Spielberger Trait Anxiety Research Articles

Effect of bitter orange blossom distillate on anxiety and sleep disorder in mothers with infants admitted to neonatal intensive care unit: A Randomized controlled clinical trial.

Mothers of neonates admitted to the intensive care unit are prone to sleep disorders due to stress and anxiety. Some herbs have anti-anxiety and sedative properties. This study aimed to investigate the effect of bitter orange blossom distillate on anxiety and sleep disorders in mothers with infants admitted to the neonatal intensive care unit. This randomized controlled clinical trial was conducted from 2021 May 15 to 2022 February 2, on 60 mothers with NICU-admitted infants in one of the medical teaching centers affiliated with Babol University of Medical Sciences, Iran. Permuted block randomization was used to assign the mothers to the experimental (bitter orange blossom distillate syrup) and control groups (syrup prepared from water and sugar). Given the impossibility of blinding the participants, allocation concealment was used to prevent the researcher from predicting the future allocation of the samples to the groups. In addition, the statistical consultant received coded data pertaining to the type of intervention in each group. A demographic questionnaire, the Spielberger State and Trait Anxiety Inventory (STAI), and the General Sleep Disorder Scale were employed to collect data. We assessed the level of anxiety and sleep disorder (in both groups before the intervention and again after the last day of the intervention). Data were analyzed using SPSS V22 software. A P-value less than 0.05 were considered significant. The mean and standard deviation of the sleep disorder score in the intervention group from (50.26±5.81) to (44.70±6.94) and in the control group from (50.46±6.95) to (48.53±8.62) changed. The covariance test showed that bitter orange blossom distillate syrup has a significant effect on the improvement of sleep disorders (P = 0.01, Effect size = 0.09), but there was no significant difference in the State and Trait anxiety level of mothers (P = 0.122, 0.144 and Effect size = 0.04, 0.03) respectively. Due to the positive effect of bitter orange blossom distillate syrup on sleep disorders of mothers with hospitalized babies, this low-cost and low-risk intervention is recommended. This study is registered at clinicaltrials.gov as Trial ID = IRCT20201209049666N1.

Prevalence of anxiety symptoms in infertile men: a systematic review and meta-analysis

BackgroundInfertility in men causes problems in various aspects of their lives, including personal, family and social life. One of the most important of these problems is anxiety. Anxiety in infertile men can affect their health, quality of life, and response to treatment, highlighting the significance of anxiety in these men. Thus, this systematic review and meta-analysis was conducted to investigate the prevalence of anxiety symptoms in infertile men.MethodsTo conduct this review study, two researchers independently searched international databases such as PubMed, Cochrane Library, Web of sciences, Scopus, PsyINFO, and the Google scholar search engine in English without considering any time limit until January 2, 2024. Keywords such as "anxiety," "infertility," "prevalence," and "epidemiology" were used, taking into account the specific search method of each database. Using the Newcastle–Ottawa Scale (NOS), the quality of the articles was evaluated by two researchers independently.ResultsIn the systematic part of the study, 27 studies were included, and given the variety of measurement tools (8 different tools) used to investigate anxiety symptoms in infertile men, 24 studies were analyzed in five subgroups of tools. The pooled prevalence of anxiety symptoms in infertile men was 21.37% (95% CI: 15.73–27.02). The lowest and highest prevalence of anxiety in infertile men were related to the Beck anxiety inventory (BAI) and Depression Anxiety Stress Scales (DASS), accounting for 7.08% (95% CI: 3.27–10.90) and 34.90% (95%CI: 28.90–40.90) values respectively. This prevalence was 19.80% (95%CI: 9.01–30.59) for the Hospital Anxiety and Depression Scale (HADS), 30.06% (95%CI: 18.59–41.52) for the Spielberger Trait Anxiety Inventory (STAI-T), and 18.52% (95%CI: 7.76–29.29) for the Self-Rating Anxiety Scale (SAS).ConclusionThe results of this systematic review and meta-analysis indicated that the prevalence of anxiety symptoms in infertile men requires special attention to healthcare planning. The healthcare system of different countries should evaluate the symptoms of anxiety in infertile men and take appropriate measures to reduce them according to the culture of the countries. It is recommended that all infertile couples be assessed for anxiety symptoms using a standardized tool during their initial evaluation.

Treatment outcomes in the inpatient management of severe functional neurological disorder: a retrospective cohort study

BackgroundFunctional neurological disorder (FND) is a heterogeneous condition; severe forms can be disabling. Multidisciplinary treatment and rehabilitation are recommended for severe FND, but there remains a lack of evidence for...

Associations of Anxiety Symptoms With 6-Year Blood Pressure Changes and Incident Hypertension: Results From the Hispanic Community Health Study/Study of Latinos.

Despite the high burden of anxiety and hypertension in Hispanic/Latino adults, little is known about their association in this population. To examine the associations of anxiety symptoms with 6-year changes in blood pressure (BP) and incident hypertension in Hispanic/Latino adults. We examined data from a probability sample of 10,881 Hispanic/Latino persons aged 18-74 who attended visits 1 (V1; 2008-2011) and 2 (V2; 2014-2017) of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study. Anxiety symptoms were assessed at V1 using the 10-item Spielberger Trait Anxiety Scale (M = 17.1; Range = 10-40) and dichotomized using a cut-point of 20, the highest quartile in this cohort. BP was measured at both visits using a standardized protocol. Adults with elevated anxiety symptoms had a 1.02 mm Hg greater increase in systolic (p = .02) and a 0.75 mm Hg greater increase in diastolic BP (p = .02) over 6.1 years than those with lower symptoms, after adjusting for sociodemographic and clinical covariates. These associations differed by sex. Elevated anxiety was associated with a greater increase in systolic and diastolic BP in men only. Among persons without hypertension at V1 (N = 7,412), those with elevated anxiety symptoms at V1 had a 22% higher incidence of hypertension (p = .02) 6.1 years later. Our findings underscore the importance of screening for and treating elevated anxiety symptoms to help prevent hypertension. Further research on the role of sex and underlying mechanisms is warranted.

The Mediating Role of Maladaptive Metacognitive Beliefs between Adverse Childhood Experiences and Trait Anxiety

IntroductionAdverse childhood experiences (ACE) have a significant negative impact on health. ACEs lead to more pronounced trait anxiety, among others, which serves as a basis for various mental and somatic symptoms. Recent findings suggest that the fact that individuals with more ACEs also have more maladaptive metacognitive beliefs may contribute to the development of these symptoms.ObjectivesWe aim to study the possible mediating role of maladaptive metacognitive beliefs, resulting from adverse childhood experiences, on trait anxiety.MethodsData was collected online, anonymously, in a non-clinical population of adults over 18 years of age. The sample consisted of 304 subjects (84.21 % women, 15.79 % men). The applied questionnaires included a demographic questionnaire, the Adverse Childhood Experiences Questionnaire 10 item version, the Meta-Cognitions Questionnaire, and the Spielberger Trait Anxiety Questionnaire. The system of correlations between the examined variables was explored using structural equation modeling (SEM). The study was carried out with ethical approval and in accordance with the Declaration of Helsinki.ResultsOur results confirm that ACEs have a significant impact on all the measured dimensions of maladaptive metacognitive beliefs. The direct effect of ACEs on adult trait anxiety is also significant. The results of the study on indirect effects support the joint mediating role of the five metacognitive dimensions. The strongest significant mediating effect was found for the uncontrollability and dangerousness of negative beliefs about worry. Both the direct and indirect effects of cognitive self-consciousness on adult trait anxiety are negative, which means that the more the cognitive self-consiousness is characteristic of someone, the lower the degree of trait anxiety in adulthood is.ConclusionsOur results confirm the mediating effect of metacognitive beliefs on trait anxiety in the context of adverse childhood experiences, which points to the importance of further research on metacognition among the population that suffered early adversities. One of the limitations of the study roots in online data collection: the examined sample is not representative. Moreover, to extend the results, it is recommended to repeat the study on a clinical population. This would enable us to compare our results with those of the clinical population, which could provide further important results in the field of metacognition and adverse childhood experiences.Disclosure of InterestNone Declared

Abstract 42: Metabolite Risk Scores of Lifestyle Measures Improve Incident Hypertension Prediction

Introduction: Metabolites capture the metabolic environment associated with exposures. Objective: To develop and assess the usefulness of metabolite risk scores (MRSs) as biomarkers representing exposure measures. Methods: We used two separate sets of individuals sampled from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Both sets of individuals had metabolite data measures on the Metabolon HD4 platform. We applied the least absolute selection and shrinkage operator (LASSO) to develop MRSs for current smoking, physical activity, Mediterranean diet, and anxiety in set 1 (n=2,178), cross-sectionally, and evaluated them for replication in set 2 individuals (n=4,002). We defined hypertension as SBP140, DBP90, or hypertension medication use, and estimated MRS associations with incident hypertension longitudinally (6 years after the baseline exam, on average) in set 2 individuals free of hypertension at baseline (426 cases and 1,556 controls). The association models were adjusted for age, sex, and BMI. We compared the estimated association with those of self-reported phenotypes. Results: All MRSs were developed in set 1 individuals have replicated associations in set 2 individuals. The figure provides the estimated association of MRSs for diet, smoking, physical activity, and anxiety with incident hypertension and compares them to the associations of self-reported Mediterranean diet, anxiety measured using the Spielberger trait anxiety scale, pack-years of smoking, and self-reported physical activity in MET-min/day. All associations are per 1 SD increase in the exposure measure. The figure shows that the MRS associations are often stronger than those of the self-reported measure. Conclusions: MRSs have the potential to serve as accurate biomarkers of self-reported exposures.

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

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

An explanatory sequential pilot inquiry on music therapy and performance anxiety in university music education majors

Music Performance Anxiety (MPA) is prevalent among amateur and professional musicians. While music therapy has established itself as an effective therapy for reducing anxiety in numerous individuals with varying health issues, in depth research on the potential benefits of music therapy for managing MPA is lacking. This explanatory sequential pilot inquiry with 15 undergraduate music education majors from two large music faculties in Canada assessed the benefits of group music psychotherapy offered for 6 weeks in person or via telehealth on the experience of MPA. Test measures included the Spielberger State and Trait Anxiety Inventories (STAI) pre and post study, a pre and post study questionnaire, pre and post music psychotherapy session Likert scales for anxiety and mood, and a post study interview. Music psychotherapy interventions included breathing exercises, grounding and guided visualizations/meditations, and musical improvisation. Quantitative data, assessed for all participants combined and by group, revealed that anxiety and mood scores on the Likert scale improved after participation in six music psychotherapy sessions, while the STAI scores remained constant pre and post study. Qualitative themes suggest the benefits of music psychotherapy for changed perception and cognitions, sense of support, reduction in symptoms and overall continued and future management of MPA. The results of this study are promising, pointing to music psychotherapy as a potential short-term therapy for MPA symptom management, having practical implications for post-secondary music education and future research.

Factors affecting self-esteem and anxiety levels in high school students in Van Province Tusba District

This cross-sectionally study aimed to determine the self-esteem and anxiety levels of young people in socio-economically and socio-culturally lower regions of the country and to evaluate whether there is a relationship between self-esteem and anxiety levels. 602 students studying in high schools were included in the study. Rosenberg scale and Spielberg trait anxiety scale (SSAS) and a survey about socio-demographic characteristics were administered to the students. In the study, 53.7% (331) of the students were female and 46.3% (285) were male. Self-esteem was found to be high in 82.6% of the students and at medium level in 17.4%. There are no students with low self-perception. Self-esteem levels of those with poor income, those who smoke and use addictive substances, and those with low academic performance were found to be significantly lower. The students' SSAS mean score is 47.36±8.13. There is a negative correlation between SSAS score and self-esteem. Income status, perception of quality of life, health status, academic performance and SSAS score show a negative correlation. As a result, negative conditions increase the SSAS score and decrease self-esteem. It is important to improve the economic conditions of students, to teach them healthy lifestyle behaviors, to have regular health examinations, and to maintain their healthy condition. Increasing the academic performance of children who are unsuccessful in school will reduce their anxiety levels. Health is a whole physically, spiritually and socially.

Analysis on the Relationships of Smartphone Addiction, Learning Engagement, Depression, and Anxiety: Evidence from China.

With the popularization of the Internet and smartphones, smartphone addiction among college students is becoming increasingly common, causing the problems of their learning engagement, anxiety, and depression. The study aimed to analyze the relationships of smartphone addiction, learning engagement, anxiety and depression among Chinese college students. Based on the Self-Determination Theory, in January 2023, 780 college students from 6 universities in Heilongjiang Province in China were selected as examples for the study. Internet Addiction Test, Utrecht Work Engagement Scale-Student, Chinese version of Beck Depression Inventory-II, and Spielberger Trait Anxiety Inventory were employed to measure smartphone use, learning engagement, depression, and anxiety among college students. Pearson correlation and multiple logistic regressions were also used. Smartphone use was negatively correlated with learning engagement (r = -0.097, P < 0.001), whereas it was positively correlated with depression (r = 0.184) and anxiety (r = 0.18, P < 0.001). Significant differences were observed in learning engagement and depression and anxiety symptoms in different degrees of smartphone use. Taking severe smartphone addiction as a comparison standard, depression and anxiety symptoms had a significant influence on different levels of smartphone use, whereas learning engagement did not have a significant influence on different smartphone use levels. The intervention and prevention of college students' smartphone addiction can improve their learning engagement, relieve their anxiety and depression, and enhance their mental health level.

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.

Evaluation of the effectiveness of artificial intelligence assisted interactive screen-based simulation in breast self-examination: An innovative approach in nursing students

BackgroundBreast self-examination is important in the early diagnosis of breast cancer. The use of traditional education methods is insufficient for student nurses to gain breast self-examination skills in nurse education. New and different education methods are needed to gain skills in nurse education. ObjectiveThe aim of this study was to evaluate the effectiveness of artificial intelligence-assisted screen-based simulations practice and standard patient simulation in teaching breast self-examination skills in nursing undergraduate students. DesignThis study was a comparative intervention trial. SettingsThis study was conducted at a university in XX, in XXX in the first semesters of the academic years 2022–2023. MethodsThis study enlisted 103 students enrolled in first year in a nursing department. Students were randomized into artificial intelligence-assisted screen-based simulations practice group (n = 52) and standard patient simulation group (n = 51). Data were collected using student description form, breast self-examination checklist, student satisfaction and self-confidence in learning scale, Spielberger's state and trait anxiety inventory. ResultsThe highest score regarding the total score means of breast self-examination skills belonged to the standard patient simulation group, and the differences between the groups were found to be statistically significant (p < 0.05). Although the mean score of anxiety levels of the students' artificial intelligence-assisted screen-based simulations practice group was higher than the standard patient simulation (p < 0.05). The mean score of the students' satisfaction with the simulation was higher in artificial intelligence-assisted screen-based simulations practice group than the standard patient simulation group (p < 0.05). ConclusionsThe results of the research showed that the use of artificial intelligence-assisted simulation learning increased students' satisfaction, but at the same time students' anxiety increased. In addition, artificial intelligence-assisted simulation learning is not as effective as standard patient simulation learning in gaining breast self-examination skills.

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&lt;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.

Social Media Use as an Impulsive 'Escape From Freedom'.

It has been suggested that avoiding choice represents an anxiety-avoidance strategy, which has not been investigated in the context of social media. To this end, the current study explored the relationship between social media dependency and a preference for 'forced' choice, along with its association with anxiety, intolerance of uncertainty, and experiential avoidance. The sample comprised 151 volunteer participants (18-32years) who completed a psychometric test battery, including: the Bergen Social Media Addiction Scale; Spielberger Trait Anxiety Inventory; Intolerance of Uncertainty Scale; and Brief Experiential Avoidance Questionnaire. They also undertook a behavioural assessment based on a paradigm developed for pigeons, in which they selected either a situation with a free choice of alternatives, and one with a forced choice. Intolerance of uncertainty mediated the relationship between social media dependency and anxiety. In addition, those with lower social media dependency preferred being able to choose the contingency they worked on, while those with higher scores exhibited no such preference. This partly confirmed that social media dependency is associated with a reduced preference for freedom, but does not suggest social media dependency actively produced a preference for a lack of freedom. The speed of decision making was also faster in those with high social media dependency scores, in line with previous findings that they show higher levels of impulsive behaviours. The results suggest that anxiety and social media dependency are related, and fear of uncertainty and is linked with digital experiential avoidance.

Depressive symptoms, anxiety and social stress are associated with diminished cardiovascular reactivity in a psychological treatment-naive population

BackgroundThere is now an increasing appreciation of how psychological health can contribute to cardiovascular disease, called the mind-heart connection. A blunted cardiovascular reactivity to depression and anxiety may be responsible for the potential mechanism, however, with inconsistent results. Anti-psychological drugs have an effect on the cardiovascular system and, thus, may disturb their relationship. However, in treatment-naive individuals with psychological symptoms, no research has specifically evaluated the relationship between psychological state and cardiovascular reactivity. MethodsWe included 883 treatment-naive individuals who came from a longitudinal cohort study of Midlife in the United States. Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), Spielberger Trait Anxiety Inventory (STAI), the Liebowitz Social Anxiety scale (LSAS) and the Perceived Stress Scale (PSS), respectively. Cardiovascular reactivity was measured using standardized, laboratory-based stressful tasks. ResultsTreatment-naive individuals with depressive symptoms (CES-D ≥ 16), anxiety symptoms (STAI ≥ 54), and higher stress levels (PSS ≥ 27) had lower cardiovascular reactivity as assessed by systolic blood pressure (SBP) reactivity, diastolic blood pressure (DBP) reactivity and heart rate (HR) reactivity (P < 0.05). Pearson analyses showed that psychological symptoms were correlated with lower SBP reactivity, DBP reactivity, and heart rate reactivity (P < 0.05). Multivariate linear regression showed that depression and anxiety were negatively related to lower cardiovascular reactivity (SBP, DBP and HR reactivity) after full adjustments (P < 0.05). Stress was associated with reduced SBP and DBP reactivity but with a nonsignificant association with HR reactivity (P = 0.056). ConclusionDepression, anxiety, and stress symptoms are associated with blunted cardiovascular reactivity in treatment-naive adult Americans. These findings suggest that blunted cardiovascular reactivity is an underlying mechanism linking psychological health and cardiovascular diseases.

Anxiety in pregnancy and stress responsiveness: An exploratory study of heart rate variability, cortisol, and alpha-amylase in the third trimester.

The present study aimed to explore the association between anxiety symptoms, including sleep, and physiological stress responsiveness in pregnant women with and without anxiety, as identified by psychiatric diagnosis. Fifty-four pregnant women with (n=25) and without (n=29) anxiety completed a laboratory cognitive stressor (the Stroop Color-Word Task) during the third trimester. Heart rate variability (HRV) (as the root mean square of successive differences, RMSSD) was recorded during baseline, stressor, and recovery periods. Salivary cortisol (sCORT) and alpha amylase (sAA) were measured at four timepoints surrounding the stressor task. Psychometric scales (Penn State Worry Questionnaire [PSWQ], Perceived Stress Scale [PSS], Spielberg Trait Anxiety Inventory Scale [STAI], and Pittsburgh Sleep Quality Index [PSQI]) were collected. Women in the anxiety group exhibited significantly less rebound in HRV (RMSSD, change of 4-ms difference, p=.025) from baseline to recovery following the Stroop than did those in the non-anxiety group. Neither neuroendocrine measure (sCORT, sAA) differed between groups at any measurement period. Across the recording period, lower reported sleep quality (PSQI, p=.0092) and higher subjective stress (PSS, p=.039) were associated with lower RMSSD. The findings suggest that women with and without anxiety in late pregnancy display differences in the degree of autonomic rebound as indicated by HRV following a stressor. In addition, levels of HRV over time were associated with subjective perceptions of increased stress and poor sleep. PREGNANCY AND ANXIOUS: The Role of the Immune and Endocrine Systems (NCT03664128).

Assessing effects of mandala painting on anxiety of 9–14-year-old children with cancer

BackgroundThere are various non-pharmacological ways to reduce anxiety, one of which is Mandala. The mandala can be considered as a tool that helps the patients to focus on themselves with the aim of getting back their normal internal balance. AimThe study aimed to determine the effect of mandala on anxiety of 9–14 year old children with cancer. Materials and methodsThis quasi-experimental study was conducted on 40 children with cancer who had mild-to-moderate anxiety, through a pre-test before the intervention started and a posttest after the intervention ended. Three weeks later, it was repeated on a single group of participant’s time series design from January to June 2019. Data were collected using the "Personal Attributes" and "Spielberger Trait Anxiety Questionnaire". Mandala was done daily for 45 min in six sessions, for children in their rooms. The data were analyzed by SPSS-25, and the repeated measures ANOVA statistical test was used in order to compare the levels of anxiety in time series. ResultsThe mean age was 11.2 ± 1.79, and the mean age of diagnosis was 9.8 ± 2.2. The mean score of anxiety level in the children with cancer was (84.20 ± 10.26), (57.52 ± 15.65), and (56.62 ± 16.52) before the intervention, after the intervention, and one month after intervention, respectively. There was a statistically significant relationship between the mean scores of time series (P-value < 0.001). ConclusionConducting the mandala sessions reduced the anxiety of children with cancer after the intervention and one month later. Mandala painting is therefore recommended as a complementary non-pharmacological treatment to reduce pediatric anxiety.

Association Between Hearing Loss and Multiple Negative Emotional States in the USHispanic Population.

Hearing loss (HL) has been linked to commonly studied detrimental mood states, such as loneliness and depression. However, its relationship with other negative emotions remained largely unstudied. We explore the association between HL and anxiety, anger, hostility, poor self-esteem, and pessimism in a national cohort of USHispanic adults. Cross-sectional study. Multicentered USnational epidemiologic study (Hispanic Community Health Study). Subjects were ages 18 to 75 with completed audiometric and emotional survey data. Multivariable regressions controlling for age, gender, and education were conducted to analyze the association between HL, measured by 4-frequency pure-tone average (PTA), and emotional states. States included anxiety (Spielberger Trait Anxiety Scale-10), anger (Spielberger Trait Anger Scale), hostility (Cook Medley Cynicism Scale-13),poor self-esteem (Self-Esteem Scale-10), and pessimism (Revised Life Orientation Test). A total of 4120 to 4341 participants met inclusion criteria, depending on the specific survey; the average age was 46.7 years (standard deviation [SD] = 13.7), and the average PTA was 13.8 dB (SD = 10.1). Controlling for age, gender, and education, HL was associated with all outcomes. Specifically, for every 10 dB worsening in HL, the anxiety score worsened by 0.41 (0.23-0.60), the anger score worsened by 0.40 (0.22-0.58), the hostility score worsened by 0.16 (0.04-0.27), the self-esteem score worsened by 0.25 (0.12-0.38), and the pessimism score worsened by 0.17 (0.04-0.30) (all p < .01). HL is related to numerous negative mood states beyond loneliness and depression. This includes worse anxiety, anger, hostility, self-esteem, and pessimism. Future studies should investigate whether treating HL improves negative emotional states.

ASSOCIATION BETWEEN STATE AND TRAIT ANXIETY AND CARDIOVASCULAR DISEASE

Abstract Cardiovascular disease (CVD) consistently ranks among the top ten leading causes of death, with prevalence rates being the highest among middle aged and older adults. Research has found that CVD has a negative bidirectional association with anxiety. However, the literature is limited regarding what specific aspects of anxiety, i.e., state and/or trait, are associated with CVD. The present study investigated the association between state and trait anxiety and CVD in a national sample of 640 middle aged and older adults. Participants (M age = 56.2, SD = 11.8) were from the Midlife in the United States (MIDUS) Biomarker sub-project. State anxiety was assessed with the Mood and Anxiety Symptom Questionnaire-anxiety subscale and trait anxiety was assessed with the Spielberger Trait Anxiety Inventory. In a binary logistic regression model including both state and trait anxiety, only trait anxiety significantly predicted presence of CVD (p = .05). In particular, trait anxiety was significantly associated with circulatory disease (p = .05), heart murmurs (p = .03), and blood clots (p = .03). Among middle-aged and older adults, trait anxiety is associated with having several different CVDs. These findings support assessing and addressing trait anxiety among middle aged and older adults with CVD.

Mental health and quality of life during weight loss in females with clinically severe obesity: a randomized clinical trial.

The purpose of this investigation was to explore the effects of dietary weight loss intervention, with and without the addition of exercise on health-related quality of life, depressive symptoms, and anxiety. As part of the EMPOWER study for women, sixty premenopausal women (BMI of 40.4 ± 6.7) were randomized to energy restriction only (ER) or to exercise plus energy restriction (EXER) for 12months. Health-related quality of life was assessed using the SF-36, depressive symptoms were assessed using the Beck Depression Inventory II (BDI), and anxiety symptoms using the Spielberger state and trait anxiety questionnaire. All measures were completed at baseline, 3, 6 and 12months. At 12months, there were significant (p < 0.05) group-by-time interactions favouring the EXER group for five of the eight domains and the mental component summary score. At 12months, a significant group-by-time interaction favouring the EXER group is reported for both state and trait anxiety (p = .005 and p = .001, respectively). At 12months, there was a significant group-by-time interaction for depressive symptoms favouring EXER (p < 0.05). Within-group changes for BDI scores were improved at all follow-up time points in the EXER group. Exercise training confers an additional benefit to energy restriction in the absence of additional weight loss at 12months for health-related quality of life, depressive symptoms, and state and trait anxiety scores when compared to energy restriction only. Exercise and an energy-restricted diet improve health-related quality of life and mental health. Exercise may protect mental health without further weight loss for women with severe obesity.