Higher State Anxiety Research Articles

Severe post-delivery blues: associated factors

Objectives: To study severe postpartum blues and associated factors. Study design: One hundred and two women in two maternity units in the suburbs of Paris completed self-administered questionnaires, including Maternity Blues questionnaire, three days after giving birth. We defined severe blues as a score on the maternity blues scale above the 90th percentile of our sample distribution (cut-off point = 12/28). Results: Severe blues was associated with the mothers' unemployment but not with their socio-demographic characteristics. Women who breast-fed had a higher frequency of severe blues. Severe blues tended to be associated with women's expectation of little or no help with child care and with problematic relationship with their baby's father. It was strongly related to high state anxiety but not to high trait anxiety. Conclusion: These results suggest that both breast feeding and insecure psychological and social surrounding, such as unemployment, may be risk-factors for severe blues.

Temporal Characteristics of Evaluation Anxiety

The temporal characteristics of evaluation anxiety are not well-defined by previous research. We examined the effects of length of the pre-evaluation interval (3, 6, or 12 minutes) and stage of the pre-evaluation interval at which evaluation anxiety was measured (start, middle, or end) on evaluation anxiety while participants performed an activity that was the focus of the impending evaluation. Participants wrote their opinion on a controversial social issue while anticipating a subject matter expert’s judgment of their social maturity, and evaluation anxiety was measured by a battery of state anxiety measures. Higher levels of evaluation anxiety were detected on the Worry-Emotionality Questionnaire (WEQ) Worry subscale at the end of the pre-evaluation interval than at earlier stages, regardless of interval length, although individual difference variables exerted an important influence. Individuals with high trait self-presentation concerns experienced particularly high state anxiety (State-Trait Anxiety Inventory) at the start of the longest pre-evaluation interval. Low self-efficacy individuals showed a U-shaped pattern across pre-evaluation stages on both the WEQ Worry and Emotionality subscales, while high self-efficacy participants showed either no change (worry) or an inverted-U pattern (emotionality). Implications for the experimental measurement of evaluation anxiety were discussed.

Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study

Objective: To investigate whether maternal anxiety in the third trimester is associated with an increased uterine artery resistance index. Design: Cohort based study. Subjects: 100 pregnant women, with a mean...

Processing Messages About Disease Detection and Health Promotion Behaviors: The Effects of Anxiety

A study was conducted to examine the effects of anxiety on the processing of messages that encourage the performance of disease detection and health promotion behaviors. It was hypothesized that under high-anxiety conditions messages about health promotion behaviors would be processed more than messages about disease detection behaviors and that this effect would reverse under lower levels of anxiety. To test this hypothesis, the participants were required to read information designed either to increase or to decrease anxiety about health. Following the anxiety manipulation, participants received a strong or weak message promoting the performance of either health promotion or disease detection behaviors. Then participants were required to indicate their attitudes about the behavior, their cognitive responses to the message, and their recall of the message. The results support the hypothesis.

Sudden Darkness Induces a High Activity-Low Anxiety State in Male and Female Rats

NASELLO, A. G., C. MACHADO, J. F. BASTOS AND L. F. FELICIO. Sudden darkness induces a high activity-low anxiety state in male and female rats. PHYSIOL BEHAV 63(3) 451–454, 1998.—The effects of sudden darkness on spontaneous motor activity in an open field and performance in an elevated plus-maze (EPM) were assessed in adult male and female rats. In the open field test, sudden darkness increased total locomotion, locomotion in central squares, rearing frequency (RF), and diminished defecation units (DU). In the dark, total locomotion remained elevated during the 20-min test period, while in the light total locomotion decreased significantly after the fourth minute, in both sexes. All the effects of sudden darkness in the open field test were more pronounced in female rats. In the EPM, sudden darkness increased the number of entries into the open arms, total entries, percentages of entries into the open arms, and time spent in the open arms. The changes were more significant in female than in male rats. These results show that sudden darkness increases general motor activity and suggest it diminishes habituation, fear, and anxiety. The results also suggest that this behavioral shift is sexually differentiated. Sudden darkness emerges as an experimental tool to simultaneously test physiologically-induced increases in spontaneous motor activity and decreases in anxiety.

Explanatory models of anxiety from the viewpoint of biopsychology and pharmacopsychology

To understand the biological basis of anxiety, the following psychological aspects are discussed: The difference between "trait" and "state" anxiety, types of anxiety as related to knowledge about causes and consequences, anxiety as a chronological process involving coping strategies and different levels of responses. The lack of specificity is physiological indicators of anxiety is demonstrated by experiments based on electrodermal and cardiovascular responses. Among hormones, special emphasis is placed on the constellation between catecholamines and cortisol as being relevant for anxiety research. It is emphasized that configurations of hormone parameters may be more relevant predictors for anxiety than single response values, and the study of postoperative catecholamine and cortisol responses is used for demonstrating differences between patients in a high and low preoperative state of anxiety. Differences are observed only on the emotional and pain response levels, but not in physiological parameters. The neurophysiological model representing central nervous system substrates for anxiety is the behavioural inhibitory system described in the theory by Gray [17], and the most relevant transmitters noradrenaline, serotonin, and the GABA-system are discussed with regard to their relevance for anxiety in animal studies, in studies using provocation tests with pharmacological substances, and in clinical studies with anti-anxiety drugs. Experimental anxiety research in psychology is frequently characterised by significant interactions between many mediators of responses, in particular the type of stressor, the level of trait anxiety and other personality variables, and the type of substances used. It is concluded that stressors as well as drugs frequently do not specifically induce anxiety but may nonspecifically affect general arousal and may only be operating in certain groups and certain levels of stress intensity.

Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination

Evaluating the independent effects of psychosocial and physiological factors on survival of cardiac patients is difficult because it requires obtaining extensive physiological and psychosocial data and long-term follow-up of high-risk patients. To examine the independent contributions of psychosocial and physiological status to survival of patients who had had myocardial infarction. The sample consisted of 348 patients in the Cardiac Arrhythmia Suppression Trial who had asymptomatic ventricular arrhythmias after myocardial infarction. Psychosocial status was assessed with the Social Support Questionnaire-6, Social Readjustment Rating Scale, State-Trait Anxiety Inventory, Self-Rating Depression Scale, Jenkins Activity Survey, and Expression of Anger Scale. Physiological data included measurement of left ventricular ejection fraction; history of previous myocardial infarction, congestive heart failure, and diabetes; and results of Holter monitoring. At the first follow-up, after the effect of the physiological predictors was controlled for, psychosocial factors were significant independent predictors of survival. Among men in the nonactive medication group (n = 263), higher state anxiety, lower anger outward, more past life events, and lower expectations of future life events were predictors of mortality. Data suggested that the relationship of anger to mortality might differ for men and women. Increases in past life events and depression from baseline to first follow-up were greater among those who died than among those who lived. Among patients who had asymptomatic ventricular arrhythmias after myocardial infarction, psychological status during the period after infarction contributed to mortality beyond the effect of physiological status. The results reaffirm the critical interrelationship between mind and body for cardiovascular health.

Fooled by a Smile: Detecting Anxiety in Others

Results from this research on facial affect indicative of state anxiety suggest that expressors' smiles may have masked self-reported state anxiety such that judges were misled in their judgments of expressors' state anxiety. While in 17 earlier studies judges were highly accurate in detecting state anxiety, judges were unable to distinguish low from high state anxiety in the present samples, and sometimes rated expressors in high state-anxiety segments as more happy and likable than in low state-anxiety segments. The critical difference between the present and earlier studies seems to be the size of the image and the resulting fact that nonenjoyment smiles were more visible to judges.

Emotional and cognitive factors connected with response to cholecystokinin tetrapeptide in healthy volunteers

This article examines the effect of baseline anxiety, anxiety sensitivity and dysfunctional attitudes on the response to cholecystokinin tetrapeptide (CCK-4) in healthy volunteers. CCK-4 and placebo were administered to 14 subjects in a double-blind manner. Four volunteers experienced a panic attack after CCK-4 administration. Those subjects who panicked had significantly higher baseline scores on dysfunctional attitudes. Dysfunctional thought patterns appeared also to predict number of symptoms and experience of cognitive and affective symptoms during injection. Baseline anxiety as well as anxiety sensitivity predicted reactions to placebo but not panic responses to CCK-4. Results suggest that a general tendency towards erroneous interpretation of information has some role in mediating the panicogenic effects of CCK-4, and also interpersonal sensitivity may constitute a vulnerability factor for panic. Psychological factors that have been considered more specific to panic disorder, namely high state and trait anxiety as well as anxiety sensitivity, appeared mainly to determine general reactions to a threatening situation.

Detecting anxiety and defensiveness from visual and auditory cues.

Defensive individuals have been shown to differ from nondefensive individuals on a number of physiological and behavioral measures. We report two studies on observers' inferences of defensiveness, and the contribution of communication channels in the inference of defensiveness. Observers judged high and low state anxious segments of high and low trait anxious defensive and nondefensive individuals. Accurate assessments were made of (a) defensiveness, (b) state anxiety, and (c) trait anxiety: Individuals with higher levels of each variable were perceived as more anxious compared with the lower level. Effects for defensiveness and state anxiety were greater in audio-only segments, while effects for trait anxiety were greater in video-only segments. Inferences of defensiveness were greater at higher levels of state anxiety and trait anxiety. Low trait anxious defensive individuals were perceived as more anxious than the true low trait anxious. Results for defensiveness and trait anxiety were replicated in Study 2, and observers' perceptions of state anxiety matched individuals' self-reports: Defensive individuals with maximal differences between high and low state anxiety were seen as more anxious in high state anxiety, while defensive individuals with minimal differences between high and low state anxiety were regarded as less anxious in high state anxiety.

Epinephrine and fear of bodily sensations in panic disorder and social phobia

Fear of bodily symptoms of arousal has been implicated in the pathogenesis of both spontaneously occurring and experimentally provoked panic. Fear of bodily symptoms may be characteristic for panic disorder (PD) and is hypothesized to predict state anxiety and panic frequency during experimentally induced peripheral arousal. Twenty-eight subjects, 14 with PD and 14 with social phobia (SP) were infused with placebo and epinephrine (20, 40 and 80 ng/kg bodyweight/min) according to a fixed schedule in a single blind design. Fear of bodily symptoms was higher in subjects with PD, who also reported more bodily symptoms and higher state anxiety scores during the experiment. The panic rate (five out of 14), however, was the same in both groups. Panickers did not differ from non-panickers in trait- or baseline measures except for fear of bodily symptoms, which was marginally higher in panickers. Panickers showed greater reactivity in heart rate, diastolic blood pressure and capillary PCO(2). Our data do not support the hypothesis of a major role for fear of bodily symptoms in epinephrine-induced panic. Also, our results do not demonstrate a different reaction to epinephrine in PD and SP with situational panic attacks.

The benzodiazepine antagonist flumazenil is anxiolytic in high state anxiety and anxiogenic in low state anxiety in a study of 23 female animal phobics

tency with either a categorical view of panic disorder as a stable clinical entity or panic disorder as one facet only of a 'general neurotic syndrome'. Result: PSE profile at baseline was virtually identical with that at follow up. Few patients had 'changed' in PSE syndrome diagnosis after 5 to 6 years. Conclusion: These data, although not conclusive, are supportive of the concept of DSM III-R Panic Disorder as a stable clinical entity and are correspondingly difficult to reconcile with the view that Panic Disorder is but one facet only of a general neurotic syndrome.

Two-dimensional anxiety: A confirmation using a computerized neuropsychological testing of attentional performance

The aim of this study was to assess the effects of anxiety on attentional performance with neutral stimuli. It was set up as follows: a fourfold comparison was made of trait anxiety and state anxiety. Sixty-two undergraduate students were included in the study, and four groups of subjects were set up by a median split of the scores obtained on the Spielberger Trait and State Anxiety Inventory (STAI): high trait-high state (N = 18); high trait-low state (N = 11); low trait-low state (N = 23); low trait-high state (N = 10). A computerized battery of neuropsychological tests, the ACE battery, was administered to provide a multidimensional assessment of attention. The ACE battery comprises five tests which assess the following aspects of attention: ability to monitor a routine task; temporal preparation; visual detection; memory span; visual spatial attention and memory. High state anxious subjects displayed impairment in executive functions, manifested by a significantly higher level of motor preparation in a simple reaction time (RT) task and a speed accuracy trade-off in a divided attention task; high trait anxious subjects performed significantly better on the visual detection task. No trait x state interaction was found. It was concluded that high state anxiety is associated with psychomotor alertness and high trait anxiety with perceptual alertness. These two dimensions of psychometric anxiety seem to have effects on attention that are independent of one another and which should be analysed separately in the future.

Anxiety sensitivity, state anxiety and perceptions of facial emotions

We investigated relationships between anxiety sensitivity and perceptions of facial emotions following relaxation and hyperventilation. The Anxiety Sensitivity Index was administered to 606 female college undergraduates and samples of high ( n = 30) and low ( n = 25) scorers were obtained from the top and bottom 15% of the distribution. Following exposure to randomly counterbalanced 5-minute relaxation and hyperventilation instructions, participants rated the intensity of seven basic emotions in photographs of faces using a standardized test of affect-receiving ability. High ASI scorers perceived significantly more intense fear and anger than did low ASI respondents and reported relatively larger increases in ratings of sadness and fear following hyperventilation. ASI was significantly correlated with heightened state anxiety and vigilance prior to beginning the experiment, and these affects mediated interpersonal perceptions. Results suggest that high ASI scorers may manifest a chronic state of vigilance that triggers heightened anxiety in ambiguous situations. The combination of high anxiety sensitivity and state anxiety appears to foster greater sensitivity to interpersonal stimuli.

Lytic effector cell activity and major depressive disorder in patients with breast cancer: a prospective study

The study examined lymphokine-activated killer cell (LAK) and natural killer (NK) cell activity in breast cancer patients prior to surgery as compared to effector cell lysis in patients with non-malignant breast tumors, further in connection with lifetime diagnosis of major depression, severity of current depression, anxiety and coping styles. Follow up studies covered a period of 6 and 12 months. Prior to surgery, life time diagnosis of major depressive disorder, trait anxiety and coping styles did not discriminate patients as far as effector cell lysis is concerned. LAK activity but not NK activity was reduced in patients with actual depressive symptoms ( P < 0.01) and high state anxiety ( P < 0.05). These findings support the hypothesis that LAK activity is a state marker of actually existing depression and anxiety prior to surgery. Affective rather than coping measures showed significant differences in LAK activity. For LAK activity, 1 year after surgery the only predicting factors were Tamoxifen therapy and chemotherapy.

To drink or not to drink: Tests of anxiety and immobility in alcohol-preferring and alcohol-nonpreferring rat strains

Previous reports have provided mixed results about emotional states in rats that voluntarily drink substantial amounts of alcohol. The purpose of the present study was to compare several strains of alcohol-preferring rats (P, AA, FH) with several strains of alcohol-nonpreferring rats (NP, ANA, FRL), and the Maudsley strains on tests reflecting anxiety and immobility. At about 70 days of age the rats were placed in the elevated plus maze for a 5-min test; a forced swim test of 10 min was given 4 days later and this test was followed 4 days later by a modified forced swim test (the capsule), in which there were four false escape alleys. The FRL rats spent more time in the open arms of the elevated plus maze than any other strain, but there was no consistent relationship between elevated plus maze scores and alcohol intake. The alcohol-preferring P rats were the most active in the standard forced swim test and the alcohol-nonpreferring Maudsley Reactive rats were the least active, but there was no consistent relationship between immobility and alcohol intake overall. All rats were much more active in the capsule and there were no significant strain differences. However, the alcohol-preferring P and FH rats attempted to escape more than the other strains, resulting in an overall significant correlation between escape attempts and alcohol intake. These findings do not provide any support for the hypothesis that alcohol-preferring rats are drinking alcohol to reduce high anxiety states.

Hemisphere preference, anxiety, and covariation bias

In Study I, normal subjects ( N = 70) completed the Preference Test (PT), the Spielberger State-Trait Anxiety Inventory, and the Anxiety Sensitivity Index. Subjects with a preference for a right hemisphere thinking style (as indexed by PT) were found to have higher state anxiety and anxiety sensitivity scores than subjects with a left hemisphere thinking style. This finding is in line with the suggestion that the right hemisphere is involved in the development and maintenance of anxiety. Study II explored whether the relationship between right hemisphere preference and anxiety may result from the different cognitive characteristics that are attributed to the two hemispheres. It might well be that cognitive biases that are thought to maintain or exaggerate anxiety states (e.g. covariation bias), emerge from a right hemisphere mode of information processing. Therefore, it was investigated whether covariation bias is linked to right hemisphere preference. Subjects were exposed to a series of slides comprising pictures of spiders, weapons, and flowers. Slides were randomly paired with either a shock, a tone or nothing. Aposteriori, subjects indicated the contingencies of each stimulus/outcome combination. Data confirmed that anxiety was related to covariation bias. However, the hypothesis that cognitive biases are linked to a right hemisphere style of thinking was only partially sustained.

Depression in male and female patients undergoing cardiac surgery

The present longitudinal study was designed to determine the prevalence of depression in male and female patients undergoing cardiac surgery, and to examine what factors are associated with depression before and after surgery. One day prior to surgery (T1), and one day prior to discharge from the hospital (T2), 141 patients completed a psychometric test battery including the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), and the Perceived Social Support Scale (PSSS). Data were also collected on 13 physiological measures. Forty-seven per cent of patients were depressed (defined as a score of 16 or above on the CES-D) at T1. Scores on the CES-D significantly increased from T1 (M = 15) to T2 (M = 20), with 61 per cent of patients classified as depressed at T2. Factors associated with depression at T1 were female gender, higher state anxiety, and less social support. Depressed patients at T2 were characterized by higher scores on the STAI at T2 and higher scores on the CES-D at T1. The prevalence of depression in cardiac surgery patients, particularly women, may be underrecognized and warrants increased attention.

Perfectionism and components of state and trait anxiety

The association between dimensions of perfectionism and state and trait anxiety was examined in three studies. Study 1 and Study 2 were correlational studies that investigated the link between dimensions of perfectionism (i.e., self-oriented, other-oriented, and socially prescribed perfectionism) and the Endler Multidimensional Anxiety Scales (EMAS). Taken together, the results indicated that self-oriented and socially prescribed perfectionsim are correlated significantly with both the cognitive-worry and autonomic-arousal components of state anxiety. As for the trait anxiety measures, self-oriented perfectionism was associated with the ambiguous and social evaluation facets in Study 1, and socially prescribed perfectionism was associated with the ambiguous and daily routines facets in Study 2. The purpose of Study 3 was to examine perfectionism and state anxiety under conditions of high versus low ego involvement. It was found that socially prescribed perfectionism was associated with higher state anxiety, but only in the high ego involvement condition. Self-oriented perfectionism was unrelated to state anxiety in either experimental condition. Overall, the findings indicate that socially prescribed perfectionism is the dimension linked most closely with components of state and trait anxiety, especially under conditions of ego threat. The results are discussed in terms of the need for an interactional approach to the study of the social aspects of both perfectionism and anxiety.

The Role of Auditory Cues in the Detection of State Anxiety 1

Detecting anxiety is essential in both help‐giving settings and in everyday social relationships. The studies reported here represent a follow‐up to an earlier set of studies in which observers (raters) accurately identified others' (expressers') state anxiety using either video‐only cues or audio‐video cues. The earlier studies had included expressers who were repressors and nonrepressors, while the present studies included only nonrepressors. Observers viewedheard selected segments of previously videotaped expressers' self‐reported high and low state anxiety experiences. Surprisingly, unlike the earlier studies, state anxiety was significantly inaccurately evaluated when video‐only cues were used, but when audio cues were available, state anxiety was correctly identified. Information in video‐only cues seemed to mislead observers since low compared with high state anxiety was rated as more anxious. These studies, and the significant comparison between studies with audio cues present and with audio cues absent, indicate the impact of auditory cues in detecting state anxiety in others.