Low Anxiety Group Research Articles

B - 108 Sleep Disordered Breathing, Cognition, and Anxiety in Young Adults

Abstract Objective Sleep disordered breathing (SDB) describes abnormal breathing during sleep due to upper airway dysfunction. SDB and anxiety are associated and independently affect cognition. The purpose of this study was to examine these associations among young adults in the domains of executive function, attention, working memory (WM), and long-term memory (LTM). Method Bronx students (N = 49, Mage = 19.8 years (SD = 1.30), female = 65%) were recruited via flyers. SDB risk assessment utilized the Berlin Questionnaire. Cognitive assessment included the Modified Rey Auditory Verbal Learning Test, Trail Making Test A and B, Controlled Oral Word Association Test, and the Cogstate computerized battery (Groton Maze Learning Test, Identification Test, One Back Test, Two Back Test, and Groton Maze Learning Test Recall). Anxiety was assessed with the Depression, Anxiety, and Stress Scales. Individuals in the normal/mild ranges were categorized in the low anxiety group, and individuals in the moderate/severe/extremely severe ranges were categorized in the high anxiety group. Results Anxiety symptoms moderated the relationship between SDB risk and WM. For high anxiety individuals, as SDB risk increased, performance on WM measures decreased (F(1,45) = 6.06, p = 0.02, η2 = 0.12). There was a trend for anxiety symptoms to moderate the relationship between SDB risk and LTM – among high anxiety individuals, as SDB risk increased, performance on LTM decreased (F(1,44) = 4.04, p = 0.05, η2 = 0.084). Conclusion For young adults, anxiety symptoms moderated the relationships between SDB and WM and between SDB and LTM, suggesting that mild levels of anxiety may have a beneficial effect on the relationship between SDB and cognition, while more severe anxiety may worsen that relationship.

The Memory Bias Toward Negative Context in Episodic Memory in Anxiety Individuals—An Exploratory Study Through ERPs

In order to explore the memory bias toward negative context in anxiety individuals, this study explored the cognitive neural mechanisms of at different cognitive process amongst 30 college students (high and low anxiety groups of 15 people each) by using event-related potentials (ERPs) measurement and source memory multiple-task paradigm. At first, it was found that the ERPs of fearful was stronger than the neutral background in the condition of hit <sub>item w/ source </sub>(both the old item and the source were judged correctly), hit item<sub> w/o source</sub> (the old item was judged correctly and the source was not judged correctly) and latter forgotten (both the old item and the source were not judged correctly) generally in the encoding phase. Combined with the behavior data, reaction times of hit item <sub>w/o source</sub> in fearful context were fasten than neutral context. Secondly, as for the memory bias, ERPs were more positive in fear context than neutral context at Fcz/Cz/Cpz in the 700-900ms in the high anxiety group under the condition of hit <sub>item w/o source</sub>. In addition, ERPs were more positive in fear context than neutral context in the 300-500ms under the condition of latter forgotten in the high anxiety group. In conclusion, the memory bias towards negative stimuli in anxiety individuals was found in the encoding phase, indicating that anxiety still had an impact in the early stages of processing, but not in the deep processing.

Anxiety and its relationship to demographic and personality traits data among special operations divers: a cross-sectional study

IntroductionSpecial operation diving is becoming increasingly prevalent but has received less attention. The anxiety profile in special operation divers and its influencing factors remain unclear, posing great challenges to medical...

Social anxiety modulating early processing for social threat words: an ERP study

ABSTRACT Even though some recent research revealed individuals with HSA typically display enhanced processing in the early stages of emotional information processing due to hypervigilance and vulnerability to negative stimuli, it is still unclear whether social anxiety affects the time course underlying processing bias for emotional stimuli. Therefore, the present study aimed to explore the early stage of processing social threat stimuli in high social anxiety (HSA) individuals by recording RTs and EEG data in the emotional Stroop task. Behavioral data showed that the HSA group responded to the threat words faster than neutral words (i.e. negative bias), but no emotional effects in the low social anxiety (LSA) group. Although the P1 component did not show any early effects, ERP data exhibited an enhanced N170 for HSA than for LSA groups. Threat words elicited larger N170 than neutral words in the LSA group only; this emotion effect was not evident in the HSA group. These findings indicated that social anxiety modulates early processing for social threat words. This study revealed the neural mechanisms underlying early emotional processing in individuals with social anxiety, providing insights for the evaluation and intervention of social anxiety.

Assessing the Influence of Patient Anxiety on the Efficacy of Endodontic Procedures.

Patient anxiety is known to influence various aspects of dental procedures, including endodontic treatments. However, the extent of its impact on the efficacy of such procedures remains uncertain. Understanding this influence is crucial for improving patient outcomes and optimizing treatment protocols. A prospective cohort study was conducted involving 100 patients undergoing endodontic procedures. Patient anxiety levels were assessed using standardized anxiety scales before and after treatment. The efficacy of endodontic procedures was evaluated based on posttreatment pain scores, success rates of root canal treatments, and patient-reported satisfaction levels. The mean pre-treatment anxiety score was 45.7 (SD = 9.2), while the mean posttreatment anxiety score reduced significantly to 32.4 (SD = 7.6), indicating a significant reduction in anxiety levels following endodontic procedures (P < 0.001). Posttreatment pain scores were lower in patients with reduced anxiety levels, with an average pain score of 2.1 (SD = 1.3) compared to 3.8 (SD = 1.6) in patients with persistently high-anxiety levels (P = 0.002). Additionally, the success rate of root canal treatments was higher in patients with lower anxiety levels (85%) than those with higher anxiety levels (65%) (P = 0.015). Overall patient satisfaction was also significantly higher in the low-anxiety group (P < 0.001). Patient anxiety significantly influences the efficacy of endodontic procedures, affecting posttreatment pain, success rates of root canal treatments, and patient satisfaction levels. Efforts to reduce patient anxiety before and during endodontic procedures may lead to improved treatment outcomes and higher patient satisfaction.

Exploring the Influence of Students' Anxiety on English Language Learning in Online Integrated Instruction

This research explores the influence of online integrated learning on students’ anxiety within the English Language Education Program at Muhammadiyah University of East Kalimantan (UMKT). The study investigates the impact of online integrated learning in the English General Course on students' anxiety levels. It examines significant differences in anxiety levels between students actively using online platforms and those who do not. The sample consisted of 117 freshmen, with data collected via questionnaires assessing comfort with technology, perceptions of its effectiveness, and its impact on anxiety levels. Statistical analyses, including descriptive statistics, the One-Sample Kolmogorov-Smirnov Test, ANOVA, and Bonferroni multiple comparisons, were employed to provide a comprehensive understanding of the findings. Key results indicate a mean anxiety score of 41.55 and a mean achievement score of 78.21, reflecting moderate anxiety and relatively high academic performance. The One-Sample Kolmogorov-Smirnov Test confirmed the normal distribution of the data (p &gt; 0.05), justifying the use of parametric methods. ANOVA results showed significant differences in anxiety levels and English scores based on online integrated learning (F = 166.159, p &lt; 0.001). Bonferroni multiple comparisons revealed that lower anxiety was associated with higher English scores, with significant mean differences observed between low, medium, and high anxiety groups (p &lt; 0.001). These findings suggest that online integrated learning significantly impacts students' anxiety levels, which in turn affects their academic performance. The study provides valuable insights for educators and policymakers on the importance of creating supportive and anxiety-reducing learning environments in technology-enhanced settings

The Impact of Foreign Language Anxiety on EFL Learners’ Attitudes Towards Blended Learning

This study investigates the attitudes of Saudi English as a foreign language (EFL) learners toward blended learning and explores the impact of foreign language anxiety on shaping these attitudes. The study sample selected purposively consisted of 118 participants. A quantitative research approach was employed, utilizing a self-reported questionnaire to assess learners&amp;rsquo; foreign language anxiety and their attitudes toward blended learning. The study yielded the following significant findings: First, the results revealed that EFL learners exhibited positive attitudes toward blended learning. Second, findings indicated that EFL learners involved in blended learning exhibited a moderate level of foreign language anxiety. Third, the study revealed that foreign language anxiety had no significant impact on the following four key constructs of attitudes toward blended learning: flexibility, study management, classroom learning, and online interaction, as well as overall attitudes. However, it was observed that the high-anxiety group exhibited more positive attitudes toward online learning and technology in blended learning compared with the low-anxiety group. These findings have pedagogical implications for educators and practitioners designing and implementing blended learning approaches in EFL classrooms. The study results recommend integrating blended learning in higher education, taking into account high-anxiety learners&amp;rsquo; preferences of two aspects of blended learning: online learning and the integration of technology.

High Anxiety Levels before Elective Cesarean Section Can Negatively Affect the Mother and Fetus.

Both pregnancy and surgery cause anxiety. This situation may negatively affect the health of the mother and baby. The effect of anxiety level before cesarean section (CS) on feto-maternal outcomes was investigated. The preoperative anxiety score was determined with the State-Trait Anxiety Inventory (STAI) in 224 pregnant women who were planned for elective CS. Among patients, 33.5% were in the low anxiety group, 27.2% in the moderate, and 39.3% in the high anxiety group. The average birth weight in the low anxiety group was noticeably higher than that of the high anxiety group (P = 0.018). The mean heart rate at postop 1st and 24th hour in the high anxiety group was higher than the moderate anxiety group (P < 0.028). In addition, diastolic blood pressure (DBP) at the sixth hour in the low anxiety group was found to be lower than in the moderate anxiety group (P < 0.05). According to these results, it was found that an increased anxiety score before CS is associated with low birth weight in the baby, higher heart rate, and DBP in the mother.

Mathematics anxiety and number processing: The link between executive functions, cardinality, and ordinality.

One important factor that hampers children's learning of mathematics is math anxiety (MA). Still, the mechanisms by which MA affects performance remain debated. The current study investigated the relationship between MA, basic number processing abilities (i.e., cardinality and ordinality processing), and executive functions in school children enrolled in grades 4-7 (N = 127). Children were divided into a high math anxiety group (N = 29) and a low math anxiety group (N = 31) based on the lowest quartile and the highest quartile. Using a series of analyses of variances, we find that highly math-anxious students do not perform worse on cardinality processing tasks (i.e., digit comparison and non-symbolic number sense), but that they perform worse on numerical and non-numerical ordinality processing tasks. We demonstrate that children with high MA show poorer performance on a specific aspect of executive functions-shifting ability. Our models indicate that shifting ability is tied to performance on both the numerical and non-numerical ordinality processing tasks. A central factor seems to be the involvement of executive processes during ordinality judgements, and executive functions may constitute the driving force behind these delays in numerical competence in math-anxious children.

The effect of working memory load on selective attention to emotional faces for social anxiety individuals.

Research has confirmed that individuals with social anxiety (SA) show an attentional bias towards threat-related stimuli. However, the extent to which this attentional bias depends on top-down cognitive control processes remains controversial. The present study investigated the effect of working memory (WM) load on selective attention to emotional faces in both high social anxiety (HSA) and low social anxiety (LSA) groups by manipulating WM load through the inclusion of forward counting in multiples of two (low load) or backward counting in multiples of seven (high load) within a modified flanker task. In the flanker task, emotional faces (angry, happy, or neutral faces) were used as targets and distractors. A total of 70 participants (34 HSA participants; 36 LSA participants) completed the flanker task in the laboratory. The results showed that the HSA individuals performed worse when responding to angry targets. Relative to LSA individuals, HSA individuals showed interference from angry distractors in the flanker task, resulting in significantly lower accuracy in identifying angry targets compared to happy targets. These results were unaffected by the manipulation of WM load. The findings imply HSA individuals have impaired attentional control, and that their threat-related attentional bias relies more on the bottom-up automatic attentional process.

Qualitative Study of Anxiety Facing Block Examinations Among Medical Students at Faculty of Medicine, Universitas Ahmad Dahlan

Background: Medical students face examinations more frequently compared to students from other faculties. Examinations are one of the causes of anxiety commonly experienced by medical students, leading to both physical and psychological responses. Effective coping mechanisms in response to stressors are necessary for medical students as a defense mechanism. Objective: This research aims to explore the causes of exam anxiety, the contributing factors to anxiety and the coping mechanism used by medical students. Methods: The research adopts a qualitative descriptive design, the sample consist of active medical students from Faculty of Medicine, Ahmad Dahlan University who have faced block examinations. Sample selection was done using a test- anxiety inventory, with participants chosen from each academic year and divided into focus group discussion (FGD) sessions. The FGD results were subsequently analyzed using content analysis in the form of research problem categories. Results: The discovered data consists of the main research issues, which are student’s anxiety when facing block exams, the factors causing anxiety, and student’s coping mechanisms. Conclusion: The high anxiety group portrays block exams as a subjective matter and tends to lead to anxiety, students in low anxiety group predominantly utilize problem-focused coping mechanism.

The cognitive neural mechanism of trait anxiety influences mind wandering: An ERP study

Converging evidence from behavioral and neuroscience studies demonstrated that our attention to the external world is influenced by emotion, especially anxiety. However, little is known about how trait anxiety influences neural and behavioral responses during mind wandering. The present study aimed to examine the neural and cognitive time courses of how trait anxiety affects mind wandering. Event-related potentials (ERPs) were recorded from 20 individuals with high trait anxiety and 20 with low trait anxiety when they performed the Sustained Attention to Response Task (SART) in which they were asked to respond to frequent ‘‘nontargets’’ (digits 0–6, 8–9) but withhold responses to infrequent ‘‘targets’’ (the digit 7). We compared the behavioral performance and electroencephalographic waves between the high and low trait anxiety groups during states of “mind wandering” (fail to withhold a response to the target number) and being “on-task” (correctly withhold a response to the target number). Results showed that a larger late positive component (LPC, 400–950 ms) was elicited when participants were “on task” than when they were mind wandering. Additionally, a larger late slow waveform (LSW, 950–1050 ms) was elicited in the high trait anxiety group than in the low trait anxiety group. Moreover, there was a positive correlation between self-reported trait anxiety scores and the LSW amplitudes during mind wandering. It was proposed that the effect of trait anxiety on the cognitive neural mechanism underlying attentional processing was primarily reflected in a later process involving the redistribution of cognitive resources.

Deficits in Emotional Perception–Related Motor Cortical Excitability in Individuals With Trait Anxiety: A Transcranial Magnetic Stimulation Study

Abnormal emotional perception may contribute to emotional dysfunction in individuals with anxiety. This study explored the progression of impaired emotional perception with the deepening of anxiety in individuals with nonclinical trait anxiety, by measuring the motor cortical excitability associated with emotional perception. In total, 87 participants were assigned to a high trait anxiety (n = 27), moderate trait anxiety (n = 30), or low trait anxiety (n = 30) group. Transcranial magnetic stimulation was applied to the right primary motor cortex at 150 ms or 300 ms after the onset of positive, negative, or neutral images, while participants performed an emotion recognition task, and motor‐evoked potentials (MEPs) were collected. For participants with low trait anxiety, MEP amplitudes were significantly higher for both negative and positive stimuli than for neutral stimuli. Participants with moderate trait anxiety showed significantly higher MEP amplitudes only for negative stimuli. Participants with high trait anxiety showed no significant difference in MEP amplitudes for positive, negative, and neutral stimuli. Trait anxiety score was negatively correlated with MEP amplitude: For higher trait anxiety scores, MEP amplitudes were correlated with lower emotional perception of positive and negative stimuli. Findings suggest that anxiety impairs emotional perception–related motor cortical excitability, starting with decreased motor cortical excitability responses to positive information and progressing to negative information as anxiety levels increase.

Uncovering Hemispheric Asymmetry and Directed Oscillatory Brain-Heart Interplay in Anxiety Processing: An fMRI Study.

Brain-heart interactions (BHI) are critical for generating and processing emotions, including anxiety. Understanding specific neural correlates would be instrumental for greater comprehension and potential therapeutic interventions of anxiety disorders. While prior work has implicated the pontine structure as a central processor in cardiac regulation in anxiety, the distributed nature of anxiety processing across the cortex remains elusive. To address this, we performed a whole-brain-heart analysis using the full frequency directed transfer function to study resting-state spectral differences in BHI between high and low anxiety groups undergoing fMRI scans. Our findings revealed a hemispheric asymmetry in low-frequency interplay (0.05 Hz - 0.15 Hz) characterized by ascending BHI to the left insula and descending BHI from the right insula. Furthermore, we provide evidence supporting the "pacemaker hypothesis", highlighting the pons' function in regulating cardiac activity. Higher frequency interplay (0.2 Hz - 0.4Hz) demonstrate a preference for ascending interactions, particularly towards ventral prefrontal cortical activity in high anxiety groups, suggesting the heart's role in triggering a cognitive response to regulate anxiety. These findings highlight the impact of anxiety on BHI, contributing to a better understanding of its effect on the resting-state fMRI signal, with further implications for potential therapeutic interventions in treating anxiety disorders.

Exploring the variations in death anxiety among oncology nurses in China: a latent class analysis

BackgroundVarious factors have been found to be associated with high levels of death anxiety experienced by oncology nurses. The aim of this study was to use a person-oriented approach to examine the death anxiety patterns of Chinese oncology nurses and to analyze the differences in anxiety characteristics and their associated influencing factors.MethodsA cross-sectional survey regarding palliative care among registered oncology nurses was conducted in Jiangsu Province, China.Latent class analyses was applied to identify their patterns of death anxiety. The score of PCQN-C (The Chinese version of the Palliative Care Quiz for Nursing) and FATCOD-B-C (The Chinese version of the Frommelt Attitude Toward Care of the Dying scale), the demographic and working characteristics were further analyzed through covariance analysis (ANCOVA) and multivariate (or logistic) regression across the subgroups.ResultsA two-potential-category model was selected based on the fit index. The results showed that 79% of oncology nurses belonged to the high pressure and pain group and 21% belonged to the low death anxiety group. The high pressure and pain group had significantly higher scores in the dimensions of emotion, stress and pain, time awareness, and cognition compared to the low death anxiety group. Factors influencing the high pressure and pain group included shorter working years, non-national or provincial oncology nursing specialists, non-national palliative care specialists, never discussing the topic of death with patients or family members, no palliative care related training, and PCQN and FATCOD scores.ConclusionsOur study suggests that oncology nurses’ death anxiety can be divided into two categories: low death anxiety and high stress pain, and certain factors, such as being female, having a short work experience, and lacking palliative care-related training, increase the likelihood of death anxiety.

Regulation of anxiety-like behaviors by S-palmitoylation and S-nitrosylation in basolateral amygdala

Protein posttranslational modification regulates synaptic protein stability, sorting and trafficking, and is involved in emotional disorders. Yet the molecular mechanisms regulating emotional disorders remain unelucidated. Here we report unknown roles of protein palmitoylation/nitrosylation crosstalk in regulating anxiety-like behaviors in rats. According to the percentages of open arm duration in the elevated plus maze test, the rats were divided into high-, intermediate- and low-anxiety groups. The palmitoylation and nitrosylation levels were detected by acyl-biotin exchange assay, and we found low palmitoylation and high nitrosylation levels in the basolateral amygdala (BLA) of high-anxiety rats. Furthermore, we observed that 2-bromopalmitate (2-BP), a palmitoylation inhibitor, induced anxiety-like behaviors, accompanied with decreased amplitude and frequency of mEPSCs and mIPSCs in the BLA. Additionally, we also found that inhibiting nNOS activity with 7-nitroindazole (7-NI) in the BLA caused anxiolytic effects and reduced the synaptic transmission. Interestingly, diazepam (DZP) rapidly elevated the protein palmitoylation level and attenuated the protein nitrosylation level in the BLA. Specifically, similar to DZP, the voluntary wheel running exerted DZP-like anxiolytic action, and induced high palmitoylation and low nitrosylation levels in the BLA. Lastly, blocking the protein palmitoylation with 2-BP induced an increase in protein nitrosylation level, and attenuating the nNOS activity by 7-NI elevated the protein palmitoylation level. Collectively, these results show a critical role of protein palmitoylation/nitrosylation crosstalk in orchestrating anxiety behavior in rats, and it may serve as a potential target for anxiolytic intervention.

Validating repurposed GAD‐7 anchored in COVID‐19 pandemic experiences: A factor‐ and person‐centered approach

AbstractGeneralized Anxiety Disorder 7‐item Scale (GAD‐7) has been found to accurately assess the presence of generalized anxiety disorder (GAD) in various populations. However, despite showing good psychometric properties in assessing GAD symptoms, there is a need to further validate GAD‐7 in milieu of the pandemic, considering that recent cross‐sectional studies have utilized this scale in understanding GAD prevalence and risk factors. The present study aimed to contextualize the GAD‐7 scale into the present condition through investigating its (1) factor structure, (2) measurement invariance, and (3) latent classes. This study utilized 1922 (63.4%) secondary and 1110 (36.6%) tertiary Filipino teachers. Confirmatory factor analyses showed that the scale is best represented by two factors: cognitive–emotional experiences and somatic experiences. Moreover, the results revealed that while the two‐factor GAD model showed good measurement equivalence across teacher groups, measurement non‐invariance was observed in gender groups. Lastly, the latent class analysis yielded a three‐class solution best fitting to the data. It specifically grouped GAD symptom intensity as low, moderate, and severe anxiety groups. These findings provide evidence of the scale's validity, supporting the utilization of the GAD‐7 scale in assessing pandemic‐related generalized anxiety.

Effect of Preoperative Anxiety on Depth of Anaesthesia and In Vitro Fertilization Success.

Infertility anxiety may have a harmful effect on embryo quality and fertilization during in vitro fertilization (IVF). Monitoring brain function gives real-time information about the depth of anaesthesia of a patient. This study examined the effect of preoperative anxiety on the depth of anaesthesia and IVF success. One hundred thirty-one patients who had undergone oocyte retrieval were divided into two groups according to the Beck Anxiety Inventory (BAI): the low-anxious Group L (n = 71) and high-anxious Group H (n = 60). Hemodynamic stability, intraoperative total propofol and fentanyl consumption, good quality embryo (GQE) rate, and fertilization rate were recorded. Fertilization and GQE rates were not significant between groups L and H. Total propofol consumption was significantly higher in group H than in group L. Heart rate (HR) preoperatively and postoperatively and systolic arterial pressure (SAP) preoperatively and diastolic arterial pressure (DAP) postoperatively were significantly increased in group H than in group L. The time for the modified Aldrete score to reach 9 (MAS 9) in group H was significantly higher than that in group L. The effect of variables that were found significantly in the univariate analysis (Propofol, HRpreop, HRpostop, SAPpreop, DAPpostop, and MAS 9) on BAI score. Total propofol consumption was higher in patients with high anxiety levels, but it did not have a negative effect on IVF success.

Social anxiety modulates emotion processing for social threat words: Evidence from ERP

The present study investigated whether the processing of social threat words was modulated by social anxiety used by recording electroencephalogram signals during the Stroop task. Behavioral results indicated that the High Social Anxiety (HSA) group exhibited slower RT than the Low Social Anxiety (LSA) group, and both groups had faster RTs when responding to threat words compared to neutral words. ERP data showed that threat words elicited more positive P2, compared with neutral words, in both groups. Neutral words elicited larger early posterior negativity (EPN) and social threat words elicited more positive LPP in the LSA group only. The HSA group did not exhibit the emotional effects of EPN and LPP. These data indicate that social anxiety can modulate the processing of social threat words.

Acute low dose caffeine affects behavior profile and activity, an examination of male rats with high or low anxiety-like behavior

Anxiety disorders affect up to one third of the population. Caffeine, an adenosine receptor antagonist, is thought to have a dose-dependent effect on anxiety. We recently showed that a high dose of caffeine (50 mg/kg) differentially affected anxiety-like behavior in rats with high or low baseline anxiety-like behavior, replicating findings using relatively high doses in human patient samples. It is not known if low doses of caffeine have similar effects. The elevated plus maze (EPM) was used to categorize male Wistar rats (13 weeks of age) into groups of high or low anxiety-like behavior. Behavior was evaluated using the multivariate concentric square field (MCSF) test and the EPM after a low 10 mg/kg dose of caffeine. Multivariate data analysis demonstrated that caffeine decreased the differences between the high and low anxiety group, whereas the separation remained for the high and low control groups. For the caffeine treated rats, univariate statistics showed an increase in parameters regarding activity in the EPM and duration in the slope of the MCSF. Regarding risk-taking, shelter-seeking, and exploratory behavior, caffeine did not affect the groups differently. In conclusion, these results demonstrate increased activity in the caffeine-treated rats, together with a potentially anxiolytic effect and increased impulsivity that did not differ between the baseline anxiety groups. In contrast to high caffeine doses, a low dose does not generally affect rats with high anxiety at baseline differently than rats with low anxiety-like behavior. Further studies are warranted to fully elucidate the effects of caffeine in anxiety.