Spielberger Trait Anxiety Inventory Scores Research Articles

Depression diagnosis based on electroencephalography power ratios.

Depression is a common mental disorder that impacts millions of people across the world. However, its diagnosis is difficult due to the dependence on subjective testing. Although quantitative electroencephalography (EEG) has been investigated as a promising diagnostic tool for depression, the associated results have proven contradictory. The current study determines whether the alpha/beta (ABR), alpha/theta (ATR), and theta/beta (TBR) ratios can serve as biological markers of depression. We used open-access EEG data from OpenNeuro to investigate power ratios in the resting state of 46 patients with depression and 75 healthy controls. Spectral data were extracted by fast Fourier transform at the theta band (4-8Hz), alpha band (8-13Hz), and beta band (13-32Hz). Neural network, logistic regression, and receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracies of each suggested index. Additionally, the cutoff point, sensitivity, specificity, positive predictive value, and negative predictive value at the maximized Youden index were compared for each variable. Decreased anterior frontal, frontal, central, parietal, occipital, and temporal ABR and decreased central and parietal TBR were observed in the depression group. The area under the curve of the ROC curves further revealed that these ratios could all effectively differentiate depression. In particular, the central, frontal, and parietal ABR exhibited high discrimination scores. Multiple logistic regression analysis demonstrated that the Beck Depression Inventory and Spielberger Trait Anxiety Inventory scores, as well as the probability of depression, increased with a decrease in the central ABR. Moreover, neural network analysis revealed that the global ABR was the most effective index for diagnosing depression among the three global EEG power ratios. The central, frontal, and parietal ABR represent potential biomarkers to differentiate patients with depression from healthy controls.

Trait anxiety is associated with blood pressure and muscle sympathetic nerve activity

Heightened anxiety is associated with an increased risk for cardiovascular diseases such as coronary heart disease and hypertension. While hyperactivity of the sympathetic nervous system has been suggested to mediate this relationship, direct measures of muscle sympathetic nerve activity (MSNA) in people with elevated anxiety have indicated little, if any, alterations in baseline sympathetic function. However, studies examining anxiety and MSNA have been limited by small sample sizes and lack of detail on anxiety severity, limiting the ability to investigate subtle interactions. The present study assessed associations between trait anxiety, mean arterial pressure (MAP), and MSNA using a large, representative sample of healthy young men and women, with an exploratory assessment of sex-specific interactions. We hypothesized that heightened trait anxiety would be associated with elevated resting MAP and MSNA. Trait anxiety was assessed using the Spielberger Trait Anxiety Inventory (STAI) in 97 healthy adults (52 male, 45 female; 25±1 years; 26±1 kg/m 2 ). In each participant, the average of three seated brachial blood pressures was recorded and used in subsequent analysis. All participants underwent an autonomic function test that simultaneously assessed heart rate (HR), beat-to-beat blood pressure, MSNA burst frequency (BF) and incidence (BI) during 5-10 minutes of supine rest. MSNA recordings were captured in 91 participants. Multiple regression was used to test the relationship between STAI, MAP, MSNA, and HR while accounting for age and sex. Sex-specific interactions were explored with correlations controlling for age. The regression model significantly predicted MAP (R 2 =.196, P<0.001), BF (R 2 =.136, P=0.005), and BI (R 2 =.150, P=0.003), but not HR (R 2 =.055, P=0.155). STAI scores were independently associated with MAP (β=.207, P=0.029), BF (β=.245, P=0.016), and BI (β=.224, P=0.027). In males, STAI was correlated with MAP (R=.277, P=0.049), BF (R=.363, P=0.009), and BI (R=.346, P=0.013), but not HR (R=.140, P=0.326). In contrast, STAI was not associated with MAP (R=.174, P=0.260), BF (R=.094, P=0.574), BI (R=.069, P=0.681), or HR (R=.226, P=0.141) in females. In a large sample of healthy adults, our results highlight the relationship between the severity of trait anxiety, resting blood pressure, and sympathetic outflow, with a more pronounced relationship in males. Support: NIH (AA-024892, 1R15HL140596-01, AG064038-01A1, U54GM115371; P20GM103474, 2TL1 TR002318). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

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.

Work and home stress: associations with anxiety and depression symptoms.

In the evolving work environment of global competition, the associations between work and home stress and psychological well-being are not well understood. To examine the impact of psychosocial stress at work and at home on anxiety and depression. In medically healthy employed men and women (aged 30-60), serial regression analyses were used to determine the independent association of psychosocial stress at work and at home with depression symptoms, measured using the Beck Depression Inventory-II (BDI-II), and anxiety symptoms, measured using the Spielberger Trait Anxiety Inventory (STAI). Psychosocial stress at work was measured using the Job Content Questionnaire to assess job psychological demands, job control, job social support and job insecurity. Psychosocial stress at home was assessed by 12 questions including stress at home, personal problems, family demands and feelings about home life. Serial regression analyses in 129 subjects revealed that job insecurity and home stress were most strongly associated with depression and anxiety symptoms. Job insecurity accounted for 9% of the variation both in BDI-II scores and in STAI scores. Home stress accounted for 13 and 17% of the variation in BDI-II scores and STAI scores, respectively. In addition, job social support was significantly and independently associated with STAI scores but not BDI-II scores. Work and home stress were associated with anxiety and depression symptoms in both men and women. Both work and home stress should be considered in studies evaluating anxiety and depression in working populations.

Markers of Disease Severity Are Associated with Malnutrition in Parkinson's Disease

ObjectiveIn Parkinson's disease (PD), commonly reported risk factors for malnutrition in other populations commonly occur. Few studies have explored which of these factors are of particular importance in malnutrition in PD. The aim was to identify the determinants of nutritional status in people with Parkinson's disease (PWP).MethodsCommunity-dwelling PWP (>18 years) were recruited (n = 125; 73M/52F; Mdn 70 years). Self-report assessments included Beck's Depression Inventory (BDI), Spielberger Trait Anxiety Inventory (STAI), Scales for Outcomes in Parkinson's disease – Autonomic (SCOPA-AUT), Modified Constipation Assessment Scale (MCAS) and Freezing of Gait Questionnaire (FOG-Q). Information about age, PD duration, medications, co-morbid conditions and living situation was obtained. Addenbrooke's Cognitive Examination (ACE-R), Unified Parkinson's Disease Rating Scale (UPDRS) II and UPDRS III were performed. Nutritional status was assessed using the Subjective Global Assessment (SGA) as part of the scored Patient-Generated Subjective Global Assessment (PG-SGA).ResultsNineteen (15%) were malnourished (SGA-B). Median PG-SGA score was 3. More of the malnourished were elderly (84% vs. 71%) and had more severe disease (H&Y: 21% vs. 5%). UPDRS II and UPDRS III scores and levodopa equivalent daily dose (LEDD)/body weight(mg/kg) were significantly higher in the malnourished (Mdn 18 vs. 15; 20 vs. 15; 10.1 vs. 7.6 respectively). Regression analyses revealed older age at diagnosis, higher LEDD/body weight (mg/kg), greater UPDRS III score, lower STAI score and higher BDI score as significant predictors of malnutrition (SGA-B). Living alone and higher BDI and UPDRS III scores were significant predictors of a higher log-adjusted PG-SGA score.ConclusionsIn this sample of PWP, the rate of malnutrition was higher than that previously reported in the general community. Nutrition screening should occur regularly in those with more severe disease and depression. Community support should be provided to PWP living alone. Dopaminergic medication should be reviewed with body weight changes.

Anxiety associations with cardiac symptoms, angiographic disease severity, and healthcare utilization: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation.

Anxiety is common among patients presenting with suspected coronary artery disease (CAD). In a sample of women with signs and symptoms of ischemia, we examined three anxiety markers as predictors of CAD endpoints including: 1) cardiac symptom indicators; 2) angiographic CAD severity; and 3) healthcare utilization (cardiac hospitalizations and 5-year cardiovascular [CVD] healthcare costs). Participants completed a baseline protocol including coronary angiogram, cardiac symptoms, psychosocial measures and a median 5.9-year follow-up to track hospitalizations. We calculated CVD costs based on cardiac hospitalizations, treatment visits, and CVD medications. Anxiety measures included anxiolytic medication use, Spielberger Trait Anxiety Inventory (STAI) scores, and anxiety disorder treatment history. The sample numbered 514 women with anxiety measure data and covariates (mean age=57.5 [11.1]). One in five (20.4%) women reported using anxiolytic agents. Anxiety correlated with cardiac symptom indicators (anxiolytic use with nighttime angina and nitroglycerine use; STAI scores and anxiety disorder treatment history with nighttime angina, shortness of breath, and angina frequency). Anxiety disorder treatment history (but not STAI scores or anxiolytics) predicted less severe CAD. Anxiolytic use (but not STAI scores or anxiety disorder treatment history) predicted hospitalizations for chest pain and coronary catheterization (HRs=2.0, 95% CIs=1.1-4.7). Anxiety measures predicted higher 5-year CVD costs (+9.0-42.7%) irrespective of CAD severity. Among women with signs and symptoms of myocardial ischemia, anxiety measures predict cardiac endpoints ranging from cardiac symptom severity to healthcare utilization. Based on these findings, anxiety may warrant greater consideration among women with suspected CAD.

Prevalence of alexithymia and its association with anxiety and depression in a sample of Greek chronic obstructive pulmonary disease (COPD) outpatients

BackgroundChronic obstructive pulmonary disease (COPD) is a major health problem, especially in adults over 40 years of age, and has a great social and economic impact. The psychological morbidity of COPD patients with regard to anxiety and depressive symptoms has been extensively studied in the past. However, few studies have investigated the prevalence of alexithymia in these patients, as well as its association with this comorbidity. Based on this fact, we studied the prevalence of alexithymia and its association with anxiety and depressive symptoms in COPD outpatients.MethodsThe present study included 167, randomly selected, outpatients diagnosed with COPD. Alexithymia, anxiety and depression were assessed using the Toronto Alexithymia Scale (TAS-20), Spielberger Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively.ResultsThe mean BDI score was 12.88 (SD: 7.7), mean STAI score 41.8 (SD: 11.0) and mean TAS-20 score 48.2 (SD: 11.5). No differences were observed between genders regarding age and alexithymia (t test P > 0.05), while female patients presented higher depression and trait anxiety scores than males (t test P < 0.05). Clinically significant levels of anxiety were present in 37.1% of men, and in 45.7% of women. The mean depression score was also higher than the corresponding mean score in the general population (one-sample t test P < 0.01), while 27.7% and 30.5% of the sample presented mild and moderate to severe depression, respectively. Finally, a strong correlation was observed between alexithymia, depression and anxiety.ConclusionsThis study confirms the high prevalence of anxiety and depression symptoms in Greek outpatients with COPD. The prevalence of alexithymia in COPD patients, contrary to what has been observed in patients with other chronic respiratory diseases, seem to be lower. However, we observed a strong association between alexithymia, depression and anxiety levels. This observation suggests that alexithymia should be taken into consideration when drafting specific psychotherapeutic interventions for these patients.

PW01-215 - Connections between trait anxiety and the mechanisms of decision making in alcohol dependence

ObjectivesAccording to recent studies anxiety has a significant impact on cognitive functioning, especially on decision-making. Alcohol dependent patients (ADP) achieve worse performance on decision-making simulation tasks compared to healthy controls. Our aim was to investigate how trait anxiety is connected to decision-making mechanisms in ADP.MethodsThe data of 76 ADP have been analyzed. To examine decision-making mechanisms we used the “ABCD” version of the Iowa Gambling Task (IGT). The IGT total score was calculated and we divided the task into 5 equal blocks to study the pattern of the decision-making process. We administered the Spielberger Trait Anxiety Inventory (STAI) and the Wechsler Adult Intelligence Scale. The patient group was arranged into two subgroups with median split method based on the STAI scores. One group (N=38) was characterized by low trait anxiety level, and the other (N=38) had high level of trait anxiety. For comparing the two groups’ decision-making mechanisms we used independent samples t-test.ResultsThe group with higher level of trait anxiety performed significantly poorer on the IGT (t=2.09, p=0.04). The detailed analysis of the two groups’ decision-making mechanisms showed that the difference between the groups became significant in the 5th block (t=2.57, p=0.01).ConclusionsDecision-making deficit is not homogenous in the ADP group, as according to our results the trait anxiety level influences the adequacy of decision-making. Psycho-biological background of the inadequate decision-making needs further investigation and this knowledge could be used in the future to improve decision-making mechanisms of the ADP.

Irritable Bowel Syndrome Patients Exhibit Depressive and Anxiety Scores in the Subsyndromal Range

Irritable bowel syndrome (IBS) patients frequently experience affective disorders and psychiatric outpatients frequently meet criteria for IBS. The exact nature of this co-morbidity is not clear. 34 patients with Rome-II diagnosed IBS were recruited from a Gastroenterology clinic. Patients with social anxiety disorder (10 SSRI-remitted and 7 un- treated subjects) were used as a psychiatric comparison, 28 normal subjects from our register were included as a fourth group (Volunteers). Depressive and anxiety symptoms were measured by the Beck Depression Inventory (BDI) and Spielberger Trait Anxiety Inventory (STAI), respectively. Personality traits were measured with the Swedish universities Scales of Personality (SSP). IBS subjects had BDI and STAI scores intermediate between those of volunteers and patients, despite their lack of a co-morbid psychiatric diagnosis. A principle component factor analysis of the SSP dataset corre- sponded closely to the solution published with other samples. ANOVA revealed significant between-group differences for 7 of the 13 SSP variables.

Gender‐Specific Differences in Salivary Biomarker Responses to Acute Psychological Stress

The stress response is regulated by two primary neuroendocrine systems, the hypothalamus-pituitary-adrenocortical (HPA) and sympathetic adrenomedullary (SAM) systems. This study investigated gender differences in the activities of these two systems in response to acute psychological stress. Subjects were categorized according to their score in Spielberger's Trait Anxiety Inventory (STAI), which assesses the predisposition to personal anxiety. High (STAI score >or=55)- and low (STAI score <or=45)-anxiety groups were selected. A video of corneal surgery was served as the stressor for 15 min. Salivary cortisol and amylase levels were used as indices of the HPA and SAM activities, respectively. beta-endorphin was also assayed as a possible index of HPA activity. There were no differences in the resting salivary parameters among the groups. As expected, cortisol and amylase levels were significantly increased in all groups after the stressful video viewing. There were no gender differences in amylase levels in either the high- or low-anxiety groups. However, cortisol levels in highly anxious females were significantly lower than those in highly anxious males. Our findings show that highly anxious females exhibited lower cortisol release than highly anxious males, suggesting that high trait anxiety in females may be associated with an inability to respond with sufficient activation of HPA under acute psychological stress.

Visual ERPs evidence for enhanced processing of threatening information in anxious university students

There is accumulating evidence that highly anxious individuals selectively attend to threatening information; however, contrary to expectations, there is no evidence of enhanced processing of threat stimuli in those individuals. We investigated this question by using a sample of 20 University students who were split into two groups consisting of 10 high-anxious and 10 low-anxious subjects according to Spielberger Trait Anxiety Inventory score (median STAI = 40). Without emphasizing speed, subjects were required to decide whether visually presented words (positive, neutral, or threat) matched semantically with previous priming sentences (threat or positive) displayed on a computer screen (altogether, two types of priming sentences and three types of probe words). There was a fixed interval of 1.1 seconds between priming sentences (SI) and probe words (S2) as well as between each priming sentence word. Response time and visual event-related potentials (ERPs) were recorded in both conditions. The results showed that, compared to the Low-Anxious group, the amplitude of N100 and P400 were enhanced for the High-Anxious group in the threat priming conditions. Low-anxious individuals showed almost identical processing of threat-related situations and positive situations. Furthermore, the P400 peak latency was shorter for emotional incongruous probes in high-anxious individuals. ERPs results of the experiment suggest that highly anxious individuals deploy more processing resources to threatening information. This bias in information processing occurs in the absence of any behavioral changes (indicated by reaction times). Attentional bias in anxiety therefore implies that threatening information is given a priority over other information and is more persistently activated in anxiety states.

Reliability of psychophysiological responding as a function of trait anxiety

This study examined the temporal stability of three psychophysiological responses (frontal electromyographic activity, hand surface temperature, and heart rate) recorded over four sessions (days 1, 2, 8, and 28) on 34 subjects, 17 with high Spielberger Trait Anxiety Inventory scores and 17 with low scores. Each session consisted of a 20-minute adaptation period, a baseline condition, and two stressors (one cognitive, the other physical). Two forms of reliability coefficients were employed, intraclass correlations and Pearson Product Moment; the two types of reliability coefficients arrived at the same conclusions. Results indicated that reliability coefficients for the two anxiety groups did not differ on frontal EMG or heart rate responses; however, hand surface temperature responding was considerably less reliable for high anxious individuals than low anxious individuals. Reliability coefficients on absolute scores were, for the most part, reliable. Treating the responses as relative measures (percent change from baseline or simple change scores from baseline) produced smaller and less reliable coefficients. Magnitudes of the three physiological responses did not significantly differ as a function of high or low trait anxiety. Findings are discussed in terms of their clinical, as well as basic psychophysiological, importance.