Spielberger Trait Anxiety Research Articles

Anxiety and depression among infertile women: a cross-sectional survey from Hungary

BackgroundInfertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. The aim of our study is to assess the psychological state of women with and without fertility problems, and to investigate the background factors of anxiety-related and depressive symptoms in women struggling with infertility.MethodsOur study was conducted with the participation of 225 (134 primary infertile and 91 fertile) women, recruited in a clinical setting and online. We used the following questionnaires: Spielberger Trait Anxiety Inventory (STAI-T), Shortened Beck Depression Inventory (BDI) and Fertility Problem Inventory (FPI). We also interviewed our subjects on the presence of other sources of stress (the quality of the relationship with their mother, financial and illness-related stress), and we described sociodemographic and fertility-specific characteristics. We tested our hypotheses using independent-samples t-tests (M ± SD) and multiple linear regression modelling (ß).ResultsInfertile women were younger (33.30 ± 4.85 vs. 35.74 ± 5.73, p = .001), but had significantly worse psychological well-being (BDI = 14.94 ± 12.90 vs. 8.95 ± 10.49, p < .0001; STAI-T = 48.76 ± 10.96 vs. 41.18 ± 11.26, p < .0001) than fertile subjects. Depressive symptoms and anxiety in infertile women were associated with age, social concern, sexual concern and maternal relationship stress. Trait anxiety was also associated with financial stress. Our model was able to account for 58% of the variance of depressive symptoms and 62% of the variance of trait anxiety.ConclusionsDepressive and anxiety-related symptoms of infertile women are more prominent than those of fertile females. The measurement of these indicators and the mitigation of underlying distress by adequate psychosocial interventions should be encouraged.

Anxious Depression and Neurocognition among Middle-Aged and Older Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Results

The purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage. Data are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45-74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups. Among men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age. Increased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.

Impact of Visual Feedback on Exercise Intensity and Motivation

PURPOSE: Determine if visual feedback motivates college-aged students to maintain a higher exercise intensity during an indoor cycling class and to ascertain the favored type of visual feedback. METHODS: Thirty participants took part in a within-subject design experiment. Participants were assigned a heart rate monitor and identification number to record and monitor exercise intensity during each class session. Participants completed three cycling classes that were randomly assigned as a no visual feedback (NF), individual feedback (IF), or group feedback condition (GF). A Spielberger Trait Anxiety survey was completed before the first session and the Spielberger State Anxiety survey was completed before every cycling session. For each condition, participants stated if they enjoyed the heart rate feedback received and using the heart rate monitors. At the end of the study, participants specified the visual biofeedback condition they preferred. RESULTS: The group feedback condition spent a higher percentage of time above 80% of their age-predicted heart rate maximum. Participants spent 17.5% of their time in the 80-90% heart rate zone and 2.8% in the 90-100% zone. No feedback and individual feedback groups spent 13.2% and 15.1% in the 80-90% heart rate zone and 0.9% and 2.7% in the 90-100% zone. A 1-way repeated measures ANOVA indicated a statistically significant difference between the time spent in the 60-70% heart rate zone between the three conditions. The group feedback condition had the highest average heart rate (138.1 bpm), maximal heart rate (174.4 bpm), and heart rate predicted caloric expenditure (293.5 kcal). A positive correlation was found between the group feedback RPE and enjoyment of group feedback (r=0.55, p=0.01). The RPE of individual feedback was positively correlated with working harder due to wearing a heart rate monitor (r=0.54, p=0.01) and receiving individual feedback (r=0.57, p=0.01). Twenty-one (70%) participants preferred group feedback, 4 participants (13.3%) favored the individual feedback, 1 participant (3.3%) chose no feedback, and 4 participants (13.3%) had no preference. CONCLUSIONS: Participants favored group feedback over individual feedback and no feedback. Visual feedback was associated with higher exercise intensity and greater enjoyment of the exercise session.

What contributes to long-term quality of life in breast cancer patients who are undergoing surgery? Results of a multidimensional study.

This study aims to examine the key determinants of long-term quality of life in breast cancer patients who are undergoing surgery using a multidimensional approach and taking into account preoperative and post-operative psychological characteristics such as anxiety, depression, posttraumatic growth, body image, and physical activity as well as medical parameters. The study involved 63 breast cancer patients from the Department of Surgery at the University of Szeged. Assessments occurred 1day before surgery as well as 3 days and 18 months after surgery using the Spielberger State and Trait Anxiety Inventory (STAI), Beck's Depression Inventory (BDI), Functional Assessment of Cancer Therapy-Breast Cancer Scale (FACT-B), Posttraumatic Growth Inventory (PTGI) and Breast Impact of Treatment Scale (BITS). Data relating to physical activity, medical parameters and sociodemographic characteristics were also collected. The level of depression did not change over time. State anxiety decreased 18 months after the surgery compared to before the surgery; however, there was a greater decrease immediately after the surgery and then anxiety increased again 18 months later. Trait anxiety was associated with quality of life, posttraumatic growth and body image. Posttraumatic growth and the level of depression were found to be possible contributing factors to the increase in long-term quality of life. The results show that the timely detection and proper management of psychological distress and the enhancement of posttraumatic growth are of great value, as they might be important contributing factors to long-term quality of life in breast cancer patients.

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.

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.

Hostility and quality of life among Hispanics/Latinos in the HCHS/SOL Sociocultural Ancillary Study

Objective: The purpose of this study was to determine if hostility is associated with physical and mental health-related quality of life (QoL) in US. Hispanics/Latinos after accounting for depression and anxiety.Methods: Analyses included 5313 adults (62% women, 18–75 years) who completed the ancillary sociocultural assessment of the Hispanic Community Health Study/Study of Latinos. Participants completed the Center for Epidemiological Studies Depression Scale, Spielberger Trait Anxiety Scale, Spielberger Trait Anger Scale, Cook–Medley Hostility cynicism subscale and Short Form Health Survey. In a structural regression model, associations of hostility with mental and physical QoL were examined.Results: In a model adjusting for age, sex, disease burden, income, education and years in the US., hostility was related to worse mental QoL, and was marginally associated with worse physical QoL. However, when adjusting for the influence of depression and anxiety, greater hostility was associated with better mental QoL, and was not associated with physical QoL.Conclusions: Results indicate observed associations between hostility and QoL are confounded by symptoms of anxiety and depression, and suggest hostility is independently associated with better mental QoL in this population. Findings also highlight the importance of differentiating shared and unique associations of specific emotions with health outcomes.

Midazolam for sedation before procedures.

Midazolam is used for sedation before diagnostic and therapeutic medical procedures. It is an imidazole benzodiazepine that has depressant effects on the central nervous system (CNS) with rapid onset of action and few adverse effects. The drug can be administered by several routes including oral, intravenous, intranasal and intramuscular. To determine the evidence on the effectiveness of midazolam for sedation when administered before a procedure (diagnostic or therapeutic). We searched the Cochrane Central Register of Controlled Trials (CENTRAL to January 2016), MEDLINE in Ovid (1966 to January 2016) and Ovid EMBASE (1980 to January 2016). We imposed no language restrictions. Randomized controlled trials in which midazolam, administered to participants of any age, by any route, at any dose or any time before any procedure (apart from dental procedures), was compared with placebo or other medications including sedatives and analgesics. Two authors extracted data and assessed risk of bias for each included study. We performed a separate analysis for each different drug comparison. We included 30 trials (2319 participants) of midazolam for gastrointestinal endoscopy (16 trials), bronchoscopy (3), diagnostic imaging (5), cardioversion (1), minor plastic surgery (1), lumbar puncture (1), suturing (2) and Kirschner wire removal (1). Comparisons were: intravenous diazepam (14), placebo (5) etomidate (1) fentanyl (1), flunitrazepam (1) and propofol (1); oral chloral hydrate (4), diazepam (2), diazepam and clonidine (1); ketamine (1) and placebo (3); and intranasal placebo (2). There was a high risk of bias due to inadequate reporting about randomization (75% of trials). Effect estimates were imprecise due to small sample sizes. None of the trials reported on allergic or anaphylactoid reactions. Intravenous midazolam versus diazepam (14 trials; 1069 participants)There was no difference in anxiety (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.39 to 1.62; 175 participants; 2 trials) or discomfort/pain (RR 0.60, 95% CI 0.24 to 1.49; 415 participants; 5 trials; I² = 67%). Midazolam produced greater anterograde amnesia (RR 0.45; 95% CI 0.30 to 0.66; 587 participants; 9 trials; low-quality evidence). Intravenous midazolam versus placebo (5 trials; 493 participants)One trial reported that fewer participants who received midazolam were anxious (3/47 versus 15/35; low-quality evidence). There was no difference in discomfort/pain identified in a further trial (3/85 in midazolam group; 4/82 in placebo group; P = 0.876; very low-quality evidence). Oral midazolam versus chloral hydrate (4 trials; 268 participants)Midazolam increased the risk of incomplete procedures (RR 4.01; 95% CI 1.92 to 8.40; moderate-quality evidence). Oral midazolam versus placebo (3 trials; 176 participants)Midazolam reduced pain (midazolam mean 2.56 (standard deviation (SD) 0.49); placebo mean 4.62 (SD 1.49); P < 0.005) and anxiety (midazolam mean 1.52 (SD 0.3); placebo mean 3.97 (SD 0.44); P < 0.0001) in one trial with 99 participants. Two other trials did not find a difference in numerical rating of anxiety (mean 1.7 (SD 2.4) for 20 participants randomized to midazolam; mean 2.6 (SD 2.9) for 22 participants randomized to placebo; P = 0.216; mean Spielberger's Trait Anxiety Inventory score 47.56 (SD 11.68) in the midazolam group; mean 52.78 (SD 9.61) in placebo group; P > 0.05). Intranasal midazolam versus placebo (2 trials; 149 participants)Midazolam induced sedation (midazolam mean 3.15 (SD 0.36); placebo mean 2.56 (SD 0.64); P < 0.001) and reduced the numerical rating of anxiety in one trial with 54 participants (midazolam mean 17.3 (SD 18.58); placebo mean 49.3 (SD 29.46); P < 0.001). There was no difference in meta-analysis of results from both trials for risk of incomplete procedures (RR 0.14, 95% CI 0.02 to 1.12; downgraded to low-quality evidence). We found no high-quality evidence to determine if midazolam, when administered as the sole sedative agent prior to a procedure, produces more or less effective sedation than placebo or other medications. There is low-quality evidence that intravenous midazolam reduced anxiety when compared with placebo. There is inconsistent evidence that oral midazolam decreased anxiety during procedures compared with placebo. Intranasal midazolam did not reduce the risk of incomplete procedures, although anxiolysis and sedation were observed. There is moderate-quality evidence suggesting that oral midazolam produces less effective sedation than chloral hydrate for completion of procedures for children undergoing non-invasive diagnostic procedures.

Genome-wide association study of generalized anxiety symptoms in the Hispanic Community Health Study/Study of Latinos.

Although generalized anxiety disorder (GAD) is heritable and aggregates in families, no genomic loci associated with GAD have been reported. We aimed to discover potential loci by conducting a genome-wide analysis of GAD symptoms in a large, population-based sample of Hispanic/Latino adults. Data came from 12,282 participants (aged 18-74) in the Hispanic Community Health Study/Study of Latinos. Using a shortened Spielberger Trait Anxiety measure, we analyzed the following: (i) a GAD symptoms score restricted to the three items tapping diagnostic features of GAD as defined by DSM-V; and (ii) a total trait anxiety score based on summing responses to all ten items. We first calculated the heritability due to common variants (h2SNP ) and then conducted a genome-wide association study (GWAS) of GAD symptoms. Replication was attempted in three independent Hispanic cohorts (Multi-Ethnic Study of Atherosclerosis, Women's Health Initiative, Army STARRS). The GAD symptoms score showed evidence of modest heritability (7.2%; P = 0.03), while the total trait anxiety score did not (4.97%; P = 0.20). One genotyped SNP (rs78602344) intronic to thrombospondin 2 (THBS2) was nominally associated (P = 5.28 × 10-8 ) in the primary analysis adjusting for psychiatric medication use and significantly associated with the GAD symptoms score in the analysis excluding medication users (P = 4.18 × 10-8 ). However, meta-analysis of the replication samples did not support this association. Although we identified a genome-wide significant locus in this sample, we were unable to replicate this finding. Evidence for heritability was also only detected for GAD symptoms, and not the trait anxiety measure, suggesting differential genetic influences within the domain of trait anxiety. © 2016 Wiley Periodicals, Inc.

Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation.

This paper evaluated long-term associations between psychosocial factors and premature mortality among women with suspected coronary artery disease (CAD). We tracked total mortality events over a median 9.3years in a cohort of 517 women [baseline mean age=58.3 (11.4) years]. Baseline evaluations included coronary angiography, psychosocial testing, and CAD risk factors. Measures included the Spielberger Trait Anxiety Scale, Beck Depression Inventory, self-rated health, and Social Network Index. Cox regression analysis was used to assess relationships. Covariates included age, CAD risk factors, and CAD severity. BDI scores (HR 1.09, 95% CI 1.02-1.15), STAI scores (HR .86, 95% CI .78-.93), and very good self-rated health (relative to the poor self-rated health group; HR .33, 95% CI .12-.96) each independently predicted time to mortality outcomes in the combined model. SNI scores (HR .91, 95% CI .81-1.06) and other self-rated health categories (i.e., fair, good, and excellent categories) were not significant mortality predictors after adjusting for other psychosocial factors. These results reinforce and extend prior psychosocial research in CAD populations.

Cardiovascular disease risk factors and psychological distress among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress, yet research examining these relationships among Hispanic/Latinos is lacking. The population-based Hispanic Community Health Study/Study of Latinos enrolled a cohort of Hispanic/Latino adults (N=16,415) 18–74years of age at the time of recruitment, from four US metropolitan areas, between March 2008 and June 2011. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale, 10 item Spielberger Trait Anxiety Scale, and a combined depression/anxiety score), socio-demographics (i.e., age, education, income, insurance, sex, and Hispanic/Latino background), acculturation (i.e., country of birth and language preference), and traditional CVD risk factors (i.e., dyslipidemia, obesity, current cigarette smoking, diabetes, and hypertension) were assessed at baseline. Associations between CVD risk factors and psychological distress measures by sex were examined using multiple linear regression models, accounting for complex survey design and sampling weights and controlling for socio-demographic and acculturation covariates. In adjusted analyses, all three psychological distress measures were significantly related to smoking. For females, greater psychological distress was significantly related to obesity and current smoking. For males, diabetes and current smoking were associated with psychological distress. For males and females, dyslipidemia and hypertension were not associated with psychological distress after adjusting for other factors. Elevated depression and anxiety symptoms were associated with CVD risk factors for Hispanic/Latino men and women. However, these results were not consistent across Hispanic/Latino groups. As promoted by the integrative care model, psychosocial concerns should be considered in research on CVD risk and chronic disease prevention.

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.

Health-related quality of life and blood pressure 12 months after renal denervation.

To examine the effect of renal denervation (RDN) on blood pressure (BP) and health-related quality of life (QoL) in patients with resistant hypertension, pseudoresistant hypertension due to a white-coat effect and in patients with uncontrolled masked hypertension. Using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory (BDI) and Spielberger's state and trait anxiety questionnaires, we examined QoL, symptoms of depression and anxiety prior to and 12 months following RDN. BP was assessed from clinic and ambulatory blood pressure monitoring (ABPM) recordings. Patients with uncontrolled masked hypertension had the highest BDI and anxiety scores among all groups at baseline. Twelve months following RDN clinic and ambulatory BP were reduced only in those patients with resistant hypertension (delta SBP: clinic -16 ± 3 mmHg, ABPMday -8 ± 2 mmHg, ABPMnight -8 ± 2 mmHg, all P < 0.01). Clinic BP was reduced in the pseudoresistant group (-17 ± 6 mmHg, P < 0.01) but was elevated in the uncontrolled masked group (+13 ± 6 mmHg, P = 0.02). In all patients, trait anxiety (P < 0.05), BDI scores (P < 0.05) and the SF-36 mental component summary (MCS) score (P < 0.001) were improved. The improvement in the SF-36 MCS was confined to those patients with resistant hypertension (+4.0 ± 1.1, P < 0.01). The change in clinic BP after RDN was related to the baseline clinic BP (systolic: r = 0.54, P < 0.001; diastolic r = 0.43, P < 0.001), the number of ablations delivered (both clinic and mean day ABPM systolic r = 0.24, P < 0.05) and to the change in SF-36 MCS score (systolic: r = 0.25, P = 0.01; diastolic r = 0.24, P = 0.02). These results indicate that in patients with confirmed resistant hypertension, RDN is associated with a reduction in BP and a sustained improvement in mental health-related aspects of QoL.

Trait anger but not anxiety predicts incident type 2 diabetes: The Multi-Ethnic Study of Atherosclerosis (MESA)

Prior studies have shown a bidirectional association between depression and type 2 diabetes mellitus (T2DM); however, the prospective associations of anger and anxiety with T2DM have not been established. We hypothesized that trait anger and anxiety would predict incident T2DM, independently of depressive symptoms. In the Multi-ethnic Study of Atherosclerosis (MESA), we prospectively examined the association of trait anger and trait anxiety (assessed via the Spielberger Trait Anger and Anxiety Scales, respectively) with incident T2DM over 11.4 years in 5598 White, Black, Hispanic, and Chinese participants (53.2% women, mean age 61.6 years) at baseline without prevalent T2DM or cardiovascular disease. We used Cox proportional hazards models to calculate the hazard ratios (HR) of incident T2DM by previously defined anger category (low, moderate, high), and anxiety quartile, as there were no previously defined categories. High total trait anger was associated with incident T2DM (HR 1.50; 95% CI 1.08-2.07) relative to low total trait anger. The association was attenuated following adjustment for waist circumference (HR 1.32; 95% CI 0.94-1.86). Higher anger reaction was also associated with incident T2DM (HR=1.07; 95% CI 1.03-1.11) that remained significant after adjusting for potential confounders/explanatory factors. In contrast, trait anxiety did not predict incident T2DM. High total trait anger and anger reaction are potential modifiable risk factors for T2DM. Further research is needed to explore the mechanisms of the anger-diabetes relationship and to develop preventive interventions.

Evaluation of Psychometric Properties of the State and Trait Anxiety Inventory Scale in a Student Sample

&lt;p&gt;&lt;em&gt;&lt;span lang="EN-US"&gt;Problems with anxiety are one of the most common presenting problems for university students that affect the mental health. A sample of students (total n=318) were administered Spielberger's State and Trait Anxiety Scale. The demographics of the participants included 38.4% (n = 122) males and 61.6 % (n =196) females, participants ranged in ages from 18 to 25 years old. The average age of respondents was 20.92 (SD =2.07). This study was conducted to evaluate of psychometric properties of the Spielberger's State-Trait Anxiety Inventory form in a student sample. The internal consistency for the STAI was calculated by Cronbach alpha coefficient (α = 0,809). Principal component analysis with Varimax rotation was performed to assess the factor structure for the total sample that yielded four factors. Descriptive statistics were also calculated for the sample. They were found to be moderately trait anxious (M = 38.89, SD = 8.92) with lower state anxiety (M = 35.79, SD = 9.80). The findings of this study suggest that the scale was shown to be reliable and may be valid for measuring anxiety in a student sample.&lt;/span&gt;&lt;/em&gt;&lt;/p&gt;

Emotional processing in Parkinson patients: An fMRI study

personality in relation to the presence of a partner by measuring symptoms of anxiety and depression, quality of life, self-perception of health status in coronary heart disease (CHD) patients and normal controls. Method: Normal controls (n = 541) and patients with CHD (n = 110) were included. All participants completed self-report measures on Type D personality, questionnaires on socio-demographic factors, the Spielberger State and Trait Anxiety InventoryState (STAI-S), and the Center for Epidemiologic Studies Depression Scale (CES-D). By stratifying participant group, personality type, and partner status, eight groups were constructed. Results: The subjects with Type D personality showed higher mean scores on the STAI-S and CES-D as well as perception of their health. In cases of depression, CHD patients with Type D personality and without partner showed about a 50-fold increase in odds ratio when compared with non-Type D normal controls with partners. Odds ratio for depression changed from 31.44 to 48.72 in CHD patients with Type D personality based on the existence of a partner. Conclusion: Having a partner significantly predicted the risk of depression. It is important to identify social support systems in CHD patients with Type D personality.

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.