Levels Of Anxiety Symptoms Research Articles

Co-occurrence of internalizing difficulties and aggression in early childhood and risk of mental health problems in middle childhood

The goal of this prospective longitudinal study was to explore whether co-occurrent internalizing difficulties and aggression in early childhood convey increased risk for later mental health problems in middle childhood. Participants were mothers from the Norwegian Mother, Father and Child Cohort Study (MoBa), who provided assessments of child internalizing difficulties and aggression at ages 3 years (n = 54,644; 26,750 girls) and 5 years (n = 38,177; 18,794 girls), as measures of child depressive, anxiety, conduct-related, and oppositional defiant (OD) symptoms at age 8 years. Using latent profile analyses (LPA) of internalizing difficulties and aggression, four profiles were identified: low-symptom/normative; primarily internalizing; primarily aggressive; and co-occurrent. Among the other results, the co-occurrent group exhibited the highest levels of depressive, anxiety, and oppositional defiant symptoms at 8 years. Most children (78%) remained stable in their profile between ages 3 and 5 years. Among the transition patterns that emerged, transitions were observed both from the normative to a risk profile and vice versa. Children who remained stable within the co-occurrent profile or who transitioned from the co-occurrent profile to one of the other two risk profiles also exhibited more depressive, anxiety, and OD symptoms at 8 years of age, when compared with children who transitioned from the co-occurrent to the normative profile. The heterogeneity between early manifestation of internalizing difficulties and aggression, and specific type of later mental health symptoms not only supports a shared etiology between internalizing and externalizing difficulties but also points toward the need for person-centered monitoring in early childhood with further implications for early identification of difficulties and preventive measures.

The mental health impact of the ongoing Russian-Ukrainian war 6 months after the Russian invasion of Ukraine.

This study aimed to investigate the impact of the ongoing war in Ukraine on the mental health of Ukrainians, focusing on war-induced trauma, disturbances in self-organization, post-traumatic stress disorder, complex post-traumatic stress disorder, anxiety, stress, and depression. Data was collected from 703 participants 6 months after the full-scale invasion using a structured questionnaire that included sections on socio-demographic information, trauma-related issues, and mental health. The study found that levels of depression and anxiety were relatively low, while stress and resilience were relatively high among Ukrainians affected by the war. However, those who were directly exposed to military actions, physical violence, or severe human suffering had higher levels of anxiety, depression, stress, and trauma-related symptoms. The war experience varied by gender, age, and living conditions. Participants who stayed in Ukraine had significantly lower anxiety, depression, stress, and trauma-related symptoms compared to those who moved abroad. Anxiety, depression, stress, low resilience, and subjective satisfaction with living conditions were predictors of trauma-related symptoms, including PTSD and CPTSD. These findings suggest that the mental health of Ukrainians affected by the war was impacted differently depending on their level of exposure to violence and their living conditions. Additionally, the study identified several predictors of trauma-related symptoms, including PTSD and CPTSD, such as anxiety, depression, stress, low resilience, and subjective satisfaction with living conditions. Future research should further explore the relationships between trauma type, sociodemographic factors, resilience, stress, anxiety, depression, and PTSD and CPTSD to better understand the mediation mechanisms underlying these relationships and to develop effective interventions to support the well-being of Ukrainians during this difficult time.

Resilience, mindfulness, anxiety, and depression within a dual-continua model of mental health approach

Mental health research is often focused on alleviating psychological distress rather than increasing well-being. This study approached mental health from a dual-continua model (DCM) framework, which allows for distress and well-being to co-occur. The aims of the present study were to expand upon DCM literature by examining differences in psychological well-being indicators among a broad adult sample with varying levels of depression and/or anxiety symptoms. Our sample was comprised of adults in the United States (n = 1,170) who reported different levels of anxiety, depression, mindfulness, resilience, and satisfaction with life. Participants who reported high anxiety symptoms, high depression symptoms, both anxiety and depression symptoms, or neither were grouped by their level of reported life satisfaction (high or low). We predicted that groups with higher life satisfaction would report higher levels of resilience and trait mindfulness than groups with lower life satisfaction, irrespective of higher levels of anxiety and/or depression, consistent with a DCM of mental health. Our results indicated that higher life satisfaction was associated with higher levels of resilience in all groups except for the high depression with low anxiety group. Higher levels of life satisfaction were also associated with higher trait mindfulness in all but the high anxiety with low depression group. Implications for mental health treatment and prevention are discussed.

Out of time, out of mind: Multifaceted time perceptions and mental wellbeing during the COVID-19 pandemic

Individuals commonly report feeling rushed in industrial societies such as the United States. However, social and economic upheavals such as disasters, recessions, and pandemics complicate perceptions of time by disrupting routines and creating experiences of trauma. In existing research, time perceptions usually are studied separately, leaving unclear how individuals in the United States might experience time in multifaceted ways while working, caring, and grieving. Moreover, previous research has not established whether multifaceted time perceptions each carry independent influences on mental wellbeing, or how they are shaped by sociodemographic background or pandemic-related stressors. Drawing on national Gallup data collected during the COVID-19 pandemic (Spring 2021), we find that Americans generally report some degree of feeling rushed, and also perceive multiple types of time disorientation involving slowness, quickness, and days and weeks blending together. Perceptions that time is moving too quickly or too slowly show an inverse relationship, as expected. Feeling rushed and that days or weeks are blending together also show relationships with both of these perceptions over a 3-month recall period. Importantly, we find that each of these time perceptions is shaped uniquely by income, work hours, age, or having children at home, and that each matters for understanding levels of depressive and anxiety symptoms and overall sense of mastery or control in life. Pandemic-related stressors, including economic strain, working from home, homeschooling a child, and severe household conflict, also show considerable relationships with these multifaceted time perceptions.

Perfectionism, Academic Stress, Rumination and Worry: A Predictive Model for Anxiety and Depressive Symptoms in University Students From Colombia

Perfectionism, academic stress, worry, and rumination are associated with increased levels of anxiety and depressive symptoms in university students. However, associations between these variables have been explored separately. Using PLS-SEM, the present study explored a multivariate model in which these variables interplay to predict affective symptoms. A sample of 403 students between ages 18 and 29 years from 55 Colombian institutions of higher education participated by completing Zung depression and anxiety scales, the Multidimensional Perfectionism Scale, the Inventory of Academic Stress, the Penn State Worry Questionnaire, and the Ruminative Responses Scale. Results indicate a positive relationship between perfectionism and academic stress, and a mediation effect of worry and rumination in the relationship between academic stress and anxiety and depressive symptoms. Findings provide evidence of a novel model that precedes the design of target prevention and intervention programs pointing to reduce the risk of affective disorders and its associated negative consequences.

Depression and anxiety before and at the beginning of the COVID-19 pandemic and incident persistent symptoms: a prospective population-based cohort study.

Many patients affected by COVID-19 suffer from debilitating persistent symptoms whose risk factors remained poorly understood. This prospective study examined the association of depression and anxiety symptoms measured before and at the beginning of the COVID-19 pandemic with the incidence of persistent symptoms. Among 25,114 participants [mean (SD) age, 48.72 years (12.82); 51.1% women] from the SAPRIS and SAPRIS-Sérologie surveys nested in the French CONSTANCES population-based cohort, depression and anxiety symptoms were measured with the Center for Epidemiologic Studies-Depression scale and the 12-item General Health Questionnaire before the pandemic, and with the 9-item Patient Health Questionnaire and the 7-Item Generalized Anxiety Disorder scale at the beginning of the pandemic (i.e., between April 6, 2020 and May 4, 2020). Incident persistent symptoms were self-reported between December 2020 and January 2021. The following variables were also considered: gender, age, educational level, householdincome, smoking status,BMI, hypertension, diabetes, self-rated health, and SARS-CoV-2 infection according to serology/PCR test results. After a follow-up of seven to ten months, 2329 participants (9.3%) had been infected with SARS-CoV-2 and 4262 (17.0%) reported at least one incident persistent symptom that emerged from March 2020, regardless of SARS-CoV-2 infection. In multi-adjusted logistic regression models, participants in the highest (versus the lowest) quartile of depressive or anxiety symptom levels before or at the beginning of the pandemic were more likely to have at least one incident persistent symptom (versus none) at follow-up [OR (95%CI) ranging from 2.10 (1.89-2.32) to 3.01 (2.68-3.37)], with dose-response relationships (p for linear trend <0.001). Overall, these associations were significantly stronger in non-infected versus infected participants, except for depressive symptoms at the beginning of the pandemic. Depressive symptoms at the beginning of the pandemic were the strongest predictor of incident persistent symptoms in both infected and non-infected participants [OR (95%CI): 2.88 (2.01-4.14) and 3.03 (2.69-3.42), respectively]. In exploratory analyses, similar associations were found for each symptom taken separately in different models. Depression and anxiety symptoms should be tested as a potential target for preventive interventions against persistent symptoms after an infection with SARS-CoV-2.

To Guide or to Self-Guide?: Predictors of Preferring a Guided Introduction to Digital Resources That Promote Postpartum Mental Health

The first postpartum year presents threats to the mental health of birthing parents and obstacles to accessing care. Digital mental health interventions (DMHIs) hold potential to increase postpartum mental healthcare access. However, DMHIs tend to promote limited engagement particularly when they are self-guided (when they do not involve contact with a provider). Yet, given that provider support is a limited resource, a balance must be struck between accessibility and intervention intensity (i.e., involving more human contact). Towards achieving this balance, this analysis seeks to identify characteristics that are associated with a reported preference for a human-guided introduction to digital resources aimed at promoting postpartum mental health. In a sample of largely White, non-Latinx, employed, married, and graduate school-educated individuals, multivariate logistic regression revealed that age (p = 0.0095), level of postpartum functioning (p = 0.0057), depression symptoms (p = 0.0099), and anxiety symptoms (p = 0.03) were associated with guide preference. Specifically, more anxious or lower-postpartum-functioning individuals were more likely to report preferring a guide while older or more depressed individuals were less likely to report preferring a guide. These findings can inform clinical recommendations surrounding who is most likely to engage with, and thus benefit from, exclusively self-guided DMHIs during the postpartum period.

Collective Self-Esteem and Well-Being Among College Students in Ghana

Abstract: Collectivist values may influence one’s display of self-esteem. Past research has established an association between psychological well-being and individuals’ appraisal of their value as a member of a social group, self-evaluation as an individual, and perception of others’ evaluation of their group (collective self-esteem). This study examined collective self-esteem, specifically whether private and public collective self-esteem and member self-esteem predicted psychological well-being alongside individual self-esteem in a sample ( N = 416) of university students in Ghana. A linear regression tested the predictive ability of collective self-esteem for depression and anxiety symptoms. The results indicated that while individual self-esteem was related to lower levels of anxiety and depression symptoms, collective self-esteem was unrelated. In our sample of Ghanaian students, these findings suggest that personal self-esteem is more meaningful than collective self-esteem for their psychological well-being. This knowledge is instrumental for informing mental health interventions for this group.

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

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

A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)

BackgroundA close association between obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents has been investigated in previous studies. However, few studies examined the relationship between lifetime comorbidity of ADHD and OCD in adults. Therefore, we sought to investigate the clinical and psychopathological features related to comorbid ADHD in Japanese adult patients with OCD. MethodsWe assessed lifetime comorbidity of ADHD in 93 adult Japanese patients with OCD. Additionally, we used the Japanese version of Conners' Adult ADHD Rating Scales to assess the characteristics and severity of ADHD in each participant. According to the results, we excluded OCD patients that did not have ADHD but who exhibited elevated levels of ADHD traits. We compared OCD patients with ADHD (ADHD+ group) and those without ADHD or its trait (ADHD− group) in terms of background profiles and clinical features, such as OCD symptomatology and psychometric test results. Additionally, the 6-month treatment outcome was compared prospectively between groups. ResultsOf the 93 OCD participants, the prevalence of lifetime comorbidity of ADHD was estimated as 16.1%. Compared with the ADHD− group, participants in the ADHD+ group had an earlier age of onset of OCD, higher frequencies of hoarding symptoms, higher levels of depressive and anxiety symptoms and lower quality of life, more elevated levels of impulsivity, and higher rates of substance or behavioral addiction and major depression. Finally, the mean improvement rate on the Yale-Brown Obsessive Compulsive Scale after 6 months of standardized OCD treatment in the ADHD+ group (16.1%) was significantly lower than that in the ADHD− group (44.6%). ConclusionThe lifetime comorbidity of ADHD is likely to exert a significant effect on clinical features and treatment outcome in adult patients with OCD. It is important to consider that underlying ADHD pathology may function as a facilitator for increased severity of global clinical features and treatment refractory conditions in OCD patients. Further studies are required to examine treatment strategies for such patients.

Neurocognitive and clinical characteristics of elementary school-aged children with a history of suicidal thoughts and behaviors

BackgroundSuicidal thoughts and behaviors (STBs) in elementary school-aged youth have increased in recent years. Understanding the risks associated with childhood STBs is necessary for prevention efforts. MethodsThe current study examined clinical and neurocognitive characteristics of a community sample of elementary school-aged children with (STB+) and without (STB-) a history of STBs. The final sample included 93 families with children average age of 7.8 years (SD = 1.3). Children in this sample were racially diverse, evenly split by sex, and most identified as non-Hispanic. Neurocognitive functioning was assessed using computerized behavioral measures. Child clinical characteristics were assessed using self-report measures and STB history was assessed using semi-structured interviews. ResultsOf the 93 families, 64 STB- children and 29 STB+ children participated. On average, STB+ children were older, reported higher levels of depressive and anxiety symptoms, and were more likely to have a parental history of suicidal behavior (PH+). Regarding neurocognitive functioning, STB+ children exhibited lower raw scores for both the NIH Dimensional Change Card Sort Task (NIH-DCCS) and NIH Flanker Inhibitory Control and Attention Test (NIH-Flanker). Multivariable regression analyses revealed raw scores for NIH-DCCS and NIH-Flanker, PH+ status, and child age were associated with childhood STBs. LimitationsProspective data is needed to confirm cross-sectional findings. ConclusionsPoorer neurocognitive functioning and PH+ status may serve as risk markers for STBs in elementary school-aged children. Targeting prevention programming for these risks may reduce the likelihood of STBs in at-risk elementary school-aged youth.

Adolescent Anxiety, Depression and Flourishing before and During COVID-19 and the Predictive Role of Baseline Psychological Capital (PsyCap) on Student Mental Health and Subjective Wellbeing During the Pandemic.

Studies indicate the COVID-19 pandemic has resulted in rises in adolescent mental health symptoms globally, although the impact of the pandemic on subjective wellbeing is under-researched in this population. Psychological capital (PsyCap), a cluster of four positive psychological constructs comprising hope, efficacy, resilience and optimism (HERO), has demonstrated preventative and promotive qualities on mental health symptoms and subjective wellbeing outcomes with adult populations (employees, university students). However, PsyCap's influence on these outcomes in young people is unclear. The present exploratory study investigated changes in self-reported anxiety and depressive symptoms (measured via the RCADS-SV) and subjective wellbeing (measured by the Flourishing Scale) from pre-pandemic levels to 3 months into the pandemic and explored gender differences at each time point in a sample of Australian Year 10 students (N = 56, Mage = 14.93 years, SD = 0.50, 51.8% male). The longitudinal predictive role of baseline PsyCap on follow-up assessments of anxiety symptoms, depressive symptoms and flourishing were also examined. There were no significant changes in levels of anxiety and depressive symptoms between the timepoints, but flourishing significantly declined from T1 to T2. Baseline PsyCap was not a significant predictor of T2 anxiety and depressive symptoms but was a significant predictor of T2 flourishing. Further, different baseline HERO constructs predicted T2 mental health symptoms and flourishing. Future larger studies building on the current preliminary findings investigating the roles of student PsyCap, mental health and subjective wellbeing are warranted to better understand these constructs in the COVID-19 era and beyond.

Comparison of stigmatizing views towards COVID-19 and mental disorders among adolescent and young adult students in China.

Infectious diseases including COVID-19 and mental disorders are two of the most common health conditions associated with stigma. However, the comparative stigma of these two conditions has received less attention in research. This study aimed to compare the prevalence of stigmatizing views toward people with COVID-19 and mental disorders and the factors associated with these views, among a large sample of adolescent and young adult students in China. A total of 9,749 adolescents and young adults aged 15-24 years completed a survey on stigmatizing attitudes toward COVID-19 and mental disorders, as well as mental health-related factors, including general mental health status and symptoms of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD). Multivariable linear regression analyses were conducted to identify factors associated with stigmatizing views. The prevalence of COVID-19 and mental disorders-related stigma was 17.2% and 40.7%, respectively. COVID-19-related stigma scores were significantly higher among male students (β = 0.025, p < 0.05), those without quarantine experience (β = 0.035, p < 0.001), those with lower educational level (p < 0.001), those with lower family income (p < 0.01), and those with higher PTSD symptoms (β = 0.045, p < 0.05). Mental disorder-related stigma scores were significantly higher among individuals with average and lower-than-average levels of family income (p < 0.01), depression symptoms (β = 0.056, p < 0.001), anxiety symptoms (β = 0.051, p < 0.001), and mental health problems (β = 0.027, p < 0.05). The stigma of mental disorders is higher in the youth population than the stigma of COVID-19. Factors associated with stigmatizing attitudes toward people with COVID-19 and mental disorders varied across the youth. Stigma-reduction interventions among the youth should be targeted specifically to COVID-19 or mental disorders conditions.

After one year in university; a robust decrease in autistic traits reporting among autistic students.

Previous research on autistic students enrolled in university support programs has reported moderate improvement in anxiety/depression or adaptive behavior. However, alterations in autistic traits have not been examined. This longitudinal study evaluated changes in university students' autistic trait and state/trait anxiety levels. Participants were 24 neurotypically developed (ND) students with high levels of social anxiety symptoms (High SA), 30 ND students with low levels of SA symptoms (Low SA), and 41 autistic students (the primary focus of this study) residing with an ND peer student mentor as part of participating in the university's integration support program. Autism spectrum quotient [AQ and State Trait Anxiety Inventory STAI] data were collected during the first semester of two consecutive academic years (T1, T2), as well as baseline (T1) levels of social anxiety, depression, and obsessive-compulsive symptoms. Significant interaction between group and time was observed, denoting a sharp decrease (2.9 SD) from T1 to T2 in the overall autistic trait level among the autistic group (AQ "attention switching" subscale demonstrating the most robust decrease), and a moderate decrease (0.5 SD) among the high SA group. Only for the autistic students were more compulsive symptoms at T1 associated with a lesser decrease in AQ scores (T1-T2), which in turn was negatively correlated with their T1 year-end grade point average. The findings suggest that attending post-secondary education (while partaking in a support/transition program) is followed by a profound change of the individual's subjective experience of autism, characterized by a sharp decline in the level of autistic traits, particularly attention switching. This change is independent of alterations in well-being indices, such as anxiety, that are known to characterize students attending university.

Death Anxiety Among Pakistani HCWs: The Role of COVID-19 Vaccine Acceptance and Positive Religious Coping Strategy.

Background: The mental health of healthcare workers (HCWs) has been significantly impacted by the COVID-19 pandemic. To address this, spirituality and religious coping mechanisms have been suggested as a way to maintain well-being and reduce anxiety levels. Additionally, vaccination has been shown to play an essential role in lowering anxiety levels, including death anxiety. However, there is a lack of evidence on how positive religious coping strategies and COVID-19 immunization affect death anxiety levels. To fill this gap, this study uses a Pakistani HCWs sample. Methods: This study collected cross-sectional data from 389 HCWs on socio-demographics, positive religious coping strategies, vaccine acceptance, and death anxiety. Hypothesis testing was done using Statistical Package for the Social Sciences (SPSS) and Partial Least Squares (PLS) by adopting the Structural Equation Modeling (SEM) technique. Results: The results showed that the positive religious coping strategy and acceptance of the COVID-19 vaccine reduced death anxiety among HCWs in Pakistan. HCWs practicing the positive religious coping strategy and vaccine acceptance had lower levels of death anxiety symptoms. Thus, the positive religious coping strategy has a direct effect on reducing death anxiety. Conclusion: In conclusion, COVID-19 immunization positively affects individual mental health by reducing death anxiety. Vaccines protect individuals from COVID-19 infection, providing a sense of security that reduces the chance of death anxiety among HCWs attending to COVID-19 patients.

A validation of the Dutch version of the Awareness of Narrative Identity Questionnaire (ANIQ-NL).

Individuals build a narrative identity through the construction of an internalised, unfolding life story based on significant autobiographical memories. The current study validated a Dutch version of the Awareness of Narrative Identity Questionnaire (ANIQ-NL), which assesses how aware individuals are of having a narrative identity as well as their perception of the global coherence within their autobiographical memories, specifically, in terms of temporal ordering, causal connections and thematic integration. The questionnaire was administered to 541 adults (65.1% female, Mage = 34.09, SDage = 15.04, age range = 18-75). The results of a confirmatory factor analysis provided evidence for a four-factor structure, consisting of awareness and the three coherence subscales. The factor loadings of the items varied between .67 and .96. Moreover, the ANIQ-NL subscales showed good to excellent internal consistency, with Cronbach's alphas ranging from .86 to .96. Furthermore, higher levels of perceived autobiographical memory coherence were found to be significantly correlated to lower levels of depression, anxiety, and stress symptoms. The ANIQ-NL was determined to be a valid and reliable tool to measure narrative identity awareness and perceived narrative coherence. Future research could utilise the ANIQ-NL to further investigate the role of narrative identity in psychological well-being.

P-567 The role of self-criticism in the relationship between infertility-related stress and anxiety and depression symptoms in women facing infertility

Abstract Study question Can self-criticism help to explain the relationship between infertility-related stress and anxiety and depression symptoms in women facing infertility? Summary answer Women with higher infertility-related stress presented also with higher anxiety and depression symptoms and their self-criticism attitudes help to explain this relationship. What is known already Infertility is a demanding and potentially stress-inducing medical condition, which can trigger anxiety and depression symptoms in women. Feelings of being inadequate, failing to achieve a major life goal, and experiences of shame might develop dysfunctional strategies such as self-criticism attitudes. Self-criticism has been associated with poor mental health outcomes. However, in the field of infertility, the role of self-criticism in the relationship between infertility-related stress and anxiety and depression symptoms has never been explored. Study design, size, duration This cross-sectional study was conducted between December 2021 and March 2022. Women (in a heterosexual relationship), having an infertility diagnosis and/or trying to conceive for more than 12 months and aged between 18 and 45 years were invited to participate in the study. Data were collected through an online platform, after the dissemination of the study on social media created specifically for this purpose, through a snowball strategy. Participants/materials, setting, methods The sample was composed of 130 women.Participants completed a self-reported questionnaire including demographic, health data, and measures of infertility-related stress (COMPI), self-criticism (FSCRS), and anxiety and depression symptoms (DASS-21). A mediation model using PROCESS was used to test whether the relationship between infertility-related stress and anxiety and depression symptoms is mediated by self-criticism. Psychological support was used as a control variable since preliminary analyses revealed that this variable has a multivariate effect on the outcomes. Main results and the role of chance Women were on average 34 years old and the majority were married. Seventy-three percent had already undergone fertility treatments and the most frequent diagnosis was unexplained infertility and female factor. About 30% were having psychological support. The results obtained through the mediation models showed significant direct effects on the relationship between infertility-related stress and anxiety (b = .13, SE = .05, p &amp;lt; .01) and depression symptoms (b = .30, SE = .05, p &amp;lt; .001), indicating that higher levels of infertility-related stress are associated with higher levels of anxiety and depression symptoms. Significant indirect effects were also identified between infertility-related stress and depression symptoms (SE = .02; IC de 95 % [.0167, .1124]) and between infertility-related stress and anxiety symptoms (SE = .05; IC de 95 % [.0100, .0906]), through self-criticism showing that this relationship can be explained by self-critical attitudes. Limitations, reasons for caution Due to the nature of our sample, the results need to be interpreted with caution. The cross-sectional design does not allow to draw causal directions; further longitudinal studies exploring the role of these variables are needed and exploring the role of possible confounders. Studies including men are needed as well. Wider implications of the findings This work highlighted the role of self-criticism as explaining the relationship between infertility-related stress and anxiety and depression symptoms. Psychological support aiming to promote self-compassion (in contrast with self-criticism) attitudes might help to develop more functional strategies and contribute to better mental health outcomes in women facing infertility. Trial registration number NA

Psychological disturbances encountered by the healthcare professionals, military professionals and general public in Sri Lanka during COVID-19 pandemic: a cross-sectional study

BackgroundThe COVID-19 pandemic is a serious global health concern, posing a greater risk of psychological vulnerabilities for frontline healthcare workers (HCWs), military professionals and the general public around the globe. These psychological issues appear to be long lasting and heighten the risk of mental health disorders. Therefore, this study aimed to identify psychological problems encountered by HCWs, military professionals, and the general public in Sri Lanka during the COVID-19 pandemic.MethodsA descriptive cross-sectional study was undertaken with 367 participants, including frontline HCWs (n = 128), military professionals (n = 102), and the general public (n = 137). Depression and anxiety were assessed using the Peradeniya Depression Scale (PDS) and the Generalized Anxiety Disorder scale (GAD-7), respectively.ResultsMean (± SD) age of the participants was 35.0 (± 10.6) years. A reasonable proportion of participants experienced depressive symptoms (39.25%, n = 144) and severe anxiety (12.8%, n = 47). Military professionals showed depressive symptoms (73.50%, n = 75) and severe anxiety (32.4%, n = 33) predominantly. Multivariate binary logistic regression revealed that only the level of education and professional engagement affected depressive symptoms and severe anxiety (p < 0.01). Having a high level of education was a protective factor for depressive symptoms (Adjusted OR = 0.34) compared to lower-level education, while being a HCW (Adjusted OR = 4.40) and military professional (Adjusted OR = 5.43) were identified as risk factors for depressive symptoms compared to the general public. Similarly, having a high level of education was a protective factor for severe anxiety (Adjusted OR = 0.29) compared to lower-level education, while being a HCW (Adjusted OR = 3.90) and military professional (Adjusted OR = 4.52) were identified as risk factors for severe anxiety compared to the general public.ConclusionThe current study revealed a greater level of anxiety and depressive symptoms among frontline HCWs and military professionals in Sri Lanka during the pandemic of COVID-19 compared to the general public. Therefore, providing psychological first aid for them to better deal with mental problems and an emergency preparedness plan to deal with sudden outbreaks of infectious situations are important.

Data-Driven Pupil Response Profiles as Transdiagnostic Readouts for the Detection of Neurocognitive Functioning in Affective and Anxiety Disorders

BackgroundNeurocognitive functioning is a relevant transdiagnostic dimension in psychiatry. As pupil size dynamics track cognitive load during a working memory task, we aimed to explore if this parameter allows identification of psychophysiological subtypes in healthy participants and patients with affective and anxiety disorders. MethodsOur sample consisted of 226 participants who completed the n-back task during simultaneous functional magnetic resonance imaging and pupillometry measurements. We used latent class growth modeling to identify clusters based on pupil size in response to cognitive load. In a second step, these clusters were compared on affective and anxiety symptom levels, performance in neurocognitive tests, and functional magnetic resonance imaging activity. ResultsThe clustering analysis resulted in two distinct pupil response profiles: one with a stepwise increasing pupil size with increasing cognitive load (reactive group) and one with a constant pupil size across conditions (nonreactive group). A larger increase in pupil size was significantly associated with better performance in neurocognitive tests in executive functioning and sustained attention. Statistical maps of parametric modulation of pupil size during the n-back task showed the frontoparietal network in the positive contrast and the default mode network in the negative contrast. The pupil response profile of the reactive group was associated with more thalamic activity, likely reflecting better arousal upregulation and less deactivation of the limbic system. ConclusionsPupil measurements have the potential to serve as a highly sensitive psychophysiological readout for detection of neurocognitive deficits in the core domain of executive functioning, adding to the development of valid transdiagnostic constructs in psychiatry.

Baseline depressive symptoms as predictors of efficacy and tolerability of the treatment with duloxetine: a network analysis approach.

Depression is considered one of the most prevalent and burdensome mental disorders. Only 50-60% of patients respond to first-line treatment. Individuals with depression might benefit from personalized treatment, tailored to the individual needs of the patient. In this study, we aimed to explore the baseline characteristics of depressive symptoms associated with a good response to duloxetine treatment using a network analysis. Additionally, the relationship between baseline psychopathological symptoms and treatment tolerability was assessed. The sample of 88 drug-free patients with active depressive episode, who started monotherapy with increasing doses of duloxetine were evaluated. The Hamilton Depression Rating Scale (HAM-D) was used to assess depression severity and the UKU side effect rating scale to monitor adverse drug reactions (ADRs). A network analysis that explored interactions of specific baseline depression symptoms, treatment efficacy and tolerability was performed. The node representing duloxetine treatment efficacy was directly connected to the nodes representing the first HAM-D item ("depressed mood") (edge weight = 0.191) and duloxetine dose (edge weight = 0.144). The node representing ADRs was directly connected to only one node representing the baseline score of the HAM-D anxiety (psychic) item (edge weight = 0.263). Our findings indicate that individuals with depression presenting greater levels of depressed mood and lower levels of anxiety symptoms might better respond to the treatment with duloxetine in terms of efficacy and tolerability.