Measures Of Trait Anxiety Research Articles

Can you escape the virtual room? A novel paradigm to assess avoidance behaviour

Anxiety patients often experience conflicts between approaching (pass barking dog) and avoiding (take detour) feared situations. In most experimental avoidance paradigms, response options are limited or forced, making it difficult to generalize the results to daily life situations. The aim of the present study was twofold: 1) to develop a more ecologically valid avoidance paradigm; 2) to examine the influence of individual characteristics (trait anxiety; distress tolerance) on approach-avoidance behaviour. To encourage free exploration behaviour, a virtual reality (VR) escape room was developed. In this room, participants searched for cues to decipher a code-locked door. Opening a marked vase (conditioned stimulus, CS) was followed by a jump scare, a rat jumping out of the vase (unconditioned stimulus, US). Avoidance was measured via questionnaires and relative manipulation time of CS-marked (EXPgen) or nonmarked (CONT) objects in the room; questionnaires measured trait anxiety and distress tolerance. EXPgen participants reported higher US expectancies and more avoidance of the (marked) vase compared to the CONT participants, yet behavioural data did not support these ratings. Additionally, higher trait anxiety scores coincided with higher US expectancies before the jump scare. The current flexible free-exploratory paradigm provides multiple opportunities to examine avoidance behaviour in different populations and settings.

Anxiety and verbal learning in typically developing primary school children: Less efficient but equally effective.

Despite evidence that high levels of anxiety can impair Working Memory (WM) functioning, little is known about how anxiety is associated with classroom learning activities, which make high demands on verbal WM. To investigate the association between anxiety and learning on a task which makes high demands on verbal WM. Participants were 119 typically developing, Australian elementary school children (M age=9.25years; SD=7.6months). In individual testing sessions, measures of trait anxiety (Spence Childhood Anxiety Scales) and state anxiety (Visual Analogue scale) were made. The Rey Auditory Verbal Learning Test, which makes similar demands on WM to many classroom activities, was administered. Neither trait nor state anxiety alone was associated with mean recall across trials, however their interaction showed a significant effect. In children high on both measures of anxiety, learning followed a different trajectory. They learned more slowly on the first three trials than less anxious peers, then caught up on the remaining trials. While their mean recall scores across trials were significantly lower than those of less anxious peers, they retained as many words on the delayed learning trial. In a group of typically developing children, learning on the early, more demanding learning trials of a verbal learning task was vulnerable to heightened anxiety. However, the extra opportunities to learn on later trials enabled more anxious children to learn as much as their less anxious peers. While they learnt less efficiently, they learnt equally effectively.

Examining the Prospective Associations Between Mindfulness Facets and Substance Use in Emerging Adulthood.

Emerging adulthood (i.e. ages 18-25) is a developmental phase associated with frequent alcohol and cannabis use, placing this population at risk for substance use problems. Depression and anxiety (i.e. emotional psychopathology) are also prevalent during this phase, and some emerging adults use substances to cope with these negative emotions. Mindfulness-a multifaceted construct-involves being present in a nonjudgmental and nonreactive way. Certain mindfulness facets are particularly relevant in buffering against substance use. A recent longitudinal study [Single A, Bilevicius E, Johnson EA. etal. (2019) Specific facets of trait mindfulness reduce risk for alcohol and drug use among first-year undergraduate students. Mindfulness 10:1269-1279] showed that specific mindfulness facets (i.e. acting with awareness, nonjudging of inner experience and nonreactivity to inner experience) predicted decreased alcohol and drug use in undergraduates. These pathways were explained by low levels of emotional psychopathology. This study expanded this recent work by using a three time-point longitudinal design and by including measures of both alcohol and cannabis use and related problems. Using MTurk, participants (N=299) completed online measures of trait mindfulness, depression, anxiety, alcohol and cannabis use and related problems at three time-points, each 2weeks apart. Structural equation modeling was used to test the hypotheses. The acting with awareness and nonjudging of inner experience facets predicted fewer alcohol problems, but not alcohol use, and this effect was mediated by low levels of emotional psychopathology. These results were not supported for cannabis use and problems. This study demonstrates that there may be differences in the pathways from trait mindfulness to alcohol and cannabis use during emerging adulthood.

The relevance of anger, anxiety, gender and race in investment decisions

This study investigates the relative importance of trait anger and trait anxiety in financial decision-making. Given the disparate economic, cultural and social environments within an emerging market, this study focuses on South Africa to provide unique insights. The use of a student experimental cohort and hypothetical scenarios allows for the assessment of prima facie evidence of the merits of future research using more experienced participants and more realistic scenarios. Gender and race are incorporated as explanatory variables given the history of South Africa and the disparate opportunities amongst individuals of different races. Both variables are also notable indicators of financial behaviour and decision-making. A questionnaire was completed by 288 university students which measured Trait anxiety and Trait anger using the Anxiety Inventory and Anger Expression Inventory-2. Using multinomial logistic regressions, the results showed that White participants (rather than Black, Indian or mixed-race participants) and those individuals with higher levels of anger are more inclined to invest in equity. Alternatively, Women and individuals with higher levels of anxiety were found to be more risk averse. These findings are relevant to financial advisers as most of the predictive outcomes relate to risk which is vital in making investment decisions. While prior research has shown the relevance of personality traits on investment performance, the added dimension of gender and race adds practicality to the findings. It also highlights the necessity of including demographic variables when assessing personality traits.

Experiential avoidance mediates the relation between mindfulness and anxiety

A substantial body of evidence indicates that mindfulness is associated with less anxiety. However, less is known about the mechanisms by which mindfulness decreases anxiety. One possibility is that mindfulness encourages individuals to be less experientially avoidant (e.g., less likely to attempt to suppress or avoid unwanted private experiences), a hallmark of anxiety. The purpose of the present research was to assess whether less experiential avoidance accounted for the inverse relation between mindfulness and anxiety. Two studies were conducted with college students (Ns = 493 and 320, respectively). Participants completed self-report measures of trait mindfulness, anxiety, and experiential avoidance online (Study 1) and in person (Study 2) for course credit. Across both studies, greater mindfulness was associated with lower experiential avoidance and anxiety, and experiential avoidance was positively associated with anxiety. Furthermore, experiential avoidance significantly accounted for the relation between mindfulness and anxiety in both studies. Alternative mediation models were also tested. These findings suggest that mindfulness may improve anxiety through its effects on experiential avoidance. Given that experiential avoidance is thought to be involved in the development and maintenance of several psychological disorders, interventions involving mindfulness training may have promising broad mental health benefits. However, further research is needed to replicate these findings across clinical populations and therapeutic settings.

Working Memory Training in Relation to Anxiety, Stress, and Motivation

Interventions for improving working memory (WM) can be used to reduce anxiety-related symptoms. Here, we examine how WM training can impact trait anxiety and test anxiety for upcoming examinations, and the role of motivation and the sustainability of training effects were also examined. Volunteers were randomly assigned either to control (non-adaptive dual 1-back training, N = 52) or training group (adaptive dual n-back training, N = 49), who trained for 14 consecutive days right before the midterm exams week. Participants completed measures of trait anxiety, test anxiety, and attentional control before and after the intervention and at follow-up times (1 week and 7 weeks). Participants rated how motivated and accomplished they felt after each daily training session. They also rated their perceived performance success and confidence during the exam week at first follow-up session. Results found that adaptive training compared with the non-adaptive control training resulted in reductions in trait anxiety across time. Additionally, exploratory analyses showed that perceived success in the training task was associated with pre-to-post-intervention reductions in test anxiety. Our findings suggest that WM training has the potential to reduce anxiety and test anxiety-related symptoms under stress and emphasize the role of perceived success.

Cardiovascular and cerebral hemodynamic responses to ego depletion in a pressurized sporting task.

This study examined the effects of ego depletion on challenge and threat states and cerebral haemodynamic responses to a pressurized muscular endurance task requiring self-control. Following ethical approval, 58 participants (39 males, 19 females; Mage = 28 years, SD = 12) were randomly assigned to either an experimental or control group. Participants then completed self-report measures of trait anxiety and self-control. Next, the experimental group performed a written transcription task requiring self-control, while the control group transcribed the text normally. Finally, before the pressurized muscular endurance task, challenge and threat states were assessed using demand and resource evaluations and cardiovascular reactivity; while cerebral perfusion in Fp1 and Fp2 was assessed using near-infrared spectroscopy. The results supported the effectiveness of the self-control manipulation, with the experimental group transcribing fewer words, making more errors, and regulating their writing habits more than the control group. Although there were no differences between the groups in terms of muscular endurance performance or challenge and threat states, there was a significant interaction of time (pre vs. post) x group (experimental vs. control) in cerebral perfusion. These findings suggest that ego depletion might not influence challenge and threat states, but may lead to reduced cerebral perfusion. As such, cerebral perfusion may be a novel marker which could be used to assess ego depletion.

Associations between latent trait negative affect and patterns of food-intake among girls with loss-of-control eating.

Momentary negative affect (NA) has been shown to predict eating patterns in the laboratory, yet, more stable mood states have not been studied in relation to eating patterns in the laboratory among youth at high risk for binge-eating disorder and obesity. One-hundred-eight adolescent girls (14.5 ± 1.7 years) with BMI between the 75th-97th percentile who reported loss-of-control (LOC)-eating completed measures of trait anxiety and depressive symptoms. Food-intake patterns were measured from a laboratory test meal (9,385 kcal). Latent factor analysis of depressive symptoms and trait anxiety was used to compute latent trait NA. Multivariate general linear models predicted total energy, snacks, and macronutrient intake from trait NA, adjusting for age, race, height, lean-mass, and percentage fat-mass. Trait NA was significantly positively related to total energy-intake, and, specifically, snacks, sweet snacks, and percentage sweet fats (ps ≤ .03), and negatively related to percentage protein consumed (p = .04). Expanding on affect theory, trait NA may relate to palatable food-intake among girls with LOC-eating. Further data are needed to determine whether those with LOC-eating and trait NA are at heightened risk for the development of binge-eating disorder and obesity.

Reliability from α to ω: A tutorial.

Reliability is a fundamental problem for measurement in all of science. Although defined in multiple ways, and estimated in even more ways, the basic concepts seem straightforward and need to be understood by practitioners as well as methodologists. Reliability theory is not just for the psychometrician estimating latent variables, it is for everyone who wants to make inferences from measures of individuals or of groups. For the case of a single test administration, we consider multiple measures of reliability, ranging from the worst (β) to average (α, λ3) to best (λ4) split half reliabilities, and consider why model-based estimates (ωh, ωt) should be reported. We also address the utility of test-retest and alternate form reliabilities. The advantages of immediate versus delayed retests to decompose observed score variance into specific, state, and trait scores are discussed. But reliability is not just for test scores, it is also important when evaluating the use of ratings. Estimates that may be applied to continuous data include a set of intraclass correlations while discrete categorical data needs to take advantage of the family of κ statistics. Examples of these various reliability estimates are given using state and trait measures of anxiety given with different delays and under different conditions. An online supplemental materials is provided with more detail and elaboration. The online supplemental materials is also used to demonstrate applications of open source software to examples of real data, and comparisons are made between the many types of reliability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mothers’ Tolerance of Own and Child Distress: Associations with Discipline Practices

SYNOPSISObjective. To evaluate the associations among negative affect, mothers’ tolerance of her own and her child’s distress, and dysfunctional disciplinary practices. Design. In Study 1, 71 mothers of children ages 2–5 years completed concurrent measures of discipline, distress tolerance, tolerance of child distress, and parenting-specific anger. In Study 2, 91 mothers of children ages 2–5 years completed concurrent measures related to parent disciplinary behavior, distress tolerance, tolerance of child distress, and measures of trait anger and trait anxiety. Results. In both studies, anger was associated with overreactivity, and own and child distress tolerance were associated with overreactive and lax discipline. In Study 1, own and child distress tolerance evidenced differential patterns of association with discipline. Moreover, there were significant indirect effects of anger on overreactive discipline via tolerance of own distress, and of anger on lax discipline via tolerance of child distress. In the second study, trait anger and anxiety were associated with lax discipline via its association with tolerance of child distress. Conclusions. Dysfunctional discipline may serve, at least in part, as an attempt to terminate or avoid emotional distress; that is, some parents may engage in less effective discipline that works to quickly reduce overwhelming emotions perceived as intolerable. As such, incorporating distress tolerance skills into parenting interventions, with an emphasis on the type of distress tolerance (own or child), may improve outcomes for parents who find implementing learned skills challenging. Notably, the correlational and concurrent nature of this study precludes causal interpretations.

Implicitly and explicitly assessed anxiety: No relationships with recognition of and brain response to facial emotions

Trait anxiety, the disposition to experience anxiety, is known to facilitate perception of threats. Trait anxious individuals seem to identify threatening stimuli such as fearful facial expressions more accurately, especially when presented under temporal constraints. In past studies on anxiety and emotion face recognition, only self-report or explicit measures of anxiety have been administered. Implicit measures represent indirect tests allowing to circumvent problems associated with self-report. In our study, we made use of implicit in addition to explicit measures to investigate the relationships of trait anxiety with recognition of and brain response to emotional faces. 75 healthy young volunteers had to identify briefly presented (67 ms) fearful, angry, happy, and neutral facial expressions masked by neutral faces while undergoing functional magnetic resonance imaging. The Implicit Association Test, the State–Trait Anxiety Inventory and the Beck Anxiety Inventory were applied as implicit and explicit measures of trait anxiety. After corrections for multiple testing, neither implicitly nor explicitly measured anxiety correlated with recognition of emotional facial expressions. Moreover, implicitly and explicitly assessed anxiety was not linked to brain response to emotional faces. Our data suggest links between discrimination accuracy and brain response to facial emotions. Activation of the caudate nucleus seems be of particular importance for recognizing fear and happiness from facial expressions. Processes of somatosensory resonance appear to be involved in identifying fear from facial expressions. The present data indicate that, regardless of assessment method, trait anxiety does not affect the recognition of fear or other emotions as has been proposed previously.

Identifying the transdiagnostic and unique domains of emotion regulation difficulties in subclinical conditions of anxiety and co-occurring anxiety-depression

It is well documented that emotion regulation difficulties are linked with various forms of psychopathology including anxiety and depression but the literature is still inconclusive regarding whether emotion regulation difficulties are transdiagnostic or pathology-specific. We speculate that certain types of emotion regulation difficulties may be transdiagnostic while others may show specificity. The present study attempts to empirically validate this speculation and tries to explore the common (transdiagnostic) and unique domains of emotion regulation difficulties associated with psychometrically identified subclinical groups of anxious and anxious-depressed individuals. University and college students (N = 192) were assessed on self-report measures of emotion regulation difficulties, positive-negative affect, depression, and trait and free-floating anxiety and classified into anxious, anxious-depressed, and normal groups based on the results of cluster analysis. Both subclinical groups reported overall higher levels of emotion regulation difficulties than normals, with anxious-depressed group showing more difficulties than anxious group. While difficulty engaging in goal-directed behaviour, lack of emotional awareness and emotional clarity were common across anxious and anxious-depressed groups, the anxious-depressed group showed a unique profile of emotion regulation difficulties characterized by non-acceptance of emotional response, impulse control difficulties, and limited access to emotion regulation strategies. Findings of discriminant function analysis revealed that while anxious-depressed group was characterised by difficulties in regulating emotions, the anxious group presented difficulties in emotional insight. The findings highlight the possible role of both unique and transdiagnostic components of emotion regulation difficulties in the development/maintenance of psychopathologies and have significant implications for predicting future development and psychotherapeutic management of these disorders.

Facing Anxiety, Growing Up. Trait Emotional Intelligence as a Mediator of the Relationship Between Self-Esteem and University Anxiety.

The current study analyzed how trait emotional intelligence (trait EI) mediates the relationship between self-esteem and state anxiety and trait anxiety. The sample was composed of 153 undergraduate students from the University of Cádiz, Spain (71.9% women and 28.1% men). Students completed measures of self-esteem, state anxiety, trait anxiety, and trait EI. Mediation analyses were completed with three trait EI dimensions (EA, emotional attention; EC, emotional clarity; and MR, mood repair) as mediating variables, self-esteem as the independent variable, and state anxiety and trait anxiety as the dependent ones. Our results confirmed that self-esteem scores explained and predicted both, state and trait anxiety values (13% for state and 21% for trait anxiety). This explanatory capacity is increased by 8% when accounting for all trait EI dimensions. Considering state anxiety, the results of the direct effects showed that a decrease in their levels is predicted through the increases in the levels of both, self-esteem and MR. Regarding trait anxiety, the results of the direct effects showed that a decrease in their levels is predicted, in addition to an increment of self-esteem and MR values, by an increase of EC and a decrease of EA. Conversely, indirect effects revealed that higher levels of self-esteem were associated with worse scores in EA and worse MR, which in turn would enhance both state and trait anxiety levels. Moreover, regarding trait anxiety higher levels of self-esteem were associated with worse scores in EA and worse EC, therefore increasing trait anxiety levels. As shown, the negative association found between self-esteem and EA becomes a key element. The effect of self-esteem on EA and the influence that the latter had on EC and MR exerts an indirect mediated effect with the power to invert the influence that self-esteem wields on both types of anxiety. In this sense, the apparent protective role of self-esteem changed, turning into a risk factor that promotes higher anxiety values.

Understanding Functional Communication in Head and Neck Cancer Survivors Using a Mixed Methods Design.

Functional communication, defined as everyday communication with family and friends, at work, and in the community, is an important but understudied concept in the head and neck cancer (HNC) survivor population. The aim of this study was to better understand functional communication by using a mixed methods approach. Head and neck cancer survivors participated in semistructured interviews and completed self-report questionnaires assessing multiple aspects of well-being and health-related quality of life (HRQOL). These qualitative and quantitative data were collected concurrently, analyzed separately, and then integrated. Survivors' perceptions of functional communication ranged from "Communication is good" to "Communication has changed" to "Communication is difficult." Using these qualitative results, survivors were categorized into 3 mutually exclusive groups. Clinically meaningful cut points were exceeded on measures of depressive symptoms (18%), state (40%) and trait (54%) anxiety, and pain (18%). Health-related quality of life scores were moderate to high for the sample as a whole. Statistically significant group differences were found only on the HNC-specific measure of HRQOL. A surprising finding was that the lowest mean score on social function was in the "Communication has changed" group. This group perceived changes in speech and voice that bothered them when communicating in social situations, although their speech was clear to a listener. An underrecognized subpopulation of HNC survivors may exist, whose day-to-day functional communication has changed in ways that impact their relationships and sense of self. Clinical identification of this subpopulation and provision of appropriate interventions are essential to facilitate optimal HRQOL after HNC treatment.

Dopaminergic Mechanisms Underlying Normal Variation in Trait Anxiety.

Trait anxiety has been associated with altered activity within corticolimbic pathways connecting the amygdala and rostral anterior cingulate cortex (rACC), which receive rich dopaminergic input. Though the popular culture uses the term "chemical imbalance" to describe the pathophysiology of psychiatric conditions such as anxiety disorders, we know little about how individual differences in human dopamine neurochemistry are related to variation in anxiety and activity within corticolimbic circuits. We addressed this issue by examining interindividual variability in dopamine release at rest using [11C]raclopride positron emission tomography (PET), functional connectivity between amygdala and rACC using resting-state functional magnetic resonance imaging (fMRI), and trait anxiety measures in healthy adult male and female humans. To measure endogenous dopamine release, we collected two [11C]raclopride PET scans per participant. We contrasted baseline [11C]raclopride D2/3 receptor binding and D2/3 receptor binding following oral methylphenidate administration. Methylphenidate blocks the dopamine transporter, which increases extracellular dopamine and leads to reduced [11C]raclopride D2/3 receptor binding via competitive displacement. We found that individuals with higher dopamine release in the amygdala and rACC self-reported lower trait anxiety. Lower trait anxiety was also associated with reduced rACC-amygdala functional connectivity at baseline. Further, functional connectivity showed a modest negative relationship with dopamine release such that reduced rACC-amygdala functional connectivity was accompanied by higher levels of dopamine release in these regions. Together, these findings contribute to hypodopaminergic models of anxiety and support the utility of combining fMRI and PET measures of neurochemical function to advance our understanding of basic affective processes in humans.SIGNIFICANCE STATEMENT It is common wisdom that individuals vary in their baseline levels of anxiety. We all have a friend or colleague we know to be more "tightly wound" than others, or, perhaps, we are the ones marveling at others' ability to "just go with the flow." Although such observations about individual differences within nonclinical populations are commonplace, the neural mechanisms underlying normal variation in trait anxiety have not been established. Using multimodal brain imaging in humans, this study takes initial steps in linking intrinsic measures of neuromodulator release and functional connectivity within regions implicated in anxiety disorders. Our findings suggest that in healthy adults, higher levels of trait anxiety may arise, at least in part, from reduced dopamine neurotransmission.

What Lies Beneath Trait-Anxiety? Testing the Self-Regulatory Executive Function Model of Vulnerability.

Vulnerability to psychological disorder can be assessed with constructs such as trait anxiety and neuroticism which among others are transdiagnostic risk factors. However, trait-anxiety and related concepts have been criticised because they don’t illuminate the etiological mechanisms of psychopathology. In contrast, the metacognitive (S-REF) model offers a framework in which metacognitive knowledge conceptualised in trait terms is part of a core mechanism underlying trait-anxiety and related constructs. The present study therefore set out to explore metacognitions as potential underlying factors in trait-anxiety (the propensity to depression and anxiety). Nine hundred and eighty two participants completed self-report measures of metacognitions and trait-anxiety at time 1, and 425 individuals completed the same measures 8 weeks later. At the cross-sectional level, metacognitions accounted for 83% of the variance in anxiety- and 64% of depression propensity. Furthermore, despite both domains of trait-anxiety showing high stability over time, negative- and positive metacognitive beliefs were significant prospective predictors of both domains of vulnerability. These findings suggests that metacognitive beliefs may be an underlying mechanism of vulnerability attributed to trait-anxiety with the implication that the metacognitive (S-REF) model informs conceptualization of psychological vulnerability, and that metacognitive therapy applications might be employed to enhance psychological resilience.

The influence of Val158Met COMT on physiological stress responsivity

We tested the extent to which the catechol-O-methyltransferase (COMT) Val158Met polymorphism is associated with stress response and pain in both men and women. The participants were assessed on measures of perceived pain and state/trait anxiety in association with their COMT allele status. We also measured cortisol and salivary alpha-amylase (sAA) levels since previous research suggests an association between the COMT Val159Met polymorphism, cortisol secretion, and sAA activity. We found significant differences between methionine (Met) allele carriers and valine (Val) homozygotes following a stress manipulation in sAA levels. Met allele carriers had a stronger sAA response when compared to Val homozygotes. Furthermore, Val homozygotes showed a positive correlation between their sAA levels and trait anxiety at baseline and 20 min post-stress manipulation but displayed a negative correlation with the change in sAA levels from baseline to 20 min post-stress manipulation. Finally, state/trait anxiety was significantly correlated in Met allele carriers. These findings add support to the COMT warror/worrier model which states under stressful situations, increased dopamine levels in Val (warrior) homozygotes affords an emotional advantage relative to Met (worrier) allele carriers, who show an increased reactivity to aversive stimuli.Summary These findings offer new support for the warrior/worrier model of COMT genotype (rs4680) on human behavior. Twenty minutes following exposure to a cold stress, Val homozygotes (warrior) showed a lower biochemical stress response (salivary alpha-amylase, sAA) relative to methionine (Met) allele carriers (worrier). We further show that the COMT genotype differentially influences state and trait anxiety measures as they relate to stress responses and to each other.

Explicit and Ambiguous Threat Processing: Functionally Dissociable Roles of the Amygdala and Bed Nucleus of the Stria Terminalis.

Highly influential models have proposed that responses to different types of threat are mediated by partially segregated neural systems, with the amygdala underlying phasic responses to explicit threat (fear) and the bed nucleus of the stria terminalis (BNST) mediating sustained responses to ambiguous threat (anxiety). However, newer models have suggested similar recruitment of both regions across a wide spectrum of threat. Therefore, to empirically test these models and further elucidate the activation profiles and connectivity patterns of the amygdala and the BNST during threat processing, 20 participants were scanned using high-resolution fMRI (1.5 mm3). Using fearful faces and human screams as aversive stimuli, two threat conditions were created: Explicit Threat in which threats were certain and predictable (fear) and Ambiguous Threat in which threats were uncertain and unpredictable (anxiety). Results indicated that, although the amygdala and the BNST both showed heightened engagement across both threat conditions, the amygdala showed preferential engagement during Explicit Threat and displayed functional connectivity with regions involved in stimulus processing and motor response. By contrast, the BNST preferentially responded during Ambiguous Threat and exhibited functional connectivity with prefrontal regions underlying interoception and rumination. Furthermore, correlations with questionnaires measuring trait anxiety, worry, and rumination suggested that individual differences in affective style play a modulatory role in regional recruitment and network connectivity during threat processing.

Obstructive sleep apnea in children: How it affects parental psychological status?

Purpose of the studyThe aim of this study was to evaluate the influence of obstructive sleep apnea (OSA) in children on maternal and paternal anxiety. Patients and methodsThis prospective study was conducted from January 2013 until January 2016 in the Ear, Nose and Throat (ENT) Department at the University Hospital of Split, Croatia. The parents of 59 children with a median age of 5 years (range: 2–9) who were suffering from obstructive sleep apnea (OSA) due to adenotonsillar hypertrophy were enrolled into the study. All children were scheduled for adenoidectomy or adenotonsillectomy because of airway obstruction. In addition, their parents completed the 20-item State-Trait Anxiety Inventory-1 (STAI-1) and 20-item State-Trait Anxiety Inventory-2 (STAI-2) questionnaires before the operation and 30 days after the surgery when their children had considerable improvements in breathing during their sleep. The STAI is an instrument that quantifies both state (STAI-1) and trait (STAI-2) anxiety. State-Trait Anxiety Inventory-1 (state anxiety) is intended to measure transitory anxiety at a specific time (related to OSA symptoms in our study), whereas STAI-2 (trait anxiety) measures long-term anxiety. ResultsOverall, the study included 57 mothers and 53 fathers of 59 children diagnosed with OSA. The mean preoperative STAI-2 score of parents was 31.1 ± 7.5; for fathers it was 28.2 ± 6.3, and for mothers it was 33.7 ± 7.6. The STAI-1 and STAI-2 scores showed significant differences before and after the surgery according to gender. The mean score of mothers was 5.5 (95% CI: 2.8 to 8.1) higher than the mean score of fathers (t = 4.1, p < 0.001) on the STAI-2 scale. The mean score of mothers was 5.6 (95% CI: 0.48 to 0.7) higher than the mean score of fathers (t = 2.2; p = 0.032) on the preoperative STAI-1 scale. The mean score of mothers was 1.95 (95% CI: 0.35 to 3.6) higher than the mean score of fathers (t = 2.4; p = 0.017) on the postoperative STAI-1 scale. The mean score of mothers was 6.22 higher than the mean score of fathers (p = 0.029) on the preoperative STAI-1 scale, adjusted for the STAI-2 scale. The mean score of mothers was 1.8 higher than the mean score of fathers (p = 0.039) on the postoperative STAI-1 scale, adjusted for the STAI-2 scale. These data suggest that differences between the preoperative and postoperative STAI-1 score for mothers was the highest (51 ± 7) in children with severe OSA and the lowest (28 ± 14) in children with mild OSA (p < 0.001). The difference between the preoperative and postoperative STAI-1 score for fathers was the highest (48 ± 6.6) in children with severe OSA and the lowest (25 ± 10) in children with mild OSA. ConclusionThe results of our study suggest that obstructive sleep apnea in children is a disturbing symptom for parents and is associated with a significant level of anxiety that depends on OSA severity. After the surgical treatment of the children (adenoidectomy or adenotonsillectomy), the anxiety level of both parents decreased. We suggest that preoperative psychological intervention should be considered in selected cases for mothers and fathers of children with severe OSA in order to diminish the symptoms of anxiety that can compromise normal postoperative recovery in operated children.

Dimensions of Anxiety, Age, and Gender: Assessing Dimensionality and Measurement Invariance of the State-Trait for Cognitive and Somatic Anxiety (STICSA) in an Italian Sample.

The State–Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a widely used measure of state and trait anxiety that permits a specific assessment of cognitive and somatic anxiety. Previous research provided inconsistent findings about its factor structure in non-clinical samples (e.g., hierarchical or bi-factor structure). To date, no psychometric validation of the Italian version of the STICSA has been conducted. Our study aimed to determine the psychometric functioning of the Italian version of the STICSA, including its dimensionality, gender and age measurement equivalence, and convergent/divergent validity in a large sample of community-dwelling participants (N = 2,938; 55.9% female). Through confirmatory factor analysis, the multidimensional structure of both State and Trait STICSA scales, with each including Cognitive and Somatic dimensions, was supported. Factor structure invariance was tested and established at configural, metric, and scalar levels for males and females. Additionally, full factorial measurement invariance was supported for the State scale across young, middle age, and old adult groups whereas the Trait scale was partially invariant across age groups. The STICSA also showed good convergent validity with concurrent anxiety measures (State-Trait Anxiety Inventory and Beck Anxiety Inventory), and satisfactory internal discriminant validity with two depression measures (Teate Depression Inventory and Beck Depression Inventory-II). Results provided support for the multidimensionality of the STICSA, as well as the generalizability of the State and Trait scales as independent measures of Cognitive and Somatic symptomatology across gender in the general population. Implications for research and personality and clinical assessment are discussed.