Higher Levels Of Anxiety Research Articles

The effects of exercise on anxiety symptoms in women with gestational diabetes mellitus: a pilot study.

Anxiety is a common mental health issue during pregnancy. Moreover, women with gestational diabetes mellitus (GDM) seem to have to cope with higher levels of anxiety, being at higher risk for several health and mental complications. Women with GDM are recommended to undertake regular physical exercise to improve metabolic and reproductive outcomes. However, there are no specific guidelines for exercise in women with GDM and data on its relationship with mental health are scarce. The aim of this study was to investigate the effect of exercise on anxiety symptoms in pregnant women with GDM. The present non-randomized, open-label clinical trial was a pilot study intended to provide initial data on the effect of exercise on anxiety symptoms of pregnant women with GDM. Forty-three women were assigned to three the following three study groups, (a) Advice Group (n = 17), Walking Group (n = 14), and Mixed Exercise Group (n = 12), from GDM diagnosis to delivery. Based on the Beck Anxiety Inventory (BAI) scores, all groups showed normal anxiety changes or mild anxiety levels pre- and post-intervention, ranging between 9.00 (1.00-32.00) (pre-intervention) and 7.5 (1.00-26.00) (post-intervention), but none experienced severe anxiety. In the present study, a trend of self-selected pace walking to reduce the BAI scores was identified since the Walking Groups had lower scores after the intervention. However, this trend did not reach statistical significance. Brisk walking (30-45min) three times per week may produce positive changes in both the treatment plan and the anxiety state of women with GDM. Moreover, the study confirms that routine medical care, counseling, and support by an interdisciplinary team are protective against anxiety in women with GDM.

The impact of COVID-19 on Health Science undergraduate students’ academic experience and mental health: A pilot study

The COVID-19 pandemic has created significant disruptions in teaching and learning at universities, predisposing university students to develop mental health issues which may impact their academic experience. This study evaluated the academic experience and mental health status of students enrolled in Health Science courses at Swinburne University of Technology via a mixed-methods cross-sectional survey conducted on 36 students (18+ years). Out of these students, 10 attended in-depth interviews. Results obtained from both quantitative and qualitative data analyses found high levels of stress, anxiety and depression, with more than 50% experiencing levels above the clinical thresholds. About 39% of the participants reported feeling able to concentrate on their learning when materials were delivered via an online mode. Students’ engagement through online learning was significantly disrupted, 97.2% of the respondents found it difficult to perform group work and 75% reported not being able to engage with their peers. Higher levels of stress, anxiety and depression were significantly associated with a compromised learning experience. Spearman’s Rank Correlation showed a significant negative association between stress and students’ engagement with online learning (Spearman’s rho=-0.49, p=0.003). Supporting the learning experiences along with monitoring the mental health of all university students should be of high priority for university authorities.

Reduction of neck pain severity in patients with medication-overuse headache

BackgroundNeck pain and primary headache disorders are highly prevalent in populations and clinical cohorts. Medication-overuse headache (MOH) is a treatable secondary headache, mainly developing in migraine sufferers, that accounts for the majority of patients presenting to headache clinics. Nevertheless, the association between neck pain and MOH has not been reported. This study evaluated the prevalence and clinical course of neck pain in patients with MOH before and after MOH treatment.MethodsWe analyzed 635 MOH patients enrolled in a nationwide, prospective, multicenter MOH registry. Demographics and clinical data were collected at baseline and 3 months to evaluate changes in the status and severity of neck pain and headache. Severity of neck pain was graded into 4 groups, and severe neck pain was defined as grade 3 or 4.ResultsAmong 635 patients with MOH, 366 (57.6%) reported neck pain at baseline. MOH patients with neck pain had an earlier onset of their primary headache disorder (23.4 ± 12.7 vs. 26.2 ± 13.3 years, p = 0.007). Although monthly headache days were comparable between the patients with neck pain and those without neck pain, the neck pain group had higher levels of anxiety (7.4 ± 5.8 vs. 6.4 ± 5.4, p = 0.017), more severe cutaneous allodynia (2.4 ± 3.3 vs. 1.8 ± 3.0, p = 0.038), and poorer quality of life (171.7 ± 70.4 vs. 184.0 ± 68.9, p = 0.029). At 3 months, 456 (71.8%) were followed-up, and 257 (56.4%) were recovered from MOH. Compared to the baseline, the proportion of severe neck pain (40.4% vs. 19.4%, p < 0.001) was decreased. The proportion of severe neck pain was much lower in patients with recovery from MOH compared to those without (4.7% vs. 15.1%, p < 0.001).ConclusionsNeck pain in MOH patients was associated with earlier onset of headache, higher levels of anxiety and allodynia, and poorer quality of life. Improvement in neck pain improvement was linked to recovery from MOH. These findings suggest the potential importance of integrating and management of neck pain into clinical practice for MOH.

Death Anxiety and Resilience in Older Adults: The Moderating Role of Attachment Patterns

The unique human awareness of the fact that life is finite, and that death is unavoidable has been shown to elicit negative psychological consequences across the life cycle. However, research has demonstrated that the ability to seek, maintain, and gain comfort from close relationships mitigates the adverse psychological effects of death awareness/anxiety. Moreover, relatively little is known about how death anxiety and social relationships in old age are associated with resilience, an important personal protective factor for dealing with general and age-related difficulties. Accordingly, the current work examined the links between death anxiety and resilience in older adults and explored the potential moderating role of attachment patterns for this link. Data were collected from 369 older Israeli adults (Mage = 73.15, SD = 6.31, range = 60–94), who completed scales examining death anxiety, attachment patterns, and resilience, as well as sociodemographic scales. The results demonstrated that death anxiety, attachment anxiety, and attachment avoidance were associated with reduced resilience. Moreover, the death anxiety-resilience link was not significant for individuals reporting high or low levels of both attachment anxiety and avoidance. The findings are discussed through the prism of Terror Management Theory, and practical implications are suggested.

Health Anxiety, Sleep Quality in Healthcare Workers Under Critical Conditions of Emerging Diseases

Background: One of the crises recently affecting human society is an emerging pandemic that has had a significant psychological impact on healthcare workers. Studies have shown that staff experience psychological disorders such as anxiety, depression, and insomnia when exposed to crises. Objectives: This study aimed to determine the association between health anxiety and the sleep quality of healthcare workers during crisis conditions. Methods: This cross-sectional, correlational descriptive-analytical study was conducted from late February 2019 to late March 2020. Using convenient sampling, 382 healthcare workers from medical universities in Golestan province participated in the survey. Data were collected via an internet link shared with participants through WhatsApp working groups. The instruments used in this research included demographic information, sleep quality, and health anxiety inventories. The data were analyzed using SPSS-21 with descriptive and analytical statistics. Results: Of the participants, 77.2% were women, 65.4% were single, 60.7% were nurses, and 64.4% had a bachelor's degree. The results revealed that 72.7% of the staff experienced moderate to high levels of anxiety. Regarding sleep quality, 28.3% (n = 108) of healthcare workers reported good sleep quality, while 71.7% (n = 274) reported poor sleep quality. Additionally, the results indicated a significant correlation between health anxiety scores and sleep quality scores (r = 0.129, P = 0.01). Conclusions: The results of this study showed that the critical conditions caused by emerging diseases have led to health anxiety among healthcare workers, negatively affecting their sleep quality. Therefore, medical center officials must address such psychological issues and implement preventive measures to maintain the mental health of healthcare workers.

Affective Filter Hypothesis and Second Language acquisition: A study on anxiety levels in the dictation part of TEM-4

The Affective Filter Hypothesis is a cornerstone of second language acquisition (SLA) theory. This hypothesis explores the influence of emotional factors on language learning, particularly the role of emotional states such as anxiety, motivation, and self-confidence in the process of language input. This work investigates the applicability of the Affective Filter Hypothesis in the context of the Dictation section of the Test for English Majors, Band 4 (TEM-4). To explore the impact of emotional factors, especially anxiety levels, on performance in the Dictation section of the TEM-4, a mixed-methods approach was employed in this paper. Participants underwent an anxiety level test and a simulated dictation test to establish baseline data. The results indicated that the overall performance trend of the low-anxiety group was higher than that of the high-anxiety group. This outcome suggests that learners with low anxiety level performed better in TEM-4 dictation than learners with high anxiety level.

Autistic Sensory Traits and Psychological Distress: Mediating Role of Worry and Intolerance of Uncertainty

Background/Objectives: Autistic adults exhibit core and comorbid features that can have an impact on their daily functioning and lead to considerable psychological distress. Significant and consistent associations have been identified between autism characteristics—restricted repetitive behaviors and sensory features—and high levels of stress and anxiety. For a better understanding of the issue, it is necessary to consider the cognitive aspects that can help explain variations in stress and anxiety levels among adults with autism. We therefore aimed to model the contributions of worry and intolerance of uncertainty on the relationship between autism characteristics (sensory sensitivities and repetitive behaviors) and psychological distress (stress and anxiety). Methods: The sample comprised 144 autistic individuals with a mean age of 35.15 (SD = 11.44). They participated in the study by completing an online questionnaire to assess the study variables. Most of the participants reported being diagnosed with Asperger syndrome (63.6%) or Level 1 autism spectrum disorder (27.1%). Results: The model fit index values tested through path analysis indicated a good fit (χ2 = 5.65; p = 0.13 ns; CFI = 0.993; NFI = 0.985; RMSEA = 0.079; SRMR = 0.025) and identified worry and intolerance of uncertainty as significant mediating variables within a comprehensive explanatory model. Conclusions: These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults.

UNIVERSITY EDUCATION AS A PHASE OF TRANSITION AND DEVELOPMENT, PSYCHOLOGICAL CHALLENGES FACED BY STUDENTS

This study investigates the psychological impacts faced by students during their academic studies. Based on an analysis of 21 students, the study examined their levels of stress, anxiety, and signs of depression. The results reveal a variety of emotional and mental issues faced by these students, including high levels of stress, severe anxiety, and moderate depression. This article discusses the possible causes of these impacts, such as the academic environment, social expectations, and curriculum demands. In addition, the collected data are examined to understand the negative effects and their implications for the well-being and mental health of students, finding significant results, with 62% of the sample presenting anxiety, 86% very high stress, and 14% severe depression, along with 38% of the sample presenting moderate depression.

Vitamin C intake, psychological distress and health outcomes in patients with heart failure

Abstract Background Patients with heart failure (HF) have lower dietary vitamin C intake than healthy adults, which may increase oxidative stress and worsen important patient-reported health outcomes (functional status and quality of life [QOL]). Patients with HF are more likely to have higher levels of psychological distress (anxiety and depressive symptoms). However, it is not known whether psychological distress is a link in the association of dietary vitamin C with health outcomes. Objective To examine the inter-relationships among dietary vitamin C intake, psychological distress (anxiety and depressive symptoms), and health outcomes (functional status and QOL) in patients with HF. Method We performed a secondary analysis of baseline data from 206 adults with HF (female: 33%, age: 61±12, NYHA class III/IV: 44%) with complete data on dietary vitamin C intake, anxiety, depressive symptoms, functional status, and QOL. Dietary vitamin C intake was assessed using a 4-day food diary and analyzed using the Nutrition Data System for Research software program. Low dietary vitamin C intake was defined as averaged daily intake below the estimated average requirement (EAR) from the Institute of Medicine of 75 mg/day for men and 60 mg/day for women. Anxiety was assessed using the Brief Symptom Inventory Anxiety subscale. Depressive symptoms were assessed using the Beck Depression Inventory II. Functional status was measured using the Duke Activity Status Index. Quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. Linear regression was conducted using the PROCESS macro in SPSS. Results Eighty-four patients (41%) had low dietary vitamin C intake based on the EAR standard. In bivariate analyses, patients with low dietary vitamin C intake had higher levels of anxiety, depressive symptoms, poorer functional status, and worse QOL (all p &amp;lt;.005). In the mediation regression model, low dietary vitamin C intake was directly associated with higher levels of anxiety, but not with depressive symptoms. Depressive symptoms were directly associated with functional status and QOL. Dietary vitamin C intake was not directly associated with functional status or QOL. Low dietary vitamin C intake was indirectly associated with poor functional status through higher levels of anxiety and depressive symptoms (Figure 1). Similarly, low dietary vitamin C intake was indirectly associated with worse QOL (Figure 2). Conclusion Anxiety and depressive symptoms link the relationship between dietary vitamin C intake and functional status and between dietary vitamin C intake and QOL. Our findings highlight the importance of including interventions to enhance diet quality and psychological well-being as part of HF treatment to improve health outcomes.Vitamin C and functional statusVitamin C and quality of life

Why students feel anxious in group work: an investigation into students’ perspectives on the sources of their anxious experiences in group work

IntroductionThis large-scale, mixed-methods study aimed to uncover sources of learner anxiety when interacting in small groups in the language classroom. A secondary aim of the study was to examine relationships between these sources and learners’ levels of small-group anxiety.MethodsData was gathered from 1,344 learners enrolled in English classes at four universities in western Japan. Qualitative content analysis was employed to identify anxiety-inducing situations described in learner’ responses, and categorize these situations based on the underlying source of anxiety.ResultsThe analysis revealed two primary sources of small-group anxiety: interacting with other learners and L2 communication. The most prominent interaction-related situations were interacting with new people, expressing opinions, and uncomfortable silence, while those related to L2 communication were competence and proficiency, conveying meaning and understanding others. Levels of small-group anxiety were significantly related to the source of anxiety. Learners with a high level of anxiety were twice as likely to cite interaction as the source of their anxiety than learners with a low level of anxiety.DiscussionThe results suggest that interaction anxiety may be more salient than foreign language anxiety when language learners work in small groups, and that the impact of this form of social anxiety needs to be taken into consideration for learners to fully receive the benefits of group work.

High Behavioral Reactivity to Novelty as a Susceptibility Factor for Memory and Anxiety Disorders in Streptozotocin-Induced Neuroinflammation as a Rat Model of Alzheimer’s Disease

Individual differences in responsiveness to environmental factors, including stress reactivity and anxiety levels, which differ between high (HR) and low (LR) responders to novelty, might be risk factors for development of memory and anxiety disorders in sporadic Alzheimer’s disease (sAD). In the present study, we investigated whether behavioral characteristics of the HR and LR rats, influence the progression of sAD (neuroinflammation, β-amyloid peptide, behavioral activity related to memory (Morris water maze) and anxiety (elevated plus maze, white and illuminated open field test) in streptozotocin (STZ)-induced neuroinflammation as a model of early pathophysiological alterations in sAD. Early (45 days) in disease progression, there was a more severe impairment of reference memory and higher levels of anxiety in HRs compared with LRs. Behavioral depression in HRs was associated with higher expression of β-amyloid deposits, particularly in the NAcS, and activation of microglia (CD68+ cells) in the hypothalamus, as opposed to less inflammation in the hippocampus, particularly in CA1, compared with LRs in late (90 days) sAD progression. Our findings suggest that rats with higher behavioral activity and increased responsivity to stressors show more rapid progression of disease and anxiety disorders compared with low responders to novelty in the STZ-induced sAD model.

Assessing the impact of implantable loop recorder placement on anxiety level

Abstract Background Anxiety is a prolonged state of apprehension or worry that can be an independent predictor of cardiovascular events, associated with a 48% increased risk of cardiac death. About one-third of patients with arrhythmias present with high anxiety levels, and subsequently worse quality of life. In our experience of patient care, many patients feel anxious about the possibility of an arrhythmia that could lead to their demise, especially if their symptoms are undiagnosed. Purpose Our project aims to explore the change in patients’ anxiety levels following implantable loop recorder (ILR) placement. Methods This is a survey-based observational study that was performed in an outpatient clinic and hospital using validated General Anxiety Disorder-7 (GAD-7) questionnaires. Individuals who met indications to undergo ILR implantation including palpitations, syncope, subclinical atrial fibrillation, and cryptogenic stroke underwent baseline assessment of anxiety prior to implantation. Individuals had repeat assessments at 6 weeks and 12 weeks post-implantation to evaluate the effect of ILR placement. Results Our study included 50 individuals. Out of the initial subjects, 10/25 females and 11/25 males were lost to follow-up. The average initial GAD-7 score was 3.3 (Range 0, 15), average 6-week score was 1.6 (Range 0, 14), and average 12-week score was 0.9 (Range 0, 10). Total decrease in GAD-7 score after 6 weeks of having ILR was 50%. Total decrease in GAD-7 score after 12 weeks of ILR was statistically significant at 73% (P=0.03). Females showed greater improvement of GAD-7 scores in comparison to males at 6 weeks (67% vs 36%) and 12 weeks (81% vs 66%). Conclusion Studies have suggested an overall decreased level of anxiety in patients receiving implantable devices that have the potential to treat arrhythmias such as implantable cardiac defibrillators and pacemakers. Our results suggest that the benefit may extend to implantable devices that seek to provide further diagnostic information and aid in the prognostication of disease burden. As seen in our study population, GAD-7 scores showed dramatic improvement with greater percentage in female than male population. After the placement of loop recorders, many patients experience a sense of security with having a device that monitors them. Our study is the first to address the association between ILR and anxiety. Future studies evaluating this association would help increase the power of the study.Figure 1:Bar graph of GAD-7 Scores

A cross-sectional study on the perceived risk of COVID-19 and its association with the usage patterns of e-cigarettes among adolescents and young adults during the COVID-19 pandemic in Nigeria

The study aimed to assess the perception of a higher risk of COVID-19 infection among young people who used e-cigarettes, and its association with a change in the use of e-cigarettes during the pandemic in Nigeria. A secondary analysis of the Nigerian component of a multi-country online survey data, which was obtained from adolescents and young adults on e-cigarette use from November 1st to December 30th, 2021, was conducted. Multi-nominal regression analyses were done to determine the associations between the dependent (use of e-cigarettes) and independent (perception that e-cigarette users are more likely to be infected with COVID-19) variables after adjusting for confounders (health status, COVID-19 status, HIV status, anxiety level, age and sex). Of the 568 respondents (52.8% male), 122 (21.5%) perceived that e-cigarette users were more likely to be infected with COVID-19. In addition, 188 (33.1%) respondents increased e-cigarette smoking during the pandemic. A greater percentage of participants who perceived that e-cigarette use is associated with a greater risk of COVID-19 infection, and a significantly higher percentage of participants with high levels of anxiety reported decreased e-cigarette use (28.6% versus 13.3%, p = 0.029). The perception that e-cigarette use increased the risk for COVID-19 was associated with higher odds of an increase in e-cigarette use (AOR: 1.328) and lower odds of a decrease in e-cigarette use (AOR: 0.580) during the COVID-19 pandemic, though these associations were not statistically significant. The persistence of e-cigarette use among the youth in Nigeria despite awareness of COVID-19 risks highlights the need for stronger public health interventions. Simply providing information on risks is insufficient; targeted strategies addressing addiction, social factors, and accessibility are crucial for meaningful behavioural change.

Anxiety, depression, and poor sleep quality in COVID-19 survivors of the first year of the pandemic

Abstract Background Psychological outcomes after SARS-CoV-2 infection have been reported primarily among patients with post-COVID-19 condition followed at COVID-specific clinics who may not represent the population of COVID-19 survivors. This study compares the frequency, 2 years after infection, of symptoms of anxiety and depression and poor sleep quality between COVID-19 survivors from the first year of the pandemic and comparison groups matched for sex, age, and level of care. Methods Participants are users of the Local Health Unit of Matosinhos (comprising almost all citizens of this municipality) classified according to hospitalization and SARS-CoV-2 infection between March, 2020 and February, 2021 in 4 groups: group#1, hospitalized due to COVID-19 (n = 101); group#2, hospitalized, uninfected (n = 87); group#3, infected, non-hospitalized (n = 252); group#4, uninfected, non-hospitalized (n = 258). They were evaluated between July, 2022 and October, 2023, with the Hospital Anxiety and Depression Scale (HADS-A, anxiety, and HADS-D, depression) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to compute OR and 95%CI adjusted for sex, age, education, marital status, employment, smoking, and level of care of the associations between the study group and clinically significant symptoms of anxiety (HADS-A scores&amp;gt;10), depression (HADS-D scores&amp;gt;10) and poor sleep (PSQI scores&amp;gt;5). Results No significant differences (p &amp;lt; 0.05) were observed for the prevalence of clinically significant symptoms of depression (overall 9.2%) and poor sleep quality (overall 59.8%) between SARS-COV-2 infected participants and comparison groups, but HADS-A scores&amp;gt;10 were more frequent in infected individuals (19.3% vs. 13.6%; OR = 1.92; 95%CI:1.21,3.05). Conclusions Healthcare services should pay special attention to COVID-19 survivors from the first year of the pandemic to identify and treat anxiety symptoms. Funding: FCT UIDB/ 04750/2020 LA/P/0064/2020 PTDC/SAU-EPI/6275/2020 Key messages • COVID-19 survivors from the 1st year of the pandemic present more frequently high levels of anxiety than the general population 2 years after COVID-19. • Specific care for anxiety symptoms are needed for COVID-19 survivors from the 1st year of the pandemic

How Psychophysical Stress Can Mediate the Effects of Anxiety and Depression on the Overall Quality of Life and Well-Being in Women Undergoing Hereditary Breast Cancer Screening

Background: Women undergoing genetic counseling for hereditary breast cancer often experience a high emotional burden. Distress and stress in the initial phases of genetic counseling can be significant predictors of long-term psychological health, influencing quality of life and well-being. Objectives: This study aimed to evaluate the mediating role of psychophysical stress in the relationship of anxiety and depression with quality of life and well-being in women undergoing genetic counseling for BRCA1/2 mutations. Methods: A sample of 193 women from two genetic counseling clinics was assessed using validated questionnaires measuring the psychological variables under study. Sociodemographic and clinical characteristics were also considered. Results: The results of path analyses indicated a mediating role of psychophysical stress on the relationship between emotional distress and mental quality of life and well-being: higher levels of anxiety and depression were associated with increased psychophysical stress, which, in turn, was linked to a reduced perceived mental quality of life and well-being. Depression was the only significant psychological predictor of physical quality of life. Conclusions: These findings indicate that addressing both anxiety and depression in genetic counseling is crucial for enhancing mental and overall well-being. Interventions should focus on stress management to improve the quality of life, emphasizing depression treatment to enhance physical health outcomes.

Cognitive processing biases of social anxiety in adults who do and do not stutter

PurposeAdults who stutter are at risk of developing high levels of social anxiety, leading to negative outcomes and contributing towards stuttering relapse post treatment. To ensure that psychological treatments for social anxiety in stuttering adults are relevant and effective, a broader empirical understanding of the mechanisms of social anxiety in stuttering populations is required. Four key cognitive processing biases identified as maintenance factors in cognitive behavioral models of social anxiety were examined: self-focused attention, safety behavior use, negative self-imagery, and interpretation bias. MethodsAdults who stutter and non-stuttering adults (N = 186) were assessed via an online survey. Participants were categorised into two groups based on stuttering: formally diagnosed stuttering and non-stuttering. Within those groups, participants were further categorised as having low or high levels of social anxiety. Cognitive processing bias was assessed in response to two hypothetical social scenarios (i.e., social interaction and social performance). ResultsAs predicted, in both adults who stutter and who are non-stuttering, high social anxiety was related to greater self-focused attention, safety behavior use and negative self-imagery compared to low social anxiety. No significant effect of social anxiety or stuttering was found in relation to interpretation bias. A significant effect of social anxiety upon negative self-imagery was observed in formally-diagnosed adults who stutter compared to non-stuttering adults. ConclusionThe results support the use of cognitive behavioral models of social anxiety as a framework for research and treatment development within stuttering populations.

Cancer Caregiver Anxiety Over Time: The Influence of Palliative Care.

Objectives: To explore anxiety experienced by caregivers providing home-based, end-of-life care to patients with cancer. We examined the relationship between caregiver anxiety and receipt of palliative care by the patient. Methods: A case series of terminal cancer patient-caregiver dyads (n = 223) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 12 months or until patient death. Data collected included qualitative, quantitative, and observational data; this analysis utilizes the quantitative data. Longitudinal Latent Growth Models were used to characterize the heterogeneity of primary caregiver anxiety over time. The influence of palliative care on caregiver anxiety over time was assessed. Characteristics associated with membership in the trajectory groups rendered from those models are presented. Results: The majority of caregivers were female (73.9%), white (54.9%), and patient spouses (45.3%). Three classes of caregivers were identified based on their anxiety scores over time (low, elevated, and high). The 2 groups who had elevated and high anxiety had significant increases in anxiety over time. Controlling for patient receipt of palliative care attenuated those increases. Caregivers with the lowest level of anxiety were more likely to be Black, report fewer symptoms of depression or caregiver burden and higher self-rated physical health. Caregivers who were younger reported higher anxiety. Conclusions: Our analysis detected 3 distinct cancer caregiver groups reporting low, elevated, and very high levels of anxiety. Caregivers with elevated or high anxiety also demonstrated increasing anxiety overtime; however increases were attenuated with patient receipt of palliative care. For cancer caregivers with elevated and high levels of anxiety, palliative care buffers further deterioration of their mental health.

Relationship between personal anxiety and genes associated with eating disorders in women aged 45-64

Aim. To study the possible relationship between personal anxiety and polymorphic variants of genes associated with eating disorders (rs17782313 MC4R, rs1800497 DRD2, rs9939609 FTO) in women aged 45-64 in Novosibirsk.Material and methods. A random representative sample of women aged 45-64 years (n=1074, mean age, 54,27±0,2 years) was examined in 2003-2005 at the Research Institute of Internal and Preventive Medicine, a branch of the Institute of Cytology and Genetics, within the Health, Alcohol and Psychosocial Factors In Eastern Europe (HAPIEE) project. Personal anxiety was assessed using the Spielberger self-assessment questionnaire included in the protocol of the Multinational Monitoring of Trends and Determinants of Cardiovascular Disease — Optional Psychosocial Study (MONICA-MOPSY), tested at screenings of the World Health Organization (WHO) MONICA program in 1983-1995. The sample for the HAPIEE program was formed at the program data processing center in Prague for each of the collaborating centers in such a way that each respondent was random. From the sample, every second woman (n=537) was selected for genotyping of the FTO rs9939609 variant (n=384); every third woman (n=358) — for genotyping the MC4R rs17782313 (n=279) and DRD2 rs1800497 variants (n=327). Genotyping was performed in the laboratory of molecular genetic studies by the polymerase chain reaction with the analysis of restriction fragment length polymorphism.Results. Among women aged 45-64, anxiety was detected in 58,3%, and in 15,9% of women the anxiety level was high. The homozygous genotype C/C rs17782313 of the MC4R gene was more common among women with high anxiety levels (17,5%) than among women with low and moderate anxiety levels (1,8 and 0,8%, respectively; p=0,001). There were no significant differences in the detection rate of the rs1800497 genotypes of the DRD2 gene among women with different levels of anxiety (p&gt;0,05). The frequency of the A/A rs9939609 genotype of the FTO gene was highest among women with high anxiety levels — 29,5%, compared to participants with low and moderate anxiety levels (15 and 15,3%, respectively; p=0,048). The probability of anxiety among carriers of the C/C+C/T genotypes of the MC4R gene was 1,29 times higher than among carriers of the T/T genotype (p=0,001). Among carriers of the A/A rs9939609 genotype of the FTO gene, the anxiety probability was 2,34 times higher than among carriers of the A/T+T/T genotypes (p=0,008).Conclusion. The association between anxiety and genes of eating disorders dictates the need for diagnosis and subsequent treatment of anxiety and its associated consequences.

RELAX (REducing Levels of AnXiety): a study protocol for a parallel two-arm randomised controlled trial evaluating a web-based early intervention for pregnant women with high levels of repetitive negative thinking to prevent escalating anxiety during pregnancy and after birth

BackgroundPerinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)—such as worrying about ways things will go wrong in the future or ruminating about past negative events—is a risk factor for the development of anxiety. RNT is maintained by the tendency to generate negative interpretations of ambiguous situations.MethodsA parallel two-arm randomised controlled trial will assess the efficacy of adding interpretation training (RELAX) to usual maternity care. Participants (N = 268) will be randomised to (i) 12 sessions of online interpretation training (RELAX) plus usual care, or (ii) usual care alone. We will assess anxiety, depression, RNT, and work and social adjustment at baseline, plus 4, 8 and 36 weeks later.DiscussionShould the intervention result in lower levels of anxiety than usual care, it could be an accessible, cost-effective way to help women who are vulnerable to experiencing anxiety in the perinatal period.Trial registrationISRCTN 12754931. Registered 25th May 2023, prior to recruitment.

Functional disability, health care access, and mental health in Ukrainians displaced by the 2022 Russian invasion

Armed conflict has negative mental health impacts on internally displaced people and refugees, however, much less is known of its effects on the mental health of displaced people and refugees with disabilities. We use pan-European data (N = 9,676), collected via an internet health needs survey across April-July 2022, to examine the mental health impacts of the 2022 Russian invasion of Ukraine on the mental health of displaced people with disabilities during the first months of the war. Regression models separately examined associations between functional impairment (vision, walking, existing mental health condition), access to healthcare, welfare payments, and anxiety and sleep quality, controlling for sociodemographic variables. The presence of pre-existing mental health conditions, mobility and vision impairment were each associated with higher levels of anxiety and poorer sleep quality. The ability to access health services and social security payments was also associated with better sleep and lower levels of anxiety. Humanitarian and local authorities must ensure Ukrainian refugees and IDPs are reviewed for their mental health needs, with particular attention to those with known disabilities.