Spielberger State Research Articles

Evaluation of state and trait anxiety levels of parents and children before electroencephalography procedures: A prospective study from a tertiary epilepsy center

BackgroundInadequate or misinformation about electroencephalography (EEG) and epilepsy may lead to anxiety in children and their parents. The purpose of this study was to make a simultaneous evaluation of the anxiety levels of children and parents before EEG procedures and to make a brief assessment of their knowledge about EEG. Methods and materialsChildren aged between 8 and 18 years who were referred for EEG tests at Department of Pediatric Neurology, Gazi University Faculty of Medicine, Ankara, Turkey and their parents were included in the study, prospectively. Data were collected through Personal Information Forms; an EEG questionnaire form, which questioned the knowledge of the participants about EEG; the Spielberger's State–Trait Anxiety Inventory (STAI) to determine anxiety levels of the parents; and the State–Trait Anxiety Inventory for Children-State form (STAIC) to determine the anxiety levels of the children. The following parameters were collected in a database: demographic data about children and parents (sex, age), indication of suspected diagnosis on EEG request (i.e., the referral diagnosis), history of epilepsy, number of EEG recordings, and results of previous EEG recordings. The state and trait anxiety test results of the children were compared between the girls and boys, between age groups, and their parents' results in terms of both trait and state anxiety in terms of EEG, sex, ages, educational levels, and working. ResultsEighty-five children (mean age: 13.25 ± 3.02 years) and 85 parents (mean age: 41.16 ± 7.65 years) were included in the study. The children's mean trait anxiety score was 32.51 ± 8.09, and the mean state anxiety score was 34.97 ± 7.62. Half of the children who had a trait anxiety score of ≤30 points had increased state anxiety levels because they received more than 30 points in the state anxiety evaluation score. No significant differences were found between the boys and girls in terms of the state and trait anxiety scores (p > 0.05). The parents' mean trait anxiety score was 39.16 ± 7.74, and the mean state anxiety score was 42.74 ± 6.22. Forty (47%) parents were found to have trait anxiety, and 52 (61.2%) parents had state anxiety before the EEG. The trait anxiety score of the mothers was statistically significantly higher than that of the fathers (p < 0.01). The investigation of the knowledge level of both parents and children about EEG demonstrated some misunderstandings or points of insufficiency. ConclusionThe present study revealed that both parents and children had insufficient knowledge about EEG, and the procedure caused anxiety for both the parents and children. When EEG procedures are requested, parents and children should be given brief information about EEG and epilepsy. We think that in this way, the knowledge of both parents and children about this issue may be increased and their anxiety may be decreased.

Facial Affective Behavior in Borderline Personality Disorder Indicating Two Different Clusters and Their Influence on Inpatient Treatment Outcome: A Preliminary Study.

BackgroundThe purpose of the present study was threefold: first, to investigate the facial affective behavior in patients with a borderline personality disorder (BPD); second, to examine whether these patients could be divided into clusters according to facial affective behavior; and third, to test whether these clusters would influence the inpatient treatment outcome.MethodsThirty inpatients with BPD were assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I, SCID II) and had to complete a series of questionnaires before and directly after the 12-week long inpatient treatment. Facial affective behavior was recorded during the structured interview for personality organization (STIPO) and afterward coded with the emotional facial action coding system (EMFACS). Measures on psychopathology [beck depression inventory (BDI), Spielberger state and trait anxiety inventory (STAI), Spielberger state and trait anger inventory (STAXI), and symptom cheklist-90-revised (SCL-90-R)], interpersonal problems [Inventory of Interpersonal Problems (IIP)], and personality organization [inventory of personality organization (IPO)] were administered.ResultsCluster analysis before the treatment yielded two groups that differed in general facial expressivity, and regarding the display of anger, contempt, and disgust. The effect sizes of the repeated measures ANOVAs showed that persons with higher scores on the affective facial expressions benefitted more from the treatment in terms of STAI state anxiety, STAXI state and trait anger, IIP total, and the two scales primitive defenses and identity diffusion of the IPO, whereas persons with lower scores benefitted more on the scale IPO reality testing.ConclusionOur results indicated some initial trends for the importance of facial affective behavior in patients with BPD and their treatment outcome.

Pre- and during- labour predictors of dystocia in active phase of labour: a case-control study

BackgroundLabour dystocia (LD) is associated with maternal and foeto-neonatal complications and increased rate of caesarean section. There are scant studies on predictive factors of labour dystocia in Iran, as well as in other countries. Therefore, this study aimed to identify the predictive factors of LD using an integrated and collaborative pre- and during- labour factors to help formulate more effective intervention strategies for prevention and management of LD.MethodsIn this case-control study, 350 women with and 350 women without LD, matched individually in terms of parity and hospital, were compared. The participants were in active labor, had singleton pregnancy, live foetus with a cephalic presentation, gestational age of 37+ 0–41+ 6 weeks, and were hospitalized for vaginal birth in two teaching hospitals in Tabriz, Iran. Data related to the socio-demographic characteristics, anxiety status (using the Spielberger State Anxiety Inventory), and woman dehydration were collected at cervical dilatation between 4 and 6 cm (before dystocia detection) and the other data at different phases of labour, and after birth (before discharge). The multivariate logistic regression was used to determine the predictors.ResultsThe predictors of LD were severe [OR 58.0 (95% CI 26.9 to 125.1)] and moderate [8.6 (4.2 to 17.4)] anxiety, woman dehydration > 3 h [18.67 (4.0 to 87.3)] and ≤ 3 h [2.8 (1.7 to 4.8], insufficient support by the medical staff in the delivery room [5.8 (1.9 to 17.9)], remifentanil administration [3.1 (1.5 to 6.2)], labour induction [4.2 (2.5 to 7.2], low income [2.0 (1.2 to 3.3)], woman’s height < 160 cm [2.0 (1.1 to 3.3)], and woman age of 16–20 y [0.3 (0.2 to 0.6)]. The proportion of the variance explained by all these factors was 74%.ConclusionThe controllable predictors, such as woman anxiety and dehydration, and insufficient support from medical staff during labour were strongly associated with the risk of LD. Therefore, it seems that responding to woman physical, psychological, and supportive needs during labour can play a significant role in LD prevention and control.Ethical codeIR.TBZMED.REC.1397.624.

Effect of Benson's Relaxation Technique on Propofol Consumption and Preoperative Anxiety of Patients Undergoing Cataract Surgery.

BackgroundBenson’s relaxation (BR) technique is a suitable non-pharmacological approach to reduce preoperative anxiety (PA).ObjectivesThis study aimed to investigate the effect of BR therapy on PA and the induction and maintenance dose of propofol during cataract surgery (CS).MethodsSeventy-two patients were randomly divided into two experiments or BR and control groups. The Amsterdam and Spielberger State-Trait Anxiety inventory (STAI) scores were used to assess PA directly two days and a half-hour before the CS. The control group did not receive any preoperation intervention or relaxation. Benson’s relaxation method was performed three times, each time for 20 minutes, including two days before surgery, a night before surgery, and an hour before the surgery in the presence of a researcher by an audio file. The induction and maintenance dose of anesthetic drug was recorded and compared between the two groups.ResultsThe mean propofol consumption was significantly reduced during the induction of anesthesia in the intervention group compared to the control group (0.99 ± 0.29 versus 1.29 ± 0.49; P = 0.005) as well as the maintenance of anesthesia (84.66 ± 17.98 versus 108.33 ± 34.38, P = 0.001). The results of the post-intervention Amsterdam anxiety score showed a significant decrease in the intervention group compared to the control group (P = 0.032, F = 9.61, Eta2 = 0.12). The control group showed a higher Spielberger state score compared to the intervention group as well as the Spielberger trait (P < 0.001, F = 14.78, Eta2 = 0.18).ConclusionsThe BR method effectively reduces the level of PA in patients undergoing CS. Moreover, it reduces the need for anesthetic drug, propofol, during surgery.

Development of the short version of the spielberger state—trait anxiety inventory

The Spielberger State-Trait Anxiety Inventory (STAI) has been widely used to measure the state and trait components of anxiety. We sought to develop a short, yet reliable and valid form of these scales for use in circumstances where the full‐form is not feasible. We abbreviated the scales using item response theory analyses to retain the items that could discriminate the best among participants. One sample (N = 922) completed the state scale, a second sample (N = 2227) completed the trait scale, while a third sample (N = 250) completed the short forms. Our participants completed the Hungarian version of STAI alongside other measures to observe external validity. We calculated cut-off scores for the state (>9.5,) and trait (>13.5) scales. A total of 19.5% and 20.1% of the respondents reached the cut-off scores. The five-item short forms of STAI had sound psychometric properties that are comparable to those obtained on the full-form. The external validity of the scales is also demonstrated. We report detailed descriptive statistics that could be used in further studies as standards. The short scales are reliable measures that could be used in clinical screening and behavioural research; especially where practical considerations preclude the use of a longer questionnaire.

831-P: Children at Increased Risk for Type 1 Diabetes Using a Study Educational Tool Have Better Understanding of Genetic Risk: The TEDDY Study

The Environmental Determinants of Diabetes in the Young (TEDDY) is an international study of 8,676 children from birth to age 15 at increased genetic risk for type 1 diabetes. Before the 10-year study visit, children received a book explaining their increased genetic risk for type 1 diabetes and TEDDY study aims. We compared children who read the book to those who did not read the book on their (1) type 1 diabetes risk perception accuracy, (2) anxiety about their increased risk for type 1 diabetes (using a modified version of Spielberg State Anxiety Inventory for children), (3) actions intended to prevent diabetes, and (4) study satisfaction. Overall, 2064/3306 (62%) children read the book; girls, children from two parent families, and Swedish and Finnish children (all p&amp;lt;0.001) were more likely to read the book. Using generalized linear modeling we examined differences in those who read versus did not read the book on child outcome measures while controlling for demographic (e.g., parent education, first-degree relative with diabetes, child sex) and parent measures (e.g., parent risk perception, anxiety, study satisfaction). Children who read the book had more accurate risk perception (read book = 30% accurate versus 24% accurate; OR=1.41, 95% CI=1.19-1.68, p&amp;lt;0.001) and greater TEDDY study satisfaction measured on a 0-2 scale (average treatment difference = 0.10, 95% CI=0.07-0.13, p&amp;lt;0.001) compared to those who did not read the book. No significant group differences in anxiety or behaviors to prevent diabetes occurred. In conclusion, the use of an educational tool is well accepted, is not related to increased child anxiety about diabetes, and is related to greater child diabetes risk perception accuracy and study satisfaction. However, even after reading the book, 70% of children had inaccurate diabetes risk perception, suggesting additional strategies are needed. Findings have implications for retention and education in long-term research cohorts. Disclosure L.B. Smith: None. R. Tamura: None. R. Karban: None. J. Melin: None. Å.E. Wimar: None. M. Gardiner: None. K.A. Driscoll: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Allergy and Infectious Diseases; Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institute of Environmental Health Sciences; Centers for Disease Control and Prevention; JDRF; National Institutes of Health/National Center for Advancing Translational Sciences (UL1TR000064, UL1TR001082)

Effect of Psychotherapy on Reduction of Fear of Childbirth and Pregnancy Stress: A Randomized Controlled Trial.

IntroductionThe fear of childbirth (FOC) has an adverse effect on the physical and mental health of pregnant women and increases adverse maternal and fetal outcomes. Previous research reported the effect of psychological interventions such as cognitive behavioral therapy, relaxation therapies, and short-term psycho-educational intervention on FOC. We examined whether adding motivational interviewing (MI) psychotherapy to prenatal usual care (PUC) is superior to PUC alone to reduce the scores of FOC, pregnancy stress, and self-efficacy.Materials and MethodsAn RCT with two-arm parallel groups and 1:1 allocation ratio assigned 70 pregnant women (aged 18–50) attending public health centers in an education hospital in Iran to receive five sessions of group MI psychotherapy plus PUC (N = 35) or to receive PUC alone (N = 35). The primary outcomes were the FOC scores (Wijma Delivery Expectancy/Experience Questionnaire, W-DEQ), pregnancy-specific stress (Prenatal Distress Questionnaire, NuPDQ), anxiety (Spielberger state anxiety), and Childbirth Self-Efficacy Index (CBSI) at 5 weeks post-randomization. Additional measures included subscales of the W-DEQ and the NuPDQ, patients’ compliance, and satisfaction with psychotherapy intervention at 5 weeks post-randomization as secondary outcomes.Main ResultsThe post-trial results indicated that the outcome scores diminished more considerably in psychotherapy than in PUC for total FOC scale with a large effect size (B = −23.54, p = < 0.001, η2η2 = 0.27), for total pregnancy stress with a large effect size (B = −4.51, p = < 0.001, η2 = 19), and for state anxiety with a large effect size (B = −12.42, p = < 0.001, η2 = 0.22). However, the score of self-efficacy and concern about physical symptoms did not differ between the psychotherapy and PUC groups (P < 0.05).DiscussionAdding 5 weeks of group psychotherapy to PUC could be considered as an adjunctive care option for reducing FOC, pregnancy stress, and general anxiety in pregnant women in the third trimester. Future research may focus on sustaining the effects and evaluating the economic impacts of adding psychotherapy to PUC.

The Correlation of SKA2 with Cortisol, IL-1β and Anxiety in Pregnant Women with the Risk of Preterm Delivery

ObjectiveThe association between preterm birth (PTB), Spindle and Kinetochore Associated Complex Subunit 2 gene (SKA2), cortisol and anxiety have been shown, but in this study, we aimed to clarify whether the expression of the SKA2 gene plays a role in interleukin-1β (IL-1β) level since increasing level of IL-1β is linked with PTB. MethodsThe case-control study was conducted on 49 and 51 women with preterm and term delivery, respectively. The score of anxiety was ranked according to the Spielberger state trait Anxiety Inventory. The concentration of cortisol and IL-1β was determined by the ELISA method. The expression of SKA2 gene was assessed by the quantitative real time real time polymerase chain reaction (qRT-PCR). The western blot analysis was also performed to confirm the expression of SKA2 at the levels of protein. ResultsThe results showed that the gene/protein expression of SKA2, the concentrations of cortisol and IL-1β were significantly higher in the preterm than the term group. In the preterm group, the expression of SKA2 was positively correlated to the other factors including cortisol, IL-1β, and the degree of anxiety. ConclusionOur findings suggest that the expression of SKA2 was correlated positively to the levels of cortisol, IL-1β and the rate of anxiety in women with PTB.

Investigating fear of childbirth in pregnant women and its relationship between anxiety sensitivity and somatosensory amplification

The causes of fear of childbirth and the factors that affect it are not fully explained. The aim of this study was to investigate the relationship between fear of childbirth in pregnant women and anxiety sensitivity and somatosensory amplification. The study included 100 healthy pregnant women who were admitted to the Obstetrics and Gynaecology Department of a tertiary hospital in Turkey at 28–40 weeks of gestation. Sociodemographic Data Form, Anxiety Sensitivity Index (ASI), Somatosensory Amplification Scale (SSAS), Spielberger State and Trait Anxiety Inventory (STAI), Wijma Expectancy/Experience Scale (W-DEQ) were applied to all cases. The mean age of the pregnant women included in the study was 29.20 ± 6.17 years, and 82% of them had high fear of childbirth. It was determined that factors such as age, education status, occupation, prior pregnancy experience, the number of pregnancies, miscarriage history, and abortion experience had no significant effect on the fear of childbirth. It was observed that there was a weak positive correlation between the fear of childbirth and the anxiety sensitivity and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase. For this reason, it is crucial to carefully monitor prenatal anxiety, somatosensory amplification and the fear of childbirth of pregnant women with state-related concerns. IMPACT STATEMENT What is already known on this subject? Fear of childbirth or what is historically referred to as tokophobia is generally defined as a fear of severe birth and fear of pathological birth. The causes of fear of childbirth are stated as biological reasons, psychological reasons and lack of social support. However, it is not possible to explain the causes of the fear of childbirth in pregnant women and the risk factors affecting them. Similarly, fear of childbirth in individuals with anxiety sensitivity and amplification of somatosensory symptoms has not been adequately investigated. What do the results of this study add? In this study, we aimed to contribute to the related literature by examining the relationship between fear of childbirth in pregnant women and anxiety sensitivity and amplification of somatosensory symptoms. It was observed that there was a weak positive correlation between the fear of childbirth and the sensitivity of anxiety and the amplification of somatosensory symptoms. According to the findings of our study, as the fear of childbirth increases, anxiety sensitivity, and somatosensory amplification increase. What are the implications of these findings for clinical practice and/or further research? For this reason, it is crucial to carefully monitor the pregnants who have prenatal anxiety sensitivity, somatosensory amplification, and state-continuous anxiety. Due to insufficient number of studies related to the subject, extensive sample studies on the subject are needed.

Validation of the Turkish version of European Organization for Research and Treatment of Cancer QLQ-OV28 ovarian cancer specific quality of life questionnaire.

Objective:To examine reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-OV28 questionnaire into the Turkish language according to the instructions provided by EORTC.Materials and Methods:Ninety-seven patients who were diagnosed as having ovarian cancer and treated between January 2005 and June 2010 with an expected survival time of at least 3 months, were enrolled into the study. The exclusion criteria were diagnoses of any disease that could disrupt consciousness and concurrent malignancies. The EORTC QLQ-OV28 module was translated into Turkish by professional translators and physicians. The test–retest reliability of the Turkish version of the questionnaire was performed on 30 patients. Answers were scored according to the instructions provided by the EORTC. The total score was calculated as explained above and after scoring procedures, all subscale scores were linearly transformed to a 0-100 scale. All patients concomitantly completed the Spielberg State Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). Patients were analyzed in two groups: on-treatment and off-treatment groups consisted of patients who did and did not undergo chemotherapy or surgery within the last two months, respectively. The demographic data of all patients were recorded. EORTC QLQ-OV28 scores of both groups were compared. Correlations between EORTC QLQ-OV28 subscales and total score of BDI and STAI were analyzed.Results:For test-retest reliability, Spearman’s rho was 0.84 (p<0.001). The on-treatment group scored statistically significantly higher than the offtreatment group in peripheral neuropathies, attitude to disease and treatment, sexual function and other chemotherapy adverse effect subscales of the questionnaire. Correlations between EORTC QLQ-OV28 subscales and the total scores of BDI and STAI of the groups were statistically significant, except the sexual function subscale.Conclusion:The Turkish translated version of EORTC QLQ-OV28 module is a reliable, consistent, and a valid instrument for assessing the impact of treatment modalities on QoL among Turkish speaking women with ovarian cancer.

Yoga as a Complementary and Alternative Therapy in Children with Hematologic and Oncologic Disease.

A diagnosis of a hematologic or oncologic disease in a child can be stressful for the patient and the family. Yoga as an intervention has been reported to decrease stress in adults diagnosed with chronic disorders but few studies have been reported with children and their families. A convenience sample of patients diagnosed with cancer or a blood disorder (ages 7-17 years) and their caregivers was selected to participate in a single bedside yoga class. Participants were surveyed pre and post yoga with the Spielberger State Trait Anxiety Scale. Children were also surveyed pre and post yoga with the Wong-Baker Faces Pain Scale. Children had a significant decrease in pain post yoga but no change in anxiety. Adolescents and parents had a significant decrease in anxiety post yoga intervention.

02: The effect of music listening on preoperative anxiety in female pelvic medicine and reconstructive surgery: A randomized controlled trial

Preoperative anxiety has been associated with increased postoperative pain and lower patient satisfaction. The purpose of this study was to evaluate the effect of listening to music just prior to surgery on preoperative anxiety compared to usual care in patients undergoing reconstructive pelvic surgery. Patients scheduled for reconstructive pelvic surgery at our tertiary care center were enrolled on the day of their surgery approximately 45 minutes prior to the anticipated surgery start time. Following consent, all participants completed the Spielberg State Trait Anxiety Inventory Y1 (STAI-Y1) to measure baseline state anxiety levels prior to surgery. Demographic information, past surgical history, and a questionnaire regarding musical background and preferences were collected. Participants were then randomized to either the usual care (control group) or listening to music on headphones (music intervention group). Those in the music group could choose between several genres of prerecorded music. After 30 minutes, the STAI-Y1 questionnaire was re-administered. The primary outcome was the change in anxiety score as measured by the STAI-Y1. Descriptive statistics, T-tests, and Fisher's Exact Test were used to analyze the data. Sixty-six women completed the study; 34 participants in the control group and 32 participants in the music group. Racial/ethnic distribution, age, prior history of surgery, and music background and preferences were similar amongst those in the control group and the music group. Surgical indications included one or more of the following diagnosis: pelvic organ prolapse (44%), stress urinary incontinence (34%), urge urinary incontinence (6%), mesh exposure (5%), vaginal mass/diverticula (5%), genitourinary fistula (4%), and sling revision (2%). Participants reported that they found classical music (26%), soft rock (26%), country (17%), jazz (11%), and gospel music (10%) most relaxing. Baseline STAI-Y1 scores on the day of surgery were similar between the two groups (37.29 ± 11.57 in control group vs. 37.25 ± 9.02 in music group). STAI-Y1 scores significantly improved in the music group after 30 minutes of music listening compared to the control group (-6.81 vs. -1.59, P = 0.006). Patients undergoing reconstructive pelvic surgery present with moderate anxiety on the day of surgery. Allowing patients to listen to their preferred music is a simple intervention that may lower preoperative anxiety in this patient population.

62: Quantifying anxiety in women at the initial gynecology visit

Anxiety can be measured in various ways. State anxiety is temporary and is sensitive to change. Our study aims to characterize the reasons for anxiety among women presenting for their initial gynecology visit, to measure the change in state anxiety after the visit, and to correlate anxiety improvement with visit satisfaction. New patients presenting to our tertiary Benign Gynecology clinic were invited to participate. Participants were asked to list their pre-visit anxieties and completed pre- and post-visit questionnaires. Pre-visit questionnaires included the Generalized Anxiety Disorder-7 (GAD-7), the Spielberg State Trait Anxiety Inventory (STAI-Y6), the Pain Catastrophizing Scale (PCS), Pain Disability Index (PDI) and Visual Analogue Scale (VAS). Post-visit questionnaires included the STAI-Y6, Patient Global Impression of Improvement (PGI-I) of participant anxiety, visit satisfaction, and the participant’s perception of how their anxiety was addressed. Providers were blinded to responses on the pre- and post-visit questionnaires. Anxieties listed by participants were reviewed and categorized independently by 2 of the authors (AR and TP). 40 women, primarily white (45%), with a median age of 43 years (SD 14.82) were enrolled. Those who were seen for a problem visit (55%) were older than those seen for a preventative visit (37 years vs. 47 years; p=.02). 60% of participants had not seen a gynecologist before and only 1 participant had a known anxiety diagnosis. The average pre-visit STAI score was 40.42 (SD = 14.93), with similar scores observed between those seen for a preventative visit and those seen for a problem visit. Pre-visit STAI scores increased with increasing GAD (Pearson r = 0.57, p<.001), PDI (Pearson r=0.43, p= .005) and PCS scores (Pearson r=0.53, p<.001). Pre-visit STAI score decreased by 9.83 points after the visit (Figure 1). The most reported causes for visit-related anxiety were related to: diagnosis, treatment and personal issues. Post-visit improvement in state anxiety was associated with improvement in PGI-I as those who reported the largest improvement in PGI-I scores had the largest improvement in STAI scores (p = .03). Changes in state anxiety were not associated with visit satisfaction, participant’s perception that anxiety was addressed during visit, visit diagnosis, GAD, PCS, PDI, or VAS scores. Women experience high level of state anxiety prior to their initial gynecology visit, especially those with generalized anxiety (GAD) or high PCS scores. All participants had significant improvement in state anxiety after the visit, regardless of visit satisfaction, participant’s perception of how anxiety was addressed, or measures of generalized anxiety or pain.

Association of Prenatal Maternal Psychological Distress With Fetal Brain Growth, Metabolism, and Cortical Maturation

Prenatal maternal stress is increasingly associated with adverse outcomes in pregnant women and their offspring. However, the association between maternal stress and human fetal brain growth and metabolism is unknown. To identify the association between prenatal maternal psychological distress and fetal brain growth, cortical maturation, and biochemical development using advanced 3-dimensional volumetric magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS). This cohort study prospectively recruited pregnant women from low-risk obstetric clinics in Washington, DC, from January 1, 2016, to April 17, 2019. Participants were healthy volunteers with a normal prenatal medical history, no chronic or pregnancy-induced physical or mental illnesses, and normal results on fetal ultrasonography and biometry studies. Fetal brain MRI studies were performed at 2 time points between 24 and 40 weeks' gestation. Prenatal maternal stress, anxiety, and depression. Volumes of fetal total brain, cortical gray matter, white matter, deep gray matter, cerebellum, brainstem, and hippocampus were measured from 3-dimensional reconstructed T2-weighted MRI scans. Cortical folding measurements included local gyrification index, sulcal depth, and curvedness. Fetal brain N-acetylaspartate, creatine, and choline levels were quantified using 1H-MRS. Maternal stress, depression, and anxiety were measured with the Perceived Stress Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), Spielberger State Anxiety Inventory (SSAI), and Spielberger Trait Anxiety Inventory (STAI). A total of 193 MRI studies were performed in 119 pregnant women (67 [56%] carrying male fetuses and 52 [44%], female fetuses; maternal mean [SD] age, 34.46 [5.95] years) between 24 and 40 gestational weeks. All women were high school graduates, 99 (83%) were college graduates, and 100 (84%) reported professional employment. Thirty-two women (27%) had positive scores for stress, 31 (26%) for anxiety, and 13 (11%) for depression. Maternal trait anxiety was associated with smaller fetal left hippocampal volume (STAI score: -0.002 cm3; 95% CI, -0.003 to -0.0008 cm3; P = .004). Maternal anxiety and stress were associated with increased fetal cortical gyrification in the frontal lobe (β for SSAI score: 0.004 [95% CI, 0.001-0.006; P = .002]; β for STAI score: 0.004 [95% CI, 0.002-0.006; P < .001]; β for PSS score: 0.005 [95% CI, 0.001-0.008; P = .005]) and temporal lobe (β for SSAI score: 0.004 [95% CI, 0.001-0.007; P = .004]; β for STAI score: 0.004 [95% CI, 0.0008-0.006; P = .01]). Elevated maternal depression was associated with decreased creatine (EPDS score: -0.04; 95% CI, -0.06 to -0.02; P = .005) and choline (EPDS score: -0.03; 95% CI, -0.05 to -0.01; P = .02) levels in the fetal brain. This study found that the prevalence of maternal psychological distress in healthy, well-educated, and employed pregnant women was high, underappreciated, and associated with impaired fetal brain biochemistry and hippocampal growth as well as accelerated cortical folding. These findings appear to support the need for routine mental health surveillance for all pregnant women and targeted interventions in women with elevated psychological distress.

FEATURES OF NEURODYNAMIC PROPERTIES, AGGRESSION AND ANXIETY IN TUVAN STUDENTS DEPENDING ON THE BEHAVIORAL AND GENERAL STRATEGY

Abstract. The success of students' adaptation to the educational process depends on individual psychophysiological features, which are manifested in the behavioral strategy. Materials and methods. The study involved 76 young males and 132 females, the average age was 21.6 ± 0.2 years. Evaluation of the behavioral strategy in conflict interaction was carried out using the method of K. Thomas; the structure of aggression was studied with the help of the A. Buss and A. Durkee hostility inventory; the level of reactive and personal anxiety was measured with Spielberger state trait anxiety inventory (Spilberger-Khanin test). The neurodynamic properties were evaluated using the results obtained in the “Simple visual-motor reaction” and “Choice reaction” test. Mathematical processing of the results was carried out using Statistiсa 6.0. The compliance of the data with the normal distribution was checked by the Kolmogorov-Smirnov criterion. Differences were considered significant at p ≤ 0.05. Results. Tuvan students revealed gender differences in behavior in conflict situations: female students mostly demonstrated an effective behavioral strategy, while male students were characterized by an ineffective behavioral strategy. Female students with a neutral behavioral strategy (16.7%) were characterized by high indices of aggressiveness and hostility and low values of reactive anxiety. A high level of personal anxiety was found in all female students regardless of their behavioral strategy. Male students with high values of aggressiveness, reactive and personal anxiety were identified in isolated cases in a group with an effective behavioral strategy. In female students, the latent period of a simple visual-motor reaction was associated with a behavioral strategy. In male students, differences in the latent period of a simple visual-motor reaction were not detected regardless of the strategies of behavior. The functional level of the central nervous system of all the students studied, regardless of the strategy of behavior, was characterized as "slightly reduced." According to the data obtained for the “stability of the nervous reaction” and “level of functionality”, gender differences were revealed. Conclusion. Neurodynamic features, the prevailing effective strategy of behavior in a conflict situation, and the structure of aggression of Tuvan female students indicate an adequate reactivity of the body, which is confirmed by a “slightly reduced” level of performance. This, probably, provides a more successful adaptation to the educational process compared to male students.

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

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Covid-19 Salgını Sırasında Sağlık Çalışanlarında Spielberger Durumluk ve Sürekli Kaygı Düzeyi: Tepecik Hastanesi Örneği

Cross-Border Reproductive Care: Psychological Distress in A Sample of Women Undergoing In Vitro Fertilization Treatment with and without Oocyte Donation.

BackgroundCross-border reproductive care (CBRC) refers to the movement of patients to foreign countries for fertility treatment. Limited evidence indicates that this phenomenon is associated with a risk of psychologi- cal distress, but few studies on the psychological impact of CBRC are currently available. The aim of this study was to compare the anxiety and depression levels of a group of cross-border patients with a local Spanish patient group, both of which underwent in vitro fertilization (IVF) treatment. We also sought to explore the clinical, sociodemographic and personality profiles of the CBRC group and local women.Materials and MethodsThis present cross-sectional study was conducted on 161 infertile females (71 CBRC patients and 90 local women) who were undergoing IVF treatment. The following questionnaires were used to collect data: Spielberger State Anxiety Inventory (STAI-S), the Beck Depression Inventory-II (BDI-II) and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Sociodemographic, clinical, reproductive and CBRC variables were also recorded.ResultsCBRC patients, specifically CBRC oocyte recipients, showed higher levels of anxiety compared to lo- cal women. However, no significant differences in depression scores were found between both groups. Finally, when analysing personality, the Activity scale scores of the ZKPQ were found to be higher in CBRC oocyte recipients, which indicated a greater tendency for general activity and higher energy levels.ConclusionCBRC oocyte recipient women may have greater vulnerability to anxiety than local women prior to infertility treatment. Screening and psychological support protocols for anxiety in this population should be considered.

Differentiating anxiety from fear: an experimental-pharmacological approach.

Gray's theory of personality postulates that fear and anxiety are distinct emotional systems with only the latter being sensitive to anxiolytic drugs. His work was mainly based on animal research, and translational studies validating his theory are scarce. Previous work in humans showed an influence of the benzodiazepine lorazepam on both systems, however, dependent on dosage (1 and 2 mg) and personality differences in negative emotionality. The present study aims to replicate these findings, and in addition tests the drug threshold effect by introducing a lower dosage of 0.5 mg lorazepam. Fifty healthy adults (23 males, agemean 22.40, SD ± 3.68) participated in an experimental threat-avoidance paradigm designed to dissociate risk assessment intensity (RAI, reflecting anxiety) and flight intensity (FI, reflecting fear) and completed two self-report questionnaires assessing facets of negative emotionality (Spielberger State Trait Anxiety Inventory and Fear Survey Schedule). In a randomized placebo-controlled within-subjects design, 0.5 and 1 mg of lorazepam were applied per os. Saccadic peak velocity was assessed by means of eye-tracking in order to control for sedating drug effects. Results showed the expected and specific anxiolytic effect of lorazepam on RAI, however, only in the 0.5 mg condition. FI was not influenced by lorazepam, and previous findings of interaction effects of lorazepam with self-reported negative emotionality could not be corroborated. Overall, this study demonstrates anxiolytic effects of lorazepam in dosages ≤1 mg in the absence of a drug effect on fear using a translational behavioural task. However, a putative moderating role of personality on defensive behaviour has to be clarified in future research.

Comparing the effects of muscle relaxation and music therapy on anxiety among candidates for coronary angiography: A randomized clinical trial

Background: Coronary angiography is associated with some levels of anxiety. Anxiety in turn can cause different complications, and hence, interventions are needed for its management. Recently, nonpharmacological therapies for anxiety management have gained great attention. Objectives: This study aimed to evaluate the effects of muscle relaxation and music therapy on anxiety among candidates for coronary angiography. Methods: This randomized controlled trial was conducted on 105 candidates for coronary angiography. Participants were consecutively recruited from the cardiology wards of Namazi hospital, Shiraz, Iran, and were randomly assigned to three 35-person groups, namely music, relaxation, and control groups. Participants in the music and the relaxation groups received 20-min music therapy and were performed 20-min muscle relaxation. Anxiety level was assessed both before and after the interventions using the Spielberger State Anxiety Inventory. Data were analyzed through the Chi-square test, the paired-sample t-test, and the one-way analysis of variance. Results: The mean score of anxiety in the relaxation and the music groups significantly reduced from 51.08 ± 6.98 and 49.02 ± 7.74 at the baseline to 41.88 ± 5.16 and 44.28 ± 5.21 at posttest (P < 0.01); however, it did not significantly change in the control group (P = 0.081). Conclusion: Both muscle relaxation and music therapy are effective in significantly reducing anxiety among candidates for angiography.