Levels Of Trait Worry Research Articles

Severity of Subjective Cognitive Complaints and Worries in Older Adults Are Associated With Cerebral Amyloid-β Load.

Subjective cognitive decline (SCD) is considered an early risk stage for dementia due to Alzheimer's disease (AD) and the development of pathological brain changes, such as the aggregation of amyloid-beta (amyloid-β) plaques. This study evaluates the association between specific features of SCD and cerebral amyloid-β load measured by positron emission tomography (PET) with 18F-florbetaben in 40 cognitively normal older individuals. Global amyloid-β, as well as regional amyloid-β load for the frontal, temporal, parietal, and cingulate cortex, was quantified. Specific features of SCD, such as subjective cognitive complaints and worry, were assessed using the 39-item Everyday Cognition Scales and the 16-item Penn State Worry Questionnaire. Spearman's rank partial correlation analyses, adjusted for age and apolipoprotein E ε4 status, were conducted to test the associations between specific features of SCD and cerebral amyloid-β load. The severity of subjective cognitive complaints in everyday memory and organization was positively correlated with amyloid-β load in the frontal cortex. In addition, the severity of subjective cognitive complaints in everyday planning was positively correlated with amyloid-β load in the parietal cortex. Higher levels of worry were associated with higher amyloid-β load in the frontal cortex. After correction of the PET data for partial volume effects, these associations were reduced to trend level. In conclusion, the severity of subjective cognitive complaints and the level of trait worry were positively associated with cortical amyloid-β burden, particularly in the frontal and parietal cortex. Further studies are required to elucidate the direction of these associations in order to develop strategies to prevent amyloid deposition and cognitive decline.

Severity of subjective cognitive complaints and worries in older adults are associated with cerebral amyloid‐β load

AbstractBackgroundSubjective cognitive decline (SCD) is considered an early risk stage for the development of Alzheimer's disease (AD) and pathological brain alterations, including the aggregation of amyloid‐β plaques (Jessen et al., Alzheimer's & Dementia 2014). This prospective study evaluates the association between specific features of SCD, including severity of subjective cognitive complaints and trait worry, and regional cerebral amyloid‐β load in cognitively normal older individuals.MethodCerebral amyloid‐β load was assessed by positron emission tomography with 18F‐florbetaben in 30 individuals with SCD (age 67 ± 4 years) at baseline in an ongoing interventional study (clinicaltrial.gov: NCT03094546) and in 10 healthy older adults (age 72 ± 8 years) following the same baseline protocol. Regional amyloid‐β load was quantified for frontal, temporal, parietal, and cingulate cortex using whole cerebellum as reference. Subjective complaints regarding different cognitive domains (memory, language, visuospatial abilities, planning, organization, and divided attention) were determined using the 39‐item Everyday Cognition Scales. Trait evaluation of pathological worry was captured by the self‐reported 16‐item Penn State Worry Questionnaire. Associations between specific features of SCD and cerebral amyloid‐β load were tested by age‐adjusted Spearman rank partial correlation analyses, uncorrected for multiple testing.ResultAcross all participants, severity of subjective cognitive complaints regarding memory, organization, and divided attention was positively correlated with amyloid‐β load in the frontal cortex (p = .008, .018, .024, respectively). Severity of subjective cognitive complaints regarding planning was positively correlated with amyloid‐β load in the parietal cortex (p = .025). Higher trait level of pathological worry was associated with higher amyloid‐β load in the frontal cortex (p = .031).ConclusionIn cognitively normal older individuals, severity of subjective cognitive complaints and level of trait worry are positively associated with cortical amyloid‐β burden, particularly in the frontal cortex. This region is considered a core region of the default mode network that is affected early in AD (Palmqvist et al., Nature Communications 2017). Interventions aiming to reduce rumination and worries may help prevent amyloid deposition in these regions, a hypothesis to be tested in future interventional trials.

Worry as a Mechanism to Motivate Information Seeking about Protective End-of-Life Communication Behaviors

Making known one’s end-of-life (EOL) care wishes via the processes of advance care planning (ACP) and advance directive (AD) completion is associated with many positive outcomes for patients including lower healthcare costs, greater patient-provider relationship satisfaction, increased quality of life, and more. Despite these benefits, fewer than 30% of patients in the United States engage in ACP or complete ADs. These low numbers are most likely due to several causes, including low self-efficacy and low motivation to engage in the process. Several researchers have examined the persuasive power of using worry to motivate patients to engage in preventive health behaviors. The present study expands upon this body of literature by examining patient intentions to seek information related to ACP and AD after being exposed to stimuli intended to arouse differing levels of worry regarding bad EOL outcomes. Participants (N = 804) were randomly assigned to either the high worry, low worry, or control group and asked to complete a questionnaire examining beliefs and information seeking intentions regarding ACP and AD completion. Additionally, to control for participants’ level of trait worry, each participant completed the Penn State Worry Questionnaire, which was treated as a covariate in the final analysis. A repeated measures MANCOVA found a statistically significant increase for the worrying conditions on the participants’ intention to seek information about ACP and ADs from time 1 to time 2 for those in the worry experimental conditions. However, those in the control group did not show a statistically significant increase. Additionally, exposure to the high worry condition was predictive of engaging in actual information seeking behavior about EOL care. Results of the experiment indicate worry is associated with greater motivation to engage in information seeking about ACP and AD. This study contributes to the literature on worry as a persuasive mechanism to motivate patients to engage in important preventative health behaviors.

Transcutaneous vagus nerve stimulation does not affect attention to fearful faces in high worriers

People suffering from chronic worries pay excessive attention to emotional information. In this study we examined whether a reduced ability to inhibit attention from fearful faces (i.e. inhibition of return; IOR) can be attributed to the low vagus nerve activity observed in high worriers. Our pre-registered hypothesis was that transcutaneous auricular vagus nerve stimulation (tVNS) would enhance IOR to fearful faces. Ninety-four students who scored above a pre-determined cut-off on the Penn State Worry Questionnaire were randomly allocated to receive either tVNS (n = 45) or sham stimulation of the earlobe (n = 49). Meanwhile, to assess IOR, they performed an emotional exogenous cueing task wherein neutral and fearful faces predicted the target location at chance level. Resting levels of HRV were also collected before stimulation onset. Results showed that levels of trait worry were associated with reduced IOR, but resting levels of HRV were not. Critically, tVNS did not affect performance on the exogenous cueing task when compared to sham stimulation. These findings did not confirm the hypothesized causal role of vagus nerve activity in maintaining disrupted IOR for emotional information. They also provide evidence that high levels of worry are associated with generally reduced IOR. This points to a clear need to understand the neurobiological basis of inhibitory problems in worriers.

Inducing unconscious stress: Cardiovascular activity in response to subliminal presentation of threatening and neutral words.

Stress-related cognitive processes may occur outside of awareness, here referred to as unconscious stress, and affect one's physiological state. Evidence supporting this idea would provide necessary clarification of the relationship between psychological stress and cardiovascular (CV) health problems. We tested the hypothesis that increases in mean arterial pressure (MAP) and total peripheral resistance (TPR) and decreases in heart rate variability (HRV) would be larger when threatening stimuli are presented outside of awareness, or subliminally, compared with neutral stimuli. Additionally, it was expected that trait worry and resting HRV, as common risk factors for CV disease, would moderate the effect. We presented a subliminal semantic priming paradigm to college students that were randomly assigned to the threat (n = 56) or neutral condition (n = 60) and assessed changes from baseline of MAP, TPR, and HRV. Level of trait worry was assessed with the Penn State Worry Questionnaire. The findings indicate that CV activity changed according to the hypothesized pattern: A higher MAP and TPR and a lower HRV in the threat condition compared with the neutral condition were found with practically meaningful effect sizes. However, these findings were only statistically significant for TPR. Furthermore, changes in CV activity were not moderated by trait worry or resting HRV. This is the first study to explicitly address the role of subliminally presented threat words on health-relevant outcome measures and suggests that unconscious stress can influence peripheral vascular resistance.

Trait worry is associated with difficulties in working memory updating

ABSTRACTThe current study investigated the effects of trait worry, a subcomponent of trait anxiety, on the process of updating information in working memory (WM). A leading theory on anxiety and executive functions, attentional control theory (ACT), states that anxiety is not related to WM updating in emotionally neutral situations. Previous research, however, has focused almost exclusively on WM span tasks that primarily emphasised storage, rather than the updating of WM representations. Moreover, few studies have directly examined the effects of trait worry. In this study, 116 subjects performed a WM updating task that required the memorisation of short lists of words and the within-trial removal of some of these items from WM. Results indicated that levels of trait worry were not related to word-span performance, but were related to performance on trials that required subjects to effectively update WM. Moreover, these effects were observed only for trait worry, not for levels of anxious arousal or comorbid levels of dysphoria. These results support the hypothesis that trait worry is related to WM updating performance and thereby extend ACT in new directions.

Beneficial effect of trait worry on episodic retrieval: A link overshadowed by trait anxiety

We investigated how individual differences in anxiety affect different forms of episodic retrieval. Specifically, we measured the level of trait anxiety and trait worry using well-known scales of these constructs and observed their impact on tasks requiring the recognition, cued recall or free recall of previously presented information. In a series of three experiments, using multiple linear regression analysis, we consistently found that trait anxiety and trait worry exert an opposite partial effect on free recall performance, a pattern referred to as suppression (e.g. McFatter, 1979, Tzelgov& Henik, 1991). Our results thus show that once the level of trait anxiety is controlled, higher levels of trait worry are associated with better performance in episodic memory tasks requiring effortful, strategic retrieval. We interpret our results using the cognitive avoidance theory of worry (Borkovec, Ray & Stober, 1998) and the attentional control theory of anxiety (Eysenck et al., 2007).

Worry as a Predictor of Fear Acquisition in a Nonclinical Sample

People seem to differ in their conditionability, that is, the ease by which fear associations (neutral stimulus-unconditioned stimulus [CS-US] contingencies) are learned. Recently, the level of trait worry has been proposed as a predictor of heightened conditionability. The current research aimed to (a) further investigate this influence of individual differences in trait worry on the strength of fear acquisition, (b) explore whether this association could be explained by trait anxiety, and (c) assess possible underlying mechanisms of this relationship. In a nonclinical sample, the amount of trait worry predicted heightened conditionability in a differential fear conditioning paradigm, both in fear ratings and in performance on a secondary probe reaction time task. A significant correlation was observed for general conditioning to the CS+ and also for differential conditioning (taking into account excitatory and inhibitory responding) in Experiment 1. These associations could not be fully explained by trait anxiety. US inflation and strengthening of the CS-US contingency through rehearsal are discussed as possible underlying mechanisms.

The rebound effect in the unsuccessful suppression of worrisome thoughts

The suppression of unwanted thoughts causes the subsequent increase in such thoughts, a phenomenon called the rebound effect of thought suppression. Thought suppression is an important factor in the cognitive model of generalized anxiety disorder (GAD). However, a limited number of studies examine the suppression of worrisome thoughts. The extent of success in suppressing thoughts varies across individuals. Moreover, unsuccessful suppression is associated with the rebound effect. Against this background, the present study investigated the influence of success and failure of suppression on the rebound effect for worrisome thoughts in relation to trait worry. A total of 47 undergraduates participated in an experiment comprising three phases of thought sampling tasks (baseline, suppression, and mention). In the suppression phase, they were required to suppress their main worrisome thought. In the subsequent phase (mention), they were instructed to think about anything they liked. Regression analysis revealed that unsuccessful suppression predicted the rebound effect in individuals with higher levels of trait worry. The findings substantiate the paradoxical effect of thought suppression on worry.

Anxiety and expectancy violations: Neural response to false feedback is exaggerated in worriers

This study investigated how individual differences in anxiety modulate the neural response to errors and performance feedback. The design included false feedback on some trials in order to test the hypothesis that anxious people show stronger neural reactions to feedback that is worse than expected. Participants completed a trial-and-error learning task that required learning the correct key to press in response to face images. EEG was recorded during the task, and the response-locked error-related negativity (ERN) and feedback-locked ERN were computed to measure neural responses to error commission and feedback. As expected, errors produced a response-locked ERN and false feedback produced a feedback-locked ERN in the group as a whole. High levels of trait worry predicted a disproportionately larger ERN following false feedback, but did not predict the magnitude of the response-locked ERN following errors. These results imply that worry-prone people react more strongly to violations of expectations, rather than to errors themselves.

Elucidating the Relationship between Worry and Physical Health

Research indicates a relationship between trait worry and physical health, such that individuals with high levels of trait worry display physical health problems (e.g., upper respiratory infections, cardiological problems, immune system impairment). However, existing studies do not address whether three constructs that are theoretically and empirically related to worry – trait anxiety, anxiety sensitivity, and depression – might better account for the observed relationship between worry and physical health status. Participants completed measures of trait worry, trait anxiety, anxiety sensitivity, depression symptom severity, and health status. Results indicated that worry serves as a proxy risk factor for health status through the influence of trait anxiety and depressive symptoms, with both of these variables being related to mental health status, and only trait anxiety being related to physical health status. Anxiety sensitivity did not explain the relationship between trait worry and either type of health status. Theoretical and clinical implications are discussed.