Spielberger Trait Anxiety Inventory Research Articles

Frontal EEG Asymmetry Differs between High and Low Trait Anxious Individuals as a Function of Lateralized Vibrotactile Stress

Anxiety is an aversive emotional state marked by hyperarousal and cognitive impairments. Studies using Quantitative Electroencephalography (QEEG) have shown asymmetric right frontal and parietotemporal activity at resting baseline in trait anxious subjects. However, there has been a lack of research investigating changes in QEEG asymmetries in trait anxious subjects following stress. The current study aimed to assess changes in QEEG asymmetries following lateralized vibrotactile and affective stress in trait anxious subjects. Following a two-minute baseline, subjects underwent two 2-minute stress periods, during which they were presented with auditory and counterbalanced unilateral vibrotactile stressors, each followed by a two-minute recording period. Subjects were classified as high or low trait anxious based on their scores on the Spielberger Trait Anxiety Inventory. A repeated measures ANOVA revealed significant asymmetry score differences between the high and low anxious groups in the F3/F4 (F(1,32) = 5.30, p < 0.03), and F7/F8 (F(1,32) = 4.20, p < 0.05) electrode pairs as a function of lateralized vibrotactile stress. No significant differences were found between groups in the Fp1/Fp2, C3/C4, P3/P4, and P7/P8 electrode pairs or between trials in any of the electrode pairs for either group. These results replicate previous findings demonstrating differences in EEG frontal asymmetries between subjects scoring high or low in trait anxiety with but do not support the use of changes in asymmetry scores as a marker of acute stress. More work needs to be done regarding EEG frontal asymmetry and acute stress.

Depression and Anxiety in Greek Male Veterans After Retirement.

Retirement is a turning point in human life, resulting in changes to physical and mental health status. The aim of this study was to examine the factors that are related with depression and anxiety symptoms in Greek male veterans after retirement. A total of 502 veterans participated in a cross-sectional study. Beck Depression Inventory for depression assessment and Spielberger Trait Anxiety Inventory for anxiety assessment were used. The Ethics Committee of the Technological Educational Institution of Thessaly granted permission for conducting the research, and informed consent was obtained from all the participants. Questionnaires were filled in electronically using a platform that was made for the specific research. Mean values, standard deviations, Student t test, nonparametric cluster analysis of variance, Pearson's and Spearman's coefficients, and linear regression were conducted, using the Statistical Program for Social Services version 19.0. Severe depression was found in 3.8% of veterans with a mean score of 6.78, whereas 23.2% displayed mild-to-moderate symptoms of depression. Mean score of state anxiety was found to be 36.55 and of trait anxiety 33.60. Veterans who were discharged because of stressful working conditions, those who have a high body mass index, consume regularly alcohol, smoke and were not satisfied by changes in their everyday life after retirement had significantly more symptoms of depression and anxiety, although those who retired because of family problems had significantly more symptoms of depression. Multivariate linear regression analyses indicated that dissatisfaction related to lifestyle changes had statistically significant effect on symptoms of depression and anxiety, and stressful working conditions as a leading cause for retirement had statistically significant effect on depression. Finally, according to linear regression analyses results, those who were satisfied with their professional evolution had 1.80 times lower score in depression scale. The sense of satisfaction derived from fulfilling work-related expectations when finishing a career, with changes in everyday life, and smoking and alcohol reduction, may contribute to a better adjustment during the retirement period. To our knowledge, this was the first study examining depression and anxiety levels in Greek veterans, and the sample size was large, covering a randomly chosen veteran population. On the other, it was a convenient sample, although the study results could not focus on direct-term effects of retirement (up to 3 years of retirement from active service). Primitive data may be used for research directions in the future.

Determinants of maternal antenatal state-anxiety in mid-pregnancy: Role of maternal feelings about the pregnancy

BackgroundThe current state of research into antenatal anxiety is lacking in a comprehensive understanding of determinants. This study aims to expand knowledge in this area, with the main objective being to determine potential determinants of maternal antenatal state-anxiety. MethodsData used for this cross-sectional study were obtained from the Prenatal Health Project: a population cohort study of 2357 women in London, Ontario. 1992 women in their second trimester met inclusion criteria for this study. The primary hypothesis was that “feelings about the pregnancy” would be a determinant of antenatal state-anxiety after controlling for other potential covariates. The abbreviated version of the Spielberger State and Trait Anxiety Inventory (STAI) was used to measure state-anxiety. Univariate analyses and multiple linear regression were performed to identify variables predictive of state-anxiety. ResultsStress, feeling unsure/unhappy about the pregnancy and having low self-esteem, low mastery and low social support from one’s partner and family were statistically significant determinants of state-anxiety during the second trimester. In addition, anxiety was found to be inversely related to gestational age. LimitationsThe two main limitations of the study were the use of a self-report screening tool (STAI) as the measure of anxious symptoms rather than a clinical diagnosis, and possible recall bias of feelings about the pregnancy. ConclusionsWe concluded that how a woman feels about her pregnancy was a determinant of state-anxiety. This study contributes knowledge aiming to help women improve their mental health during pregnancy by identifying important determinants of state-anxiety.

Endoscopic findings and psychometric abnormalities: what is the relationship in upper endoscopic outpatients?

Psychological disorders are often associated with diseases of the upper digestive tract. Although emotions can influence gastrointestinal function in healthy individuals, psychological setting in upper gastrointestinal patients are unclear. We evaluate the psychological alterations prevalence in outpatients submitted to upper endoscopy. A total of 130 patients (50 males and 80 females; mean age 54±17 years) submitted to upper gastrointestinal endoscopy, were enrolled over the period May 2009 - September 2010. Subjects were asked to complete questionnaires before endoscopic examination. Alexithymia, anxiety, depression and coping style were assessed using the Toronto Alexithymia Scale, Spielberger Trait Anxiety Inventory, Beck Depression Inventory and Coping Inventory for Stressful Situations, respectively. Coping impairment, Alexithymia, Anxiety and Depression were found respectively in 80.3%, 25.4%, 24.6% and 17.2%, often in association. Task-oriented, emotion-oriented and avoidance-oriented alterations were found in 41.8%, 40% and 30.6%, respectively. No correlations were demonstrated between diagnosis of upper gastrointestinal disease and psychometric results. In our study, a high prevalence of psychometric alterations in gastrointestinal outpatients was unconnected with endoscopic findings, especially considering coping style alterations. This aspect should be taken into account in patients management and a long-term follow-up should clarify a possible role of these factors in patients prognosis and compliance.

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.

Validation of the Fear of Pelvic Examination Scale (F-PEXS) – measuring students’ fear of performing a pelvic examination

Introduction: Medical students of both genders often show signs of fear before they perform their first pelvic examination. This situation puts a novice in a special setting of intimacy never experienced before and where different emotions may emerge. A specially designed questionnaire, the Fear of Pelvic Examination Scale (F-PEXS) has been developed to assess fear in this context. The aim of this paper is to describe the validation of the F-PEXS.Methods: Undergraduate medical students (N = 100) answered the F-PEXS one week before, prior to and after a learning session with professional patients to assess levels of anxiety towards performing the pelvic exam. The validity of the scale was examined using item analysis, reliability assessments and analysis of the construct validity in comparing the F-PEXS with the Spielberger State and Trait Anxiety Inventory and Beck’s Anxiety Inventory.Results: The F-PEXS has very good reliability (Cronbach’s alpha 0.96) and good construct validity. The mean score on the F-PEXS did not differ between gender either before or after the learning session.Conclusions: The F-PEXS can be used to assess students’ fear of performing the pelvic examination, to evaluate new strategies for learning the pelvic exam and to evaluate the outcome of such interventions.

The Behavioural Inhibition System, anxiety and hippocampal volume in a non-clinical population

BackgroundAnimal studies have suggested that the hippocampus may play an important role in anxiety as part of the Behavioural Inhibition System (BIS), which mediates reactivity to threat and punishment and can predict an individual’s response to anxiety-relevant cues in a given environment. The aim of the present structural magnetic resonance imaging (MRI) study was to examine the relationship between individual differences in BIS and hippocampal structure, since this has not received sufficient attention in non-clinical populations. Thirty healthy right-handed participants with no history of alcohol or drug abuse, neurological or psychiatric disorders, or traumatic brain injury were recruited (16 male, 14 female, age 18 to 32 years). T1-weighted structural MRI scans were used to derive estimates of total intracranial volume, and hippocampal and amygdala gray matter volume using FreeSurfer. To relate brain structure to Gray’s BIS, participants completed the Sensitivity to Punishment questionnaire. They also completed questionnaires assessing other measures potentially associated with hippocampal volume (Beck Depression Inventory, Negative Life Experience Survey), and two other measures of anxiety (Spielberger Trait Anxiety Inventory and the Beck Anxiety Inventory).ResultsWe found that high scores on the Sensitivity to Punishment scale were positively associated with hippocampal volume, and that this phenomenon was lateralized to the right side. In other words, greater levels of behavioural inhibition (BIS) were positively associated with right hippocampal volume.ConclusionsOur data suggest that hippocampal volume is related to the cognitive and affective dimensions of anxiety indexed by the Sensitivity to Punishment, and support the idea that morphological differences in the hippocampal formation may be associated with behavioural inhibition contributions to anxiety.

Akt2 Gene is Associated with Anxiety and Neuroticism in Humans

Background: The exact cellular and molecular mechanisms underlying the pathophysiology, successful treatment and prevention of the highly associated anxiety and depressive disorders have not been identified. Akt2 is a key protein in the Phosphatidylinositide-3 (PI3K)/ Glycogen Synthase 3 kinase (GSK3) signaling pathway. This pathway is involved in Brain-Derived Neurotropic Factor (BDNF) signaling, fear memory, mood stabilization and action of several antidepressant drugs. In this study, we examined whether Akt2 Single Nuclear Polymorphisms (SNP) are associated with anxiety and depression associated personality traits. Methods: Four hundred and sixty-three healthy participants completed a self-rating scale for anxiety traits (Spielberger Trait-Anxiety Inventory, STAI) and depressive personality traits (NEO-FFI). Four SNPs of the Akt2 gene (rs7247515, rs3730256, rs892118, rs11671439) were examined. Results: The ANCOVA showed that the dependent variable anxiety trait score was significantly affected by all four genotypes. The anxiety state score was a significant covariate in three genotypes. Neuroticism was influenced by three of the four examined genotypes. Conclusion: We found a connection between different genotypes of the Akt2 gene and personality traits concerning anxiety and depression. These findings may be of importance for the understanding of the pathophysiology of depressive and anxiety disorders. Furthermore, Akt2 might be a potential novel therapeutic target in the treatment of those devastating mood disorders.

Selected Attentional Bias in Different Level of Trait Anxiety

Anxiety is one of the most common mental disorders and has attracted attention of more and more researchers. A number of behavioral studies suggest that attentional bias towards threat among anxious populations is a relatively robust phenomenon. The attentional biases are observed not only across different experimental tasks but also across different anxiety disorders. However, studies of the neural mechanisms of this phenomenon are currently rare and inconsistent. It was found that compared to low trait anxiety(LTA), high trait anxiety(HTA) evoked different P2 between angry and neutral faces, with a larger P2 to the angry face in some studies. In contrast, others found that threatening stimuli elicited a larger P2 in both groups. Similarly,inconsistent findings also exited for the P1. In addition, the N1 effect on the attentional bias to fearful imageswith a complex context is still unclear. Therefore, the present study aimed at investigating the electrophysiological markers of attention bias for fearful images with a complex context in anxiety.Participants were selected out of a pool of 70 undergraduate students. The participants were screend on the basis of their response to Spielberger's Trait Anxiety Inventory. Those with scores in the top quartile of the distribution(n=17, 6 males and 11 females) were assigned to the HTA group, and those in the bottom quartile of the distribution(n=17, 10males and 7 females) were assigned to the LTA group. All participants were right-handed, and had normal or corrected normal vision. ERPs were recorded when subjects viewed 30 fear and30 neutral pictures which were presented twice. ERP data from five midline electrode sites was selected for further statistical analysis: Fz, FCz, Cz, CPz, and Pz. We measured mean amplitudes in four windows following stimulus onset: 120~140 ms(N1), 230~250 ms(N2), 300~500 ms(P3), and 500~1000 ms(Slow wave, SW).Anxiety group(HTA vs. LTA) ×picture type(fearful vs. neutral) ×electrode sites(Fz, FCz, and Cz) analysis of variance(ANOVA) was conducted on the amplitude of N1, N2, P3, and SW. For all analyses, the significance level was set at 0.05. Post-hoc testing of significant main effects was conducted using BONFERRONI method.Significant interactions were analyzed using simple-effect models.Results showed that the HTA group exhibited a enhanced N1 in comparison to the LTA group, F(2, 64) =19.28, p 0.01. And the interactions of the three factors was significant, F(1, 32) = 11.94, p0.01. The interactions between picture and group was significant [Cz: F(1, 32) = 6.93, p0.05, FCz: F(1, 32) = 5.22,p0.05]; compared to LTA, HTA elicited different N1 amplitude between fearful and neutral images, with enhanced N1 to the fearful images. LTA elicited enhanced N2 compared with HTA, F(1, 32) = 4.83, p 0.05. A significant relation between N2 and the trait score was found by using the stepwise regression analysis, F=6.97,p0.05, R2=0.18.These results indicate that the HTA group allocated more attention resource to fearful images at the early emotional process stage(120~140 ms), whereas LTA group began to distinguish fearful from neutral at the later stage(230~250 ms). The executive function of inhibition might decrease with HTA, These results provide new evident to support the cognition-motivation model.

Anxiety reactivity and anxiety perseveration represent dissociable dimensions of anxiety vulnerability: A replication and extension

Trait anxiety is a unitary construct reflecting individual differences in the tendency to experience anxious symptomatology, typically measured with questionnaires such as the Spielberger Trait Anxiety Inventory (STAI‐T). Recent research by Rudaizky, Page, and MacLeod has found evidence that two different dimensions of trait anxiety account for independent variance in trait anxiety scores. These dimensions are anxiety reactivity (AR), reflecting the probability of experiencing an anxious reaction, and anxiety perseveration (AP), reflecting the persistence of anxious symptoms once elicited. There are two key issues addressed in this study: first, the replicability of Rudaizky et al.'s findings and second, the ability of the measures of AR and AP developed by Rudaizky et al. to predict independent variance in STAI‐T scores after statistically controlling for variance shared with a measure of depression. Regression analysis determined that AR and AP do account for independent variance in STAI‐T trait anxiety scores even after statistically controlling for depression. The implications of these findings for the understanding of anxiety vulnerability are discussed.

Anxiety reactivity and anxiety perseveration represent independent dimensions of anxiety vulnerability: an in vivo study

Trait anxiety is a relatively stable disposition reflecting an individual's tendency to experience anxious symptomatology, typically measured using questionnaires such as the Spielberger Trait Anxiety Inventory (STAI-T). While trait anxiety commonly is considered a unitary construct, recent questionnaire research suggests that two different dimensions of anxiety vulnerability account for independent variance in trait anxiety scores. These dimensions are anxiety reactivity (AR), reflecting the intensity of anxiety reactions to stressors, and anxiety perseveration (AP), reflecting the persistence of anxiety symptoms. This study investigated whether in vivo measures of these two facets independently contribute to anxiety vulnerability. Seventy-two participants were exposed to a novel stress task designed to yield measures of AR and AP. Regression analysis determined that these in vivo measures were unrelated to each other, and each accounted for independent variance in trait anxiety scores. The implications of these findings for the assessment and understanding of anxiety vulnerability are discussed.

The Subjective Happiness Scale: Translation and Preliminary Psychometric Evaluation of a Spanish Version

The aim of the present study was to investigate the psychometric properties of the Spanish version of the Subjective Happiness Scale (Lyubomirsky and Lepper in Soc Indic Res 46:137–155, 1999) in a wide sample of 1,155 participants (448 men, 707 women) from three different groups (high school students, college students, and community adult participants). The participants completed the following measures: the Spanish version of SHS, the Satisfaction with Life Scale, the Beck Depression Inventory and the Spielberger Trait Anxiety Inventory. The results revealed preliminary evidence of adequate internal consistency, appropriate test–retest reliability and convergent validity for research purposes. Also, results from confirmatory factor analyses showed a clear one-factor structure, identical with the English version. No significant sex effects were evidenced, although differences between the high school student group and the undergraduate university group were found. In general, our findings add empirical evidence of the usefulness of such a brief measure for the assessment of subjective happiness in large-scale national and international studies with native Spanish-speaking populations. Finally, practical recommendations and future lines of research are suggested.

The effect of a single episode of short duration heart rate variability biofeedback on measures of anxiety and relaxation states.

This study examines the acute effect of heart rate variability (HRV) biofeedback on anxiety and relaxation states. Eighteen healthy males exposed to work-related stress were randomized into an HRV biofeedback group (BIO) or comparative group (COM). The device used by the COM group appeared identical to the HRV biofeedback device, however, it did not provide biofeedback, rather it displayed a wave which the subjects were instructed to observe. Subjects completed a modified Stroop task before and after a 10-min intervention. The Spielberger Trait Anxiety Inventory (STAIT) was completed at recruitment, and the Spielberger State Anxiety Inventory (STAIS) and Smith Relaxation States Inventory 3 (SRSI3) were completed before and after testing. Subjects rated perceived efficacy and feelings of sleepiness using a visual analogue scale (VAS). Analysis of the VAS scores revealed that the COM group felt sleepier than the BIO group after using the intervention. After testing, HRV biofeedback resulted in large improvements in scores for mindfulness, energized positive feelings and basic relaxation, and the comparative intervention resulted in a moderate improvement in basic relaxation, small improvement in mindfulness, and no improvement in energized positive feelings. Both groups had moderate improvements in transcendence. There was a large decrease in state anxiety in the BIO group and moderate decrease in the COM group. These findings suggest that although there was benefit to both interventions, a single episode of short duration HRV biofeedback led to greater benefit and may be a valuable tool to include in the

Quality of life and its socio‐demographic and psychological determinants after bone marrow transplantation

A host of medical, socio-demographic, and psychological factors that affect bone marrow transplantation (BMT) patients' quality of life (QOL) have been identified, but due to the methodological diversity of the studies, the findings have been contradictory. The aim of this study was to examine the influence of somatic status, social characteristics, and psychological symptoms on QOL in BMT patients. The study had a cross-sectional design. QOL was evaluated using the Hungarian version of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale. Anxiety and depression were assessed using Spielberger's State and Trait Anxiety Inventory (SSTAI) and the Beck Depression Inventory (BDI). A questionnaire designed for the study was used to record socio-demographic variables. One hundred and twenty-one patients formed the study sample. Patients' QOL was better in our sample than in another study with similar mean time after BMT. BDI scores indicated mild depression; SSTAI scores corresponded with healthy population levels. QOL was strongly influenced by psychological symptoms (depression P < 0.001; anxiety P = 0.001; psychiatric comorbidity P = 0.001), employment status (P = 0.042), and gender (P = 0.05). The somatic factors influenced only separate aspects of QOL; somatic comorbidity only affected cancer-associated QOL (P = 0.004). This is the first study on a Hungarian BMT sample that included economic factors in the assessment of QOL. Psychological variables were the strongest determinants of QOL in this study.

Trait Anxiety Levels Before and After Antidepressant Treatment

The aim of this study was to examine change in "trait anxiety" levels assessed repeatedly before and after antidepressant treatment in a large cohort of men and women. A total of 18,732 participants of the Finnish Public Sector Study with no initial record of depression or self-reported doctor diagnosis of depression completed the short form of the Spielberger Trait-Anxiety Inventory in 2000-2002 (T1), 2004-2005 (T2), and 2008-2009 (T3). We used prescription data from the nationwide Drug Prescription Register to identify antidepressant treatment between T1 and T2 (n = 710). Both men (β = 0.435, P < 0.001) and women (β = 0.300, P < 0.001) who received antidepressant treatment had higher trait anxiety levels at T1. Mixed models analyses of repeated measures showed a small but statistically significant decrease in trait anxiety scores for the overall sample of men (β = 0.023, P = 0.033) and women (β = 0.011, P = 0.031) between T1 and T3. The interaction term between time and antidepressant treatment status suggested a greater decrease in trait anxiety levels among men receiving antidepressant treatment, with an adjusted excess decrease in mean trait anxiety scores of 0.163 (P = 0.012) between T1 and T3. We found some evidence suggesting that this is also the case in women, although the evidence in our data was less consistent for women. This large-scale study provides evidence suggesting that antidepressant treatment is associated with a reduction in trait anxiety levels, particularly in men.

Pregnant Turkish women with low income: Their anxiety, health-promoting lifestyles, and related factors

This paper presents anxiety levels, health-promoting lifestyles and related factors among pregnant Turkish women with low income. A descriptive correlation and cross-sectional study was conducted at a state maternity hospital in Western Turkey. The paper reports on the data (n = 195) from the Spielberg State and Trait Anxiety Inventory (STAI), the Health-Promoting Lifestyle Profile (HPLP) and a sociodemographic questionnaire. The average HPLP score was low (mean 2.57, SD 0.42). The average STAI score was high (40.67 ± 9.48; 46.40 ± 8.09, respectively). A significant relation was detected between the trait anxiety, state anxiety, antenatal visit, perception of social support, living environment, family type and HPLP (P < 0.05). A moderately negative relation was detected between the mean STAI and HPLP scores. The findings indicate information and data should be provided for service planning and community care to support pregnant Turkish women with low income in communities.

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.

Attributional Style in Healthy Persons: Its Association with 'Theory of Mind' Skills

ObjectiveAttributional style, especially external personal attribution bias, was found to play a pivotal role in clinical and non-clinical paranoia. The study of the relationship of the tendency to infer/perceive hostility and blame with theory of mind skills has significant theoretical importance as it may provide additional information on how persons process social situations. The aim of this study was whether hostility perception bias and blame bias might be associated with theory of mind skills, neurocognition and emotional factors in healthy persons.MethodsTotal 263 participants (133 male and 130 female) were recruited. The attributional style was measured by using the Ambiguous Intentions Hostility Questionnaire (AIHQ). Participants were requested to complete a Brüne's Theory of Mind Picture Stories task, neurocognitive task including Standard Progressive Matrices (SPM) and digit span, and other emotional dysregulation trait scales including Rosenberg's self-esteem, Spielberg's trait anxiety inventory, and Novaco anger scale.ResultsMultiple regression analysis showed that hostility perception bias score in ambiguous situation were found to be associated with theory of mind questionnaire score and emotional dysregulation traits of Novaco anger scale. Also, composite blame bias score in ambiguous situation were found to be associated with emotional dysregulation traits of Novaco anger scale and Spielberg's trait anxiety scale.ConclusionThe main finding was that the attributional style of hostility perception bias might be primarily contributed by theory of mind skills rather than neurocognitive function such as attention and working memory, and reasoning ability. The interpretations and implications would be discussed in details.

Nutritional behavior and attitudes in food allergic children and their mothers

BackgroundAvoidance of food allergens requires adapting dietetic habits, changing nutritional approach. A restriction of food choice can result in a monotonous diet and impact social life. This study investigated the impact of food allergy on nutritional behavior and attitudes of patients and their families.MethodsA survey involving mothers of food allergic children aged 0–16 years was carried out. We primarily studied the variables related to the child (age, gender, clinical history, food and social events attitudes). In addition, Spielberg Trait-Anxiety Inventory (STAI-T) test was applied to the mothers. We assessed separately the associations between characteristics of child-mother pairs and diet monotony, and attendance to social events, by means of proportional odds regression models.ResultsNearly 10% of the 124 participants completely banned allergenic foods at home and 15.3% consumed their meals separately. More than one fourth attended parties rarely or never. Most of the participants reported a “monotonous diet”. Model results suggested significant associations between child age (p = 0.05), mother age (p = 0.05), number of excluded foods (p = 0.003) and monotony of the diet. The attendance of social events was inversely associated with the number of excluded foods (p = 0.04) and the mother’s STAI-T T-score (p = 0.04).ConclusionsThe results highlighted the impact of food allergy in reducing interest about food and influencing patients’ approach to social life. It is important to support families in managing allergens avoidance.