Spielberger State Anxiety Scale Research Articles

The effect of reiki and acupressure on pain, anxiety and vital signs during femoral sheath removal in patients undergoing percutaneous coronary intervention: A randomized controlled study

ObjectiveThis study was conducted to determine the effect of reiki and acupressure on pain, anxiety, and vital signs during femoral sheath removal in patients undergoing percutaneous coronary intervention. MethodsThe study, which was conducted as a prospective randomized controlled study, was carried out with 84 patients: reiki group (n = 28), acupressure group (n = 28), and control group (n = 28). Twenty minutes before the femoral catheter was extracted, 18 minutes of reiki was applied to the seven chakra regions in the reiki group, and 20 minutes of acupressure was applied to the LI4, HT7, and PC6 points in the acupressure group. The control group received standard care. All three groups were given the assessment with Visual Analog Scale, Spielberger State Anxiety Scale, and 5 minutes before & 5 minutes after sheath removal and vital sign data also collected at these time points. ResultsAfter the intervention, it was determined that the pain and anxiety scores of both the reiki and acupressure groups were significantly lower than the pain and anxiety scores of the control group (p < 0.05). In addition, heart rate and respiratory rates were significantly lower than the control groups in the measurements made after the intervention of both reiki and acupressure groups (p < 0.05). Systolic and diastolic blood pressures after acupressure, but not after reiki, were significantly lower compared to the control group. ConclusionsAccording to the results of the study, reiki and acupressure applied before the removal of the femoral sheath after percutaneous coronary intervention reduce pain and anxiety and improve vital signs to some extent.

The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia

Introduction. The aim was to evaluate the effect of preoperative anxiety on the sympathetic block that developed after spinal anesthesia and therefore the duration of motor and sensory blockade. Materials and Methods. After the approval of the ethics committee, 90 patients between the ages of 18 and 55 years who were to be operated under spinal anesthesia were included in the study. Preoperative anxiety of the patients was evaluated with the Spielberger trait and State Anxiety Scale and Visual Analog Scale (VAS). The Bromage scores of the patients were followed up intermittently. Onset time of sensory block, onset time of motor block, and motor block recovery time were recorded. Cases with bradycardia and hypotension were noted. Results. No statistically significant correlation was found between the duration of motor block onset (5.81 ± 4 min), the sensory block onset time (0.89 ± 0.4 min), and the motor block recovery time (92.06 ± 36.9 min) with other variables. VAS (5.81 ± 2.5), STAI‐1 (40.4 ± 9.8), and STAI‐2 (41.69 ± 8.2) values had a statistically significant effect on the occurrence of bradycardia (14.4%). The variables of VAS, STAI‐1, STAI‐2, sensory block onset, motor block onset, and motor block recovery time were statistically significantly higher in women (mean 5.24 ± 2.4, 38.97 ± 9.9, 41.43 ± 8.7, 0.89 ± 0.42, 5.64 ± 3.82, and 88.77 ± 38.74 in males and mean 7.15 ± 2.1, 43.74 ± 8.9, 42.30 ± 7.0, 0.88 ± 0.27, 6.20 ± 4.35, and 99.70 ± 31.70 in females, respectively). Conclusion. It was observed that preoperative anxiety had no effect on motor and sensory block onset and duration.

Positive psychological effects of seated acupressure massage are associated with a rise in plasma oxytocin without affecting CGRP levels or circulating IL-6

Work-related stress is a major public health issue. Given the relationship between acute stress responses and health, finding strategies to deal with the unpleasant symptoms brought on by stress is essential. Massage therapy is a popular stress-reduction technique, but its effectiveness has yet to be shown. In that matter, this study investigates the effects of a 17-minute session of seated Amma massage on young healthy people. Subjective stress perception, anxiety and self-confidence were assessed before and after the massage using the Spielberger State Anxiety Scale (STAI-Y, Spielberger et al., 1983) and the Competitive State Anxiety Inventory (EEAC, Cury et al., 1999), together with cardiovascular parameters. Cortisol, CGRP, IL-6, and oxytocin plasma levels were measured before and after the massage to investigate its possible mode of action. This study enrolled 59 people: 33 receiving the massage, and 26 controls only seated on the massage chair.Interaction Time x Group demonstrates significant differences for all psychological measurements (STAI, EEAC) before and after the Amma massage, showing a beneficial effect of this treatment, in particular on perceived anxiety and self-confidence. No evidence was found of any correlation between cortisol plasma levels and psychological outcomes. No relationship was shown between the decrease of perceived stress and measured CGRP or IL-6 release, but the data demonstrated that heart frequency could be slightly decreased. The oxytocin plasma levels were significantly increased by the massage and could be responsible for the recovery of psychological outcomes.We conclude that seated acupressure Amma massage could be a useful tool to ameliorate quality of life at work.

Do glycaemic treatment targets affect the perinatal mental health status of women with gestational diabetes? – Data from the TARGET Trial

BackgroundGestational diabetes mellitus is associated with perinatal mental disorders. Effective management may reduce this risk, but there is little evidence on effects of different glycaemic treatment targets. We assessed whether tight glycaemic treatment targets compared with less-tight targets reduce the risk of poor mental health outcomes in women with gestational diabetes.MethodsThis was a secondary analysis of data from women who consented to complete perinatal mental health questionnaires as participants in the TARGET Trial, a stepped-wedge cluster randomized trial in 10 hospitals in New Zealand. All hospitals initially used less tight glycaemic targets for management of gestational diabetes and were sequentially randomized, in clusters of two at 4-monthly intervals, to using tighter glycaemic targets.Data were collected from 414 participants on anxiety (6-item Spielberger State Anxiety scale), depression (Edinburgh Postnatal Depression Scale), and health-related quality of life (36-Item Short-Form General Health Survey) at the time of diagnosis (baseline), 36 weeks of gestation, and 6 months postpartum. The primary outcome was composite poor mental health (any of anxiety, vulnerability to depression, or poor mental health-related quality of life). Generalized linear mixed models were used to determine the main treatment effect with 95% confidence intervals using an intention-to-treat approach.ResultsWe found no differences between randomised glycaemic target groups in the primary outcome at 36 weeks’ (relative risk (RR): 1.07; 95% confidence interval 0.58, 1.95) and 6 months postpartum (RR: 1.03; 0.58, 1.81). There were similarly no differences in the components of the primary outcome at 36 weeks’ [anxiety (RR: 0.85; 0.44, 1.62), vulnerability to depression (RR: 1.10; 0.43, 2.83), or poor mental health-related quality of life (RR: 1.05; 0.50, 2.20)] or at 6 months postpartum [anxiety (RR:1.21; 0.59, 2.48), vulnerability to depression (RR:1.41; 0.53, 3.79), poor mental health-related quality of life (RR: 1.11; 0.59, 2.08)].ConclusionWe found no evidence that adoption of tighter glycaemic treatment targets in women with gestational diabetes alters their mental health status at 36 weeks’ gestation and at 6 months postpartum.Trial registrationThe Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12615000282583 (ANZCTR—Registration). Date of registration: 25 March 2015.

Surgeons' personality, characteristics and presence of meaning in life

BackgroundSurgeons work long shifts and are frequently on call. Pressure to make quick and accurate decisions along with the responsibility of performing complex procedures contribute to surgeons' high stress-levels, anxiety and altered empathy level. We aimed to study surgeons' personality and meaning in life at two different centres. MethodsGeneral surgeons completed 47 questions. Visual analogous scale-items with controlled internal consistency (Cronbach alpha) coefficients varying from .77 to .85 were used from the following scales: Global Measure of Perceived Stress; Hostility Questionnaire; Jefferson Scale of Physician Empathy; Meaning in Life Questionnaire–SF; Rosenberg Self-Esteem Scale; Spielberger State Anxiety Scale and Quality of Work life Scale. Multiple linear regression analyses, parametric or non-parametric tests were employed when considered adequate. ResultsFifty-four participants were recruited from 3 different levels of training. Gender differences in Anxiety, Physician Empathy and presence of meaning in life (MIL-P) were revealed. Junior trainees differed from senior trainees and consultants as regards MIL-P, Anxiety, Stress and work-related factors. The surgeons' self-rated self-esteem was work-related. Surgeons' Quality of Work Life was best predicted by Physician Empathy but also their self-rated Self-Esteem contributed significantly to the prediction. Surgeons' MIL-P was significantly predicted by Physician Empathy and State Anxiety. ConclusionSurgeons’ current personality attributes might not apply to all of them. Female surgeons were more empathetic and felt more presence of meaning in life than male surgeons, and men were less anxious than female surgeons. Junior trainees experienced less anxiety than senior trainees but were more stressed than consultants. The most significant predictors of surgeons' personality were their experience of presence of meaning in life along with their level of empathy.

The effects of music in cardiac surgery patients: early results

Abstract Funding Acknowledgements Type of funding sources: Private hospital(s). Main funding source(s): Sundry fund to Massachusetts General Hospital. Background/Significance Research into the health benefits of music has expanded, driven by a desire to see how it can be better applied in healthcare. There has been an interest in the chemical and biological biomarkers of music. Most studies have focused on physical, and psychological findings. There have been few systematic studies that consider the parallel psychological, physical, and biological effects of music in cardiac surgical patients. Purpose The purpose of this study is to measure psychological, physiological, and biological responses to a music intervention compared to standard of care in cardiac surgical patients. The primary outcome is serum cortisol levels pre and post a 30-minute music intervention compared to the standard of care group. The secondary outcomes are state anxiety, pain, blood pressure, heart rate, respirations, and serum Immunoglobulin A (IgA). Methods This is a randomized, placebo-controlled, pre/post clinical trial to compared responses to the study intervention of music versus standard of care. Psychological responses were measured for anxiety by the Spielberger State Anxiety Scale, and pain by a visual analogy scale, physical responses were measured by blood pressure, heart rate, and respirations, and the biologic markers were measured by serum cortisol and IgA. Results Sixty-three patients were approached, 14 were excluded and 25 declined participation. Most patients who declined stated that they did not feel well enough to participate or did not want more blood samples taken. There were 20 subjects, 15 males and 5 females, mean age of 58.8 years, who did participate. The groups were similar on demographics and pre intervention outcome measures. There was no difference between standard of care and treatment group in the primary outcome, serum cortisol levels (17.8+7.4 vs 15.6+7.6) and no differences in the secondary outcomes post the intervention period. Conclusions This is the early results of a study on use of music as a nursing intervention in cardiac surgery patients. Subject enrollment will continue to provide evidence of the benefits for patients after cardiac surgery. Implications for Nursing Practice Nurses are poised to provide the evidence for non-pharmacological interventions to enhance the patient experience after cardiac surgery.

Evaluation of anxiety and coping strategies among tunisian health professionals in the pandemic of the covid 19

IntroductionThe rapid spread of coronavirus has forced the healthcare systems in Tunisia to reorganize its structures, thus mobilizing all caregivers. Their professional and emotional burden was put to the test.ObjectivesTo evaluate the level of anxiety and to study coping strategies among caregivers during this pandemic.MethodsA cross-sectional descriptive and analytical study among150 caregivers in two hospitals in Sfax in Tunisia; during April 2020. We used anonymous questionnaire, the Spielberger State Anxiety Scale(STAI) to assess tension felt at anxiety-producing situations; and the Coping Inventory Scale for Stressful Situations (CISS): to assess coping strategies.ResultsThe average age was 30.33± 6,93 years and the sex-ratio M/W = 0,29. Caregivers followed the news of this pandemic with these means of communication: 96% Facebook, 80%TV. The increase of the time spent in front of media:84% Sleep disorders were present in 64.7%: insomnia (36%), chopped sleep(34%). Caregivers used sleeping pills in 12% of case. STAI: The mean ascore =48.85 and a high anxiety level was noted in72% of case. CISS: Task-oriented coping strategies : a mean score= 47.90 and Emotion-centered coping : a mean score = 40,49 High anxiety was correlated with: age&gt;40 years old (p=0.042). The increase of the time spent in front of media, chopped sleep and use of sleeping pills are correlated respectively (p= 0,043, p=0,003, p=0,003) with an emotionally focused coping strategy.ConclusionsHealth professionals had a painful psychological experience with significant anxiety. Strengthening prevention strategies, management of health crises should be a priority of our health-system.

Correction.

British Journal of Clinical PsychologyVolume 59, Issue 2 p. 276-276 CorrectionFree Access Correction This article corrects the following: The development of a six-item short-form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI) Theresa M. Marteau, Hilary Bekker, Volume 31Issue 3British Journal of Clinical Psychology pages: 301-306 First Published online: July 12, 2011 First published: 09 January 2020 https://doi.org/10.1111/bjc.12243Citations: 2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In the paper by Theresa M. Marteau and Hilary Bekker (1992), The development of a six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI), the following correction has been made in the associated appendix, Appendix A: Self-evaluation questionnaire (Y-6 item). A citation to the original copyright holder of the Spielberger State-Trait Anxiety Inventory (STAI) scale had been omitted from the appendix. The 6-item questionnaire validated in this study is replaced with a sample item and instructions made available by Mind Garden illustrating the format of the 20-item Spielberger State Anxiety Scale (https://www.mindgarden.com/145-state-trait-anxiety-inventory-for-adults#horizontalTab2). It is accompanied by the following copyright citation, ‘Reproduction by special permission of the Publisher, Mind Garden, Inc., www.mindgarden.com from the State-Trait Anxiety Inventory for Adults by Charles D. Spielberger. Copyright © 1968, 1977 by Charles D. Spielberger. Further Reproduction is prohibited without the Publisher's written consent. This is not an assessment. Selected sample items only’. Reference Marteau, T. M., & Bekker, H. (1992). The development of a six-item short-form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI). British Journal of Clinical Psychology, 31, 301– 306. https://doi.org/10.1111/j.2044-8260.1992.tb00997.x Citing Literature Volume59, Issue2June 2020Pages 276-276 ReferencesRelatedInformation

Substantiation, Development and Implementation of Person-Centered Assessment of Psychosocial Significance of Chronic Dermatosis at the Stage of Primary Healthcare

High prevalence and incidence of chronic dermatoses among different age groups of Ukrainian population in combination with their multifactorial etiology and the progredient clinical course determine the need for the provision of general family medicine physicians with simple and accessible at the stage of primary healthcare technologies of medical care delivery to such patients. Patients with chronic dermatoses are known to be characterized by certain metabolic features, clinicopathologic cutaneous manifestations, as well as the development of special mental state associated with psychological trauma due to chronic dermatoses.&#x0D; The objective of the research was to substantiate, develop and implement person-centered assessment of psychosocial significance of chronic dermatoses at the stage of primary healthcare delivery by general family medicine physicians.&#x0D; Materials and methods. The study was carried out according to a specially developed program for collecting, accumulating and analyzing the results and included 114 patients with chronic dermatoses at the age of 29-58 years. Patients were divided into 2 groups: Group I included patients with chronic dermatosis duration of &lt;10 years and Group II comprised patients with chronic dermatosis duration of over 10 years. Medical and psychological examination of patients with chronic dermatoses was performed using the method of differentiated self-assessment of the functional state - the WAM (well-being, activity, mood), the Spielberger State Anxiety Scale modified by Khanin Yu.L., the personality questionnaire of the Bekhterev Institute (LOBI) etc.&#x0D; Conclusions. The prognostic value of the decrease in strength and energy is an adverse effect on a relatively long clinical course of the disease. The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). The diagnostic value of work/study limitations is 0.896 bit, and the prognostic value of this factor is a psychological limit of psychosocial functioning of an individual due to long-term clinical course of the disease. The presence of chronic skin disease was found to affect the patients’ daily lives; taking (physical, aesthetic, intellectual, etc.). This indicated greater (p&lt;0.050) psychosocial limitation in individuals with long-term clinical course of chronic dermatoses being an indicator of the need for psycho-educational activities at the stages of clinical manifestations of chronic dermatoses.

Maternal Prenatal Positive Affect, Depressive and Anxiety Symptoms and Birth Outcomes: The PREDO Study.

BackgroundWe investigated whether maternal prenatal emotions are associated with gestational length and birth weight in the large PREDO Study with multiple measurement points of emotions during gestation.MethodsAltogether 3376 pregnant women self-assessed their positive affect (PA, Positive and Negative Affect Schedule) and depressive (Center for Epidemiologic Studies Depression Scale, CES-D) and anxiety (Spielberger State Anxiety Scale, STAI) symptoms up to 14 times during gestation. Birth characteristics were derived from the National Birth Register and from medical records.ResultsOne standard deviation (SD) unit higher PA during the third pregnancy trimester was associated with a 0.05 SD unit longer gestational length, whereas one SD unit higher CES-D and STAI scores during the third trimester were associated with 0.04–0.05 SD unit shorter gestational lengths (P-values ≤ 0.02), corresponding to only 0.1–0.2% of the variation in gestational length. Higher PA during the third trimester was associated with a significantly decreased risk for preterm (< 37 weeks) delivery (for each SD unit higher positive affect, odds ratio was 0.8-fold (P = 0.02). Mothers with preterm delivery showed a decline in PA and an increase in CES-D and STAI during eight weeks prior to delivery. Post-term birth (≥ 42 weeks), birth weight and fetal growth were not associated with maternal prenatal emotions.ConclusionsThis study with 14 measurements of maternal emotions during pregnancy show modest effects of prenatal emotions during the third pregnancy trimester, particularly in the weeks close to delivery, on gestational length. From the clinical perspective, the effects were negligible. No associations were detected between prenatal emotions and birth weight.

Anxiety and depressive disorders in patients with diabetes mellitus type 2 and cerebrovascular disease

Aims. Current study was aimed to identify symptoms and risk factors for depression and anxiety and to estimate quality of life (QoL) in patients with diabetes mellitus type 2 (T2DM) and cerebrovascular disease (CVD). Materials and methods. We examined 73 patients with T2DM. 1st group included 49 patients with T2DM and CVD, 2nd group - 24 patients with T2DM and no cardiovascular pathology. The groups were not significantly different in terms of age, BMI, level of HbAlc, fasting and postprandial glycemia. All patients received antihyperglycemic and antihypertensive therapy. Anxiety and depression were diagnosed with Beck Depression Inventory and Spielberger State and Trait Anxiety Scale (SSTAS). SF-36 questionnaire was used for estimation of QoL. Results. 2nd group showed symptoms of anxiety and depressive disorders in 100% and 75% of cases, respectively. 1st group showed significantly more prominent anxiety and depression symptoms. Risk factors for anxiety and depressive disorders in patients with T2DM and CVD were found to be senior age, obesity and atherogenic dyslipidemia. Conclusion. Cardiovascular comorbidity in T2DM significantly decreases QoL, especially in aspects of physical functioning and vitality. Timely diagnostics of anxiety and depression in patients with T2DM and CVD requires development of screening and rehabilitation programs.

Clinical effects of korean red ginseng on attention deficit hyperactivity disorder in children: an observational study.

We investigated the clinical effects of Korean red ginseng on attention deficit hyperactivity disorder (ADHD) in children. Eighteen subjects aged between 6 and 14 diagnosed with ADHD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis criteria were enrolled. Korean red ginseng (Panax ginseng) at 1,000 mg b.i.d. was administered to the subjects for 8 weeks. Eighteen children completed the questionnaire and clinical assessment by visiting the hospital at baseline, then in the first, fourth and eighth weeks. Clinical assessments were performed by using the ADHD Diagnostic System (ADS, a computerized attention assessment program), the abbreviated Conners’ rating scale in addition to psychiatric interviews. After 8 weeks, significant differences were found in the omisssion errors of ADS (78.56±43.33 at baseline, 55.17±21.44 at 8 weeks, p<0.023), Conners ADHD Rating Scale (13.78±6.32 at baseline, 9.50±4.80 at 8 weeks, p<0.042) and Spielberger State Anxiety Scale (30.94±6.25 at baseline, 28.83±6.23 at 8 weeks, p<0.024). In the Korean Personality Inventory for Children, a significant reduction of score was found in the physical development scale (56.44±9.63 at baseline, 50.94±8.91 at 8 weeks, p<0.017) and social dysfunction scale (56.33±6.82 at baseline, 51.94±7.13 at 8 weeks, p<0.025). These results suggest that Korean red ginseng may be effective in improving inattentiveness in ADHD children, but it remains uncertain if it improves the general severity of ADHD, depression, anxiety personality and behavioral changes.

Measuring Patient Anxiety in Primary Care: Rasch Analysis of the 6-item Spielberger State Anxiety Scale

Objectives The 6-item Spielberger State Anxiety Scale has been used as a replacement of the original version in many health-care studies. The purpose of this study was to evaluate the measurement properties of the shortened 6-item Spielberger State Anxiety Scale using Rasch analysis in general medical practice patients (N = 297). Methods Participants (aged 16 years or above) were recruited on a consecutive basis from three general medical practices. Prior to their appointment, participants were asked to complete a 6-item Spielberger State Anxiety Scale. Results The results of the study showed that the scale is unidimentional, and each item measures a different level of patient anxiety. The rating scale operated well and item and person reliability was good. Furthermore, principal-components analysis of the residuals confirmed the scale measures a unitary concept. A scoring key was generated to allow conversion of raw scores to a continuous measurement. Conclusion The 6-item Spielberger State Anxiety Scale is shorter than the original version and has good psychometric properties. This would suggest the scale is a valid alternative to the full version for use in primary health-care practice and research.

Peaceful Play Yoga: Serenity and Balance for Children With Cancer and Their Parents

Children with a cancer diagnosis experience symptom distress, including anxiety, because of the disease and its treatment. Parents experience stress and anxiety because of the uncertainty of the disease as well as the suffering of their children. Yoga is a complementary intervention that has physiological and psychological benefits in healthy children and healthy and chronically ill adults. On an inpatient hematology/oncology unit, 11 children aged 6 to 12 years, 5 adolescents aged 13 to 18 years, and 33 parents participated in a single yoga session tailored to the needs and abilities of the patients and parents. Sense of well-being pre- and postclass was measured with the Spielberger State Anxiety Scale. Children had normal anxiety scores preclass that did not change. Adolescents and parents experienced significant decreases in anxiety scores, and all cohorts gave positive feedback about the experience. The authors conclude that yoga is a feasible intervention for this population and is beneficial to adolescents and parents.

P01-273 - Anxiety and hope in the relatives of the patients in intensive care unit

ObjectivesThe this study was carried out to determine the anxiety and hope status of the relatives of the patients in intensive care unit.MethodsFirst degree relatives of 116 patients in the intensive care unit of a hospital were involved in the present study. The data of the research was collected using a personal information form, the Spielberger State Anxiety Scale and Hope Scale.ResultsIt was found that the relatives of the patients were anxious. There was a statistically significant negative relationship between the numbers of visit by the relatives of the patients and their hope scores (r=-.357, p=.000). The more they visited the patient the more they lost hope. It was found that hope score was low in the patient's relatives who were female, spouse or parents of the patient, anxiety was high and hope was low in the patient's relatives who were literate and who had low income, hope was high in the patient's relatives who lived in a city and who had social security.ConclusionsThe first-degree relatives of the patients in the intensive care unit experience anxiety. As the number of visits by the relatives of the patients increases, their hopes about the recovery of the patient decrease. Therefore, continuous communication with the medical personnel and being continuously informed about the status of the patient will be helpful for the relatives of the patients in the intensive care unit to deal with the present situation.

Higher body fat percentage is associated with increased cortisol reactivity and impaired cognitive resilience in response to acute emotional stress

Cortisol is elevated in individuals with both increased emotional stress and higher percentages of body fat. Cortisol is also known to affect cognitive performance, particularly spatial processing and working memory. We hypothesized that increased body fat might therefore be associated with decreased performance on a spatial processing task, in response to an acute real-world stressor. We tested two separate samples of participants undergoing their first (tandem) skydive. In the first sample (N=78), participants were tested for salivary cortisol and state anxiety (Spielberger State Anxiety Scale) during the plane's 15-min ascent to altitude in immediate anticipation of the jump. In a second sample (N=20), participants were tested for salivary cortisol, as well as cardiac variables (heart rate, autonomic regulation through heart rate variability) and performance on a cognitive task of spatial processing, selective attention and working memory. In response to the skydive, individuals with greater body fat percentages showed significantly increased reactivity for both cortisol (on both samples) and cognition, including decreased accuracy of our task of spatial processing, selective attention and working memory. These cognitive effects were restricted to the stress response and were not found under baseline conditions. There were no body fat interactions with cardiac changes in response to the stressor, suggesting that the cognitive effects were specifically hormone mediated rather than secondary to general activation of the autonomic nervous system. Our results indicate that, under real-world stress, increased body fat may be associated with endocrine stress vulnerability, with consequences for deleterious cognitive performance.

Body Fat is Associated with Decreased Endocrine and Cognitive Resilience to Acute Emotional Stress

Abstract *Objective:* Cortisol is elevated both in individuals with increased emotional stress as well as with higher percentages of body fat. Cortisol is also known to affect cognitive performance, particularly spatial processing, selective attention, and working memory. We hypothesized that increased body fat might therefore be associated with decreased performance on a spatial processing task, in response to an acute real-world stressor. *Design:* We tested two separate samples of subjects undergoing their first (tandem) skydive. In the first sample (N=78), subjects were tested for salivary cortisol and state-anxiety (Spielberger State Anxiety Scale) during the plane's fifteen-minute ascent to altitude in immediate anticipation of the jump. In a second sample (N=20), subjects were tested for salivary cortisol, as well as cardiac variables (heart rate, autonomic regulation via heart rate variability) and performance on a cognitive task of spatial processing, selective attention, and working memory. *Results:* In response to the skydive, individuals with greater body fat percentages showed significantly increased reactivity for both cortisol (on both samples) and cognition, including decreased accuracy of our task of spatial processing, selective attention, and working memory. These cognitive effects were restricted to the stress response and were not found under baseline conditions. There were no body fat interactions with cardiac changes in response to the stressor, suggesting that the cognitive effects were specifically hormone-mediated rather than secondary to general activation of the autonomic nervous system. *Conclusions:* Our results indicate that, under real-world stress, increased body fat may be associated with endocrine stress-vulnerability, with consequences for deleterious cognitive performance.

Increased Blood Pressure in the Emergency Department: Pain, Anxiety, or Undiagnosed Hypertension?

We determine the proportion of patients with increased emergency department (ED) blood pressure and no history of hypertension who have persistently increased blood pressure at home, describe characteristics associated with sustained blood pressure increase, and examine the relationship between pain and anxiety and the change in blood pressure after ED discharge. This was a prospective cohort study. Patients with no history of hypertension and 2 blood pressure measurements of at least 140/90 mm Hg who were treated in an urban ED were enrolled, provided with home blood pressure monitors, and asked to take their blood pressure twice a day for 1 week. Outcome measures were increased mean home blood pressure (140/90 mm Hg or greater), and correlations between ED anxiety (Spielberger State Anxiety Scale) or pain (10-point scale) and the change in blood pressure after discharge. Potential relevant predictors were recorded and a multivariate model was constructed to assess the relationship between these predictors and increased home blood pressure. 189 patients were enrolled and 156 returned the monitors and completed the protocol. Increased mean home blood pressure was present in 79 of 156 (51%) patients and was associated with older age and being black. Of patients with ED blood pressures meeting criteria for stage I hypertension, 6% had home blood pressures meeting stage II hypertension, 36% stage I, and 52% prehypertension, and 6% had normal blood pressure For patients with ED blood pressures meeting stage II criteria, the corresponding percentages were 28%, 31%, 33%, and 8%, respectively. The difference between home and ED systolic blood pressures was not associated with anxiety (r=-.03; P=.69) and showed a slight association with pain in the opposite direction from what was expected (r=.18; P=.03). Patients without diagnosed hypertension and increased ED blood pressures often have persistently increased home blood pressures, which does not appear to be related to pain or anxiety in the ED.

Psychosocial Factors in Alcohol Use-Related Problems of Working Youth

This study investigated the psychosocial correlates of alcohol use related problems in a sample of 581 working adolescents (N = 4405), recruited from five vocational schools in Ankara in June 2004 with the CAGE questionnaire, The Beck Depression Inventory, the Beck Hopelessness Scale, the Spielberger State Anxiety Scale, and the Coopersmith Self-Esteem Inventory. Using a multivariate analysis, the anxiety and hopelessness scores, and the length of stay in Ankara were found to be related to alcohol-use problems of the working youth. The study's limitations were noted and future research was suggested.

Diabetes screening anxiety and beliefs

This study assesses the impact of screening for diabetes on anxiety levels in an ethnically mixed population in the UK, and explores whether beliefs about Type 2 diabetes account for these anxiety levels. This cross-sectional study recruited individuals who were identified at high risk of developing diabetes through general practitioners' (GPs) lists or through public media recruitment. Participants completed an oral glucose tolerance test (OGTT). Between blood tests, participants completed the Spielberger State Anxiety Scale Short Form, the Emotional Stability Scale of the Big Five Inventory 44 and three scales from the Diabetes Illness Representations Questionnaire, revised for this study. Of the 1339 who completed the OGTT and questionnaire booklet, 54% were female, with 21% from an Asian background. Forty-five per cent of participants reported little to moderate amounts of anxiety at screening (mean 35.2; sd = 11.6). There was no significant effect of family history of diabetes, ethnic group or recruitment method on anxiety. The only variable significantly associated (negatively) with anxiety was the personality trait of emotional stability. Of responders, 64% and 61% agreed that diabetes was caused by diet or hereditary factors, respectively. Only 155 individuals (12%) agreed that diabetes was serious, shortens life and causes complications. The results of this study replicate that of previous studies, indicating that screening for diabetes does not induce significant anxiety. Bivariate analysis indicated that individuals who perceived diabetes to be serious, life shortening and resulting in complications had higher anxiety scores, the personality trait of emotional stability being the strongest predictor of anxiety.