Self-reported Anxiety Levels Research Articles

Mental Health during Medical Transition in a US and Canadian Sample of Early Socially Transitioned Transgender Youth

PurposeThis study aimed to shed light on the mental health of a unique group of medically transitioning transgender adolescents: those who had made a binary social transition during childhood and who, in general, had not experienced substantial gender-incongruent puberty. MethodsStudy participants were part of a broader longitudinal study comprising 3 groups: transgender youth, their cisgender siblings, and unrelated cisgender peers. Using multilevel models, we compared self-reported and parent-reported levels of anxiety and depressive symptoms among transgender youth at 3 stages: before youth had begun puberty blockers; after they had begun blockers; and after they had begun hormone therapy. We also compared age-based mental health trajectories in transgender and cisgender youth. ResultsIn this sample of transgender youth who sought and received gender-affirming medical care, participants experienced stable and relatively low levels of psychological distress across stages of medical transition and across time. There was one exception: transgender girls showed increased, followed by decreased, parent-reported depressive symptoms over time. In contrast, cisgender girls showed increases in internalizing symptomatology (with the exception of parent-reported anxiety) as they got older, and cisgender boys showed decreased self-reported anxiety and increased, followed by decreased, parent-reported depressive symptoms. By mid-adolescence, levels of anxiety and depressive symptoms among transgender girls and transgender boys generally fell between those of cisgender girls and cisgender boys. DiscussionResults demonstrate that transgender youth who are socially and medically supported in their gender identity can experience stable and positive mental health throughout the notoriously challenging developmental period of adolescence.

OSCE RELATED ANXIETY IN ASSOCIATION WITH PERCEIVED VS ACTUAL PERFORMANCE

Objectives: The study investigates the impact of anxiety on medical students performance in Objective Structured Clinical Examinations (OSCEs), focusing on the relationship between self-perceived and actual performance. Methods: Conducted among 5th-year medical students at Taif University, the study used an online questionnaire with the PHQ-4 scale to measure anxiety and depression. The aim was to correlate these levels with students self-assessment and actual performance in OSCEs. Results: The study analyzed responses from 62 students. The average self-reported anxiety level was 8.95 ± 1.348 on a 10-point scale, with 64.5% of students reporting severe anxiety and depression. No significant gender differences in anxiety and depression severity were noted (p=0.308). Higher levels of anxiety and depression were reported by students who perceived their grades as lower, although this was not statistically significant (p=0.431). There was no statistically significant correlation between anxiety/depression severity and actual grades (p=0.280). Conclusions: The study underscores the prevalent issue of anxiety among medical students and its potential influence on their self-perceived performance in critical evaluations like OSCEs. It suggests the necessity for targeted interventions to manage student anxiety, which could enhance self-assessment accuracy and overall performance.

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study

BackgroundThe response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time. Methods297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships. ResultsLCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional. ConclusionsOn a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

Death Anxiety: An Exploration of Professional Counselor Experiences.

This quantitative research study guided by Terror Management Theory (TMT) provides a theoretical framework to understand death anxiety among practicing counselors while providing support for implementing death education into counseling graduate programs. The total sample comprised 97 total practicing counselors and current counseling students who were recruited from online platforms consisting of professional memberships, listservs, private practice, and Facebook groups. This study explored the level of death anxiety in counselors (measured by the Death Anxiety Scale-Extended (DAS-E; Templer et al., 2006) and examined the relationships between religious and/or spiritual affiliation, death education exposure, and years of practice (measured by a demographic questionnaire) through an online survey that measured counselor's religious and/or spiritual affiliation, death education exposure, years of practice in the field, and their self-reported levels of death anxiety. A Pearson correlation indicated that religious and/or spiritual affiliation and death education were significantly positively associated with years of practice in the counseling field. A regression analysis revealed that death education significantly predicted death anxiety levels. The results of the study indicated that the more death education an individual had received the less likely they were to experience death anxiety. The findings of this study affirm the need for support of a death education curriculum and to encourage CACREP counseling graduate programs to promote knowledge and awareness around death in order to better prepare counseling master's students to serve clients.

Modeling Sensor-based Vigilance Decrement in the Healthcare Environment

Vigilance refers to an individual’s ability to maintain attention over time. Vigilance decrement is particularly concerning in clinical environments where shift work and long working hours are common. This study identifies significant factors and indicators for predicting and monitoring individuals’ vigilance decrement. We enrolled 11 participants and measured their vigilance levels by recording their reaction times while completing the Psychomotor Vigilance Test. Additionally, we measured participants’ physiological responses and collected their sleep deprivation data, demographic information, and self-reported anxiety levels. Using repeated-measures correlation analysis, we found that decreased vigilance levels, indicated by longer reaction times, were associated with higher electrodermal activity ( p < .01), lower skin temperature ( p < .001), shorter fixation durations ( p < .05), and increased saccade frequency ( p < .05). Moreover, sleep deprivation significantly affected vigilance decrement ( p < .001). Our findings provide the potential to develop a predictive model of vigilance decrements using physiological signals collected from non-intrusive devices, as an alternative to current behavior-based methods.

Nurse academics and the teaching of undergraduate nursing numeracy: A cross-sectional study of self-reported confidence and anxiety

BackgroundNumeracy and mathematics are terms that can cause anxiety, not only in students, but this emotion can also be experienced in teachers. Anxiety can inhibit teacher performance and is correlated with low self-confidence. The anxiety felt by school teachers when teaching mathematics is widely reported, however, the self-reported confidence and anxiety levels of nurse academics when teaching numeracy concepts to undergraduate nursing students has never been studied. AimTo explore and analyse Australian nurse academics' self-reported confidence and anxiety levels when teaching nursing numeracy to undergraduate nursing students. DesignCross-sectional survey. SettingAustralian universities that provide an undergraduate nursing degree leading to nursing registration. ParticipantsAustralian nurse academics employed either permanent full time or part time; casual /sessional; or on a fixed term contract, who teach nursing numeracy and medication calculations to undergraduate nursing students. MethodsA combination of convenience and purposive sampling was used to recruit Australian nurse academics (n = 170). Data were collected between Nov 2023 and Feb 2024 using an online survey platform. ResultsAlmost 50 % of participants self-reported feeling either not confident or somewhat confident and very or somewhat anxious when teaching nursing numeracy. There were no significant differences in overall confidence and anxiety based on demographic variables, indicating this is a widespread issue. A non-significant trend towards level A academics experiencing higher anxiety and less confidence was noted. ConclusionsA significant proportion of students are being taught nursing numeracy by nurse academics who lack confidence and experience anxiety, which can be transferred to students, affecting learning and performance. The downstream consequences are potentially poor numeracy skills in students and compromised patient safety. Strategies that have been effective in reducing school teachers' anxiety could be used to support nurse academics.

Enhancing Safety in Autonomous Vehicles: The Impact of Auditory and Visual Warning Signals on Driver Behavior and Situational Awareness

Semi-autonomous vehicles (AVs) enable drivers to engage in non-driving tasks but require them to be ready to take control during critical situations. This “out-of-the-loop” problem demands a quick transition to active information processing, raising safety concerns and anxiety. Multimodal signals in AVs aim to deliver take-over requests and facilitate driver–vehicle cooperation. However, the effectiveness of auditory, visual, or combined signals in improving situational awareness and reaction time for safe maneuvering remains unclear. This study investigates how signal modalities affect drivers’ behavior using virtual reality (VR). We measured drivers’ reaction times from signal onset to take-over response and gaze dwell time for situational awareness across twelve critical events. Furthermore, we assessed self-reported anxiety and trust levels using the Autonomous Vehicle Acceptance Model questionnaire. The results showed that visual signals significantly reduced reaction times, whereas auditory signals did not. Additionally, any warning signal, together with seeing driving hazards, increased successful maneuvering. The analysis of gaze dwell time on driving hazards revealed that audio and visual signals improved situational awareness. Lastly, warning signals reduced anxiety and increased trust. These results highlight the distinct effectiveness of signal modalities in improving driver reaction times, situational awareness, and perceived safety, mitigating the “out-of-the-loop” problem and fostering human–vehicle cooperation.

Excessive smartphone use increases self-reported auditory and vestibular symptoms.

With widespread smartphone use, there is growing concern about their potential impact on human health. The effects of smartphone use on self-reported hearing ability, tinnitus, balance, falls, and anxiety level were investigated in this study. This study included 682 participants who were divided into 2 groups: ahigh smartphone use (HSU) group and alow smartphone use (LSU) group. Both groups were evaluated for hearing ability using the Amsterdam inventory for auditory disability and handicap; balance status using the vertigo, dizziness, imbalance symptom scale; anxiety status using the Beck anxiety index; and fall and tinnitus status using the visual analog scale. The HSU group showed significantly worse hearing ability, tinnitus, balance, falling, and anxiety status results than the LSU group (p < 0.001). There was apositive correlation between smartphone addiction severity and auditory impairment, tinnitus, risk of falling, and anxiety, as well as anegative correlation with balance score (p < 0.001). The findings suggest that individuals with excessive smartphone use are more likely to experience hearing, tinnitus, balance, falling, and anxiety problems than those who use smartphones less frequently. Excessive smartphone use may be considered apotential risk factor for these problems.

A multidimensional tool to measure farm stressors: development and initial validation of the farmer stress assessment tool (FSAT)

BackgroundFarming is a stressful occupation, and a growing body of research shows that farm stressors are associated with poor mental health. To date, there are few methodologically sound surveys that assess farm stressors, and none have been validated for the Canadian context. Our study aimed to: (a) investigate the types of stressors experienced by farmers, (b) develop a farm stress assessment tool and test its factor structure and internal consistency, and (c) assess its criterion-related validity to self-reported levels of anxiety, depression, burnout, and resilience among farmers.MethodsWe developed a 20-item survey based on a review of the literature, examining existing farm stress surveys, and consulting 10 farmers and agricultural industry experts. Then, a convenience sample of farmers living in Alberta, Canada (Sample 1, N = 354) completed a questionnaire containing the 20-item farm stress survey and four validated measures that assessed depression, anxiety, burnout, and resilience. Sample 1 was used to assess the factor structure using exploratory factor analysis (EFA), internal consistency, and criterion-validity of the survey. Next, a convenience sample of farmers living outside of Alberta (Sample 2, N = 138) was used to evaluate the factor structure of the survey using confirmatory factor analysis (CFA).ResultsThe results of the EFA revealed five underlying dimensions of farm stressors: Unexpected work disruptions, Agricultural hazards, Farm and financial planning, Isolation, and Regulations and public pressure. The subscales accounted for 61.6% of the variance, and the internal consistency (Cronbach’s alpha) ranged from 0.66 to.75. Subscale correlations were below 0.44, indicating evidence of discriminant validity. Correlations between the five subscales and the four mental health outcome variables supported the criterion-related validity of the survey. The results of the CFA indicated that the data fit the model, and fit was further improved by correlating one pair of error terms.ConclusionsPreliminary analysis of our Farmer Stress Assessment Tool (FSAT) suggests it is a reliable and valid instrument for measuring a range of stressors farmers face. Implications for policy and community-based mental health interventions that help farmers manage the enduring stressors of agriculture is discussed.

Comparison of first-year nursing students' GAD-7 scores: a pilot study focusing on Generation Z.

In a post-pandemic landscape, Generation Z (Gen Z) nursing students are increasingly facing mental health challenges, notably anxiety. This study investigated these challenges among first-year nursing students. The primary objective was to assess self-reported anxiety levels in first-year undergraduate nursing students, focusing on Gen Z, before or at the onset of their initial clinical placement post-pandemic. Employing a cross-sectional design, this study used the Generalized Anxiety Disorder-7 (GAD-7) questionnaire to evaluate anxiety levels. It encompassed first-year nursing students from various fields at a university in North East England, considering generational differences, field of nursing, and demographic variables. Results indicated anxiety levels among generational groups, with Gen Z students exhibiting extreme variations. Notably, students in Mental Health Nursing reported less anxiety than their counterparts in other nursing fields. The study also sheds light on the ramifications of the COVID-19 pandemic on student mental health. The study underscores the necessity for bespoke support systems in educational and clinical environments, particularly for Gen Z students. It advocates for comprehensive strategies in universities and clinical settings to nurture nursing students' emotional health, thereby enhancing their resilience and long-term career prospects.

Wearable Technology Insights: Unveiling Physiological Responses During Three Different Socially Anxious Activities

Wearable technology holds promise for monitoring and managing Social Anxiety Disorder (SAD), yet the absence of clear biomarkers specific to SAD hampers its effectiveness. This paper explores this issue by presenting a study investigating variances in heart rate, heart rate variability, and skin conductance between socially anxious and non-anxious individuals. One hundred eleven non-clinical student participants participated in groups of three in three anxiety-provoking activities (i.e., speech, group discussion, and interview) in a controlled lab-based study. During the study, electrocardiogram (ECG) and electrodermal activity (EDA) signals were captured via on-body electrodes. During data analysis, participants were divided into four groups based on their self-reported anxiety level (“None”, “mild”, “moderate”, and “severe”). Between-group analysis shows that discriminating ECG features (i.e., HR and MeanNN) could identify anxious individuals during anxiety-provoking activities, while EDA could not. Moreover, the discriminating ECG features improved the classification accuracy of anxious and non-anxious individuals in different machine-learning techniques. The findings need to be further scrutinized in real-world settings for the generalizability of the results.

PublicVR: a virtual reality exposure therapy intervention for adults with speech anxiety

Speech anxiety, or Glossophobia, currently affects approximately 75% of the population with potentially severe negative effects on those with this condition. There are several treatments currently available with research showing that the use of Virtual Reality (VR) as a non-pharmacologic treatment can have positive effects on individuals suffering from such social phobias. However, there is a significant lack of treatments currently available for speech anxiety, even though such a large number of the population are affected by it. In this paper, we aim to contribute to efforts to improve the effects of speech anxiety through a VR intervention. Our VR solution was designed following the Exposure Therapy approach for treating social anxiety disorders. The evaluation of this work was twofold: A. to assess the ability of our solution to positively change participants’ perception of factors related to non-verbal communication contributing to anxiety toward public speaking, and B. to determine whether it is able to induce a sense of presence. We carried out an empirical evaluation study that measured participants’ self-reported anxiety level towards public speaking using the Personal Report of Public Speaking Anxiety and their perceived sense of presence using the iGroup Presence Questionnaire. Our results demonstrate the potential of VR Exposure Therapy solutions to assist towards positively changing perception of factors related to non-verbal communication skills that contribute to increasing public speaking anxiety for participants suffering from self-reported speech anxiety symptoms. Our findings are of wider importance as they contribute to ongoing efforts to improve social anxiety-related phobias.

A prospective study on EEG default mode network associated with subsequent posttraumatic stress disorder following sexual assault

This study aimed to explore the predictors of posttraumatic stress disorder (PTSD) in women who have recently experienced sexual assault, by examining psychological and neurophysiological factors using a prospective design with resting-state electroencephalogram (EEG) functional connectivity. The study enrolled 33 women who had been recently traumatized by sexual assault and conducted assessments within a month of the trauma. These survivors were evaluated for PTSD three months later and were classified into two groups: PTSD positive (n = 12) and PTSD negative (n = 21). They were compared to two control groups comprising women who had not experienced any extremely traumatic events: 25 with depression and 25 healthy controls. The evaluation focused on resting-state EEG functional connectivity within default mode network (DMN) using small-worldness (SW), based on graph theory. We also assessed self-reported levels of depression, anxiety, anger, and executive functions. The findings indicated that survivors who developed PTSD three months post-trauma exhibited higher anxiety levels and reduced DMN SW in the beta 3 frequency, compared to those who did not develop PTSD. Contrary to expectations, survivors without PTSD showed decreased executive functioning and lower prefrontal centrality compared to those with PTSD. This study underscores the importance of early assessment and intervention for sexual assault survivors at risk of developing PTSD.

Effectiveness and safety of Buzzy device in needle-related procedures for children under twelve years of age: A systematic review and meta-analysis.

Pain transcends simple physiology, encompassing biological, emotional, psychological, and social facets. Children show pronounced immediate and enduring responses to pain-related procedures. The aim of this meta-analysis is to investigate the efficacy and safety of the Buzzy device for needle-related procedures in children aged twelve years or younger. PubMed, Web of Science, and Embase were searched from inception to July 2023. Only randomized controlled trials utilizing the Buzzy device for needle-related procedures in children under twelve years old were included. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment. Random-effects models were utilized, and analyses were performed using mean differences or standardized mean differences as well as risk ratios. A total of 19 studies were included, involving 2846 participants (Buzzy = 1095, Control = 1751). Compared to no intervention, the Buzzy device significantly reduced pain response [self-report SMD = -1.90 (-2.45, -1.36), parental SMD = -3.04 (-4.09, -1.99), observer SMD = -2.88 (-3.75, -2.02)] and anxiety scores [self-report SMD = -1.97 (-3.05, -0.88), parental SMD = -2.01 (-2.93, -1.08), observer SMD = -1.92 (-2.64, -1.19)]. Compared to virtual reality (VR), the Buzzy device reduced self-reported anxiety levels SMD = -0.47 (-0.77, -0.17), and compared to distraction cards, the Buzzy device reduced parental and observer-reported pain [parental SMD = -0.85 (-1.22, -0.48), observer SMD = -0.70 (-1.00, -0.40)] and anxiety [parental SMD = -0.96 (-1.46, -0.47), observer SMD = -0.91 (-1.40, -0.42)]. Subgroup analysis results showed that procedure type, patient age, measurement scales used, and distance of operation were not the reason of heterogeneity. The summarized first puncture attempt success rate did not differ from other interventions. There were no significant adverse events in the included studies. The Buzzy device reduces pain and anxiety in children during needle procedures, ensuring success and safety. Additionally, the effectiveness of the Buzzy device in reducing pain during venipuncture is superior when compared to its effectiveness during intramuscular injections.

Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem.

To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. The reporting follows the STROBE checklist. People who were invited to participate voluntarily completed a range of questionnaires.

The correlation between self-reported sleep quality, anxiety levels, and balance confidence among university students

Recently, the incidence of poor sleep quality and anxiety levels has increased among university students. The psychological and physical factors that students commonly experience may also correlate with their ability to balance confidently during daily activities. This study aimed to examine the relationship between sleep quality, anxiety levels, and balance confidence among university students. A total of 217 participants, aged between 18 and 25 years, with no hearing loss or vestibular/balance disorder, no metabolic, neurological, or psychiatric diseases, and no sleep apnea, were included in the study. The Activities-Specific Balance Confidence Scale, Pittsburgh Sleep Quality Index, and Beck Anxiety Inventory were used. Anxiety level and poor sleep quality were negatively correlated with balance confidence ( r = −.323 for anxiety, r = −.293 for sleep quality, p &lt; .001). In addition, a moderate positive correlation was observed between sleep quality and anxiety level ( r = .504, p &lt; .001). Participants with good sleep quality had higher balance confidence scores than those with poor sleep quality ( p &lt; .001). Similarly, those with mild anxiety levels had higher balance confidence scores than those with moderate or high anxiety levels ( p = .03). Poor sleep quality, an increase in anxiety, and a decline in balance confidence were interrelated among university students. These findings can aid the development of interventions to improve sleep quality, anxiety levels, and balance confidence among university students, thereby improving their health and wellbeing.

Dual-Vaping of Nicotine and Cannabis Among Adults Who Currently Use Tobacco Products in Five New England States.

Current measures of vaping behaviors in the U.S. do not distinguish what substances participants are vaping and to what extent they are dual-vaping nicotine and cannabis. This study describes the use of new survey questions that more specifically ask whether participants who vape are vaping nicotine, cannabis, cannabidiol (CBD), or another substance. Adults, who reported any past 30-day tobacco use, from five New England states participated in an online survey from April 2021 to July 2022. Participants who vaped were asked, "Have you used any of the following vape substances in the past 30 days?" with the possible responses of nicotine, cannabis, CBD, other, and "don't know." Dual use of both nicotine and cannabis was defined as the vaping of both nicotine and cannabis and/or CBD in the past 30 days, operationalized as a dichotomous outcome. Data were collected in monthly, repeated cross-sectional waves. Multinomial logistic regression was used to examine correlates of dual-vaping. The analytic sample included 1547 adults who reported past 30-day tobacco use (mean age 42.9 years, 62.8% female, 85.4% White, 48.5% income of less than $50 000). Over one-quarter (26.1%) reported dual-vaping in the past 30 days. Identifying as male (p = .002) and self-rated anxiety (p = .043) were associated with a higher odds of dual-vaping. Our findings show that a sizable proportion of a sample of New England adults who have used tobacco in the past 30 days are dual-vaping nicotine and cannabis. Adequate survey measures for assessing the vaping of multiple substances can help in better screening and characterization of health behaviors around dual-use. This study addresses a key gap in adequate survey measures for assessing vaping of multiple substances. We found that among adults with past 30-day tobacco use, dual-vaping was prevalent and associated with different correlates, such as self-reported anxiety and education level, compared to sole-vaping of nicotine or cannabis. Our findings may help in characterizing and targeting future population-level surveillance and intervention efforts for multiple substance use behaviors.

Association of pre-migration socioeconomic status and post-migration mental health in Syrian refugees in Lebanon: a descriptive sex-stratified cross-sectional analysis

BackgroundRefugee populations present with high levels of psychological distress, which may vary among sociodemographic characteristics. Understanding the distribution across these characteristics is crucial to subsequently provide more tailored support to the most affected according to their specific healthcare needs. This study therefore seeks to investigate the association between pre-migration socioeconomic status (SES) and post-migration mental health separately for male and female Syrian refugees in Lebanon.MethodsIn a cross-sectional study, a cluster randomized sample of 599 refugees from Syria were recruited between 2016 and 2019 within 12 months after they fled to Lebanon. Logistic regression was used to determine the association between self-reported pre-migration SES and levels of anxiety and depressive symptoms assessed on the Hopkins Symptoms Checklist-25 (HSCL-25) scale, both for the entire sample and stratified by sex. To assess the informative value of self-reported SES, its correlation with education variables was tested. All analyses were conducted in R version 4.3.ResultsUsing complete cases, 457 participants (322 female, 135 male) were included in the analyses. Females showed on average more symptoms of anxiety (Median: 2.5) and depression (Median: 2.4) than males (Median: 2.10 and 2.07, respectively). Below average SES was associated with significantly higher odds for mental illness compared to average SES (anxiety: OR 4.28, 95% CI [2.16, 9.49]; depression: OR 1.85, 95% CI [1.06, 3.36]). For anxiety, differences between SES strata were larger for males than females. The self-reported SES measure showed only a weak positive correlation with education.ConclusionsThis study adds additional descriptive data highlighting mental health differences in Syrian refugees in Lebanon, whereby below average SES is associated with worse mental health outcomes compared to average SES. These findings demand further research into the underlying mechanisms. Improving our understanding of the observed differences will provide valuable insights that can contribute to the future development of targeted measures.

Stress, depression, and anxiety: psychological complaints across menopausal stages.

With the number of menopausal women projected estimated to reach 1.2 billion by 2030 worldwide, it is critically important to understand how menopause may affect women's emotional well-being and how many women are affected by this. This study aimed to explore (i) the relationship between psychological complaints (depression, anxiety, poor memory) across different menopausal stages and (ii) investigate the correlation between resilience, self-efficacy, and perceived stress levels, with psychological complaints and whether this was associated with menopausal stage and/or age. 287 respondents completed the Menopausal Quality of Life (MenQoL), Perceived Stress Scale (PSS-10), Brief Resilience Scale (BRS), and General Self-efficacy (GSE) scales. Parametric and non-parametric analysis were used to analyse how bothered women were by self-reported poor memory and feelings of depression and anxiety, alongside perceived stress, resilience, and self-efficacy between women in different menopausal stages using STRAW criteria. The association between protective factors (self-efficacy and resilience) and psychological complaints was analysed with partial correlation analysis controlling for menopausal stages and/or age. A significant difference was found between the levels of perceived stress, and how bothered women were by feelings of depression and anxiety between early-perimenopausal and post-menopausal women. However, with the inclusion of age as a covariate, menopausal stage no longer predicted the level of self-reported stress and anxiety in menopausal women. There was also no difference between poor self-reported memory, or of self-efficacy or resilience between women in different menopausal stages. However, self-efficacy and resilience were associated with how bothered women were by feelings of depression and anxiety, and the experience of stress. Stress was the only variable to be associated with poor self-reported memory independent of age and/or menopausal status. Early perimenopausal women experienced the highest level of stress and were more severely bothered by feelings of depression and anxiety, with the poorest overall self-reported psychosocial quality of life. Post-menopausal women, however, reported to have similar experiences as premenopausal women. Age explained the associations between menopausal stage, stress and anxiety, but not between depression and different menopausal stages. Resilience and self-efficacy were associated with psychological complaints independent of menopausal stage and age, suggesting that therapies focusing on increasing resilience and self-efficacy may be beneficial to help target these psychological complaints at any time.

Read the Feed: High-Emotion Simulation of Preterm Feeding to Enhance Graduate-Level Training.

Therapeutic bottle feeding is a critical skill for speech-language pathologists (SLPs) managing the increasing and medically complex neonatal intensive care unit (NICU) and early intervention caseloads. Thus, we explored the role of a high-emotion preterm simulator, known as "Paul," to increase knowledge, skills, and confidence related to infant feeding management for speech-language pathology graduate students. A randomized controlled study compared learning outcomes of 27 participants following either a 1-hr lecture or 1-hr training with a preterm simulator. Outcomes included knowledge demonstrated on written examination, accuracy in identifying stress cues during simulated feeding, and self-reported anxiety levels related to clinically assessing infant feeding. No baseline group differences were found on written examination or during a simulated bottle feeding. Both groups improved in written examination scores and identification of stress cues (p < .001). Gains in written examination scores did not significantly differ between groups; however, after training, the simulator group correctly identified more stress cues during a simulated bottle feeding (p < .001), and the lecture group reported reduced anxiety related to clinically evaluating infant feeding compared to simulator-trained students (p < .05). All students demonstrated gains in written knowledge and identification of stress cues; however, simulation-based training was superior in developing the feeders' ability to identify stress cues during a hands-on simulated bottle-feeding scenario. Lecture-based training may have inflated students' perceptions in their clinical skills as they were less accurate in identifying stress cues during a simulated feeding but reported significantly reduced anxiety for administering a clinical evaluation of infant feeding compared to simulation-trained students. Hands-on training using high-fidelity simulation may capitalize on experiential learning to better build clinical feeding skills for future SLPs who may serve in NICU and early intervention settings, while eliminating the risk of potential errors during learning that could affect fragile neonates.