Measures Of Anxiety Research Articles

Comparison of the Beck Anxiety Inventory and the Geriatric Anxiety Scale in an Older Adult Neurology Clinic Sample.

The Beck Anxiety Inventory (BAI) is a commonly used anxiety measure, but it was not specifically designed for use among older adults. Previous research has raised concern that it may inflate anxiety ratings among older adults because of its emphasis on physical symptoms. The Geriatric Anxiety Scale (GAS) is designed for older adults but has not been examined in a neurology clinic setting. This study sought to compare the psychometric properties of the BAI and the GAS in an older adult neurology clinic sample. An exploratory aim was to determine the influence of motor symptoms on anxiety scores. Participants included 68 adults age 60+ referred for a neuropsychological evaluation in an outpatient neurology clinic. Measures included the BAI, GAS, and the Montreal Cognitive Assessment (MoCA). Psychometric properties were determined. A McNemar test compared the proportion of anxiety classifications between the BAI and GAS. Referral source (cognitive disorder versus movement-oriented teams) was used as a proxy for grouping patients who were likely to have prominent motor symptoms versus those who were not. An independent t-test compared scale performance between these groups to examine the influence of motor symptoms on anxiety ratings. Both scales had good internal consistency (GAS α = 0.93; BAI α = 0.88). Convergent validity (GAS and BAI: r = 0.81, p < .001) and discriminant validity (GAS and MoCA, r = 0.18, p = .20) were supported. The BAI detected anxiety among 40% of participants, while the GAS detected anxiety among 56%, which was a statistically significant difference (p = .002). Anxiety ratings did not differ based on referral source (t(66) = -1.59, p = .12). Both scales had good psychometric properties, though the GAS detected a higher rate of anxiety compared to the BAI despite having less focus on motor symptoms that could be attributed to age-related physical changes or movement disorders. The GAS may capture aspects of anxiety not assessed by the BAI among older adults.

Childhood allergy and anxiety/depression in early adulthood: A longitudinal study in the ALSPAC birth cohort.

Allergic disease and common mental disorders frequently co-occur. However, little is known about the longitudinal impact of childhood allergy on the subsequent risk of developing anxiety or depression, and the possible biological mechanisms for this. We performed longitudinal analyses of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. The baseline sample comprised n=5256 children with allergy data available at age 7yrs. We used multivariable regression to test associations between childhood allergy at age 7yrs and: a) four inflammatory markers at age 9yrs; b) depression and anxiety measures between ages 10-24yrs. Allergy measures included biological markers (total serum immunoglobulin E (tIgE), number of positive skin prick tests (SPTs)), and presence of eczema, asthma and/or food allergy (mother reported). Inflammatory markers were interleukin-6 (IL-6), C-reactive protein (CRP), IL-4 and IL-13. We used structural equation modelling to test whether inflammatory markers mediated the association between tIgE and depression/anxiety. tIgE and having≥1 positive SPT at age 7 were associated with IL-6 levels at age 9 (adjusted β=0.09; 95% CI 0.06-0.13; p<0.001 and adjusted β=0.06; 95% CI 0.03-0.09; p<0.001 respectively), but not with CRP, IL-4 or IL13 levels. We found no strong evidence of an association between childhood allergy and subsequent depression/anxiety during adolescence and early adulthood. This finding was consistent across biological and mother-reported allergy measures. Biological markers of childhood allergy are associated with IL-6, a key inflammatory cytokine. However, childhood allergy may not have a large long-term effect on subsequent depression/anxiety.

Walk-and-Talk Therapy Versus Conventional Indoor Therapy for Men With Low Mood: A Randomised Pilot Study.

While psychotherapy is effective for treating depression, men are less likely than women to attend and more likely to drop out. The value of alternative therapeutic approaches for men needs to be investigated. In this randomised pilot trial, we investigated the feasibility and preliminary efficacy of outdoor 'walk-and-talk' therapy compared to conventional indoor therapy for 37 men with low mood (mean [SD] PHQ-9 score = 11.4 [5.0]; mean [SD] age = 44.1 [15.8] years). Over 6 weeks at the University of Newcastle participants received weekly 60-min sessions delivered (i) while walking along a 4-km route on campus or (ii) indoors in a psychology clinic, delivered by provisional psychologists using non-directive supportive counselling. Outcomes included validated measures of depression, anxiety, stress and overall psychological distress, male-type depression, mental well-being, behavioural activation and therapeutic alliance. At post-intervention, all pre-registered feasibility benchmarks were exceeded including recruitment capability, retention (89%), average attendance (walk-and-talk: 91%, indoor: 89%), proportion of sessions delivered in intended setting (walk-and-talk: 100%, indoor: 98%) and overall perceived acceptability of the therapy (walk-and-talk: 4.4/5, indoor: 4.2/5, where 1 = poor and 5 = excellent). Linear mixed model analysis demonstrated both groups achieved similar improvements in depressive symptoms (d = -0.02), but the walk-and-talk group reported greater improvements in overall psychological distress (d = -0.5), anxiety (d = -0.4) and stress (d = -0.7). In contrast, male-type depression improved more in the conventional indoor group (d = 0.6). Other outcomes were comparable between groups. Results indicate that walk-and-talk therapy may be acceptable and effective for men with depression. A powered trial to interrogate these effects and identify moderators of effectiveness is warranted. Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12622001318774.

Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI): Protocol for a cluster randomized controlled cross-over trial of life story work and facilitated advance care planning among older Australian adults in community settings.

Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services. The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) trial is an open-label, cross-over, cluster randomized controlled trial with 12 participating aged care organizations in New South Wales and Western Australia. Participants are aged 65 years or older, receiving home care services and capable of providing informed consent at initial recruitment. Recruitment occurs across a two-year period, with study sites randomized to receive the four-session intervention in the first or second year (or a single session 'active control' condition). Primary outcomes are participant-reported ACP engagement and ACP documentation in the aged care client record 12 weeks post-recruitment. Secondary outcomes include measures of decisional conflict, anxiety and depression, meaning-based coping and relationship quality. Analysis will take an intention-to-treat approach. This trial tests a novel method of reaching older adults using a holistic, person-centered approach to promoting ACP engagement. Enhancing ACP engagement may reduce decisional conflict, minimize hospital admissions and improve outcomes for people and their families. ANZCTR Trial Registration ID: ACTRN12622001399785.

Prevalence, correlates of postpartum depression during the COVID-19 pandemic; and validation of the arabic edinburgh postnatal depression scale among Lebanese women

BackgroundCultural variations in pregnancy and childbirth experiences can influence the causes and contributing factors of postpartum depression (PPD). However, research on this issue remains scarce in Arab countries, especially in Lebanon. This study aimed to assess the prevalence of PPD and explore socio-contextual factors affecting it in Lebanon during the COVID-19 pandemic. It also sought to validate the psychometric reliability of the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) among Lebanese women.MethodsA cross-sectional study was conducted between May 2022 and July 2022, with 402 Lebanese adult postpartum women (mean age 31.46 ± 4.88 years) enrolled from the maternity ward at CHU-Notre Dame des Secours Hospital in Byblos, Lebanon by responding to an online survey after obtaining informed concent. Along with the EPDS, the following measures were administered to participants: The Multidimensional Scale of Perceived Social Support, the Fear of COVID-19 Scale, and the Lebanese Anxiety Scale-10.ResultsOur findings demonstrated appropriate psychometric properties of the Arabic one-factor, 10-item EPDS in our sample of Lebanese women. The scale yielded good composite reliability (ω = 0.97), and appropriate patterns of correlations with anxiety and social support measures, thus attesting for its convergent validity. A total of 239 women (59.5%) had potential postpartum depression. Multivariate analysis showed that perceived childbirth experience (as “normal” (Beta= -2.57), “good” (Beta= -3.45) and “very good” (Beta= -4.14)), with worries that the newborn will get hurt/die during labor (“rarely” (Beta = 1.43) and “never” (Beta = 1.24)), a lower financial burden (Beta = − 0.19) and a higher social support (Beta = − 0.02) were significantly associated with lower rates of PPD; while higher levels of anxiety (Beta = 0.32) were associated with increased symptoms of PPD.ConclusionThe study highlights the significant burden of PPD among Lebanese women, with an alarmingly high prevalence. Key factors associated with PPD—such as anxiety, childbirth experience, and social support—are largely preventable and modifiable. Nonetheless, there is an imperative need for future longitudinal and qualitative research, to better understand obstetrical experiences, address PPD and confirm causality of the associations found.

Vagal nerve stimulation dynamically alters anxiety-like behavior in rats.

Electrical vagal nerve stimulation (VNS), at currents designed to target sensory, interoceptive neurons, decreases anxiety-like behavior. We hypothesized that different VNS current intensities would differentially alter anxiety-like behavior through the activation of distinct brainstem circuits. Electrodes were implanted to stimulate the left vagus nerve and to record diaphragm muscle and electrocardiogram activity. The VNS current required to elicit the A-fiber-mediated Hering-Breuer Reflex (HBR) was determined for each animal. Based on this threshold, animals received either sham stimulation or VNS at 1.5 (mid-intensity VNS) or 3 (higher-intensity VNS) times the threshold for HBR activation. Anxiety-like behavior was assessed using the elevated plus maze, open field test, and novelty-suppressed feeding test. Additionally, a place preference assay determined whether VNS is rewarding or aversive. Finally, a c-Fos assay was performed to evaluate VNS-driven neuronal activation within the brainstem. Mid-intensity VNS reduced anxiety-like behavior in the elevated plus maze and open field test. Higher-intensity VNS was aversive during the place preference assay, confounding anxiety measures. Both intensities increased overall c-Fos expression in neurons within the nucleus of the solitary tract, but mid-intensity VNS specifically increased c-Fos expression in noradrenergic neurons within the nucleus of the solitary tract while decreasing it in the locus coeruleus. In contrast, higher-intensity VNS had no effect on c-Fos expression in noradrenergic neurons of either the nucleus of the solitary tract or locus coeruleus. Delivery of VNS induced reproducible, current intensity-dependent, effects on anxiety-like and aversive behavior in rats.

Exploring the mediating role of metacognitions in the link between somatosensory amplification and health anxiety among college students

Purpose Health anxiety is a multidimensional trait characterized by a predominant fear of having a serious illness. This study aims to examine the impact of somatosensory amplification on health anxiety and explores the mediating role of metacognitive beliefs. Design/methodology/approach Participants (n = 307) were recruited online from university students to complete the measures of health anxiety (C-HAQ), metacognitive beliefs (MCQ-HA) and somatosensory amplification (SSAS). Findings The results suggest that somatosensory amplification is a significant predictor of health anxiety. Each of the three dimensions of metacognition partially mediated the effect of somatosensory amplification on health anxiety. In the parallel mediation model, two metacognitive beliefs partially mediated the relationship between somatosensory amplification and health anxiety, while the mediation effect of biased thinking beliefs did not reach significance. In summary, individuals with a higher tendency toward somatosensory amplification exhibit more health anxiety-related metacognitions and subsequently experience higher levels of health anxiety, supporting the Self-Regulatory Executive Function (S-REF) model. Originality/value This study validates the importance of metacognition in the maintenance and development of health anxiety, demonstrating the utility of metacognitive therapy for individuals experiencing health anxiety.

The Relationship Between Fatigue, Pain Interference, Pain-Related Distress, and Avoidance in Pediatric Hypermobile Ehlers–Danlos Syndrome

Background/Objectives: Fatigue is a known predictor of disability and reduced quality of life in youth with hypermobility and chronic pain in general. Given the added relationship between chronic fatigue and connective tissue disorders, including hypermobile Ehlers–Danlos Syndrome (hEDS), this study aims to investigate the comparative role of fatigue on important predictors of outcomes for youth with and without hEDS who have chronic pain. Methods: In this retrospective study, pediatric patients with chronic pain diagnosed with hEDS (n = 100) were compared to an age- and sex-matched group of youth with chronic pain without diagnosed hypermobility (n = 100). Participants completed measures of pain-related distress (PCS-C), avoidance (FOPQ-A), and pediatric PROMIS measures for fatigue, anxiety, and pain interference. Data were analyzed using chi-square tests, t-tests, and ANCOVAs in RStudio. Results: Fatigue scores were higher and clinically elevated fatigue was more prevalent in those with hEDS than in matched chronic pain peers. Fatigue was significantly positively related to pain interference, avoidance, and pain-related distress in youth with and without hEDS. Conclusions: The current study supports the need for multidisciplinary treatment and rehabilitation for pediatric chronic pain and hypermobility and suggests that fatigue may be an important factor to consider when treating youth with hypermobility.

Supplemental Material for A Meta-Analysis of Client–Therapist Perspectives on the Therapeutic Alliance: Examining the Moderating Role of Eating Disorders Versus Anxiety Disorders, Treatment Orientation, and Measurement Time Points

Supplemental Material for A Meta-Analysis of Client–Therapist Perspectives on the Therapeutic Alliance: Examining the Moderating Role of Eating Disorders Versus Anxiety Disorders, Treatment Orientation, and Measurement Time Points

Psychometric Properties of a Questionnaire for Assessing the Extent and Severity of the Concerns of People With an Implanted Cardioverter-Defibrillator.

Background and Purpose: Considering the numerous concerns patients express about having implantable cardioverter-defibrillators (ICDs) and the potential clinical implications of these concerns, it is essential to develop a valid and reliable measure of ICD-related concerns. The implantable cardioverter-defibrillator concerns (ICDC) questionnaire was initially designed for ICD recipients in England to assess and address these concerns. However, it remains uncertain whether this questionnaire possesses similar measurement properties and is suitable for ICD recipients in the United States. The purpose of this study was to provide evidence of the reliability and validity of the ICDC among ICD recipients in the United States with the aim to evaluate the internal consistency reliability of the ICDC, provide evidence of construct validity using Exploratory Factor Analysis (EFA), and test the hypothesis that higher scores on the ICDC would predict higher anxiety levels as measured by the Brief Symptoms Inventory-Anxiety (BSI-6). Methods: Data from a cross-sectional observational study of 240 adult ICD recipients were used to test their knowledge, attitudes, and perceptions of ICDs. Cronbach's coefficient α (alpha) was calculated to assess reliability. EFA using principal components analysis was conducted to evaluate validity. Results: Cronbach's coefficient α (alpha) was .94, indicating high reliability. The results of the EFA suggested that a one-component solution was optimal. The correlation between the BSI-6 measure of anxiety and the ICDC total score was positive and statistically significant. Conclusions: The findings from this study support the reliability and validity of the ICDC questionnaire among ICD recipients in the United States.

The Role of Information Processing as an Underlying Mechanism in the Experience of Anxiety Reactivity and Anxiety Perseveration, Two Dissociable Dimensions of Trait Anxiety

Abstract Purpose While long considered a unitary dimension, research has moved towards a multidimensional understanding of trait anxiety, and has identified two dissociable dimensions of trait anxiety: anxiety reactivity and anxiety perseveration. Despite the consolidation of this understanding over the past decade, the mechanisms underlying these two dimensions are not well established. The present study examined the novel role of information processing in the experience of anxiety reactivity and perseveration, specifically, how enhanced processing of situational information influences reactivity, and how enhanced processing of implicational information influences perseveration. Method Undergraduate university students (N = 142) were exposed to an interview-based stressor. As participants approached this stressor, they were provided with information reflecting one of the two content categories, intended to encourage a situational or implicational processing mode. Anxiety reactivity and anxiety perseveration were measured by assessing changes in state anxiety (measured using a single item visual analogue state anxiety measure) in the lead up and wake of this stressor. Results Mixed-design ANOVAs did not reveal a significant relationship between enhanced processing of situational information and anxiety reactivity, nor between enhanced processing of implicational information and anxiety perseveration. An experimental manipulation involving valence revealed that receiving positive information reduced the intensity of state anxiety elevations in the aftermath of the information processing task. Conclusions Findings are discussed with reference to limitations and future extensions that could investigate the potential role of cognitive biases in this proposed relationship between enhanced information processing and anxiety reactivity and perseveration.

Assessing the stability of psychobiological stress reactivity during adolescence: mixed-effect modelling of cortisol responses to laboratory stressors.

Puberty has been historically considered as a time of risk and vulnerability for young people. It is associated with rapid development in the hypothalamus, which is central in the production of both stress and sex steroids. While patterns of stress reactivity are calibrated in early life, this time of rapid development may provide a means for these patterns to change. This purpose of this study was to examine whether patterns of cortisol reactivity remained stable across one year of pubertal development, and whether variations in pubertal development impacted on this stability. This study used a secondary dataset comprised of 102 adolescent-aged children and adolescents. Children and adolescents took part in the Trier Social Stress Test to elicit a physiological stress response. Cortisol reactivity was measured as the increase in salivary cortisol concentration taken at five time points throughout the session. Pubertal stage was measured by nurse report where possible, and parent/self-report otherwise and was used to calculate pubertal timing and tempo relative to peers. Measures of anxiety, BMI, and socio-economic status were taken and included in analysis. Results of a linear mixed-effect model found there to be a significant difference in cortisol reactivity over time, indicating that cortisol stress reactivity did not remain stable during this time (Estimate= 3.39, t=3.67, p<.001, CI[1.56, 5.22]). Additionally, results show children and adolescents who developed slower/quicker than peers displayed decreased stress reactivity (Estimate= -3.59, t=-2.13. p=.03, CI[-6.92, -0.25]). This research contributes to a relatively small but consistent body of research noting pattern of increased cortisol reactivity during pubertal development. While a significant effect was found for pubertal tempo, this finding should not be considered indicative of any true effect.

Online risk exposure and mental health in Chinese junior high school students: A latent profile analysis

We explored the latent profile of online risk exposure and its relationship with school students’ mental health. Junior high school students (n = 1 178; female = 49.5%, male = 50.5%; Grade 7 = 57.1%, Grade 8 = 42.9%) completed measures of online risk exposure, anxiety, depression, self-esteem, and subjective well-being. Latent profile analysis yielded heterogeneity in online risk exposure, which could be divided into security group, explicit content exposure group, and risk group. Of these groups, the security group had the best mental health status, followed by the explicit content exposure group, and the risk group had the worst mental health status. By demographics, girls, junior high school students with a poor family socioeconomic status and poor academic performance had lower mental health levels. Our findings indicate a need for phased prevention programs by online risk characteristics to improve junior high school students’ mental health.

High fatigue levels among psychiatric outpatients – the validity of the Danish Patient Reported Outcomes Measurement Information System Fatigue Short-Form (PROMISF-SF)

BackgroundPatient Reported Outcomes Measurement Information System Fatigue Short-Form (PROMIS-F-SF) is a self-administered, patient reported outcome (PRO) designed to assess fatigue in healthy and clinical populations and for tracking progress during treatment for disorders complicated with fatigue.MethodsPatients in the Mental Health Service Outpatient Clinics and healthy volunteers were invited to complete a survey, which included the Danish translation of the PROMIS-F-SF, the Chalder Fatigue Scale (CFS-11), and measures of depression and anxiety. We conducted a confirmatory factor analysis of the previously suggested single-factor structure of the instrument. We furthermore evaluated the construct validity of the PROMIS-F-SF by means of its relationship with the CFS-11. Finally, we evaluated the utility of the PROMIS-F-SF to identify patient-status by conducting receiver operating characteristic curves.Results70 healthy volunteers and 62 patients completed the instruments. The PROMIS-F-SF had a average fit to the previously reported single-factor structure. Cronbach’s alpha and McDonald’s omega showed good internal reliability (α = 0.96, ωtotal = 0.97). PROMIS-F-SF score was positively correlated with the CFS-11 (r =.76) and it correlated highly with depression (r =.78) and anxiety (r =.74) score. The optimal cut-off point in the ROC-analyses was 15, which yielded a sensitivity of 89% and a specificity of 67% in the prediction of patient status.ConclusionsLevel of fatigue among psychiatric outpatients is high in patients with psychiatric illness, compared to levels measured in healthy volunteers. The Danish PROMIS-F-SF shows good psychometric properties in this combined sample of healthy adults and psychiatric patients with non-psychotic disorders and it is recommended as PRO measure for psychiatric populations. Examination of psychometric properties in patient populations with somatic disorder could be a natural next step.

Czech Version of the Multidimensional Assessment of Interoceptive Awareness (MAIA): Psychometric Evaluation and Network Model

Abstract Objectives Interoceptive awareness is crucial in mental health research, yet the psychometric characteristics of the most commonly used tool to measure it, the Multidimensional Assessment of Interoceptive Awareness (MAIA), have been underexplored, as the results of previous studies have been inconclusive. This study aimed to evaluate the psychometric characteristics of the Czech version of the tool (MAIACZ). Method Participants were sampled from seven clinical sites in the Czech Republic and the final sample consisted of 431 Czech clinical patients (75% women, M age = 39.20 ± 11.04 years), suffering from various psychiatric diagnoses. Patients were measured weekly across 8 weeks. A combination of factor analysis and network models was employed. Results Confirmatory factor analysis (CFA) supported the commonly used eight-factor structure of the MAIA, consistent with the original English version, though subscales Not distracting, Not worrying, and Noticing showed poor internal consistency. Invariance across gender, age, and measurement waves was confirmed using multigroup CFA. Convergence validity was established through correlations between MAIACZ subscales and measures of anxiety, depression, alexithymia, and symptom acceptance. A bootstrapped dynamic network model, conducted over 8 weekly measurement waves, showed the dynamic associations between MAIA subscales and its relation to wellbeing. Conclusions Contrary to the theoretical model, the temporal graph revealed that the main source nodes were related to the subjective mindset towards interoception, such as the tendency not to worry or distract from bodily signals, rather than the neutral perception of interoceptive stimuli. Well-being was also a prerequisite rather than a consequence of interoceptive awareness-related mechanisms. The Trusting subscale, which has received significant support for its predictive effects in previous literature, was found to be related to wellbeing primarily at the between-person level.

Comparison of patient-reported symptoms with multi-item patient-reported outcome measures of fatigue, anxiety, and depression in the clinical care of women undergoing chemotherapy for early breast cancer.

As patient-reported symptoms are increasingly incorporated into routine clinical practice and captured in electronic medical records these data can be used to conduct health-related quality of life research studies. This study compares symptom reports from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) and its precursor patient reported symptom monitoring (PRSM) (hereafter PRSM/PRO-CTCAE) with multi-item patient-reported outcome (PRO) scales for fatigue (Functional Assessment of Chronic Illness Therapy/FACIT-Fatigue) and depression and anxiety (Mental Health Index/MHI). This is a secondary analysis of data collected from women with early breast cancer (Stage I-III) scheduled for chemotherapy who completed PRSM/PRO-CTCAE, FACIT-Fatigue, and MHI scales pre- and post-chemotherapy. Spearman correlation coefficients estimated the magnitude and direction of correlations between measures (convergent validity). For each symptom, patients were then categorized based on who improved, stayed the same, or worsened on the composite PRSM/PRO-CTCAE score, and changes in scores on the PRO scales were compared. In a sample of 374 women, mean age was 57years (SD 12.6) with 76% White. PRSM/PRO-CTCAE fatigue measures were strongly correlated with FACIT-Fatigue total scale and had mixed moderate to strong correlation for individual items within the FACIT-Fatigue scale. PRSM/PRO-CTCAE Sad and Anxiety measures were strongly correlated with MHI-Depression and MHI-Anxiety total scales, respectively, and had mixed moderate to strong correlation with individual items within the MHI subscales. PRSM/PRO-CTCAE pre-post changes in symptom scores mirrored pre-post changes in FACIT-Fatigue and MHI subscales.

Effect of Model of Neonatal Care on Neurodevelopment at the 18 Month Follow-Up in Moderate and Late Preterm Infants.

Background: Preterm birth, even for moderate or late preterm infants (MLPIs), is associated with longer-term developmental challenges. Family Integrated Care (FICare) models of care, like Alberta FICare, aim to improve outcomes by integrating parents into neonatal care during hospitalization. This follow-up study examined the association between models of care (Alberta FICare versus standard care) and risk of child developmental delay at 18 months corrected age (CA) and explored the influences of maternal psychosocial distress. Methods: We assessed 257 mothers and 298 infants from a cluster randomized controlled trial (ID: NCT0279799) conducted in ten Level II NICUs in Alberta, Canada. Risk of delay was assessed using developmental screening tests. Maternal psychosocial distress was assessed using self-reported measures of depressive symptoms, anxiety, parenting stress, and self-efficacy. Results: There was no association between model of care and risk of developmental delay. Higher maternal parenting stress was associated with increased risk of developmental delay. Conclusions: Alberta FICare was not associated with decreased risk of developmental delay at 18 months CA. Maternal parenting stress may play an important role in the development of MLPIs and should be addressed post-discharge.

Characteristics of patients diagnosed with psychogenic non-epileptic seizures (PNES) who request reinstatement of their driving privileges.

Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p=0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p=0.006, DKEFS T2, p=0.001, DKEFS T3, p=0.002, DKEFS T4, p=0.001; GPT dominant, p=0.05, GPT non-dominant, p=0.003). Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.

Predicting ALS informant distress from cognitive and behavioural change in people with ALS

BackgroundThe cognitive and behavioural changes that occur in around 50% of people with amyotrophic lateral sclerosis (ALS) may significantly affect people around them, contributing to heightened burden, anxiety, and depression. Despite existing evidence linking behavioural impairment to caregiver distress, the role of cognitive impairment remains less clear, with mixed findings on its impact.MethodsThis study assessed the influence of cognitive and behavioural impairments in people with ALS on the distress of their nominated informants. The data were collected face-to-face and remotely due to the COVID-19 pandemic. The cognitive and behavioural impairments were measured using established screening tools. Informants’ distress was evaluated through composite measures of burden, anxiety, and depression. Regression analyses were employed to determine the predictive value of cognitive and behavioural impairment on informant distress.ResultsA total of 98 ALS patients and 84 informants participated. Behavioural impairment predicted informant distress across various tools. In contrast, cognitive impairment was a less consistent predictor of informant distress across screening measures and did not significantly interact with behavioural impairment in predicting distress. Administration mode did not affect predictive relationships.ConclusionsBehavioural impairment in ALS significantly predicts informant distress, with varying predictive power across different screening tools. Cognitive impairment also affects informant distress, but its impact is less substantial compared to behavioural factors. The interaction between cognitive and behavioural impairments did not significantly predict informant distress.

Refining PREVENT prediction models for 10-year risk of cardiovascular disease using measures of anxiety and depression

Refining PREVENT prediction models for 10-year risk of cardiovascular disease using measures of anxiety and depression