Spielberger State-Trait Anxiety Inventory Research Articles

Evaluation of the effects of avatar on learning temporomandibular joint in a metaverse-based training.

Avatars, representing users in the digital world, can influence users' behavior and attitudes. This study evaluates the impact of representing dental students receiving temporomandibular joint (TMJ) education in the metaverse via an anonymous or identified avatar. Participants included 80 dental students in their fourth and fifth years of study. They were randomly assigned to either the avatar group (identified avatar) or the control group (anonymous avatar). Prior to training, participants completed a demographic questionnaire and a pretraining knowledge assessment. TMJ training was conducted in the metaverse for both groups. Pre- and post-training assessments included the Spielberger State-Trait Anxiety Inventory and a shyness scale to ensure group comparability. A post-test consisting of five questions was administered to both groups after 2 weeks of training. There were no significant differences in pretraining scores for prior knowledge (p=0.67), trait anxiety (p=0.28), state anxiety (p=0.92), or shyness (p=0.42) between the avatar and control groups, indicating comparability at baseline. Post-training analysis revealed significantly higher post-test scores in the avatar group (median=80) compared to the control group (median=60) (p=0.03). Metaverse environments offer various benefits for students, educators, and educational institutions in health education programs. Representing learners and their identities in training environments can enhance learning outcomes.

Changes in Resting-State Functional Connectivity and Cognitive-Affective Symptoms in Patients With Post-Concussion Syndrome Treated With N-Acetyl Cysteine.

Concussion accounts for more than 80% of people experiencing traumatic brain injury. Acute concussion is associated with characteristic cognitive and functional deficits that may persist for weeks to months. A subgroup of these patients (from 10% to 50%) have persistent symptoms referred to as chronic post-concussion syndrome (PCS). There are limited treatment options for these patients and the pathophysiology is poorly understood, though oxidative stress is thought to be a contributing factor. The purpose of this study was to evaluate whether an antioxidant, N-acetylcysteine (NAC), might be beneficial in patients with PCS. Outpatient medicine center. Fifty patients with chronic PCS for at least 3 months post injury. The patients with PCS were enrolled in this randomized unblinded clinical trial to receive the antioxidant NAC as a combination of daily oral and weekly intravenous infusions, or assigned to a waitlist control group where they would continue to receive standard of care. Resting-state functional connectivity (FC) magnetic resonance imaging (rsFC-MRI) was performed pre and post either NAC or the waitlist period along with cognitive, emotional, and sensory symptom assessments. The results demonstrated significant (P <.05) improvements in symptoms as determined by the Rivermead Post-Concussion Symptoms Questionnaire, Spielberger State-Trait Anxiety Inventory, and Profile of Mood Scale in the PCS group receiving NAC as compared to patients receiving ongoing standard care. Importantly, there were significant (P<.01) changes in FC in the NAC group, particularly in networks such as the default mode network, salience network, and executive control network. These changes in FC also correlated with improvements in symptoms. In patients with chronic PCS, NAC treatment was associated with significant changes in resting state FC and improvement in a variety of symptoms, particularly cognitive and affective symptoms.

The effect of educational- supportive program on the anxiety of mothers of infants admitted to the neonatal intensive care unit (NICU)

IntroductionThe admission of preterm infants to the neonatal intensive care unit (NICU) often causes stress and anxiety in their mothers. Nurses must implement nursing interventions for mothers as the most important caregivers of infants. Accordingly, the present study aimed to explore the effect of Educational- Supportive Program (multi-sensory stimulation) on the anxiety of mothers of preterm infants admitted to neonatal intensive care units. MethodsThe present study used a quasi-experimental design with two groups and pretest and posttest and was conducted on 100 mothers of preterm infants admitted to the neonatal intensive care unit. The mothers who met the inclusion criteria were selected as the participants using convenience sampling and were randomly placed into intervention and control groups (50 persons in each group) by drawing lots. The participants in the intervention group performed multi-sensory interventions for the infant for 12 min at a time, once a day for 5 days a week according to the instructions provided by the researcher. The mothers in the control group did not perform any intervention for their infants. The participants in both groups completed the Spielberger State-Trait Anxiety Inventory (STAI) on the first day and one week after admission. ResultsThe results showed that the mean scores of maternal anxiety for the participants in the intervention and control groups before the intervention were 38.98 ± 3.44 and 35.86 ± 7.16, respectively, showing a statistically significant difference (P = 0.007). Besides, the mean scores of maternal anxiety for the participants in the intervention and control groups one week after the intervention were 33.36 ± 3.46 and 36.22 ± 7.46, respectively, showing a statistically significant difference (P < 0.001). ConclusionThe present study showed that the multisensory stimulation intervention had a positive and significant effect on the anxiety of mothers of preterm infants and reduced it. Therefore, this simple and practical relaxing measure can be used by nurses in clinical settings to reduce maternal anxiety.

Investigating the association between hair progesterone, anxiety, sleep quality, and other determinants in South African females

BackgroundAnxiety symptoms and poor sleep quality are common in women. The role of sex hormones, particularly progesterone, in anxiety and sleep quality in women is understudied. Measurement of hair progesterone concentrations (HPC) is a promising method to investigate the effects of progesterone on anxiety symptoms and sleep quality in women. ObjectivesWe analysed sociodemographic, hair-related, and clinical factors associated with HPC and investigated the association between HPC and anxiety severity and sleep quality in a sample of 159 South African women (mean age: 46.5 years; range: 18–79 years). MethodsData were obtained from control participants from the SHARED ROOTS study. HPC were determined using an established liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Unadjusted and adjusted multiple linear regression models were used to investigate whether sleep quality, measured with the Pittsburgh Sleep Quality Index (PSQI), and anxiety, measured with the Spielberger State-Trait Anxiety Inventory (STAI), were associated with HPC. Significant sociodemographic, hair-related, and clinical factors were adjusted for. ResultsHPC was significantly associated with age, duration of sample storage, hormonal treatment, postmenopausal status, and the number of different types of trauma exposures in adjusted models. Neither anxiety severity nor sleep quality was significantly associated with HPC. ConclusionsCertain demographic, hair related, and clinical factors were associated with HPC and need to be considered in future research using HPC. Although anxiety and sleep were not associated with HPC, greater trauma exposure was associated with higher HPC, suggesting an association between severe stress and hypothalamic-pituitary-gonadal (HPG) axis functioning.

Yoga, Physical Therapy and Home Exercise Effects on Chronic Low Back Pain: Pain Perception, Function, Stress, and Quality of Life in a Randomized Trial.

Low back pain is a common health problem. In this study, we investigated the effects of yoga, physical therapy (PT), and home exercise (HE) on pain perception, function, stress, and quality of life in chronic low back pain (cLBP). We randomly assigned 54 participants to three distinct treatment groups: (a) a physical therapy group (PT) who received spinal stabilization exercises (SSE) combined with local heat and transcutaneous electrical stimulation; (b) a home exercise group (HE) who received SSE as part of the home program; and (c) a yoga group who received yoga exercises. The primary outcome measures were a Visual Analog Scale (VAS) for measuring pain, and the Oswestry Disability Index (ODI) to measure function. Secondary outcome measures were the Tampa Kinesiophobia Scale (TKS), Central Sensitization Inventory (CSI), pain sensitivity (L3 and deltoid R/L PPTs), Spielberger State-Trait Anxiety Inventory (STAI), plasma cortisol and DHEA-S levels, Transversus Abdominis (TrA) muscle activation, and the Nottingham Health Profile (NHP). Assessments were conducted before and after a six-week intervention period. All three groups demonstrated improvements in pain on the VAS, function on the ODI, pain sensitivity on the L3 and deltoid R/L PPTs, CSI, anxiety on the STAI, TrA muscle activation, and quality of life on the NHP (p < .05). The PT group exhibited a more pronounced improvement on the ODI score (p < .05) than the other groups. Cortisol levels only decreased in the PT group (p < .05). The exercises did not impact DHEA-S and NHP-S parameters. Thus, all interventions resulted in decreased stress, pain intensity, pain sensitivity, central sensitization, and improved function and quality of life; there was no singularly superior approach between interventions. These findings will aid in tailoring treatment programs for managing cLBP according to individual needs.

Effectiveness of a peer-to-peer, self-management intervention for young people with depression and anxiety in Denmark: an observational study and a propensity score-matched comparison.

This study investigated the effectiveness of a 7-weeks peer-to-peer program for young people aged 15 to 25 years with depression or anxiety symptoms in Denmark. A total of 483 participants (72% women) participated in the program and the evaluation. The participants completed questionnaires at baseline, postintervention, and at 5-month follow-up to assess changes in depression symptoms (using Beck's Depression Inventory-II), anxiety symptoms (using Spielbergers State-Trait Anxiety Inventory for Adults) and self-efficacy in controlling or managing the illness (using the personal control subscale from the Illness Perception Questionnaire-Revised). Analyses were done using repeated measures mixed linear regression models. Moreover, a register-based matched comparison group was derived as a comparison to assess changes in being in education and employment at 8-month follow-up. Within the intervention group, both depression and anxiety scores declined across the 5-month follow-up compared to baseline (b = -9.6, 95% CI: -11.2, -8.1 for depression symptoms). The self-efficacy score increased from baseline to post-intervention (b = 1.4, 95% CI: 1.0, 1.8) and this level was maintained at follow-up. More than half of the participants were in education at baseline while 24% received social transfer payments. Compared with matched comparison group, a lower proportion of the intervention group remaining in education (71% vs. 80%). Among participants who were employed at baseline, a higher proportion of the intervention group were enrolled in education (27% vs. 19%) and were unemployed (14% vs. 4%) compared to the matched comparison group. This study supports the effectiveness of a peer-to-peer intervention for depression and anxiety symptoms, and self-efficacy in symptom control. However, mixed effects on education and employment were observed, indicating a negative impact on education among those initially enrolled and a higher proportion of employed participants starting education.

Relationship between sleep quality during pregnancy and postpartum anxiety: a prospective birth cohort study

The present study aimed to determine the relationship between sleep quality during pregnancy and postpartum anxiety.A total of 237 pregnant women participated in this birth cohort study, using the sequential sampling method. The data collection tools included a demographic information form, Pittsburgh Sleep Quality Inventory, and Spielberger State-Trait Anxiety Inventory. The PSQI was completed by the participants at 28 and 40 weeks of gestation, and the STAI was completed in two stages, that is, once in the third trimester and once at eight weeks postpartum.The mean global PSQI score of the participants was 8.11 (SD=5.41) in this study. Overall, 138 (58.2%) women had poor sleep quality. The mean score for overt anxiety was 36.58 (SD=9.37), and the mean score for latent anxiety was 37.56 (SD=9.44). There was a significant positive correlation between the total score of sleep quality during pregnancy and the scores of overt anxieties (r=0.314, P&lt;0.001) and latent anxiety (r=0.344, P&lt;0.001) after delivery.The results of the present study indicated a significant relationship between sleep quality during pregnancy and postpartum anxiety. Therefore, it is recommended to evaluate the quality of sleep of pregnant women and design appropriate interventions during pregnancy to reduce postpartum anxiety. Keywords: Sleep; pregnant woman; postpartum period.

Comparison of State-Trait Anxiety and Fear of Childbirth According to Attachment Styles of Pregnant Women.

Fear of childbirth (FoC) and its extreme form, tokophobia, is a clinical condition that can lead to many negative consequences, and its importance is increasingly understood. This article aims to assess the severity of FoC and anxiety levels according to different attachment styles and to investigate the relationships between these factors. A cross-sectional study was conducted in a state hospital in the largest city in Turkey. Three hundred pregnant women attending the Antenatal Outpatient Clinic were included. A sociodemographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire-version-A (W-DEQ), Spielberger State-Trait Anxiety Inventory and Adult Attachment Style Scale were administered. 8.1% of participants had tokophobia (W-DEQ sum score ≥85). FoC was significantly higher in pregnant women who had a history of pregnancy loss and past psychiatric history. For multiparous women, adverse birth outcomes were also associated with higher FoC. State and trait anxiety were positively correlated with FoC levels. Regarding the attachment patterns, pregnant women with avoidant attachment styles presented with higher levels of FoC than those with secure attachment styles. In logistic regression analysis, higher anxiety levels, adverse birth outcomes, and insecure attachment styles were found to predict severe and clinical FoC. FoC has a considerable effect on pregnant women, albeit at different clinical levels. Adverse birth outcomes, high anxiety levels, and insecure attachment styles were associated with higher FoC. Therefore, antenatal patients with adverse birth outcomes and higher anxiety levels, which are risk factors for FoC, should be carefully evaluated in terms of tokophobia and referred to mental health professionals when necessary.

A Pilot Survey of Patient Perspectives on an Artificial Intelligence-Generated Presenter in a Patient Information Video about Face-Down Positioning after Vitreoretinal Surgery

Introduction: Video education is a commonly used patient education tool. However, the impact of integrating artificial intelligence (AI) into video education remains unexplored. This study aimed to examine the acceptability of an AI-generated presenter in a patient information video about face-down positioning after vitreoretinal surgery. Method: We prospectively enrolled participants who were planned for vitreoretinal surgery in which postoperative face-down positioning was recommended at the Royal Adelaide Hospital between December 2022 and September 2023. Participants were preoperatively provided with an educational video presented by an AI-generated presenter, incorporated into a surveyredcap. A pre- and post-video questionnaire was administered electronically. Results: There were 15 participants included in the study. In the pre-video questionnaire, most participants rated their awareness of special equipment for positioning as “not aware” (33%) and “slightly aware” (33%). The median pre-video six-item Spielberger State-Trait Anxiety Inventory Score was 12 (interquartile range 12–15). In the post-video questionnaire, most participants rated the video’s quality as “excellent” (73%) and would recommend it to others (73%). The majority of participants strongly agreed that they understood the AI presenter (60%), felt at ease with the presenter (60%), and trusted the presenter (60%). Four participants (22%) disagreed with the statement: “I was aware the presenter was computer generated.” Conclusions: Video-based education may provide information that patients find useful, particularly for physical maneuvers such as face-down positioning. The use of an AI-generated presenter was well-received by the majority of patients. Further research regarding the use of AI to develop educational video content is warranted.

Mindfulness-based therapy for insomnia in Black women: a pilot randomized controlled trial.

The purpose of the study was to evaluate the feasibility, acceptability, and preliminary efficacy of mindfulness-based therapy for insomnia (MBT-I) among Black women. The MBT-I group received weekly sessions that included mindfulness meditation and behavioral sleep strategies. The time and attention control group received lifestyle health education (HE) that included healthy eating, physical activity, and sleep hygiene. The primary outcome was post-intervention changes in insomnia severity score by the Insomnia Severity Index (ISI) at week 10. Other measures included: Pittsburgh Sleep Quality Index, Sleep Hygiene Practice, Spielberger State-Trait Anxiety Inventory (STAI), and Patient Health Questionnaire-9 (PHQ-9). Objective sleep was measured by Actiwatch™ at baseline and week 10. Thirty Black women completed the interventions with no attrition. About 97% of all participants attended 6-8 out of 8 sessions. The ISI scores were reduced at week 10 (MBT-I vs. HE: -7.67 vs. -7.22, p < .05). Anxiety and depression symptoms were significantly improved only in the MBT-I group. This is the first MBT-I for Black women with insomnia. Online MBT-I may be feasible and acceptable for Black women. The MBT-I and HE showed a clinically significant improvement in insomnia symptoms (ISI reduction > 7). MBT-I may be more effective in improving anxiety and depression symptoms than HE. Our findings encourage further study efforts with a longer follow-up and larger sample size to address sleep health disparities among Black women.

How Does the Anxiety of Primiparae Affect Their Readiness for Newborn Care? Ethnic Primiparous Experiences.

The study was conducted to investigate the relationship between pregnancy-related anxiety levels of primiparae living in an ethnic region and their readiness for postnatal hygienic care of newborns. The study conducted between February and May 2023 included 201 "18-40-year-old primiparae" who lived in an ethnic region and volunteered to participate in the study. The population of the study consisted of all pregnant women who presented to the Gynecology and Obstetrics Clinic, Pregnancy Outpatient Clinic of a city hospital. The "Pregnant Women Personality and Obstetric Characteristics Form," "Pregnant Women's Readiness for Newborn Hygienic Care Scale," and "Spielberg State-Trait Anxiety Inventory" were used as data collection tools. The mean age of the 201 primiparae participating in the study was 26.11 ± 3.05years. Although 71.1% of them felt confident about baby care before the baby was born, 95.5% needed help with baby care after birth. Their readiness for stress and newborn hygienic care was at a "medium" level. There was a statistically significant negative relationship between the scores they obtained from the Pregnant Women's Readiness for Newborn Hygienic Care Scale and Spielberg State-Trait Anxiety Inventory (p = 0.011; r = - 0.180). The participating primiparae experienced moderate levels of anxiety, and the increase in their anxiety levels negatively affected their readiness for the hygienic care of their newborn babies. Thus, when primiparae are provided with healthy newborn care, their anxiety levels should.

Association of quality of life with marital satisfaction, stress, and anxiety in middle-aged women.

Marital satisfaction is one of the important components of quality of life. Women's marital satisfaction is affected when they enter the middle age period, due to the mental and emotional tensions caused by the physical changes. In this regard, the present study aimed to investigate the association of quality of life with marital satisfaction, stress, and anxiety in middle-aged women referring to health centers of Ahvaz city, Iran. This cross-sectional descriptive-analytical study was conducted on 1,000 middle-aged married women (30-59 year of age) under the auspices of health centers of Ahvaz city, Iran in 2019. The subjects were selected by simple random sampling method, and were asked to complete demographic characteristics, quality of life questionnaire, Enrich marital satisfaction questionnaire, Holmes-Raheh stress questionnaire, and Spielberger state-trait anxiety inventory. The data were analyzed by using SPSS 0.22 software through mean, standard deviation, frequency, Pearson correlation and regression (p = 0.05). Based on the results, 42.4% of the participants were between 40 and 50 years of age, 35.6% had a high school diploma, and 50% of them were housewives. Also, the results of Pearson's correlation showed a positive and significant relationship between quality of life and marital satisfaction (r = 0.178) (p < 0.001). However, quality of life had a negative and significant relationship with anxiety (r = -0.552) (r < 0.001) and stress (r = -0.188) (p < 0.001). Given the positive and significant relationship between quality of life and marital satisfaction, appropriate trainings are highly recommended for couples to increase the quality of life and marital satisfaction of middle-aged women and thus strengthen the health of family and society.

A cross-sectional study on dental anxiety and state anxiety related to removal of fixed partial dentures.

This study aimed to evaluate the effect of the clinical removal of fixed partial dentures on oral health-related quality of life and the anxiety values of individuals and to determine the clinical factors of high anxiety levels. In total, 300 participants were included in the study. Six different reasons for the clinical removal of fixed partial dentures (oral examination, denture renewal, endodontic treatment, tooth extraction, periodontal treatment, and composite filling restoration) were defined. The United Kingdom Oral Health-Related Quality-of-Life Measure (OHRQoL-UK), the Modified Dental Anxiety Scale (MDAS), and the Spielberger State-Trait Anxiety Inventory- State (STAI-S) and Trait (STAI-T) were answered. The reason groups were compared using one-way analyses of variance. Binary logistic regression analyses were performed to evaluate the risk factors for high anxiety. There was no significant difference in OHRQoL-UK scores (P &#61; .279) among the reason groups, but there were significant differences in MDAS, STAI-S, and STAI-T scores (P &#61; .004, P .001, P &#61; .018, respectively) among the reason groups. Endodontic treatment, tooth extraction, and sex were determined to be risk factors, considering the anxiety scales. Females are 2.2 times more likely to have trait anxiety than men. Although the effect of the reason for the clinical removal of fixed partial dentures on oral health-related quality of life was similar among the groups, it is concluded that endodontic treatment and tooth extraction reasons for the clinical removal of fixed partial dentures could be risk factors for high anxiety regardless of fixed partial denture usage time.

Evaluation of Anxiety Levels and Family-Centred Care Receipt Status among Turkish Mothers with Babies Admitted to the Neonatal Unit: A Two-Centre Study

This study was conducted to evaluate the anxiety levels and family-centred care receipt status of mothers whose babies were treated in the neonatal intensive care unit (NICU). This research was conducted in a descriptive and cross-sectional design between January and December 2022 in the NICU of two separate hospitals, one of which is a university hospital, and the other is a public hospital located in the east of Turkey. An Introductory Information Form, Spielberger State-Trait Anxiety Inventory, and Newborn Family-Centred Care Scale were used to collect data. The mothers’ state anxiety level mean score was 41.51±9.6, their trait anxiety level mean score was 40.31±7.7, and they experienced a moderate level of anxiety. The total mean score of the Newborn Family-Centred Care Scale was 3.7±0.7 (min 1-max 5). Mean scores from the subscales were 4.0±0.7 for dignity and respect, 3.9±0.8 for information sharing, 4.0±0.8 for participation in care, and 3.3±1.1 for cooperation with the family. A significant negative relationship was found between the mothers’ family-centred care scale total score and mean subscale scores and their state and trait anxiety levels (p

Evaluating The Effectiveness of Nurse-Led Education on The Anxiety Level of Preoperative Candidates for Opening Vascular Access in Shariati Hospital

Background: Every year, many patients with Chronic Kidney Disease (CKD) undergo surgeries to provide suitable vessel access for hemodialysis. These surgeries cause significant anxiety in these patients. Therefore, this study was conducted to examine the effectiveness of nurse-led training on reducing the level of anxiety experienced by these patients. Methods: 38 patients were randomly selected from the candidates for vascular access opening at Shariati Hospital, Tehran, Iran. They were divided equally into two groups: cases and controls. The anxiety level was measured in both groups using the Spielberger State-Trait Anxiety Inventory at baseline. After 30 minutes of personalized training, the anxiety level was reevaluated in the cases and statistically compared with the anxiety level before the intervention using a paired t-test. Results: The mean baseline anxiety level was 40.94 in the cases and 40.42 in the controls. These numbers changed to 34.78 in the cases and 40.05 in the controls after the training intervention. Statistical comparison revealed a significant decrease in the case group (p = 0.048), while the observed difference was statistically insignificant in the controls (p = 0.788). Conclusions: Providing an appropriate personalized nurse-led educational package can significantly reduce the anxiety level in preoperative candidates for vascular access opening in kidney failure cases. Further studies are required to better develop the content of this training and also to determine whether a gap between the training and surgery is required to increase effectiveness.

Prediction of correlation between preoperative parents' anxiety and their child's anxiety before elective surgery under anaesthesia: An observational study.

Preoperative parental anxiety can have a profound impact on their children undergoing surgery. The present study was done to analyse the correlation between preoperative parental anxiety and their child's anxiety in paediatric patients undergoing elective surgery. Paediatric patients aged 2-12 years, scheduled for elective surgeries under general anaesthesia, were included in the study. The child's behaviour and anxiety were assessed in the preoperative area using the modified Yale Preoperative Anxiety Scale (m-YPAS). The parent filled out the demographic questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) form in the preoperative area on the day of surgery. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) statistics software version 23.0 (IBM Corp, Armonk, NY, USA). A total of 150 children undergoing elective surgery were analysed. Our results showed a strong positive correlation between a child's m-YPAS and his/her parents' anxiety on the day of the surgery (STAI-state) (r = 0.545, P < 0.001). However, the correlation between a child's m-YPAS and his/her parents' anxiety levels (STAI-trait) was not found to be significant (r = 0.109, P = 0.188). A positive correlation was observed between a parent's STAI-state and STAI-trait (r = 0.366, P < 0.001). Factors like area of residence, type of surgery and previous hospitalisation had an influence on the anxiety levels of the child. The birth order of the child, previous hospitalisation and gender of the parent also influenced parental anxiety. Parental anxiety has a significant impact on the child's anxiety during the preoperative period.

Clinical Utility of Impact of Event Scale-Revised for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition Posttraumatic Stress Disorder.

The Impact of Event Scale-Revised (IES-R) is a widely used self-report for assessing posttraumatic stress disorder (PTSD), originally aligned with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic criteria. This study aimed to evaluate the applicability of the IES-R under the DSM-5 guidelines and establish a cutoff point for DSM-5 PTSD diagnosis. A total of 238 participants recruited from multiple psychiatric centers, including 67 patients with PTSD, 72 patients with psychiatric controls, and 99 healthy controls, were included in the study. All participants completed the Korean version of the Structured Clinical Interview for the DSM-5 research version to confirm the presence of PTSD, the Korean version of PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory-II, the Beck Anxiety Inventory, and the Spielberger State Trait Anxiety Inventory. The IES-R demonstrated good internal consistency and a high correlation with the PCL-5. Through factor analysis, 5 distinct dimensions emerged within the IES-R: sleep disturbance, intrusion, hyperarousal, avoidance, and numbness-dissociation. A proposed cutoff score of 25 on the IES-R was suggested for identifying patients with PTSD. These findings underscore the scale's concurrent validity with the DSM-5 PTSD criteria and its effectiveness as a screening tool. Implementing a cutoff score of 25 on the IES-R can enhance its utility in identifying DSM-5 PTSD cases.

Preoperative psychological factors influence analgesic consumption and self-reported pain intensity following breast cancer surgery

BackgroundPsychological factors such as anxiety and mood appear to influence acute postoperative pain; however, there is conflicting evidence on the relationship between preoperative psychological parameters and the severity of postoperative pain. In the context of the stressful setting of initial surgery for breast cancer, we conducted a prospective observational study of patients who were scheduled to undergo initial breast cancer surgery.MethodsThe objectives were to examine the potential associations between predefined preoperative psychological parameters and (i) Self-reported pain scores at discharge from the postoperative acute care unit, (ii) Cumulative perioperative opioid consumption at four hours postoperatively and (iii) Self-reported pain as measured during the first seven days after surgery. Patients completed the following questionnaires during the three hours prior to surgery: the Spielberger State Trait Anxiety Inventory (STAI State and Trait), the Pain Catastrophizing Scale (PCS), the Cohen Stress Questionnaire (CSQ), the Hospital Anxiety and Depression Scale (HADS A and D), and the short-form McGill Pain Questionnaire. Postoperative pain experience was assessed using patient self-reports of pain (SF Magill Pain questionnaire on discharge from the postanaesthesia care unit and a pain diary for seven days postoperatively) and records of analgesic consumption.ResultsPre- to postoperative self-reported pain was significantly different with respect to the STAI State, Cohen score and PCS for both low and high values (p < 0.001), but only patients categorized as having low STAI Trait, HADS A, and HADS D values achieved significant differences (p < 0.001). A significant positive correlation was demonstrated between preoperative state anxiety (STAI) and the most severe pain reported during the first seven days postoperatively (r = 0.271, p = 0.013). Patients who were categorized preoperatively as having a “high value” for each of the psychological parameters studied (HADS A and D, STAI State and Trait and PCS) tended to have greater perioperative opioid consumption (up to four hours postoperatively); this trend was statistically significant for HADS D and HADS A only. Using a linear regression model, state anxiety was found to be a significant predictor of postoperative pain based on self-reports during the first seven postoperative days (standardized β = 0.271, t = 2.286, p = 0.025).ConclusionPreoperative state anxiety, in particular, is associated with the severity of postoperative pain experienced by women undergoing initial breast cancer surgery. Formal preoperative assessment of anxiety may be warranted in this setting with a view to optimize perioperative analgesia and wellbeing.

Nonendoscopic Screening for Barrett's Esophagus and Esophageal Adenocarcinoma in At-Risk Veterans.

Although rates of esophageal adenocarcinoma (EAC) in the United States continue to rise, many patients at risk of disease are not screened. EsoCheck (EC), a nonendoscopic esophageal balloon sampling device coupled with EsoGuard (EG), a DNA-based screening assay, is an US Food and Drug Administration-approved minimally invasive alternative to the traditional screening method of upper endoscopy. The objective of this study was to prospectively determine the diagnostic accuracy, tolerance, and acceptability of the EC/EG test in a screening population. We recruited veterans who met the American College of Gastroenterology Guideline criteria for endoscopic Barrett's esophagus (BE) and EAC screening at the Louis Stokes Cleveland Veterans Affairs Medical Center. All study participants completed unsedated EC-guided distal esophageal sampling followed by a sedated esophagogastroduodenoscopy (EGD). Diagnostic yield of the EG assay and EGD was recorded and used in calculation of sensitivity and specificity of EC/EG in prospective screening. The abbreviated Spielberger State-Trait Anxiety Inventory questionnaire was administered before and after completion of EC. Overall tolerance of EC sampling was evaluated on a 10-point Likert scale. Esophageal cancer screening was accepted by 130 of 782 eligible veterans (16.6%), and we analyzed results of those who completed both screening tests (N = 124). Prevalence of BE/EAC among studied veterans was 12.9% (16/124), based on EGD. Sensitivity and specificity of EC/EG for EGD-detected BE/EAC were 92.9% (95% confidence interval [CI] 66.1-99.8) and 72.2% (95% CI 62.1-80.8), respectively. Positive and negative predictive values were 32.5% (95% CI 18.6-49.1) and 98.6% (95% CI 92.4-100), respectively. Baseline Spielberger State-Trait Anxiety Inventory-6 scores were reflective of notable levels of anxiety among veterans in the periprocedural setting. The mean postprocedure acceptability score for the EC test was 7.23 (SD 2.45). Our data suggest excellent sensitivity and negative predictive value of EC/EG in a screening population of veterans, making this modality a powerful screening tool for BE and EAC.

Age-related reduction in anxiety and neural encoding of negative emotional memory.

Older adults experience less anxiety. We examined how memory of negative emotional images varied with age and may reflect age-related differences in anxiety. Fifty-one adults, age 22-80 years, underwent imaging with a memory task where negative and neutral images were displayed pseudo-randomly. They were queried post-scan about the images inter-mixed with an equal number of images never displayed. Sensitivity (d') and reporting bias (Z-score of false alarm rate; Z[FAR]) were quantified with signal detection theory. Age was negatively correlated with both Spielberg State Trait Anxiety Inventory (STAI) state score and d' (negative - neutral) and positively with Z[FAR] (negative - neutral). However, STAI score and d' or Z[FAR] (negative - neutral) were not significantly correlated. In whole-brain regression, STAI score was correlated with higher activity of the right middle/superior temporal gyri/temporal parietal junction (MTG/STG/TPJ) for "negative correct - incorrect" - "neutral correct - incorrect" trials. Further, the MTG/STG/TPJ activity (β) was also negatively correlated with age. Mediation analyses supported a complete mediation model of age → less anxiety → less MTG/STG/TPJ β. Together, the findings demonstrated age-related changes in negative emotional memory and how age-related reduction in anxiety is reflected in diminished temporoparietal cortical activities during encoding of negative emotional memory.