Lower Levels Of Anxiety Symptoms Research Articles

Anxiety and Depression Levels in Women with Hyperglycemia in Pregnancy: A Comparative Study with Normoglycemic Women

Aim: The aim of this study is to investigate the anxiety and depression levels of women with hyperglycemia in pregnancy and to compare them with normoglycemic women at similar gestational weeks. Materials and Methods: Diabetic pregnant women (pregestational diabetes mellitus, gestational diabetes mellitus) at 32-34 weeks and normoglycemic pregnant women at similar gestational weeks were evaluated with the Hospital Anxiety and Depression Scale to determine anxiety and depression levels. Results: In our study patients with fetal complications associated with poorly controlled diabetes, such as large for gestational age (p: 0.04) and polyhydramnios (p: 0.03), exhibited significantly lower levels of anxiety symptoms. No significant difference was found between the diabetes group and the control group in terms of anxiety and depression symptoms Conclusion: The fact that anxiety symptoms were significantly less in polyhydramnios and large for gestational age patients, which are the result of poorly controlled diabetes, suggests that hyperglycemia may have an impact on anxiety levels.

Social Media Use

The aim of the present study was to examine the relationship between social media use and digital stress (availability stress, approval anxiety, fear of missing out, connection overload and online vigilance), and whether social media use and digital stress predict anxiety and depression symptoms. In addition, we aimed to examine the moderating role of digital stress in the relationship between social media use and anxiety and depression symptoms. The study was conducted with 267 university students (M = 21.06, SD = 2.01; 81.3% female). To achieve the objectives of the study, a new measure of social media use was developed, and the Multidimensional Digital Stress Scale was applied. The results showed that the association between social media use and anxiety and depression symptoms is weak. Higher digital stress is associated with more anxiety and depression symptoms. Availability stress, approval anxiety, and connection overload were significant positive predictors of anxiety, and connection overload was significant positive predictor of depression. Availability stress and connection overload were significant moderators of association between Instagram use and anxiety symptoms while availability stress was significant moderator of association between Instagram use and depression symptoms. Results showed that among individuals with higher availability stress, less time on Instagram was associated with more severe psychological symptoms of depression and anxiety. Similarly, among individuals with lower connection overload, more time on Instagram was associated with lower levels of anxiety symptoms.

Dynamic Associations Between Anxiety Symptoms and Drinking Behavior From Early Adolescence to Young Adulthood

PurposeResearch is inconclusive with respect to the possible risk-increasing effect of anxiety symptoms on heavy drinking behavior among adolescents and young adults. Adult role transitions and changes in the social context from early adolescence into young adulthood may impact the association between anxiety symptoms and alcohol use. MethodsThe TRacking Adolescents’ Individual Lives Survey, including 2,229 individuals at baseline, was used to evaluate the bi-directional and longitudinal associations between anxiety symptoms and alcohol use, using data at 14, 16, 19, 22, and 25 years of age. ResultsCross-lagged models revealed a relatively stable negative association at 14, 16, and 19 years, showing that relatively higher anxiety symptoms were associated with relatively lower drinking levels three years later. This effect was absent in young adulthood. There was no evidence for significant associations between alcohol use and subsequent anxiety symptoms, with the exception of alcohol use at age 19, which predicted relatively lower levels of anxiety symptoms at age 22. DiscussionOverall, the results indicated that anxiety symptoms may withhold adolescents from (heavy) drinking, although this protective effect disappeared in young adulthood. Transitions in social contexts as well as autonomy and adult responsibilities could underlie the changing association between alcohol use and anxiety symptoms throughout adolescence and young adulthood.

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.

Explicit and implicit self-esteem and their associations with symptoms of anxiety and depression in children and adolescents

ABSTRACT Negative self-esteem is an important transdiagnostic factor underlying various youth psychological problems. Most studies so far have examined the role of more conscious, explicit self-esteem, assessed with self-report questionnaires. Our study investigated the role of explicit as well as implicit self-esteem (with Rosenberg’s self-esteem scale and the implicit association test, respectively), and the nature of their interaction in explaining children’s and adolescents’ internalizing symptomatology. Self-esteem, depression, and anxiety symptoms were assessed in 279 youths (mean age: 13.92; 52% females). Explicit self-esteem (ESE) was consistently negatively related to internalizing symptoms, whereas implicit self-esteem (ISE) was not. For DSM-related anxiety symptoms, the interaction between ISE and ESE was significant: in youths who displayed low to average ESE, higher ISE predicted more anxiety symptoms, whereas for youths with high ESE, increased ISE was associated with lower levels of anxiety symptoms. Overall, our results suggest that explicit self-esteem is an important factor in explaining internalizing symptomatology for children and adolescents.

Ethnic–racial socialization, family climate, and anxiety among African American and Latinx emerging adults.

Ethnic-racial socialization (ERS) is an essential strategy that families of color utilize to discuss race, racism, and promote ethnic-racial pride. These strategies are necessary to help youth navigate a racialized world, particularly in emerging adulthood as youth transition away from home. There are mixed findings about the psychological benefits of messages focused on racial barriers, which raise questions about whether certain ERS messages may elicit anxiety symptoms and if there are conditions (e.g., family climate) under which ERS messages are most beneficial. Further, the interplay between ERS and family climate may vary across ethnic-racial groups. Thus, the present study examined the associations between ERS (i.e., cultural socialization, preparation for bias, promotion of mistrust) and anxiety symptoms, and whether the moderating effects of family climate (i.e., cohesion, conflict) varied for 142 African American (AA; 83% women) and 275 Latinx (LX; 70.5% women) college students (M = 18.89, SD = 1.06). Cultural socialization and family cohesion were negatively associated with anxiety symptoms, while promotion of mistrust and family conflict were positively associated with anxiety symptoms. Preparation for bias was not associated with anxiety symptoms. For both AA and LX youth who reported high family cohesion, cultural socialization was associated with lower anxiety symptoms. Additionally, among AA youth who reported high levels of family conflict, cultural socialization was associated with lower levels of anxiety symptoms. The findings have important implications for understanding the unique and interactive effects of ERS and family climate on anxiety symptoms for AA and LX emerging adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anxiety symptoms, rule learning, and cognitive flexibility in non-clinical psychosis

Individuals with psychotic-like experiences (PLEs) represent a critical group for improving the understanding of vulnerability factors across the psychosis continuum. A growing body of literature has identified functional deficits associated with PLEs. However, it is unclear if such deficits purely reveal the underlying psychosis vulnerability or if they are also linked with comorbid anxiety symptoms. Although anxiety disorders are often associated with impairments in psychosis-risk, symptoms of anxiety may facilitate executive functioning in certain psychosis groups. The Community Assessment of Psychic Experiences was completed to assess psychosis-like symptoms in a total of 57 individuals, and its median score was used to categorize PLE groups (high-PLE = 24, low-PLE = 33). Anxiety symptoms were measured via the Beck Anxiety Inventory, and cognitive flexibility was measured by the Penn Conditional Exclusion Test. The high-PLE group endorsed more anxiety symptoms, demonstrated poorer accuracy and efficiency on the cognitive task, and made more perseverative errors compared to the low-PLE group. Within the high-PLE group, higher levels of anxiety symptoms were associated with better performance and less perseverative errors compared to individuals with lower levels of anxiety symptoms. Conversely, greater anxiety symptoms were associated with poorer performance in the low-PLE group. Taken together, these findings provide a preliminary support for a potential psychosis vulnerability × anxiety symptom interaction. Given the interest in the psychosis continuum and potential treatment implications, the present findings warrant replication efforts.

Black College Students’ Ethnic Identity and Academic Achievement: Examining Mental Health and Racial Discrimination as Moderators

The purpose of the current study was to test the role that components of ethnic identity (i.e., exploration and resolution) play in academic achievement, and to examine mental health, racial discrimination, and gender as moderators of these associations among Black college students. Participants included 341 college students who identified as a Black/African American female or male ( M age = 18.4; SD = .34), and completed measures of ethnic identity, perceived racial discrimination, and mental health. Results indicated that higher levels of ethnic identity exploration were associated with a lower grade point average (GPA) among males with higher levels of depressive symptoms, but not among males with lower levels of depressive symptoms. Similarly, higher levels of ethnic identity resolution were associated with a lower GPA among males with higher levels of anxiety symptoms, but not males with lower levels of anxiety symptoms. Findings may have implications for clinical and educational interventions by highlighting the nuanced ways that ethnic identity, mental health, and gender affect Black college students’ academic achievement.

Associations between religiosity and perinatal anxiety symptoms among women of Mexican descent

BackgroundOver half of pregnant women experience anxiety symptoms, however perinatal mental health disparities exist. Women of Mexican descent exhibit higher levels of anxiety symptoms which may be linked to sociocultural stressors. However, little is known about culturally relevant factors that may protect against anxiety in this fast-growing population, such as religiosity, an important facet of Mexican culture. MethodsPregnant women of Mexican descent (n = 197) were recruited from a local community clinic and followed into the postpartum period. Women completed surveys assessing religiosity, acculturation, acculturative stress, and anxiety symptoms. ResultsHigher levels of religiosity were associated with lower levels of anxiety symptoms throughout pregnancy, but not postpartum (b = -1.01, p = .002). Additionally, religiosity significantly buffered the relationship between acculturative stress and anxiety symptoms during early (R2 = .13, b = -.12, p = .041), mid- (R2 = .19, b = -.19, p < .001) and late pregnancy (R2 = .14, b = -.13, p = .023), and at six weeks postpartum (R2 = .08, b = -.12, R2 = .08, p = .016). LimitationsThe study was limited to women of Mexican descent and it is possible that other immigrant groups may exhibit different patterns of religiosity and anxiety symptoms. ConclusionsThese results suggest that religiosity may be protective against maternal anxiety among women of Mexican descent, which has important implications for culturally relevant perinatal interventions and treatments.

Investigation of physician burnout and the development of symptoms of anxiety and depression: burnout in consultant doctors in Ireland study (BICDIS)

AimsThe objectives of this study were to investigate burnout in a sample of Irish Hospital Consultants and its association with psychopathology (symptoms of depression and anxiety). We examined the effect of personality factors on the development of psychopathology in response to burnout and in relation to work-related stress among the participants.MethodThis is a cross-sectional survey, utilising validated psychometric measures. Self-reported online questionnaires were distributed to all hospital consultants registered with the Irish Hospital Consultants Association distribution list and were completed between September to December 2016. Questionnaires sought to determine demographic information; work-related characteristics; burnout related phenomena: emotional exhaustion, depersonalization, and a reduced sense of personal effectiveness (Maslach Burnout Inventory [MBI-GS]); symptoms of depression and anxiety (Depressive Anxiety Stress Scale [DASS]; and personality characteristics (Big Five Inventory [BFI-10]).ResultA total of 477 hospital consultants (Male = 56.6%) from hospitals in Ireland took part in the study. Of those studied, 42% reported high levels of burnout. The Depression and Anxiety Stress Scale revealed that Consultants were experiencing high levels of stress symptoms but comparatively low levels of anxiety symptoms. The study population scored highest on the conscientiousness and agreeableness subscales and lowest on the neuroticism subscale. Those who scored higher in the neuroticism subtype appeared to be at an increased risk of burnout.ConclusionThe prevalence of work-related burnout in consultants is of concern. The psychological burden of burnout is reflected in reported symptoms of stress and depression. Personality, particularly conscientiousness and agreeableness appears to impact the development of physician burnout. Strategies that modulate the relationship between personality and burnout may be beneficial for optimal health care delivery. Further research is needed to identify appropriate short and long-term strategies to ensure physician wellbeing and optimal delivery of patient care.

Illness perceptions and affective symptoms: Predictors of self‐management behaviors in mild cognitive impairment

AbstractBackgroundAlthough a recent guideline on mild cognitive impairment (MCI) recommends non‐pharmacological interventions (i.e., self‐management behaviors such as exercise and cognitive training) for the management of MCI, predictors of such behaviors have not been identified in this population. We explored predictors of four categories of self‐management behaviors (i.e., physical activity, cognitive‐enhancing medication, mental activity, and vitamin/herbal supplements) in persons with MCI (PwMCI).MethodsUsing a cross‐sectional design, we conducted a secondary analysis pooling two existing datasets. We examined the predictive role of perceptual factors (i.e., individuals’ perceived understanding of MCI and its cause), affective symptoms (i.e., anxiety and depression), and clinical/sociodemographic factors. We also measured the total number of (range: 0‐4), and performance of each (‘yes’ or ‘no’) of the four categories of self‐management behaviors. We performed hierarchical linear (for the total number of self‐management behaviors) and binary logistic (for each self‐management behavior) regression analyses, controlling for age, sex, years of education, and the number of comorbid conditions as potential covariates.ResultsParticipants (N=137) were on average 71.5 years old with 16.1 years of education. Most were Caucasian (92.0%) and diagnosed with amnestic MCI (82.5%). Although we did not find any main effects of predictors, some interactions were significant through further model expansion. Better performance of self‐management behaviors was associated with 1) lower levels of perceived understanding of MCI in men (b= ‐0.090, =.037), and 2) lower levels of anxiety symptoms in Caucasian participants (b= ‐0.206, p=.049). In hierarchical logistic regression analyses, higher levels of perceived understanding of MCI were associated with the better performance of physical (OR=0.942, 95%CI=[0.898, 0.980]) and mental (OR=0.959, 95% CI=[0.922,0.998]) activities among participants with lower levels of education. Among participants with more years of education, higher levels of perceived understanding of MCI were associated with better adherence to cognitive‐enhancing medication (OR=1.043, 95% CI=[1.002, 1.085]), and more anxiety symptoms were associated with better performance of mental activity (OR=1.048, 95% CI=[1.003,1.095]).ConclusionOur findings suggest that perceived understanding of MCI, levels of anxiety, and demographic factors should be considered together when evaluating the performance of self‐management behaviors to prevent or delay further cognitive changes among PwMCI.

Mindfulness, Anxiety Symptoms, and Quality of Life in Heart Failure.

An estimated 6.5 million American adults live with heart failure (HF). Elevated anxiety symptoms may worsen HF symptoms and contribute to decreases in overall quality of life (QOL). Mindfulness has been associated with better psychological health with lower levels of anxiety symptoms. Mindfulness may be a modifiable target for reducing anxiety symptoms and increasing QOL in patients with HF. The objective of this study is to examine the relationships among anxiety symptoms, dispositional mindfulness, and QOL in patients with symptomatic HF. In this cross-sectional study, we conducted a secondary analysis of baseline data from 70 participants. We performed descriptive statistics, bivariate Pearson correlations, and multiple linear regression. The sample included 70 individuals with a mean age of 65 ± 10.5 years, 89% male, mean left ejection fraction of 45.7 ± 13.6, mean total QOL of 36.9 ± 21.7, mean total mindfulness of 82.2 ± 12.8, and mean anxiety of 4.8 ± 2.9. In multiple regression analyses, total mindfulness was significantly associated with lower anxiety (β = -0.491, P < .01), greater observational mindfulness was significantly associated with lower anxiety (β = -0.377, P < .01), and greater nonreactivity to inner experience was significantly associated with lower anxiety (β = -0.320, P < .05). Lower anxiety was associated with greater total QOL (β = 0.488, P < .01), greater physical QOL (β = 0.381, P < .01), and greater emotional QOL (β = 0.639, P < .01). Mindfulness may be a way of improving both anxiety symptoms and QOL in this population.

Psychological risk factors for exercise dependence

The main aim of this study was to investigate if exercisers' personality characteristics were associated with exercise dependence. Specifically, the purpose was to examine if anxiety, obsessive passion, and physical appearance orientation were associated to an increased risk for exercise dependence. Participants were 330 exercisers from exercise groups, sport clubs and university sport science classes in the southwest of Sweden. Data were analysed using CHAID (Chi-squared Automatic Interaction Detection) analysis. The CHAID analysis indicated that anxiety was the main predictor of exercise dependence. More specifically, 12.7% more exercisers who experienced high levels of anxiety symptoms (i.e. scores above 6), were, in comparison to the exercises experiencing low levels of anxiety, classified as “at risk for exercise dependence”. For exercisers that reported low levels of anxiety symptoms (i.e. scores below 7), obsessive passion for exercise was a positive statistically significant predictor (absolute risk difference = 8.6%). Overall, the results highlight anxiety as a main risk factor behind exercise dependence. Also, the risk of exercise dependence may increase either from obsessive passion or as a coping strategy for anxiety. Furthermore, results may illustrate two types of exercise dependence; “primary” exercise dependence driven mainly by an obsessive passion for exercise and “secondary” exercise dependence where exercise function as a strategy to cope with anxiety.

Anxiety symptom levels are persistent in older adults with a mental disorder: A 33-month follow-up study.

Anxiety symptoms are common in old age and have been suggested as risk factors for development of cognitive impairment and mortality. The objective of the present study was to investigate whether anxiety symptoms among older adults with a mental health diagnosis are persistent, and severity of anxiety predicts cognitive decline and mortality. We collected data from 201 patients referred to specialist mental health service in a department of geriatric psychiatry. Of these, 150 were reexamined after 33months, while 51 patients died before follow-up. Mean age (SD) at baseline among the patients that were reexamined was 73.4 (7.3) years, and 67% were women. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety symptoms at baseline and follow-up. We investigated whether higher GAI scores at baseline were associated with persistence of anxiety. Associations with cognitive decline or mortality were also explored. The associations were estimated by use of trajectory analysis and regression models. Seventy-four percentages had the same level of anxiety symptoms, and 29% had a high level of anxiety at baseline and follow-up. GAI score at baseline was not associated with cognitive decline or mortality at 33-month follow-up. In a longitudinal study of anxiety symptoms among older adults in specialist mental health services, we demonstrate persistent high or low levels of anxiety symptoms. Anxiety trajectories over time were not predicted by patient characteristics. Also the level of anxiety cannot be used as predictor for future cognitive decline or mortality in a clinical population.

Evaluating the role of mindfulness in terms of asthma-related outcomes and depression and anxiety symptoms among individuals with asthma

ABSTRACTThe aim of the current study was to examine the unique role of mindfulness skills in terms of: (1) asthma-related outcomes (i.e., asthma control, asthma quality of life); (2) depression symptoms; and (3) anxiety symptomatology (i.e., anxiety sensitivity, panic symptoms, global anxiety) among non-smoking adults with current asthma. Participants were 61 (61.9% female; Mage = 34.72 years, SD = 13.58, range = 18–65) non-smoking adults with current asthma who completed a battery of self-report measures. Results indicated that, after controlling for the effects of race and age, greater ability to describe present moment experiences was significantly associated with better asthma-related quality of life and lower levels of anxiety symptoms. Though mindfulness skills together were associated with lower levels of panic symptoms, there were no significant individual associations between specific skills and panic symptoms. Greater nonjudgment of present moment experiences was associated with lower levels of anxiety and anxiety sensitivity. Greater nonreactivity was significantly associated with lower levels of depression symptoms and anxiety sensitivity. Lastly, a greater ability to observe present moment experiences was associated with lower levels of anxiety sensitivity. Mindfulness was not significantly associated with asthma control. These findings suggest that it may be useful to target the mindfulness skills of describing, nonjudgment, and nonreactivity among individuals with asthma, particularly those with elevated levels of anxiety and depression, in order to improve psychological and asthma-related outcomes.

Impact of alcohol use motives and internalizing symptoms on mood changes in response to drinking: An ecological momentary assessment investigation

BackgroundTheory implies that individuals who use alcohol to cope with negative emotions experience the acute mood-altering effects they desire. However, no study to date has directly tested whether alcohol coping motives map onto alcohol-induced changes in mood in real-time or how co-occurring internalizing symptoms (i.e., depression and anxiety) impact the relation between coping motives and alcohol-induced changes in mood. MethodThe current study tested the unique and interactive effects of alcohol coping motives and internalizing symptoms on mood changes during drinking using ecological momentary assessment (EMA) in a sample of young adults (n=257). Participants completed a battery of questionnaires and a 7-day EMA assessment protocol. ResultsIn general, alcohol use was associated with greater positive mood and reduced negative mood while drinking. However, individuals who reported that they use alcohol to cope with anxiety, but not depression, experienced less mood benefits from alcohol relative to those without mood coping motives. In contrast, individuals with high internalizing symptoms experienced greater mood benefits while drinking relative to those with low levels of internalizing symptoms; and at high levels of anxiety, alcohol consumption was reinforcing for everyone regardless of coping motives. Only at low levels of anxiety symptoms, did coping with anxiety motives attenuate alcohol’s acute reinforcing effects. ConclusionsThese results together confirm that alcohol has a robust impact on real-time mood in young adults and sheds light on the processes that may contribute to repeated alcohol use within individuals who do, and do not, use alcohol as a means of coping.

Transgender and anxiety: A comparative study between transgender people and the general population

ABSTRACTBackground: Anxiety disorders pose serious public health problems. The data available on anxiety disorders in the transgender population is limited by the small numbers, the lack of a matched controlled population and the selection of a nonhomogenous group of transgender people.Aims: The aims of the study were (1) to determine anxiety symptomatology (based on the HADS) in a nontreated transgender population and to compare it to a general population sample matched by age and gender; (2) to investigate the predictive role of specific variables, including experienced gender, self-esteem, victimization, social support, interpersonal functioning, and cross-sex hormone use regarding levels of anxiety symptomatology; and (3) to investigate differences in anxiety symptomatology between transgender people on cross-sex hormone treatment and not on hormone treatment.Methods: A total of 913 individuals who self-identified as transgender attending a transgender health service during a 3-year period agreed to participate. For the first aim of the study, 592 transgender people not on treatment were matched by age and gender, with 3,816 people from the general population. For the second and third aim, the whole transgender population was included.Measurements: Sociodemographic variables and measures of depression and anxiety (HADS), self-esteem (RSE), victimization (ETS), social support (MSPSS), and interpersonal functioning (IIP-32).Results: Compared with the general population transgender people had a nearly threefold increased risk of probable anxiety disorder (all p < .05). Low self-esteem and interpersonal functioning were found to be significant predictors of anxiety symptoms. Trans women on treatment with cross-sex hormones were found to have lower levels of anxiety disorder symptomatology.Conclusions: Transgender people (particularly trans males) have higher levels of anxiety symptoms suggestive of possible anxiety disorders compared to the general population. The findings that self-esteem, interpersonal functioning, and hormone treatment are associated with lower levels of anxiety symptoms indicate the need for clinical interventions targeting self-esteem and interpersonal difficulties and highlight the importance of quick access to transgender health services.

Early inherited risk for anxiety moderates the association between fathers' child-centered parenting and early social inhibition.

Studies of the role of the early environment in shaping children's risk for anxiety problems have produced mixed results. It is possible that inconsistencies in previous findings result from a lack of consideration of a putative role for inherited influences moderators on the impact of early experiences. Early inherited influences not only contribute to vulnerabilities for anxiety problems throughout the lifespan, but can also modulate the ways that the early environment impacts child outcomes. In the current study, we tested the effects of child-centered parenting behaviors on putative anxiety risk in young children who differed in levels of inherited vulnerability. We tested this using a parent-offspring adoption design and a sample in which risk for anxiety problems and parenting behaviors were assessed in both mothers and fathers. Inherited influences on anxiety problems were assessed as anxiety symptoms in biological parents. Child-centered parenting was observed in adoptive mothers and fathers when children were 9 months old. Social inhibition, an early temperament marker of anxiety risk, was observed at child ages 9 and 18 months. Inherited influences on anxiety problems moderated the link between paternal child-centered parenting during infancy and social inhibition in toddlerhood. For children whose birth parents reported high levels of anxiety symptoms, greater child-centered parenting in adoptive fathers was related to greater social inhibition 9 months later. For children whose birth parents reported low levels of anxiety symptoms, greater child-centered parenting in adoptive fathers was related to less social inhibition across the same period.

The effect of the video game Mindlight on anxiety symptoms in children with an Autism Spectrum Disorder.

BackgroundIn the clinical setting, a large proportion of children with an autism spectrum disorder (ASD) experience anxiety symptoms. Because anxiety is an important cause of impairment for children with an ASD, it is necessary that effective anxiety interventions are implemented for these children. Recently, a serious game called Mindlight has been developed that is focused on decreasing anxiety in children. This approach is based on recent research suggesting that video games might be suitable as an intervention vehicle to enhance mental health in children. In the present study it will be investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children who are diagnosed with an ASD.Methods/DesignThe present study involves a randomized controlled trial (RCT) with two conditions (experimental versus control), in which it is investigated whether Mindlight is effective in decreasing (sub) clinical anxiety symptoms in children with an ASD. For this study, children of 8–16 years old with a diagnosis of an ASD and (sub) clinical anxiety symptoms will be randomly assigned to the experimental (N = 60) or the control (N = 60) condition. Children in the experimental condition will play Mindlight for one hour per week, for six consecutive weeks. Children in the control condition will play the puzzle game Triple Town, also for one hour per week and for six consecutive weeks. All children will complete assessments at baseline, post-intervention and 3-months follow-up. Furthermore, parents and teachers will also complete assessments at the same time points. The primary outcome will be child report of anxiety symptoms. Secondary outcomes will be parent report of child anxiety, child/parent report of depressive symptoms, and parent/teacher report of social functioning and behavior problems.DiscussionThis paper aims to describe a study that will examine the effect of the serious game Mindlight on (sub) clinical anxiety symptoms of children with an ASD in the age of 8–16 years old. It is expected that children in the experimental condition will show lower levels of anxiety symptoms at 3-months follow-up, compared to children in the control condition. If Mindlight turns out to be effective, it could be an important contribution to the already existing interventions for anxiety in children with an ASD. Mindlight could then be implemented as an evidence-based treatment for anxiety symptoms in children with an ASD in mental health institutes and special education schools.Trial registrationDutch Trial Register NTR5069. Registered 20 April 2015.

Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease.

To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD). This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn's disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky's SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL. Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL. Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.