental group and a control group, each consisting of 78 farmers. The experimental group conducted psychological health recording tests under the exploration of innovative farmer income models; The control group was engaged in routine income activities without any changes. The experiment used Excel software and SPSS20.0 software to statistically analyze the results.ResultsThe results showed that there was a significant difference in anxiety symptoms between the two groups of farmers after innovating their income (P<0.05). The anxiety symptoms of the experimental group of farmers have significantly improved, and the proportion of people with reduced anxiety symptoms is as high as 90%.ConclusionsTo sum up, the emergence of farmers’ anxiety disorder is related to many factors, such as agricultural production, market contraction, and imperfect rural infrastructure. Innovating farmers’ income models can effectively alleviate the anxiety symptoms of farmers.

Adolescent Mental Health during the COVID-19 Pandemic: The Interplay of Age, Gender, and Mental Health Outcomes in Two Consecutive Cross-Sectional Surveys in Northern Italy.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the mental health and well-being of adolescents. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health among adolescents in Northern Italy by comparing cross-sectional surveys conducted in 2021 and 2022, with a particular focus on the influence of age and gender. The sample included adolescents aged 11-19 years from public schools in South Tyrol. Validated psychometric instruments were used to assess HRQoL, anxiety and depression symptoms, and psychosomatic complaints. Sociodemographic variables, COVID-19 burden, and pandemic-related factors were measured. Statistical analyses included chi-square tests, correlation coefficients, and logistic regression analyses. The results indicated that while the self-reported burden of adolescents decreased significantly in 2022 (n = 1885) compared to 2021 (n = 1760), there were no significant differences in symptoms of anxiety, depressive symptoms, low HRQoL, and increased psychosomatic complaints between the two surveys for both early and late adolescents. Females consistently had higher percentages for all outcome variables, and symptoms of anxiety increased with age in females, but not in males. Both genders experienced an increase in depressive symptoms and low HRQoL with age. The co-occurrence of mental health outcomes was observed, suggesting overlapping patterns among anxiety, depression, low HRQoL, and psychosomatic complaints. These findings underscore the intricate relationship between age, gender, and mental health outcomes among adolescents during the pandemic. It is important to recognize that late adolescents may exhibit distinct vulnerabilities and may require tailored support approaches to address their specific mental health challenges, differing from those needed for early adolescents.

Examining Predictors of Depression and Anxiety Symptom Change in Cognitive Behavioral Immersion: Observational Study

Background Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through various modalities including virtual reality (VR) head-mounted displays or flat-screen devices. Combining its ability to offer empirically supported therapy skills in a digital setting that can still facilitate interpersonal variables (eg, working alliance and sense of social support) with the aid of lay coaches, CBI has the potential to help fill this critical need. Objective This study had 2 primary aims. First, we aimed to examine changes in depression and anxiety symptoms in a sample of individuals who participated in CBI. Second, we aimed to examine 2 interpersonal process variables (working alliance and web-based social support) as predictors of symptom changes. We predicted CBI participants would experience depression and anxiety symptom improvements and that such improvements would be associated with an increase in both interpersonal process variables. Methods The study sample consists of 127 participants who endorsed clinical levels of depression or anxiety symptoms during their first CBI session and attended at least 2 sessions. Participants were asked to complete self-report measures of depression symptoms, anxiety symptoms, alliance, and web-based social support throughout their participation in CBI. Results Repeated measures ANOVAs determined that depression and anxiety symptom scores differed significantly across sessions (Ps<.01). We also found participants’ web-based social support predicted improvement in depression symptoms (P=.01), but neither the alliance nor web-based social support predicted change in anxiety symptoms (Ps>.05). We also observed a significant difference in anxiety symptoms between participants who used a VR head-mounted display to access CBI and those who did not, such that participants who used VR head-mounted displays endorsed lower anxiety symptoms than those who did not at nearly every session (P=.04). Conclusions Participation in CBI is associated with both depression and anxiety symptom improvement. Web-based social support may play an important role in fostering changes in depression symptoms. Future studies are encouraged to continue examining the process of change in CBI with special attention paid to methods that can elucidate causal mechanisms of change.

Neuropsychological assessment of Romanian burning mouth syndrome patients: stress, depression, sleep disturbance, and verbal fluency impairments.

Burning Mouth Syndrome (BMS) is a chronic condition characterized by a burning sensation in the oral mucosa, lasting more than 2 hours daily for more than 3 months, without clinical and/or laboratory evidence. BMS is often comorbid with mood, and psychiatric disorders, and a complex pathophysiology and interaction between impairments in nociceptive processing and psychologic function is occurring. In this work, we aimed to define the neuropsychological profile specific for BMS patients for a better management of this complex disease. We conducted a case-control study comparing 120 BMS patients and 110 non-BMS individuals (CTRL). Sociodemographic data and lifestyle habits, were collected, along with data regarding quality of life (SF-36 scale), stress (PSS), depression and anxiety (MADRS and HADS scales), sleep quality (PSQI scale), and cognitive functions (MoCA, SVF and PVF tests). The statistical analysis revealed a lower general quality of life (p < 0.001), worse sleep quality (p < 0.001) in BMS patients than CTRL. The BMS patients also displayed a higher prevalence of mild depressive symptoms than CTRL applying the MADRS (p < 0.001) and HADS-Depression scales (p = 0.001), whereas no differences in anxiety symptoms were found between the two groups (p = 0.174). Moreover, reduced scores semantic and phonemic verbal fluency tests (p < 0.05) were found, but no change in cognition was observed through MoCA (p = 0.551). Our results highlight that synergy between dentistry and neuropsychiatric assessment is essential for a successful management of BMS.

Sex differences in symptoms of anxiety, depression, and post-traumatic stress disorder among cardiac arrest survivors

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Anxiety, depression, and post-traumatic stress disorder (PTSD) among out-of-hospital cardiac arrest (OHCA) survivors may impact their long-term recovery and quality of life. Gaining knowledge on sex differences in psychological consequences following cardiac arrest is important to explore strategies aiming to reduce these symptoms. Purpose To explore sex differences in anxiety, depression and PTSD levels after discharge among OHCA survivors hospitalized at a cardiovascular intensive care unit. Methods This was a prospective observational study in OHCA survivors that attended a follow-up after 4 months, (median, IQR 3-8). Presence of symptoms of anxiety and depression was measured using Hospital Anxiety and Depression Scale (HADS), range 0-21. Scores between 8 to 10 suggest the possible presence of a mood disorder whereas scores of 11 and above indicate the probable presence of a mood disorder. Symptoms of PTSD were measured with PTSD Checklist for DSM-5 (PCL-5), a 20-item self-report measure that assesses symptoms of PTSD, range 0-80. Results Between 2016 and 2021, 245 consecutive OHCA survivors admitted in coma (44 women, 18% and 201 men, 82%) completed the survey. Mean values measured on HADS were 2.7 ±3.2 for depression and 4.8±3.9 for anxiety. Depression and anxiety levels were significantly higher in women (3.3±3.4 and 6.1±3.8), respectively, compared to men (2.6±3.2 and 4.5± 3.9), respectively (p&amp;lt;0.0001 for both). Anxiety scores of 8 or more were observed in 43% of women, and 23% of men (p=0.007). Scores of 8 to 10 suggesting the possible presence of anxiety were found in 23% of women and 11% of men (p=0.007), whereas one out of five women scored ≥ 11 (20%) indicating probable anxiety disorder, while one in ten of men(12%), (p=0.02). Further, female sex was significantly associated with higher levels of PTSD (median for women: 33, IQR 24-54, and for men 26, IQR 22-35), (p=&amp;lt;0.0001). Finally, anxiety was significantly correlated to post-traumatic stress symptoms (correlation coefficient 0.81, p=&amp;lt;0.0001). Conclusion Symptoms of anxiety and PTSD are frequent in OHCA survivors and female cardiac arrest survivors report significantly higher symptom levels of anxiety, depression, and PTSD compared to men. These results underline the presence of long-term symptoms in these patients and support further research in sex-specific approaches to alleviating these symptoms in patients surviving OHCA.

Examining Differences in Behavioural Avoidance Between Younger and Older Adults

ABSTRACT Objectives Studies have found older adults report fewer anxiety symptoms than younger adults. As behavioral avoidance is theoretically associated with maintaining anxiety, this study sought to examine age-related differences in avoidance and anxiety in a cross-cultural sample of older (n = 60, 60–92 years) and younger adults (n = 70; 17–24 years). Methods Community dwelling participants from Australia and the United States of America completed self-report measures of anxiety, worry, and depression. Participants also self-rated levels of avoidance to 133 common fearful situations using a card sort task. Results Older adults reported significantly less avoidance of age-adjusted social and medical scenarios, more avoidance of aggressive scenarios, with no significant difference for animal or agoraphobic scenarios when compared to younger adults. Age-related effects were no longer significant in full models, in which the main effect of anxiety explained variance in avoidance for social, medical, animal, agoraphobic, but not aggression scenarios. Conclusions Age differences in avoidance behavior were accounted for by differences in anxiety symptoms, except for avoidance of aggressive scenarios, which was not associated with anxiety. CLINICAL IMPLICATIONS: Age differences in levels of avoidance of common fearful situations were found, and may be associated with differences in anxiety symptom severity.

Self-reported Symptoms of Anxiety in a Sample of Public versus Private Secondary School Students in a District in Southwest Nigeria

Few studies have examined the symptoms of anxiety among students in Nigeria. This article describes the prevalence, severity, and gender differences in symptoms of anxiety, as well as factors that engender fear and anxiety among public versus private secondary school students in Nigeria. A convenience sample of 502 students from three private and five public secondary schools in southwest Nigeria completed a questionnaire and anxiety scale in the classroom. Findings show that symptoms of obsessive-compulsive disorder (n = 104, 20.7%) and fear of physical injury (n = 60, 12%) were the most and least frequently reported, respectively. Similarly, public school students were more likely than private school students to report symptoms of anxiety. From the qualitative responses, fear and anxiety about the future and academic pressure (n = 27, 24.3%) emerged as the major thing students were really afraid of. More female and public-school students reported being anxious about many things than their male and private school counterparts. Identifying symptoms of anxiety among students is critical to determining educational policies for improving their educational outcomes. Understanding school differences in symptoms of anxiety may help bridge the gap in learning outcomes among students in private and public schools.

The pandemic not only increased depression and PTSD in college students, but also changed how they categorize emotions

Objective: In March 2020, the emergence of COVID-19 as a pandemic prompted large scale, social lockdowns internationally. Participants/Method: Here, we compared the mental health symptoms and social functioning of pre-pandemic college students collected during the Spring 2020 semester to those of a pandemic group collected during the Fall 2020 semester. Results: Results reveal that students assessed during the pandemic reported more severe symptoms of posttraumatic stress and depression, yet no difference in anxiety symptoms, relative to students assessed before the pandemic. Furthermore, students assessed during the pandemic conceptualized and categorized their emotions with significantly more neutral emotions and significantly fewer positive emotions, yet no difference in negative emotions, relative to students assessed before the pandemic. Despite these mental health effects, we found no difference between the two groups in self-reported social functioning. Conclusion: Overall, these results suggest young adults’ mental health was significantly impacted by the pandemic, with the potential for long lasting effects.

Neuropsychiatric Status of Patients With Multiple Sclerosis Across Disease Duration Intervals.

The neuropsychiatric sequelae of multiple sclerosis (MS) are important predictors of morbidity and mortality. The authors examined how symptoms of depression, anxiety, fatigue, subjective cognitive impairment, and objective cognitive dysfunction varied with disease duration. They also explored changes in the use of disease-modifying therapies, psychotropic medications, and psychotherapies in relation to disease duration. A retrospective sample of 464 people with MS was stratified into three groups based on disease duration: <5 years (N=129), 5-10 years (N=101), and >10 years (N=234). Symptoms of depression and anxiety were recorded with the Hospital Anxiety and Depression Scale (HADS); fatigue, with the five-item version of the Modified Fatigue Impact Scale (MFIS-5); subjective cognitive impairment, with the five-item version of the Perceived Deficits Questionnaire (PDQ-5); and cognition, with the Minimal Assessment of Cognitive Function in MS (MACFIMS). There were between-group differences in anxiety symptoms (p<0.01) and degree of cognitive impairment (p=0.03), but there were no differences in depressive symptoms, fatigue, or subjective cognitive difficulties. Anxiety was higher during the first 5 years after diagnosis, and cognitive dysfunction was higher when assessed more than 10 years after diagnosis. With longer disease duration, a greater proportion of participants received psychotropic medications (p<0.01), and lower proportions received disease-modifying therapies (p<0.01) or psychotherapies (p<0.01). Findings indicated that rates of some neuropsychiatric symptoms, such as anxiety and cognitive dysfunction, may shift with disease duration, whereas other symptoms, such as fatigue and depression, may not. These findings highlight the importance of closely monitoring the mental state of people with MS over time.

Longitudinal Patient-Reported Outcomes in Patients Receiving Chimeric Antigen Receptor (CAR) T-Cell Therapy

Background: CAR T-cell therapy is a novel treatment for patients with hematologic malignancies that carries risk of unique toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurologic toxicity (ICANS). Patients are at risk for quality of life (QOL) deterioration and immense physical and psychological symptom burden given these toxicities, their illness, and the need for a prolonged hospitalization. Yet, data that comprehensively depict the longitudinal patient-reported outcomes (PROs) of patients receiving CAR T-cell therapy are limited. Methods: We conducted a longitudinal cohort study of 100 consecutive adult patients with hematologic malignancies receiving CAR T-cell therapy at Massachusetts General Hospital (MGH) between 4/2019 and 11/2021. Patients completed baseline questionnaires prior to receipt of CAR T-cell therapy about sociodemographic data, QOL (Functional Assessment of Cancer Therapy-General), physical symptoms (Edmonton Symptom Assessment Survey-revised [ESAS-r]), and psychological distress (Hospital Anxiety and Depression Scale and Post-Traumatic Stress Checklist) and completed PRO questionnaires at 1 week, 1 month, 3 months, and 6 months after CAR T-cell infusion. We used descriptive statistics to summarize patient characteristics and PROs at each timepoint and rates of clinically significant depression, anxiety, and post-traumatic stress disorder (PTSD) based on establish cutoffs. We conducted paired t-tests analyzing changes in QOL, physical, and psychological symptoms from baseline to 1 week, 3 months, and 6 months. We used multivariable linear regression models to examine factors associated with QOL at three months after CAR T-cell infusion. Results: We enrolled 71.4% (100/140) of eligible patients (median age 66 years; 63% male sex; 77% married/living with partner). The most common diagnosis was lymphoma (71%) followed by multiple myeloma (28%); A plurality (34%) received tisagenlecleucel, followed by lisocabtagene maraleucel (16%), axicabtagene ciloleucel (13%), and idecabtagene vicleucel (12%). The overall response rate was 80%, and with a median follow up of 14 months after CAR T-cell infusion, 38% died. CRS and ICANS occurred in 76% and 33% of patients, respectively. At baseline, median QOL score was 77.9 (range: 34-107), and was 70.0 (35-107) at 1 week, 76.0 (46-106) at 1 month, 83.5 (29-108) at 3 months, and 83.7 (34-107) at 6 months. Severe physical symptoms (ESAS-r score >=7) were reported by 47%, 52%, 35%, 28%, and 28% of patients at baseline, 1 week, 1 month, 3 months, and 6 months, respectively. The rates of clinically significant anxiety, depression, and PTSD symptoms at each time point are depicted in figure 1. Patient's QOL decreased at 1 week (mean difference [md]=5.1, p=0.04), but increased at 3 months (md -5.2, p=0.04) and 6 months (md=-5.3, p=0.07) compared to baseline. Patient's physical symptoms increased at 1 week, but decreased at 3 months (md 5.1, p=0.03) and 6 months (md=4.5, p=0.07), compared to baseline. There was no significant difference in anxiety symptoms from baseline to 1 week, 1 month, or 3 months. Anxiety symptoms improved at 6 months compared to baseline. There was no significant difference in depression or PTSD symptoms across all time points compared to baseline. In univariate linear regression, older age (β=0.4; p=0.01) and undergraduate or graduate degree (β=7.53, p=0.04) were associated with better QOL, whereas baseline anxiety symptoms (β=-14.3, p<0.01), baseline depression symptoms (β=-16.6, p<0.01), and baseline PTSD symptoms (β=-18.8, p<0.01) were associated with worse QOL at 3 months. In separate multivariable models including age, sex, education, marital status, and Eastern Cooperative Oncology Group performance status given collinearity among baseline PROs, anxiety (β=-10.6, p<0.01), depression (β=-12.6, p<0.01), and PTSD symptoms (β=-16.2, p<0.01) were the only factors associated with QOL at 3 months. Conclusion: Patients receiving CAR T-cell therapy experience significant QOL impairment and physical and psychological symptom burden, which peaks 1 week after cell infusion and improves by 6 months post-infusion. Given high rates of persistent severe symptoms and clinically significant psychological distress, interventions to improve the QOL of these patients are warranted. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Maintenance of Self-Care Activities During COVID-19 Lockdown in Patients with Type 2 Diabetes That Received a Comprehensive Care Program Training.

IntroductionIn 2020, several countries established a global emergency state. Lockdowns restricted people’s lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown.MethodsPatients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18–70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters.ResultsA total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment.ConclusionA multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.

Investigating Early Adolescent Sex Differences in Hippocampal and Amygdala Volumes, Sleep Quality and Psychological Distress

Adolescence is a period of significant brain development and decreased sleep quality, making it an ideal period to investigate early indicators of anxiety disorders such as psychological distress. The amygdala and hippocampus have been implicated in the neurobiology of anxiety symptoms. Sex-based differences in anxiety symptoms and sleep quality suggest sex-specific indicators may be preferable to a “one size fits all” approach. N = 70 early adolescents (12 years) completed the Pittsburgh Sleep Quality Index (PSQI), Kessler psychological distress scale (K10) and MRI scanning. Female participants were found to be poorer sleepers and to have higher psychological distress levels. Females also had larger right amygdala and hippocampal volumes than males controlling for total brain volume. Findings of sex-based differences in amygdala and hippocampal volumes as well as sleep and psychological distress at age 12 may represent an important step in elucidating sex specific early indicators of future mental health disorders.

Self-Reported Symptoms of Depression and Anxiety After ACL Injury: A Systematic Review.

Background:Depression and anxiety symptoms can occur in patients following an anterior cruciate ligament (ACL) injury, and the presence of these symptoms has been associated with poorer self-reported knee function in this type of injury.Purpose:To investigate the prevalence and severity of self-reported symptoms of depression and anxiety following an ACL injury.Study DesignSystematic review; Level of evidence, 4.Methods:PubMed, Cochrane Library, Embase, PsycINFO, AMED, and PEDro databases were searched using a combination of keywords relating to ACL, depression, anxiety, and their synonyms. Inclusion criteria were clinical studies written in English that reported on patients with an injured and/or reconstructed ACL and assessed symptoms of depression and/or anxiety. Data extraction was performed independently by 2 authors. Data synthesis was performed using an emergent synthesis approach. The quality of the included studies was assessed using the methodological index for non-randomized studies or the Mixed-Methods Appraisal Tool. Certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation.Results:After abstract screening, 37 studies were assessed in full text, of which 16 were included. The studies comprised 682 patients (417 male [61%]). The depression symptoms appeared to be more severe in elite athletes compared with recreational athletes. Symptoms decreased over time from moment of ACL reconstruction to up to 2 years postoperatively. The prevalence of self-reported symptoms of anxiety after an ACL injury was reported in 1 study (2%). There were no differences in anxiety symptoms between professional and amateur athletes or between adolescents and adults. The overall quality of the studies was low or very low.Conclusion:Patients who sustain an ACL injury can suffer from symptoms of depression, especially during the first 6 weeks after ACL reconstruction. Depressive symptoms are more common among professional versus nonprofessional athletes. Levels of anxiety symptoms were not above the cutoffs for a diagnosis of anxiety after an ACL injury.

Prioritization and surgical wait lists: A cross-sectional survey of patient's health-related quality of life

IntroductionIn many countries, there are waits for elective (planned) surgery. In these settings, processes for triaging patients are applied to determine how long patients wait for their surgery. There are very few instances that evaluate the effectiveness of surgical triage processes. MethodsA sample of patients from four acute care hospitals in Vancouver, Canada, completed a number of patient-reported outcomes shortly after being registered on the surgical wait list. Patients’ diagnosis was used to triage and determine their expected wait for surgery. The associations between patient-reported outcomes with surgical triage were measured. ResultsThe mean wait times for participants were similar across wait times categories. Participants whose expected waits for surgery were the longest reported successively lower levels of self-rated health (p < 0.01) and successively higher levels of pain (p < 0.01.) There was no difference in symptoms of anxiety among participants expected to wait the longest. DiscussionThe diagnosis-based system for prioritizing patients found higher levels of pain and lower health status among those expected to wait the longest for their surgery. Screening waiting patients for treatable mental health conditions should be implemented and the process of surgical triage could be redesigned to allow for a broader set of attributes of health to determine how long a patient waits for their elective surgery.

Return to classes impact on mental health of university students during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic and the necessary social isolation and distancing measures - that were adopted to prevent spreading the virus, including the suspension of university classes - negatively impacted the mental health of young adults. The aim of the current study was to investigate whether returning to online classes, even not presential, during the social isolation of the COVID-19 pandemic, affected the mental health of university students. Forty students (10 men and 30 women) (age, 22.3 ± 3.8 years; body mass, 62.5 ± 17.8 kg; height, 165.6 ± 8.7 cm) from undergraduate health courses participated in the study. The students answered a self-administered questionnaire designed to gather personal and quarantine information as well as information about the frequency of depression (PHQ-9) and anxiety (GAD-7) symptoms. The questionnaire was answered before and after the return to online classes. There was a significantly lower frequency of depression symptoms after the return to online classes (Z = -2.27; p = 0.02). However, there was no difference in anxiety symptoms before and after returning to online classes (Z = -0.51; p = 0.61). Return to online classes positively impacted the mental health (decrease of frequency of depression symptoms) of university students. Future studies are needed to observe whether the changes observed after returning to school are maintained over time.

Alcohol use, cannabis use, and psychopathology symptoms among college students before and after COVID-19

College students have experienced significant disruptions related to COVID-19, and limited international data suggest they may be at elevated risk for mental health symptom increases related to COVID. Given their potentially elevated risk, our aim was to evaluate differences from pre-college closures to post-closure in mental health symptoms, alcohol, and cannabis use. Participants (N = 4749) were from seven U.S. public universities/colleges. They were 70.1 % female and 48.5 % white, non-Hispanic/Latino, with 48.1 % in their first college/university year. 30-day retrospective assessments of alcohol and cannabis use, and past 2-week retrospective assessments of anxiety, depression, anger, and insomnia were captured at the time of the survey. We examined differences between those providing data pre- and post-university closure via linear and negative binomial regressions. Alcohol and cannabis use days were 13 % and 24 % higher, respectively, from pre-to post-university closure; also, prevalence of any 30-day alcohol use and alcohol use consequences were both higher in the post-closure sample (odds ratios = 1.34 and 1.31, respectively). In contrast, days of binge alcohol use were 4 % lower in the post-closing sample. Depressive symptoms and anger were both modestly higher in post-closing participants (d < 0.1), with no differences in anxiety symptoms or insomnia. The modest differences in substance use and mental health from pre-closure through two months post-college closure suggest unexpected resilience in a large and diverse sample of students. College health providers will need to identify those students experiencing the greatest increases in mental health symptoms and substance use, using innovative outreach and treatment.

Peer-to-Peer Support and Changes in Health and Well-being in Older Adults Over Time

Literature on peer-to-peer (P2P) programs suggests they improve health and well-being of older adults. Analysis from a previous study showed P2P to be associated with higher rates of hospitalization and no significant differences in rates of emergency department or urgent care visits; however, it is not known whether measures of health and well-being varied by group over time. To compare the association between receiving P2P support and secondary outcomes (ie, health status, quality of life, and depressive and anxiety symptoms) with receiving standard community services (SCS) over time. This cohort study was conducted among a volunteer sample of older adults (≥65 years) who were new to P2P or were already receiving P2P and a corresponding control group. Participants were matched between groups on age, sex, and race/ethnicity. The study was conducted from March 2015 to December 2017 at 3 community-based organizations that delivered P2P in California, Florida, and New York. Data analysis was performed from October 2018 through May 2020. P2P support, provided by trained older adult volunteers. Mental and physical components of the health status and quality of life measure and depressive and anxiety symptoms were collected over 12 months. The hypothesis was that older adults receiving P2P support would maintain higher health status and quality of life than the SCS group. A total of 503 participants were screened, 456 participants were enrolled and had baseline data, and 8 participants only had baseline information with no follow-up data, leaving 448 participants (231 [52%] in the SCS group; 217 [48%] in the P2P group; 363 [81%] women; mean [SD] age, 80 [9] years). The P2P group had improvements in mental health (change at 12 months, 1.1 points; 95% CI, -0.8 to 3.0 points) and physical health (change at 12 months, 1.0 points; 95% CI, -0.7 to 2.8 points). However, the difference of differences between the 2 groups did not differ significantly from baseline to 12 months (mental health: 0.2 points; 95% CI -2.3 to 2.7 points; physical health: 1.7 points; 95% CI, -0.6 to 3.9 points). The P2P and SCS groups had a statistically significant difference of differences in anxiety symptoms of 0.36 points (95% CI, 0.04 to 0.61 points). There were no significant differences in depressive symptoms or mental and physical components of the health status and quality of life. These findings suggest that receiving P2P support did not slow the decline of health and well-being in older adults compared with those who received SCS. Baseline imbalance in key characteristics, even after adjusting for the imbalance using the propensity score method, may explain the results. Randomized trials are needed.

Tactile P300 to unpredictable electric shocks: Association with anxiety symptoms, intolerance of uncertainty, and neuroticism

The no, predictable, and unpredictable threat (NPU-threat) task is an experimental paradigm that delineates the anticipation of predictable vs. unpredictable threat. The current literature suggests that heightened defensive motivation in anticipation of unpredictable threat is associated with anxiety disorders and increased symptoms. Few investigations have examined whether a heightened response to actual threat is also associated with anxiety-related phenomenology. The present study examined the relationship between the tactile P300 to shock delivery during the NPU-threat task and individual differences in anxiety symptoms, intolerance of uncertainty, and neuroticism. Overall, the tactile P300 was enhanced in response to unpredictable shocks relative to predictable shocks. Greater tactile P300 enhancement to unpredictable shocks was associated with greater anxiety symptoms, intolerance of uncertainty, and neuroticism. The present study suggests that temporal unpredictability enhances attentional engagement to threat, which is greater in individuals characterized by narrow and broad anxiety constructs.

Consider the Source: Examining Attrition Rates, Response Rates, and Preliminary Effects of eHealth Mindfulness Messages and Delivery Framing in a Randomized Trial with Young Adult Cancer Survivors.

Purpose: Young adults with cancer often experience stress, depression, and anxiety. Mindfulness meditation is an effective intervention for these outcomes, and maintenance support may be needed for long-term improvements. eHealth technologies provide a promising delivery strategy for maintenance interventions. Methods: Following an 8-week mindfulness-based stress reduction (MBSR) course, 62 young adult cancer survivors were randomized to 8 weeks of instructor-framed messages, peer-framed messages, or no messages. On average, participants were 33.6 years old. The majority of participants were college-educated Caucasian females. We examined attrition rates between participants who received messages and those who did not, and compared response rates from different perceived sources. In addition, we evaluated the preliminary effects of eHealth support on mindfulness and associated outcomes. Results: No significant differences in attrition or message response rates across groups were observed. Repeated measures models revealed significant group by time interactions on perceived stress, anxiety, and depression. There were no differences between the groups that received eHealth messages and the group that did not. There was a significant difference in anxiety symptoms from post-MBSR to post-messaging between messaging groups. Individuals who received instructor-framed messages reported increased symptoms of anxiety over time. Conclusion: Attrition and response rates did not differ across groups, suggesting that eHealth may be a feasible strategy for providing maintenance support. However, further evaluation of feasibility, acceptability, and optimal content and dose of such an intervention is needed. Additionally, young adult cancer survivors may be more likely to benefit from eHealth interventions that are not delivered by authority figures.

Device-measured sedentary behaviour and anxiety symptoms during adolescence: a 6-year prospective cohort study.

Sedentary behaviour is potentially a modifiable risk factor for anxiety disorders, a major source of global disability that typically starts during adolescence. This is the first prospective study of associations between repeated, device-based measures of sedentary behaviour and anxiety symptoms in adolescents. A UK cohort with 4257 adolescents aged 12 at baseline (56% female). Main exposures were sedentary behaviour and physical activity measured using accelerometers for 7-days at ages 12, 14, and 16. Primary outcome was anxiety symptom scores at age 18 from a Clinical Interview Schedule-Revised. We used adjusted negative binomial regression and iso-temporal substitution methods to analyse the data. We found a positive association between sedentary behaviour at ages 12, 14, and 16, with anxiety symptoms at age 18, independent of total physical activity volume. Theoretically replacing an hour of daily sedentary behaviour for light activity at ages 12, 14, and 16, was associated with lower anxiety symptoms by age 18 by 15.9% (95% CI 8.7-22.4), 12.1% (95% CI 3.4-20.1), and 14.7% (95% CI 4-24.2), respectively. Whereas, theoretically replacing an hour of sedentary behaviour with moderate-to-vigorous physical activity was not associated with differences in anxiety symptoms. These results were robust to a series of sensitivity analyses. Sedentary behaviour is a possible risk factor for increasing anxiety symptoms during adolescence, independent of total physical activity volume. Instead of focusing on moderate-to-vigorous activity, replacing daily sedentary behaviour with light activity during adolescence could be a more suitable method of reducing future anxiety symptoms.