7-item Generalized Anxiety Disorder Research Articles

Effects of Bullying on Anxiety, Depression, and Posttraumatic Stress Disorder Among Sexual Minority Youths: Network Analysis

Background Bullying victimization is highly prevalent among sexual minority youths, particularly in educational settings, negatively affecting their mental health. However, previous studies have scarcely explored the symptomatic relationships among anxiety, depression, and posttraumatic stress disorder (PTSD) among sexual minority youths who experienced bullying on college campuses. Objective The objectives of our study were to (1) characterize the anxiety-depression-PTSD network structures of gay or lesbian, bisexuals, and other sexual minority youths previously bullied on college campuses; and (2) compare symptomatic associations in the anxiety-depression-PTSD networks among bullied sexual minority youths and heterosexual youths’ groups. Methods This cross-sectional study recruited college participants from Jilin Province, China. Data were analyzed using a subset of the data extracted after screening for sexual orientation and history of bullying victimization. Sexual minority youths were then divided into 3 subgroups: gay or lesbian (homosexual), bisexual, and other. Mental health symptom severity was assessed using scales: the 7-item Generalized Anxiety Disorder Scale measuring anxiety, the 9-item Patient Health Questionnaire measuring depression, and the 10-item Trauma Screening Questionnaire measuring PTSD symptoms. Combining the undirected and Bayesian network analyses, the anxiety-depression-PTSD networks were compared among sexual minority youths subgroups, and the difference between heterosexual youths and sexual minority youths was investigated. Chi-square tests were used to compare the difference in categorical variables, while independent-sample t tests were run on continuous variables. Results In this large-scale sample of 89,342 participants, 12,249 identified as sexual minority youths, of which 1603 (13.1%, 95% CI 12.5%-13.7%) reported being bullied on college campuses in the past year. According to the expected influence (EI) and bridge expected influence (bEI) index, in the global network structure of anxiety, depression, and PTSD, sad mood (EI=1.078, bEI=0.635) and irritability (EI=1.077, bEI=0.954) were identified as central and bridge symptoms; emotional cue reactivity (EI=1.015) was a central symptom of PTSD in this global network. In the anxiety-depression-PTSD Bayesian network, anhedonia had the highest prediction priority for activating other symptoms; and feeling afraid linked symptoms from anxiety to the PTSD community. Compared to their heterosexual counterparts, sexual minority youths exhibited a stronger association between difficulty concentrating and appetite. The “sad mood-appetite” edge was strongest in the gay or lesbian network; the “irritability-exaggerated startle response” edge was strongest in the bisexual network. Conclusions For the first time, this study identified the most central and bridge symptoms (sad mood and irritability) within the depression-anxiety-PTSD network of sexual minority youths with past bullying-victim experiences on college campuses. Emotional cue reactivity, anhedonia, and feeling afraid were other vital symptoms in the comorbid network. Symptomatic relationships existed showing heterogeneity in bullied heterosexual youths and sexual minority youth networks, which also was present within the sexual minority youth subgroups. Consequently, refined targeted interventions are required to relieve anxiety, depression, and PTSD symptoms.

47 The Impact of COVID-19 Infection on Objective and Subjective Cognitive Functioning: Resilience as a Protective Factor

Objective:Growing evidence indicates that COVID-19 infection adversely impacts cognitive functioning, with COVID-19 patients demonstrating high rates of objective and subjective cognitive impairments (Daroische et al., 2020; Miskowiak et al., 2021). Given the prevalence and potentially debilitating nature of post-COVID-19 cognitive symptoms, understanding factors that mitigate the impact of COVID-19 infection on cognitive functioning is paramount to developing interventions that facilitate recovery. Resilience, the ability to cope with and grow from challenges, has been associated with improved cognitive performance in healthy adults and linked to decreased perceived cognitive difficulties in post-COVID-19 patients (Connor & Davidson, 2003; Deng et al., 2018; Jung et al., 2021). However, resilience has not yet been examined as a potential attenuator of the relationship between COVID-19 and either perceived or objective cognitive function. This study aims to investigate the role of resilience as a protective factor against experience of cognitive function difficulties in COVID-19 patients by probing the role of resilience as a moderator of the relationship between COVID-19 diagnosis and cognitive functioning (both perceived and objective).Participants and Methods:Participants (mean age=36.93, 30.10% male) were recruited from British Columbia and Ontario. The sample included 53 adults who had never been diagnosed with COVID-19 and 50 adults diagnosed with symptomatic COVID-19 at least three months prior and not ventilated. Participants completed online questionnaires (n=103) to assess depression (the Center for Epidemiological Studies Depression Scale), anxiety (7-item Generalized Anxiety Disorder Scale), subjective cognitive functioning (The Subjective Cognitive Decline Questionnaire), and resilience (2-item Connor-Davidson Resilience Scale). Participants then completed neuropsychological tests (n=82) measuring attention, processing speed, memory, language, visuospatial skills, and executive function via teleconference, with scores averaged to create a global objective cognition score. Moderated multiple regression was employed to assess the impact of resilience on the relationship between COVID-19 diagnosis and both objective and perceived cognition, controlling for gender, ethnicity, income, age, anxiety, and depression.Results:Average scores in the COVID-19 group exceeded diagnostic cut-offs for clinical depression (M=16.67, SD=10.77) and mild anxiety (M=5.27, SD=4.99), while the control group scored below diagnostic thresholds for depression (M=11.96, SD=9.76) and mild anxiety (M=4.48, SD=5.07). Controlling for sociodemographic and mental health characteristics, COVID-19 diagnosis was not associated with objective global cognitive functioning (b=-.07, se=1.71, p=.624) or subjective cognitive functioning (b=.16, se=1.32, p=.12), nor was resilience associated with objective global cognitive functioning (b=.19, se=1.50, p=.44) or subjective cognitive functioning (b=-.02, se=1.09, p=.89).Conclusions:Findings indicate that COVID-19 patients may be at risk for depression and anxiety. Results of this study fail to support a relationship between COVID-19 and cognitive functioning beyond the impact of sociodemographic and mental health variables. Thus, the role of resilience as a protective factor against COVID-19 related cognitive difficulties could not be fully explored. However, findings should be considered in the context of study limitations, including a small sample size. Future research should employ larger samples to further examine the relationship between COVID-19 infection and cognition, focusing on mental health characteristics and resilience as potential risk and protective factors.

Depression and anxiety symptoms among Vietnamese migrants in Japan during the COVID-19 pandemic

This study aimed to examine the mental health status and related factors among Vietnamese migrants in Japan during the COVID-19 pandemic. We conducted an online cross-sectional survey between September 21 and October 21, 2021. Along with Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scores, we collected data on demographics, changes in socioeconomic status due to the pandemic, language proficiency, social support, and health conditions. Multivariate logistic regression was performed to identify factors related to symptoms of depression and anxiety. Among 621 participants who completed the questionnaire, moderate-to-severe symptoms of depression (PHQ-9 score ≥ 10 points) and mild-to-severe symptoms of anxiety (GAD-7 score ≥ 5 points) were observed in 203 (32.7%) and 285 (45.9%) individuals, respectively. Factors related to depressive symptoms were age (95% confidence interval [CI]=0.89-0.99), pre-existing health conditions (95% [CI]=1.61–3.76), and a low subjective socioeconomic status (95% [CI]=1.64–3.71). Factors related to anxiety symptoms were being single (95% [CI]=1.01–2.93), having pre-existing health conditions (95% [CI]=1.63–3.88), subjective socioeconomic status (95% [CI]=1.87–3.97), and absence of a partner to discuss one’s health with (95% [CI]=1.11–2.47). Vietnamese migrants in Japan experienced a decrease in income, worsening working conditions, and poor mental health status during the COVID-19 pandemic. Further investigations are necessary to find an effective way to increase their social support and mitigate socioeconomic adversities.

Mental health and care utilization in survivors of adolescent and young adult cancer.

Adolescent and young adult cancer survivors experience mental health challenges, yet little is known about the evolution of these difficulties. This study explored mental health symptoms and utilization among long-term adolescent and young adult cancer survivors. Using 30 432 respondents from the 2019 National Health Interview Survey, this study compared adults with a history of adolescent and young adult cancer (diagnosed when patients were between 15 and 39 years of age) to adults without adolescent and young adult cancer. Mental health symptom severity was measured using the Patient Health Questionnaire depression scale and 7-item Generalized Anxiety Disorder questionnaires. Care utilization constituted psychotherapy and mental health medication use. Inverse propensity score weights were used to balance demographics and combined with survey weights. Descriptive statistics, multivariable generalized linear models, and structural equation modeling with 2-sided tests were used for analysis. We compared 639 adolescent and young adult survivors with 29 793 controls. Survivors were, on average, 20.5 years (SE = 0.74) past their cancer diagnosis dates. After adjusting for survey and propensity score weights, adolescent and young adult survivors reported more severe depression (incidence rate ratio = 1.42, 95% confidence interval [CI] = 1.09 to 1.84, P < .01) and anxiety (incidence rate ratio = 1.85, 95% CI = 1.55 to 2.21, P < .001). They were more likely to use psychotherapy (odds ratio = 1.91, 95% CI = 1.16 to 3.17, P < .05) and mental health medications (odds ratio = 1.89, 95% CI = 1.15 to 3.11, P < .05). Time since diagnosis was negatively associated with symptoms and utilization. Structural equation modeling demonstrated mediation of utilization effect by symptom severity. Adolescent and young adult survivors experience worse mental health in late survivorship, despite small improvements over time. We highlight the importance of survivorship care that addresses the long-term mental health needs of these survivors.

The Arabic Hospital Anxiety and Depression Scale: validation in a sample of Lebanese patients with cancer

BackgroundDepression and anxiety are common comorbid psychological disorders among patients with cancer. Despite the wide use of the Arabic Hospital and Anxiety Scale (HADS) in oncological settings, it has not been yet validated among Lebanese patients with cancer. We aimed to assess the reliability and validity of the HADS in a sample of Lebanese patients with cancer. One-hundred one Lebanese patients diagnosed with cancer presenting to the Ambulatory Care Center in the Hematology Oncology Department at the American University of Beirut Medial Center filled the Arabic version of the HADS. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire 9-Item Scale (PHQ-9) were used to assess its concurrent validity in capturing anxiety and depression, respectively.ResultsReliability analysis using Cronbach’s alpha (α) coefficient revealed good internal consistency for the Arabic HADS (α = 0.89) and both subscales (α = 0.86 for depression and α = 0.78 for anxiety). Correlations between HADS with both GAD-7 and PHQ-9 were statistically significant and strong for both depression (r = 0.795; p < 0.0001) and anxiety (r = 0.727; p < 0.0001). Confirmatory factor analysis revealed that the observed data fits the two-factor model of depression and anxiety (Kaiser–Meyer–Olkin = 0.86; Tucker Lewis Index = 0.879; root-mean-square error of approximation = 0.08). Depression and anxiety rates were approximately 52% and 25%, respectively.ConclusionWe conclude that the Arabic version of the HADS is a credible and valid tool for clinical assessment of psychological distress (anxious and depressive states) among Lebanese patients with cancer.

A prospective study of antepartum anxiety screening in patients with and without a history of spontaneous preterm birth

Maternal stress has been identified as one of the most common clinical phenotypes associated with preterm birth. The American College of Obstetricians and Gynecologists recommends anxiety screening at least once in the perinatal period. The prevalence of perinatal anxiety is challenged by the absence of formalized screening protocols and underreporting in high-risk populations, such as those with a history of adverse pregnancy outcomes. This study administered a validated anxiety screening tool in a cohort of patients with and without a previous spontaneous preterm birth and compared differences in score and rate of a positive screen between groups. Moreover, this study evaluated perinatal outcomes associated with a positive screen and described a referral protocol involving evaluation by a perinatal mental health counselor and clinical diagnoses. A hypothesis was made that patients with a previous history of spontaneous preterm birth would have higher self-reported anxiety symptoms than controls and that those with recurrent preterm delivery at <35 weeks of gestation would have the highest anxiety screening scores. This was a prospective observational cohort study administering the Generalized Anxiety Disorder 7-item screen to patients enrolled in 2 prenatal care clinics at our institution. The preterm birth cohort consisted of patients with a history of spontaneous preterm labor, premature rupture of membranes, or cervical insufficiency compared with the control cohort without this history. Screening was initiated at entry to prenatal care or referral to our high-risk obstetrical clinic. The inclusion criteria included English- or Spanish-speaking patients and singleton pregnancy, and the exclusion criteria included pregnancies complicated by a major congenital anomaly, enrollment after 34 weeks of gestation, delivery at <20 weeks of gestation, and incomplete delivery data. Referral to a mental health counselor was offered to those with a Generalized Anxiety Disorder 7-item screen score of ≥10. Perinatal outcomes as a comparison between the Generalized Anxiety Disorder 7-item screen-positive group and Generalized Anxiety Disorder 7-item screen-negative group were performed with statistical methods, including the Student t test, chi-square test, and Wilcoxon rank-sum test, with a P value of <.05 to determine significance. Between September 2020 and December 2021, 1349 participants were analyzed, with 143 patients (11%) in the previous preterm birth cohort and 1206 (89%) patients in the control cohort. Patients with a history of preterm birth and subsequent delivery at ≤35 weeks of gestation in the study pregnancy had significantly higher Generalized Anxiety Disorder 7-item screen scores than controls with delivery after 35 weeks of gestation (median score: 4 [interquartile range, 1-9] vs 2 [interquartile range, 0-6], respectively; P=.006). Overall, 187 participants (14%) screened positive with significantly higher rates in the previous preterm birth group than in the control group (20% vs 13%; P=.036). Of note, 117 patients (63%) accepted a referral, and 32 patients (17%) with a positive screen were diagnosed with a perinatal mood disorder. Patients with recurrent preterm birth have higher self-reported anxiety using the Generalized Anxiety Disorder 7-item screen than controls. Of those with a positive screen, 17% were diagnosed with a perinatal mood disorder.

Model Clinic to Increase Preventive Screenings Among Patients With Physical Disabilities: Protocol for a Mixed Methods Intervention Pilot Study.

People with physical disabilities often experience premature multimorbidity and adverse health events. A tailored primary care approach for this vulnerable population that also accounts for social and functional risk factors could promote healthier aging and more equitable health care. This project will evaluate the implementation of a health program designed for people with physical disabilities. The proposed evaluation result is to generate the first best-practice protocol focused specifically on developing primary care to help reduce preventable causes of morbidity and improve functioning among people with physical disabilities. We will design and implement a pilot health program for people with physical disabilities at a primary care clinic within Michigan Medicine. The health program for people with physical disabilities will be an integrated intervention involving a tailored best practice alert designed to prompt family medicine providers to screen and monitor for common, preventable health conditions. The program will also collect social and functional status information to determine the patient's need for further care coordination and support. Adult participants from this clinic with identified physical disabilities will be targeted for potential enrollment. To create a quasi-experimental setting, a separate departmental clinic will serve as a control site for comparison purposes. A quantitative analysis to estimate the treatment effect of implementing this health program will be conducted using a difference-in-differences approach. Outcomes of interest will include the use of preventative services (eg, hemoglobin A1c for diabetes screening), social work assistance, and emergency and hospital services. These data will be extracted from electronic health records. Time-invariant covariates, particularly sociodemographic covariates, will be included in the models. A qualitative analysis of patient and health care provider interviews will also be completed to assess the effect of the health program. Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scores will be assessed to both screen for depression and anxiety as well as explore program impacts related to addressing health and functioning needs related to physical disabilities in a primary care setting. These will be summarized through descriptive analyses. This study was funded in September 2018, data collection started in September 2021, and data collection is expected to be concluded in September 2023. This study is a mixed methods evaluation of the effectiveness of an integrated health program designed for people with physical disabilities, based on a quasi-experimental comparison between an intervention and a control clinic site. The intervention will be considered successful if it leads to improvements in greater use of screening and monitoring for preventable health conditions, increased social worker referrals to assist with health and functioning needs, and improvements in emergency and hospital-based services. The findings will help inform best practices for people with physical disabilities in a primary care setting. DERR1-10.2196/50105.

The mediation effect analysis of nurse's mental health status and burnout under COVID-19 epidemic.

The objective of this study is to investigate the mental health status of nurses during the outbreak of novel coronavirus pneumonia. Additionally, we aim to analyze the relationship between anxiety, depression, and burnout among nurses. The findings will provide a scientific basis for promoting the psychological health of nurses. Using a cross-sectional study, nurses in Quanzhou in May 2020 completed a general information questionnaire, the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the Maslach Burnout Inventory (MBI). Data analysis was conducted using structural equation model. 372 questionnaires were returned, with a response rate of 92.5%. The prevalence of anxiety and depression among the participants were 45.2 and 41.4%, respectively. The prevalence of severe burnout among nurses was found to be 7.3%. There was a correlation between nurses' anxiety, depression, and job burnout. The correlation coefficients between anxiety and job burnout, depression and job burnout, and anxiety and depression were found to be statistically significant (p < 0.001). Depression plays a mediating role between anxiety and jod burnout (0.584/1.413, 41.3%). The COVID-19 epidemic has resulted in moderate to high levels of job burnout among nurses. In this context, depression has been found to play a mediating role in the relationship between anxiety and job burnout. It is imperative for hospital administrators to prioritize the mental health of nurses and the provide necessary support to ensure their well-being.

Depression and anxiety outcomes of adults undergoing intermittent theta burst stimulation (iTBS) treatment for major depressive disorder: A naturalistic study

BackgroundStandard repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) are approved treatments for major depressive disorder (MDD). iTBS offers shorter treatment durations and increased accessibility. This study examines the clinical outcomes of iTBS for MDD in a tertiary medical center. MethodsPatients who underwent iTBS for MDD at Mayo Clinic Rochester between March 2021 and January 2023 were included. Baseline and endpoint scores of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) were compared using t-tests. Response, remission, and a single question patient-reported outcome (PRO) of "Did the treatment help?" were reported. Outcomes of patients with anxious depression (GAD-7 ≥10) were also reported. ResultsForty-two patients (mean age 41.7 years, 59.5% female) were analyzed. iTBS resulted in a significant reduction in depression symptoms (PHQ-9: baseline mean 19.9, endpoint mean 13.0, p < 0.001). The response rate was 38.1%, remission rate was 9.5%, and PRO was 57.1%. Anxiety symptoms also significantly improved (GAD-7: baseline mean 13.0, endpoint mean 9.1, p < 0.001). The response rate for anxiety was 33.3%, and remission rate was 28.6%. Our response rate for depression was comparable to existing literature, while the remission rate was lower. ConclusioniTBS demonstrated significant reductions in depression and anxiety symptoms among patients with MDD, and in the subset of patients with anxious depression. The single question PRO can be a practical aid in patient discussions. These findings contribute to the growing body of literature on iTBS for MDD.

Problematic Smartphone Use and Its Relationship With Anxiety and Suicidal Ideation Among South Korean Adolescents.

This study aimed to investigate the prevalence of problematic smartphone use (PSU) among adolescents and its association with anxiety and suicidal ideation. The 16th cross-sectional, population-based Korea Youth Risk Behavior Web-Based Survey was administered in 2020 and included 54,948 adolescents. We used the Korean version of the smartphone overdependence scale and the 7-item Generalized Anxiety Disorder scale to assess PSU and anxiety. Suicidal ideation was assessed through responses to the self-report question. Multiple logistic regression analyses with complex sampling were conducted to identify the association of PSU with anxiety and suicidal ideation. In total, 25.1% of the adolescents reported PSU, 33.2% had anxiety symptoms, and 10.9% had seriously considered suicide during the past 12 months. Girls with PSU had a higher risk of anxiety (adjusted odds ratio [aOR], 2.81; 95% confidence interval [CI], 2.65 to 2.97) and suicidal ideation (aOR, 1.77; 95% CI, 1.64 to 1.91) than non-PSU girls. Boys with PSU reported more anxiety (aOR, 2.89; 95% CI, 2.72 to 3.07) and suicidal ideation (aOR, 1.82; 95% CI, 1.66 to 1.99) than the non-PSU group. In addition, girls with the lowest household income reported more suicidal ideation than girls with the highest household income (aOR, 3.40; 95% CI, 2.69 to 4.28). This study demonstrated the prevalence of PSU among South Korean adolescents in 2020. The prioritization of the detection of PSU and the identification of psychological factors may help improve the diagnosis and management of mental health problems and potentially yield significant psychosocial benefits.

Treatment of insomnia in myasthenia gravis-A prospective study on non-benzodiazepine hypnotics in the treatment of myasthenia gravis patients with insomnia.

This study aimed to evaluate the efficacy and safety of non-benzodiazepine hypnotics in the treatment of myasthenia gravis (MG) patients with insomnia. This is a prospective longitudinal study. Outpatients who met the criteria for stable MG and insomnia diagnosis according to the International Classification of Sleep Disorders (third edition) were included in the study. They took a regular dose of non-benzodiazepine hypnotics (zolpidem 10 mg per night or zopiclone 7.5 mg per night) based on their own preferences. Patients received psychotherapy (including sleep health education) and were followed up for 4-5 weeks. Cases with lung diseases, respiratory disorders, or inappropriate use of hypnotic medications were excluded. The primary outcome is the difference in total Pittsburgh Sleep Quality Index (PSQI) score between baseline and the end of follow-up period. Secondary outcomes include the difference in Myasthenia Gravis Activities of Daily Living (MG-ADL) score, 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) between baseline and the end of follow-up period and the safety of medication. A total of 75 MG patients with insomnia were included in this study. After 4-5 weeks of treatment, the total PSQI score and MG-ADL score were lower than baseline (p < 0.01). No patients had an increased MG-ADL score. The incidence rate of adverse events was 16.0% (12 cases), including dizziness (6 cases, 8.0%), drowsiness (3 cases, 4.0%), fatigue (2 cases, 2.7%), and nausea (1 case, 1.3%), all of which were mild. No patients had new onset breathing disorders. Non-benzodiazepine hypnotics are safe and effective for stable MG patients who need insomnia treatment.

An empirical investigation of the associations between metacognition, mindfulness experiential avoidance, depression, and anxiety

BackgroundThe aims of this study were to explore the possible relation between metacognition, mindfulness, and experiential avoidance, as well as their association with symptoms of anxiety and depression.MethodsCross-sectional data was collected from a community sample (N = 364) who completed the Metacognitions Questionnaire-30 (MCQ-30), the Five Facet Mindfulness Questionnaire-24 (FFMQ-24), the Acceptance and Action Questionnaire-II (AAQ-II), the Generalized Anxiety Disorder 7-item (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9).ResultsThere were moderate-strong associations between mindfulness (FFMQ-24), metacognition (MCQ-30), and experiential avoidance (AAQ-II) (0.62 − 0.67), and they showed similar relations with symptoms of depression (PHQ-9) and anxiety (GAD-7) (0.57 − 0.71). Mindfulness, experiential avoidance, and the non-judging subscale of FFMQ-24 constituted a latent factor of flexibility in cognition and emotional experience, while three FFMQ-24 subscales (describing, acting with awareness, and observing) constituted a present-centered attention and awareness factor. Regression analyses indicated that flexibility explained more of the variance in symptoms of anxiety and depression than present-centered attention and awareness.ConclusionsThe results suggest that flexibility in cognitive and emotional regulation skills could be important in explaining symptoms of anxiety and depression.

Exploring media consumption and mental health among young adults during the second wave of COVID-19 in Bangladesh

BackgroundThis study examined the association between media exposure and mental health during the second wave of lockdown among the general population of Bangladesh. MethodsA total of 449 adult participants were enrolled in the study to evaluate their levels of exposure to total media, electronic media, and social media. Mental health was assessed using a 7-item generalized anxiety disorder (GAD-7) scale. A multivariate logistic regression model was constructed to explore the relationships between media exposure levels and anxiety. The models included covariates such as sex, daily working hours, health problems, media distraction, and income from social media. ResultsThe results showed that 44.5%, 39.2%, and 16.3% of participants reported low, medium, and high levels of exposure to different media during the COVID-19 period, respectively. Additionally, 96.4%, 2.7%, and 0.9% of participants had low, medium, and high levels of exposure to electronic media, respectively, and 89.1%, 10.5%, and 0.4% of participants had low, medium, and high levels of exposure to social media, respectively. The overall prevalence of anxiety was 25.38% among the respondents. Participants with high levels of total media exposure were significantly more likely to experience anxiety, with an odds ratio of 2.75 (95% CI = 1.40–5.14, p < 0.01). Females were 2.26 times more likely to experience anxiety than males (95% CI = 1.37–3.74, p < 0.01), and participants with health problems were also more likely to develop anxiety compared to those who did not. ConclusionOur results show a positive relationship between increased media exposure and anxiety levels, providing useful insights for both academics and public health practitioners.

The impact of reduced worry on general functioning: Amediation analysis from a randomized trial.

Previous lab findings have indicated that excessive worry may impair cognitive performance and problem solving capabilities but it is unclear if excessive worry also leads to broader impairments in general functioning. We report a secondary process data analysis of a large randomized waitlist-controlled trial (N=670) of a self-guided online psychological intervention for dysfunctional worry related to the Covid-19 pandemic. Specific aims were to investigate (1) if improvements in general functioning were mediated by reductions in worry related to Covid-19 during the acute intervention phase, and (2) if reduced worry related to Covid-19 during acute intervention phase had a positive long-term impact on general functioning up to 1year after the end of the intervention. To address aim 1, we used a mediation analysis framework where outcome (general functioning measured with an adapted version of the Work and Social Adjustment Scale) and the hypothesized mediator (worry measured with an adapted version of the Generalised Anxiety Disorder 7-Item Scale) were administered weekly during the controlled phase of the trial of 3weeks. To address aim 2, we investigated if reductions in worry during the 3-week treatment period predicted improved general functioning at 1- and 12months after treatment completion. Results showed that improvements in general functioning at week 3 were mediated by reductions in worry during the first 2weeks of treatment (indirect effect estimate -0.08; 95% CI -0.15, -0.02). A sensitivity analysis indicated that the mediation effects dropped significantly when the residual correlation values between the mediator and the outcome exceeded r=0. A reversed causation model was not significant. Additionally, reductions in worry during treatment predicted subsequent improvements in general functioning at both 1- and 12-month follow-ups (p<.05, -.001). Altogether, these results provide further support of the importance of targeting worry as a way to improve functioning among the large population of individuals with high levels of worry.

Depression and anxiety in patients with head and neck cancer undergoing free flap reconstruction

PurposeTo determine the prevalence and severity of depression and anxiety in patients with head and neck cancer (HNC) undergoing treatment with free-flap (FF) reconstruction. MethodsParticipants with HNC undergoing FF reconstruction were given the validated 9-item Patient Health Questionnaire (PHQ-9) and a 7-item Generalized Anxiety Disorder (GAD-7) questionnaire prior to surgery. Patient factors and responses were analyzed. ResultsSeventy-one patients were included. Mean (SD) pre-operative PHQ-9 was 7.6 (7.04) with 34 % (n = 24) having moderate to severe depression. Mean (SD) pre-operative GAD-7 was 6.5 (6.86) with 30 % (n = 21) having moderate to severe anxiety. ConclusionPrevalence of depression and anxiety is high in this cohort and undiagnosed in 22 % and 18 % of patients, respectively. Due to the findings, it is prudent to screen HNC patients at initial diagnosis and offer mental health services.

Factors influencing nurses self-efficacy two years after the COVID-19 outbreak: A cross-sectional study in Wuhan, China.

This study explored the anxiety, depression, and self-efficacy of nurses in Wuhan, China 2 years after the corona virus disease 2019 outbreak. A total of 552 nurses were enrolled in the study. Four well-established test tools were applied: The 9-item patient health questionnaire, The 7-item generalized anxiety disorder, generalized self-efficacy scale, Connor Davidson resilience scale. Twenty-eight points twenty-six percentage of the nurses had mild depression, and 5.62% had moderate or severe depression. Twenty-one points seventy-four percentage of nurses had mild anxiety and 1.82% had moderate or severe anxiety. The average score of self-efficacies is negatively correlated with the average score of the 9-item patient health questionnaire (r = -0.303, P < .01), and the7-item generalized anxiety disorder (r = -0.275, P < .01). The average score of self-efficacies is correlated with the resilience score (R = 0.799, P < .01). Through multiple linear regression analysis, the tenacity dimension and monthly income are most closely related to the sense of self-efficacy. Nurses self-efficacy and resilience are important factors in promoting their psychological well-being. This study suggests that increasing the salary and providing some strategies to increase nurses mental tenacity can promote self-efficacy.

Psychological well-being and associated factors among parents of adolescents with non-suicidal self-injury: a cross-sectional study.

Non-suicidal self-injury (NSSI) impacts not only adolescents who engage in it but also their parents. However, there has been limited research into the psychological well-being of these parents. This cross-sectional study aims to investigate the symptoms of anxiety and depression among parents of adolescents who engaged in NSSI in China and the factors associated with them. A total of 400 parents of adolescents with NSSI were included. Socio-demographic information of these parents was collected. The Generalized Anxiety Disorder 7-item (GAD-7), the Patient Health Questionnaire 9-item (PHQ-9), and the Connor-Davidson Resilience Scale (CD-RISC) were used to assess symptoms of anxiety, depression, and psychological resilience, respectively. The majority of the parents were female (83.5%), married (86.3%), and had a senior high school or equivalent and lower education level (67.1%). The study found that 35.3% of the parents experienced clinically significant symptoms of anxiety (GAD-7 ≥ 7) and 40.1% had clinically significant symptoms of depression (PHQ-9 ≥ 7). Parents with larger ages and lower levels of psychological resilience were more likely to experience symptoms of anxiety and depression (p < 0.05). Parents who reported bad parent-child relationships showed a higher level of anxiety. This study provides important insights into the symptoms of anxiety and depression among parents of adolescents with NSSI. Parental age, parent-child relationship, and psychological resilience were associated with symptoms of anxiety and depression in these parents. Implications for the development of interventions aimed at addressing symptoms of anxiety and depression in parents of adolescents with NSSI were discussed.

Psychosocial Outcomes in Nondirected Uterus Donors 1 Y After Donation.

As uterus transplantation transitions to a clinical procedure for women with absolute uterine-factor infertility, transplant centers performing uterus transplantation need information about the experience of living donors. This study examined the psychosocial impact on 17 nondirected uterus donors in the Dallas UtErus Transplant Study 1 y following donation. A prospective longitudinal study was conducted to measure psychosocial outcomes of depression, anxiety, posttraumatic stress, quality of life, and resilience [measured using the Hospital Anxiety and Depression Scale or Patient Health Questionnaire 9-Item, Generalized Anxiety Disorder 7-Item, Posttraumatic Stress Disorder Checklist for the DSM-5, health-related quality of life Short Form-36, and Connor-Davidson Resilience Scale 10-Item, respectively) assessed at baseline, at 6-mo and 1-y follow-up. Differences among baseline, 6-mo, and 1-y postdonation were analyzed. The median age was 38.0 y, 16 were married, 15 were of non-Hispanic/Latino ethnicity. Most donors did not report psychosocial distress; however, 1 donor reported decline on the role limitations because of Emotional Problems Scale and also showed an increase in depression symptoms at the 6 mo, but at 1 y was below the clinical cutoff for depression. A second donor showed modest decline in emotional well-being. Improvements were seen in other donors on the Physical Functioning Scale and posttraumatic stress symptoms. Although most nondirected donors appeared to remain stable, both positive and negative changes were observed over the first year. Larger studies are needed to determine psychosocial risks and benefit and what additional resources might be needed to ensure optimal psychosocial outcomes.

Comparison of Baseline and Test Day Cardiovascular Parameters, Anxiety Scores and Coffee Consumption Among Medical Students Undergoing Objective Structured Clinical Examinations in Jordan.

Objective Structured Clinical Examinations (OSCEs) are considered an integral part of the assessment process of many schools of medicine worldwide. Close monitoring by examiners, scrutinized interactions with patients, and fear of the unknown, among other factors have been reported to cause psychological stress among students during the examinations period. In this study, we aimed to assess changes in cardiovascular parameters, anxiety scores, and lifestyle patterns of medical students during their OSCEs as compared to their baseline. We recruited healthy medical students from our institution's medical school. General demographics, academic, and baseline lifestyle characteristics were collected 1-2 months before the OSCE day. The Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure anxiety symptoms. Data related to coffee consumption in addition to systolic, diastolic blood pressure and heart rate measurements were collected both at baseline and on OSCE day. This study included 325 students (144 (44.3%) males and 181 (55.7%) females). The mean systolic blood pressure, diastolic blood pressure, and heart rate measurements were significantly higher on OSCE day as compared to the baseline. In addition, the daily consumption of coffee increased significantly during OSCE day as compared to the baseline. Although the anxiety score increased during OSCE day compared to the baseline, the difference was not statistically significant. However, the change in anxiety score (OSCE day - baseline) was significantly higher in females compared to males. In our study, we observed significant increases in blood pressure, heart rate, and coffee intake on the day of the test compared to baseline measurements. These findings underscore the significance of implementing measures to reduce the harmful effects of stress on students during exam preparations and medical school assessments.

The influence of benefit finding on academic engagement among Chinese college students: A moderating effect model

ObjectiveTo explore how college students’ academic engagement has changed in the outbreak of coronavirus disease 2019 (COVID-19) (hereinafter referred to as “in the outbreak”), this research will encompass more than just looking into the relationship among anxiety, benefit finding (BF) and academic engagement, but also involve evaluating how anxiety moderates the positive impact of BF on academic engagement. MethodAmong college students, this study comprised an online-based cross-sectional survey in cities where COVID-19 broke out. Convenience sampling method was used. The survey took place between November 10 and November 19, 2021, during which all the cities surveyed were in the outbreak. With language revision, scales include Student Version of the Utrecht Work Engagement Scale (UWES-S), recompiled Benefit Finding Scale (BFS) and 7-item Generalized Anxiety Disorder Scale (GAD-7), as methods for gauging the academic engagement, BF and anxiety experienced by college students, respectively. ResultsAcademic engagement in the outbreak is higher than that before the outbreak stage of COVID-19 (hereinafter referred to as “before the outbreak”) (Z = −18.201, P < 0.001). Between anxiety and BF, a negative correlation can be observed in the outbreak (P = 0.001), whereas BF and anxiety have an adverse correlation with academic engagement (P < 0.001). The positive effect of BF on academic engagement will be debilitated by anxiety. Further analysis shows that college students who are close to medium-and high-risk areas, worried about the infection, unvaccinated and concerned about the epidemic, are more likely to be anxious (P < 0.001). Those with confidence in government's ability to prevent and control the epidemic, as well as increased trust in medical workers, have a higher BF (P < 0.001). ConclusionsWhile COVID-19 could still exert adverse effects on psychology of college students, but it can also stimulate college students to perceive the meaning of life. In the outbreak, an increase in academic engagement seems to be a manifestation of growth in adversity. Compared with short-term negative emotional intervention, life meaning and gratitude in education may stimulate their potential ability for a longer time.