STAI State Anxiety Research Articles

A network analysis of eating disorder, PTSD, major depression, state-trait anxiety, and quality of life measures in eating disorder patients treated in residential care.

The network approach in the eating disorder (ED) field has confirmed important links between EDs and posttraumatic stress disorder (PTSD) symptoms. However, studies including comorbid symptoms are scarce, which limits our understanding of potentially important connections. We hypothesised that anxiety, depression and poor quality of life (QOL) would provide a more complete picture of central, maintaining factors. Network analysis using R was performed in 2178 adult ED patients (91% female) admitted to residential treatment. Assessments included the ED Examination Questionnaire (EDEQ), the Eating Disorders Inventory (EDI-2), the PTSD Checklist for DSM-5 (PTSD clusters (PCL-5)), the Patient Health Questionnaire (PHQ-9), the Spielberger State-Trait Anxiety Scale (STAI), and the ED QOL Scale (EDQOL), which measure symptoms of EDs, PTSD, major depression, state-trait anxiety, and QOL, respectively. EDI-2 ineffectiveness showed the highest centrality (expected influence) followed by EDI-2 interoceptive awareness, STAI state anxiety, EDEQ shape concern, EDQOL psychological subscale, and PTSD cluster D (hyperarousal) symptoms. Eating Disorder Quality of Life psychological and physical-cognitive subscales and PHQ-9 major depressive, STAI state anxiety and PCL-5 PTSD cluster E (negative alterations in mood and cognition) symptoms showed the highest bridge expected influence, suggesting their interactive role in maintaining ED-PTSD comorbidity. This is the first network analysis of the interaction between ED and PTSD symptoms to include the comorbid measures of depression, anxiety, and QOL in a large clinical sample of ED patients. Our results indicate that several symptom clusters are likely to maintain ED-PTSD comorbidity and may be important targets of integrated treatment.

Effects of obsessive beliefs and anxiety on sexual function in HPV-positive men.

Our study aimed to investigate the effects of anxiety and obsessive beliefs on sexual function in men with human papillomavirus (HPV) and healthy men. Ninety HPV-positive men (mean age=32.26 ± 6.63 years) from the Urology Outpatient Clinic and 75 healthy men (mean age=33.51 ± 5.67 years) who worked in the hospital were assessed using the International Index of Erectile Function-15 (IIEF-15), Obsessive Beliefs Questionnaire-44 (OBQ), and State-Trait Anxiety Inventory (STAI) in 2023. The mean IIEF-15 scores of the patients with HPV and healthy individuals were 24.59 ± 6.14 vs. 23.16 ± 6.23 for the IIEF-erectile function; 8.30 ± 2.34 vs. 7.79 ± 1.77 for the IIEF-orgasmic function; 7.40 ± 1.73 vs. 7.23 ± 1.53 for the IIEF-sexual desire; 11.30 ± 3.38 vs. 11 ± 3.10 for the IIEF-intercourse satisfaction; and 7.62 ± 2.18 vs. 7.53 ± 2.02 for the IIEF-overall satisfaction (p > 0.05 for all). However, the mean OBQ and STAI scores of patients with HPV and healthy individuals were 46.66 ± 16.06 vs. 36.44 ± 19.25 for the OBQ-inflated responsibility/overestimation of threat (OBQ-RT); 45.91 ± 17.31 vs. 36.53 ± 19.08 for the OBQ-perfectionism/intolerance of uncertainty (OBQ-PU); 28.04 ± 12.31 vs. 23.80 ± 11.74 for the OBQ-importance of thought/control thoughts (OBQ-IC); 37.58 ± 12.06 vs. 33.59 ± 11.09 for the STAI-state anxiety (p < 0.05 for all); and 32.83 ± 8.34 vs. 33.44 ± 11.05 for the STAI-trait anxiety (p = 0.689). Our results showed that the STAI-state anxiety (β = -0.37; β = -0.32; and β = -0.43, respectively) and OBQ-IC (β = -0.57; β = -0.43; and β = -0.48, respectively) scores were the main predictors of the IIEF-erectile function, IIEF-orgasmic function, and IIEF-overall satisfaction scores in the HPV-positive group. The OBQ-RT (β = 0.46), OBQ-PU (β = -0.51) and STAI-state anxiety (β = -0.56) scores were unique predictors of the IIEF-sexual desire score, and the OBQ-RT (β = 0.41), OBQ-PU (β = -0.42), and OBQ-IC (β = -0.43) scores were the main predictors of the IIEF-intercourse satisfaction score in the HPV-positive group. However, regression models for the IIEF-15 subscales for the control group were not significant (p ˃ 0.05). Understanding the role of obsessive beliefs and anxiety in sexual dysfunction among HPV-positive men might be important for developing psychotherapeutic interventions.

Anxiety and mood in patients receiving intravitreal injection.

The goal of this study was to examine how anxious patients were before and after receiving intravitreal injections, which are commonly used in the treatment of ophthalmologic illnesses. The study was performed by administering a questionnaire containing sociodemographic information as well as two scales (Beck Anxiety and State-Trait Anxiety Inventory) to patients undergoing intravitreal injection in the ophthalmology department. The two scales were given to patients before and after the intravitreal injection. The patients who completed part of the study were 45% male and 55% female. There was a significant difference (p<0.001) between the median values of STAI Trait anxiety inventory scores prior to intravitreal injection and STAI Trait anxiety inventory scores after intravitreal injection. The median values of STAI State anxiety inventory scores before intravitreal injection and after intravitreal injection differed (p<0.001). There was a difference (p<0.001) between the median values of Beck anxiety inventory scores before intravitreal injection and after intravitreal injection. Patients who will have intravitreal injections may experience a high rate of anxiety before the treatment due to the invasive nature of the technique. As a result, intravitreal injection patients will benefit from psychological assistance and anxiety-reduction approaches.

Resilience and its correlates in patients with narcolepsy type 1.

This study aimed to explore resilience and its possible association with sociodemographic and clinical features in patients with narcolepsy type 1 (NT1). This was a cross-sectional study involving patients with NT1 and age-/sex-matched controls (comparison group). Sociodemographic and clinical data were collected through semistructured interviews and validated questionnaires, including the Epworth Sleepiness Scale (ESS), State-Trait Anxiety Inventory (STAI)-State Anxiety, Beck Depression Inventory (BDI), 36-item Short Form Survey (SF-36), and the Resilience Scale (RS). Different statistical approaches were used to investigate the relationship between resilience and NT1 and associations with sociodemographic and clinical features. The participants comprised 137 patients (mean age, 38.0 years; 52.6% female) and 149 controls (39.6 years; 55.7% female). Compared with controls, patients had a significantly lower (122.6 vs 135.5) mean RS score and a 2-fold risk of having low/mild-range resilience (adjusted odds ratio = 1.99, 95% confidence interval 1.13-3.52). Patients with high resilience had sociodemographic and narcolepsy characteristics similar to patients with low resilience, but they reported anxiety and depressive symptomatology less frequently (4.2% vs 55.8% and 58.3%, respectively), and their SF-36 scores were comparable to those of the comparison group. In patients, RS score was strongly associated with STAI-State Anxiety and BDI (rho = -0.57 and -0.56, respectively) and weakly with ESS (rho = -20) scores. The results of this study suggest that resilience may play a key role in patients' adaptation to NT1. Furthermore, this study supports interventions aimed at increasing patients' resilience and provides a base for further studies, preferably longitudinal and including objective measures, directed toward understanding the relationship between resilience, depression, and quality of life in patients with narcolepsy. D'Alterio A, Menchetti M, Zenesini C, etal. Resilience and its correlates in patients with narcolepsy type 1. J Clin Sleep Med. 2023;19(4):719-726.

Pre- and Post-Activity Anxiety for Sustainable Rafting

This study aimed to (i) analyze the levels of state-anxiety of rafting customers, before and after the activity; and (ii) characterize the levels of trait-anxiety and the amount of physical activity performed weekly by clients of a rafting activity. The sample had 100 subjects of a nature sports company, in the rafting activity, with a mean age of 33.27 ± 10.10 years, with 44% female and 56% male participants. They were evaluated in two moments M1 (pre-activity) and M2 (post-activity). In M1, the STAI—State-Anxiety questionnaire and the IPAQ—International Physical Activity Questionnaire (short version) were applied. In M2, the STAI Form 1 State-Anxiety questionnaire was applied again, followed by the STAI trait-anxiety. The results showed no correlation between the amount of weekly physical activity and levels of trait-anxiety (rho(100) = −0.144; p-value = 0.152), thus not corroborating with the existing literature. Regarding state-anxiety, we found that in 55% of cases, it decreased with the practice of rafting, which suggests that the practice may have an anxiolytic effect and promote the well-being and relaxation of participants promoting, in this way, the sustainability of the rafting activity.

Nonlinear Probability Weighting in Depression and Anxiety: Insights From Healthy Young Adults.

Both depressive and anxiety disorders have been associated with excessive risk avoidant behaviors, which are considered an important contributor to the maintenance and recurrence of these disorders. However, given the high comorbidity between the two disorders, their independent association with risk preference remains unclear. Furthermore, due to the involvement of multiple cognitive computational factors in the decision-making tasks employed so far, the precise underlying mechanisms of risk preference are unknown. In the present study, we set out to investigate the common versus unique cognitive computational mechanisms of risk preference in depression and anxiety using a reward-based decision-making task and computational modeling based on economic theories. Specifically, in model-based analysis, we decomposed risk preference into utility sensitivity (a power function) and probability weighting (the one-parameter Prelec weighting function). Multiple linear regression incorporating depression (BDI-II) and anxiety (STAI state anxiety) simultaneously indicated that only depression was associated with one such risk preference parameter, probability weighting. As the symptoms of depression increased, subjects’ tendency to overweight small probabilities and underweight large probabilities decreased. Neither depression nor anxiety was associated with utility sensitivity. These associations remained even after controlling covariates or excluding anxiety-relevant items from the depression scale. To our knowledge, this is the first study to assess risk preference due to a concave utility function and nonlinear probability weighting separately for depression and anxiety using computational modeling. Our results provide a mechanistic account of risk avoidance and may improve our understanding of decision-making deficits in depression and anxiety.

The influence of visual objects and music on anxiety levels of breast cancer patients scheduled to experience chemotherapy for the first time: a prospective randomized clinical study.

To investigate the influence of music together with visual objects as an ambiance in the waiting room on anxiety levels of breast cancer patients scheduled to receive chemotherapy in outpatient setting for the first time. Breast cancer patients planned to receive adjuvant or neoadjuvant chemotherapy for the first time between November 1, 2020, and July 31, 2021, were included. Two designs, including a standard waiting room (StWR) and an intervention waiting room (IWR) that was created by adding music and visual objects to the standard room, were constructed. These 2 designs were repeated sequentially in monthly periods, and a total of 104 patients with 52 in each group were randomized. The State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADs) were used for assessments. Results of the patients in StWR and IWR groups were compared. Both HADs anxiety and STAI-state anxiety scale scores were lower in patients who waited in IWR compared to those who waited in StWR (p = 0.041, p = 0.012, respectively). In patients in the IWR group, mean heart rate was lower by 7.6bpm (p = 0.009). No difference was found between the groups with regard to HADs depression score and STAI-trait anxiety score (p = 0.305, p = 0.535, respectively). For all patients, HADs anxiety scale (r = 0.400, p = < 0.001) and STAI-state anxiety scale (r = 0.475, p = < 0.001) scores increased as the waiting time increased. The present study is the first to investigate the influence of adding music together with visual objects to the standard ambiance of the chemotherapy waiting room on anxiety levels of breast cancer patients. We propose that introduction of paintings, artificial plants, and music to the ambiance of the waiting room has a significantly positive effect on alleviating anxiety levels of cancer patients waiting for chemotherapy.

Mindfulness augmentation for anxiety through concurrent use of transcranial direct current stimulation: a randomized double-blind study

Transcranial direct current stimulation (tDCS) have revealed the capability to augment various types of behavioural interventions. We aimed to augment the effects of mindfulness, suggested for reducing anxiety, with concurrent use of tDCS. We conducted a double-blind randomized study with 58 healthy individuals. We introduced treadmill walking for focused meditation and active or sham tDCS on the left dorsolateral prefrontal cortex for 20 min. We evaluated outcomes using State-Trait Anxiety Inventory-State Anxiety (STAI) before the intervention as well as immediately, 60 min, and 1 week after the intervention, and current density from electroencephalograms (EEG) before and after the intervention. The linear mixed-effect models demonstrated that STAI-state anxiety showed a significant interaction effect between 1 week after the intervention and tDCS groups. As for alpha-band EEG activity, the current density in the rostral anterior cingulate cortex (rACC) was significantly reduced in the active compared with the sham stimulation group, and a significant correlation was seen between changes in STAI-trait anxiety and the current density of the rACC in the active stimulation group. Our study provided that despite this being a one-shot and short intervention, the reduction in anxiety lasts for one week, and EEG could potentially help predict its anxiolytic effect.

O-166 A smartphone video clip on the patient journey to reduce patient’s anxiety: a randomized controlled trial

Abstract Study question Can a smartphone video clip detailing the patient journey decrease the anxiety of women and men on the day of their first oocyte aspiration? Summary answer The video clip does not affect the anxiety of women but does reduce the anxiety of men on the day of couples’ first oocyte aspiration. What is known already Infertility and in vitro fertilisation (IVF) decrease the personal wellbeing of women and men. Couples shared that this contributed to their IVF discontinuation despite a good prognosis and reimbursement of IVF. Previous longitudinal studies confirmed that pre-IVF anxiety is associated with IVF discontinuation. Limiting treatment anxiety is, therefore, relevant for fertility patients and clinics. Studies from the field of reproductive medicine examining the effect of preparatory information on anxiety suggest that focussed interventions seem more effective than complex interventions. Several randomized controlled trials (RCTs) found that preparatory information movies reduce anxiety for out-patient cardiology procedures in women and men. Study design, size, duration This monocentric RCT randomized (1:1 allocation; computerized) 190 heterosexual couples about to start their first IVF cycle between care as usual (i.e. preparatory information session 1-3 months before IVF) and care as usual combined with a novel intervention during a 24 months recruitment period (2018-2020). The novel intervention is a 5-minute smartphone video clip detailing the patient journey on the day of oocyte aspiration, which was sent to both partners the day before oocyte aspiration. Participants/materials, setting, methods Upon arrival at a private fertility clinic for their first oocyte aspiration women and men independently filled out the ‘STAI-State anxiety inventory’ and the ‘infertility distress scale (IDS)’ and evaluated the novel intervention, if applicable. A minority of randomized couples didn’t comply with the standard IVF trajectory (n = 27) or didn’t fill out the questionnaires (n = 8). The data of 155 couples (76-79/group, a-priori sample size calculation requested minimally 76/group) was subjected to a modified intention-to-treat analysis. Main results and the role of chance Women and men were on average 33 and 35 years old, respectively. Couples had a mean duration of infertility of 27 months and 63 of them (41%) had tried intrauterine insemination. The background variables were equally distributed between the intervention (IG) and control group (CG). The video clip did not affect women’s anxiety on the day of oocyte aspiration (mean STAI-State score IG 42.7±8.1 vs CG 42.1±8.5, p = 0.67). However, men who watched the video clip were significantly less anxious than men who did not watch it (mean STAI-State score IG 35.8±6.4 vs CG 38.2±7.6, p = 0.04). Surprisingly, infertility-specific distress was higher among women and men who watched the video clip (mean IDS scores of 25.8±4.9 and 22.6±5.0, respectively), as compared to women (p = 0.05) and men (p = 0.02) who did not watch the video clip (mean IDS score 24.3±4.6 and 20.8±4.7, respectively). All women and men of the intervention group, except one woman, would recommend the video clip to friends and family going through IVF. The intervention and control group did not differ significantly regarding clinical pregnancy rate (31/76 vs. 29/79, p = 0.60) or miscarriage rate (2/76 vs. 3/79, p = 0.68) 12 weeks after their first oocyte aspiration. Limitations, reasons for caution Patients nor assessors were blinded and there was no attention control group. Selection bias is plausible although the participation rate was 89%. Assessing infertility-specific distress the day after watching the video clip was not optimal, as priming couples to feel infertility-specific distress short term is less problematic than longer term. Wider implications of the findings Providing additional procedural information is interesting for clinics as patients recommended the video clip and as it decreased men’s anxiety. A follow-up study should examine whether the video clip’s priming effect on infertility-specific distress lasts longer than only the day after and whether the video clip affects IVF discontinuation. Trial registration number NCT03717805

Associations of Thyroid Hormones Profile During Normal Pregnancy and Postpartum With Anxiety, Depression, and Obsessive/Compulsive Disorder Scores in Euthyroid Women.

ObjectiveThyroid dysfunction (overt and subclinical) has been consistently linked to pregnancy adversity and abnormal fetal growth and development. Mood disorders such as anxiety, depression, and obsessive-compulsive disorder (OCD) are frequently diagnosed during pregnancy and at postpartum, and emerging evidence suggests association with impaired offspring neurodevelopment and growth. This study aimed to examine potential associations between thyroid function and mood symptoms during pregnancy and postpartum.DesignThis is a prospective study measuring thyroid hormones and assessing mood symptoms by employing specific questionnaires in the same cohort of 93 healthy pregnant women at the 24th (2nd trimester) and 36th (3rd trimester) gestational weeks and at the 1st postpartum week.MethodsSerum thyroid hormones, TSH, anti-TPO, and anti-Tg antibodies were measured at the 24th (2nd trimester) and 36th (3rd trimester) gestational weeks and at the 1st postpartum week. Specific validated questionnaires were employed at the same time-points to assess separately symptoms of anxiety [Generalized Anxiety Disorder Inventory (GADI), Penn State Worry Questionnaire (PSWQ), STAI-State Anxiety inventory (STAI-S), STAI-Trait Anxiety Inventory (STAI-T)], depression [Edinburgh Postnatal Depression Scale (EPDS), Stein’s Blues Scale (BLUES), Beck Depression Inventory (BDI)], and obsessive compulsive disorder (OCD) [Yale-Brown Obsessive Compulsive scale (Y-BOCS)].ResultsAt the 2nd trimester, GADI score correlated negatively with FT3 (p < 0.010, r = −0.545) and positively with TSH (p < 0.050, r = 0.837) concentrations; GADI, PSWQ, EPDS and Y-BOCS scores correlated negatively with FT4 concentrations (p < 0.010, r = −0.768; p < 0.010, r = −0.384; p < 0.050, r = −0.364; p < 0.010, r = −0.544, respectively). At the 3rd trimester, BLUES score correlated positively with rT3 concentrations (p = 0.00, r = 0.89); GADI, EPDS, and Y-BOCS scores correlated negatively with FT4 concentrations (p = 0.001, r = − 0.468; p = 0.036, r = −0.39; p = 0.001, r = −0.625, respectively); GADI, STAI-S, and Y-BOCS scores correlated positively with TSH concentrations (p = 0.015, r = 0.435; p = 0.024, r = 0.409 p = 0.041, r = 0.389, respectively). At postpartum, PSWQ, STAI-T, EPDS, and BDI scores correlated positively with rT3 concentrations (p = 0.024, r = 0.478; p = 0.014, r = 0.527; p = 0.046, r = 0.44; p = 0.021, r = 0.556, respectively, Y-BOCS score correlated positively with TSH (p = 0.045, r = 0.43), and BLUES score correlated positively with anti-TPO antibody concentrations (p = 0.070, r = 0.586).ConclusionThe reported findings demonstrate positive associations between low-normal thyroid function at the 2nd and 3rd trimesters of pregnancy and postpartum with anxiety, depression, and OCD scores.

The development of the postpartum mobile support application and the effect of the application on mothers' anxiety and depression symptoms

ObjectiveThe study aimed to develop the postpartum mobile support application to support postpartum mothers and to examine the effects of the use of mobile app on mothers' anxiety level and depression symptoms. Research design/settingIt is a parallel group pretest-posttest randomized controlled study carried out between July 2017 and February 2020. The mothers (62 in the experiment and 62 in the control group) who gave birth in full-term at a university hospital in Konya province in Turkey and who had healthy newborns constituted the study group. Data were collected using the Information Form, the STAI State and Continuity Anxiety Scale, and the Edinburgh Postpartum Depression Scale. Mixed pattern variance analysis (mixed anova), t test in dependent groups, t test and chi square analysis in independent groups were used to analyze the data. FindingsMost of the mothers who used the application fed their baby only with breast milk and felt more sufficient about breastfeeding. The depression symptoms of mothers using the postpartum mobile support application was lower than that of the mothers in the control group; however, it was found that the application was not adequate alone to decrease anxiety levels and depression symptoms (p > 0.05). ConclusionsThe postpartum mobile support application is an important and useful source in accessing reliable information; however, it was found to be insufficient to lower anxiety levels and prevent depression symptoms at the end of the six-week postpartum period.

Functional Brain Networks of Trait and State Anxiety in Late-Life Depression

<h3>Introduction</h3> Late-life depression (LLD) is associated with psychiatric comorbidities that may worsen mood outcomes in older adults, yet the neural mechanisms that underlie these comorbid conditions remain understudied. Anxiety and neuroticism have been independently associated with LLD, and its mood and cognitive outcomes. In a preliminary behavioral data analysis we found that anxiety measures correlated with depression measures in older adults. We also found that several baseline neuroticism and anxiety traits predicted depression scores over time. In this study, we analyzed neuroimaging data in the setting of anxiety and neuroticism measures in LLD and hypothesized that there would be differences in resting state activity patterns in the Salience network (SN), Default-Mode network (DMN) and Executive Control network (ECN) related to severity of: (1) generalized anxiety, (2) state and trait anxiety, and (3) neuroticism. <h3>Methods</h3> This was a cross-sectional secondary data analysis on clinical and MRI data collected from our NBOLD project. LLD patients without dementia were included. Generalized anxiety disorder (GAD) symptoms, state and trait anxiety, neuroticism and depression were assessed using a GAD questionnaire, State-Trait Anxiety Inventory (STAI), NEO Personality Inventory (NEO PI), and Montgomery-Asberg Depression Rating Scale (MADRS), respectively. A study psychiatrist confirmed or ruled out diagnosis of depression. There were 102 older adults with LLD, and among them, 87 subjects who had measures of STAI-trait, STAI-state anxiety, GAD symptoms and neuroticism as well as usable neuroimaging data were included into our final analyses. The neuroimaging data was collected from 3T Siemens Skyra scanner. The imaging parameters for T1-weighted images were: TR/TE=2200/2.8ms, flip angle=13^o, matrix = 256 × 256 × 169, Voxelsize=1×1×1mm³. The 7-min resting-state fMRI data was collected using EPI sequence with FOV=240mm, flip angle=90^o, TR/TE=2000/31ms, matrix=64×64×34, voxelsize = 3.8×3.8×3.75mm³. The fMRI data was preprocessed using the default protocol setting recommend by DPABI software. The Amplitude of Low-Frequency Fluctuations (ALFF) was calculated using DPABI. Multiple regression model was used to examine the association between ALFF and GAD, state and trait anxiety as well as neuroticism controlled for age, gender and depression severity (MADRS) using SPM12. Significance was set at p<0.05 with FDR correction for multiple comparisons. <h3>Results</h3> Data analyses revealed that trait anxiety was positively correlated with greater ALFF in the ECN (left dorsolateral prefrontal cortex - dlPFC, bilateral inferior parietal cortex - IPS, and precuneus) and lateral orbitofrontal cortex (OFC). Higher state anxiety was correlated with lower ALFF in bilateral OFC and frontal pole. GAD symptom severity was positively correlated with ALFF in the right superior temporal cortex (STG), Heschl's gyrus, and dorsomedial frontal cortex (dMFC). The GAD symptom severity was also negatively correlated with ALFF in the right hippocampus, parahippocampus and temporal pole (TP), whereas there was no significant clusters found between ALFF and neuroticism after regressing out the covariates. <h3>Conclusions</h3> This is one the few studies that examined resting state neural oscillation pattern (ALFF) specific to state and trait anxiety and GAD symptoms in LLD. Higher trait anxiety was associated with greater ALFF in the ECN and OFC, all of which are related to emotion regulation, whereas higher state anxiety was correlated with lower ALFF in regions related to emotion regulation. Higher GAD was specifically correlated with higher ALFF in brain regions related to sound and social information processing, but with lower ALFF in regions related to memory. No significant clusters were found related to neuroticism suggesting that neuroticism might be able explained by trait and state anxiety as well as GAD. These results suggests a distinct neural construct that may distinguish state and trait anxiety in LLD. Uncovering the brain connectivity changes related to state and trait anxiety would deepen our understanding in the neural mechanisms and mood outcomes of LLD. Future studies are needed to determine differences in these networks between depressed and non-depressed individuals. <h3>Funding</h3> The Leo and Anne Albert Charitable Trust, National Institute of Mental Health Grant R01 MH108578, The University of Connecticut Department of Psychiatry

Personal and Family Resources Related to Depressive and Anxiety Symptoms in Women during Puerperium.

Introduction: This study investigated the relationship between personal and family resources (i.e., social support, family functioning, self-efficacy in care, sense of coherence and perceived burden of care) and depressive and anxiety symptoms in women during the puerperium, adjusting for stressors. Methods: This is a quantitative research design, carried out through a descriptive, cross-sectional correlation study. This study includes 212 women over the age of 19 who gave birth from March to September 2019 in Maternal and Child Hospital of Jaén (Spain). Women were selected during the immediate postpartum period. The variables analysed were postpartum depressive symptoms (Edinburgh scale), anxiety symptoms (STAI state anxiety questionnaire), perceived social support (Duke-UNC-11), family functioning (family APGAR), self-efficacy in care (Lawton), sense of coherence (SOC-13), perceived burden (Caregiver Strain Index) and stressful life events (Holmes and Rahe). The main analysis consisted of a multiple linear regression. Results: The regression model of depressive symptoms found a positive association with perceived burden (β = 0.230, p = 0.015) and negative associations with self-efficacy in care (β = −0.348, p < 0.001), social support (β = −0.161, p < 0.001) and sense of coherence (β = −0.081, p = 0.001). The regression model of anxiety symptoms obtained a positive association with perceived burden (β = 1.052, p < 0.001) and negative associations with self-efficacy in care (β = −0.329, p = 0.041), social support (β = −0.234, p = 0.001) and sense of coherence (β = −0.262, p < 0.001). Discussion: Firstly, depressive and anxiety symptoms in the puerperium period may be more prevalent than in other periods of a woman’s life. Secondly, perceived social support, self-efficacy in caring for the newborn and sense of coherence may be protective factors for depressive and anxiety symptoms in the puerperium period. Finally, perceived burden in caring for the newborn may be a risk factor for these symptoms.

Validity and reliability of State-Trait Anxiety Inventory in Danish women aged 45 years and older with abnormal cervical screening results

BackgroundState Trait Anxiety Inventory (STAI) scale was developed in the 1980’s and has been widely used both in clinical settings and in research. However the Danish version of STAI has not been validated. The aim of this study was to assess the validity and reliability of STAI - state anxiety scale in Danish women aged 45 years and older with abnormal cervical cancer screening results.MethodsWomen ≥45 years referred with an abnormal cervical cytology and healthy volunteers (n = 12) underwent cognitive interview after completing STAI. Further, STAI was sent out in an electronic questionnaire to women (n = 109) seen at the gynecological department with abnormal cervical cancer screening test during 2018. Validity and reliability of STAI was evaluated according to the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist by examining internal consistency, test-retest reliability, measurement error, floor and ceiling, construct validity and content validity.ResultsIn the cognitive interviews the content validity was evaluated to be very good. The internal consistency of the scale was excellent with Cronbach’s α = 0.93. Test-retest reliability was good with an intra-class correlation coefficient of 0.80 and the systematic difference between test-retest results was negligible. The construct validity was good.ConclusionTo our best knowledge, this is the first validation study of the Danish translation of STAI-state anxiety scale. This version of STAI demonstrates an acceptable reliability and validity when used in a gynecological setting.

COMPARISON OF THE PREVALENCE AND DYNAMICS OF ANXIETY, DEPRESSION AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC RHEUMATIC HEART DISEASE

The objective. The assessment of the severity, prevalence and five-year dynamics of anxiety and depression in those studied with rheumatic heart disease.Materials and methods. The study included 168 patients with rheumatic heart disease: mean age 58,69±0,47 years; 141 women (83,93%) and 27 men (16,07%). To assess anxiety and depression, the following scales were used: HADS (hospital anxiety and depression scale), CES-D (depression scale of the epidemiological research center), and STAI (Spielberger anxiety scale). Quality of life was assessed using total scale SF-36 (Short Form Medical Outcomes Study), KCCQ (Kansas questionnaire for patients with cardiomyopathy), and MHFLQ (Minnesota questionnaire for the quality of life of patients with CHF).Results. Initially, patients with rheumatic heart disease had mild depression and anxiety, except for the high level of state anxiety according to STAI — 48.00 ± 0.95. More pronounced depressive disorders were revealed in patients with CHF NYHA III and IV. According to CES-D — 17,58±1,27 for FC I and 23,4±0,75 for FC IV, for HADS — 7,00±0,64 for FC I and 13,6±0,78 for FC IV. Anxiety disorders, on the contrary, were less with III and IV FC CHF: 8,5±0,49 with FC I and 8,2±1,02 with FC IV in HADS. According to STAI state anxiety — 47,58±1,22 (FC I) and 42,8±1,76 (FC IV), for trait anxiety — 42,67±1,08 (FC I) and 40,4±1,85 (FC IV). For the five-year period there was no negative and positive dynamics according to the questionnaires of anxiety and depression. The only exception was the increase in anxiety according to HADS by 0.66 points. In terms of quality of life, there was a decrease in physical health according to SF-36 by 1.78, and in overall summary score according to KCCQ by 1.55 and MHFLQ by — 3.99.Conclusions. In patients with rheumatic heart disease, the severity of anxiety and depression is insignificant and does not increase during five years of observation. Indicators of depression are more pronounced in the group with CHF NYHA III and IV, and anxiety indicators in patients with CHF NYHA I and II. An increase in depression rates in subjects with rheumatic heart disease is associated with a deterioration in the quality of life. With an improvement in the quality of life values, depressive symptoms decrease, and anxiety rates increase.

Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder.

Numerous studies have provided evidence for the effectiveness of cognitive behavioral therapy (CBT) on panic disorders (PDs). There has also been growing attention on brief CBT with regard to delivering intensive treatment efficiently. This study investigated the essential parts of mindfulness-based brief CBT to optimize treatment benefits.A total of 37 patients were retrospectively enrolled in this study. They were recruited from the anxiety/panic/fear clinic of Seoul National University Hospital. The patients participated in group CBT once a week for a total of 4 sessions over a 4-week period, when they were assessed using the Panic Disorder Severity Scale (PDSS), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after brief CBT. Twenty-nine patients completed the 1-month follow-up.There were significant reductions in PDSS (P < .001), ASI-R-fear of respiratory symptoms (P = .006), ASI-R-fear of publicly observable anxiety reaction (P = .002), ASI-R-fear of cardiovascular symptoms (P < .001), ASI-R-fear of cognitive dyscontrol (P = .001), ASI-R-Total (P < .001), APPQ-Agoraphobia (P = .003), APPQ-Total (P = .028), STAI-State anxiety (P < .001), STAI-Trait anxiety (P = .002), BAI (P = .003), and BDI (P < .001) scores. We also found significant associations between ASI-R-fear of cardiovascular symptoms, ASI-R-Total, and changes in PDSS scores. A stepwise multiple linear regression analysis indicated that anxiety sensitivity for fear of cardiovascular symptoms predicted an improvement in panic severity (β = 0.513, P = .004).Our findings suggested that behavioral aspects, especially physiological symptom control, needed to be considered in brief, intensive CBT for PD. The results also suggested that a mindfulness-based brief CBT approach might be particularly helpful for patients with PD who have severe cardiovascular symptoms.

Factores asociados al nivel de ansiedad y de conocimientos sobre puericultura y lactancia de embarazadas primerizas

ObjectiveTo know the level of anxiety and knowledge of childcare and lactation of the current pregnant women, and the clinical-demographic variables with which they are related. DesignCross-sectional study. SettingSeven health centers of Area V (Asturias). ParticipantsFirst-time pregnant women who completed preparatory courses from 01.06.2015 to 31.10.2015, excluding multiple gestation, risk pregnancy, contraindicated breastfeeding and language problems. InterventionsSociodemographic variables questionnaire, STAI state anxiety questionnaire and 23 questions about childcare and lactation. Main measurementsWe performed descriptive and multivariate analysis (program R) of the variables of the questionnaire. ResultsWe captured 104 pregnant women; average age 34.2(SD: 4.5), 94.2% Spanish, 61.5% university, 17.3% smokers in pregnancy, 23.1% with psychopathological antecedents; 88.4% planned to give breastfeeding. The mean STAI-S was 18.1(SD: 7.4) and scored 4.5(SD: 2.3) mean errors. The most faulty ones were on causes of fever (56.7%), fever measurement (54.8%) and physiological stools (55.7%). The multivariate analysis between knowledge and profile showed statistically significant associations with: being foreign, university, pregnancy planning and matron. In relation to the STAI-S was significant for being a smoker, receiving breastfeeding, psychopathological antecedents and matron. ConclusionsThe current pregnant women who complete preparatory courses are mainly mature, university and Spanish. They have good concepts about breastfeeding but many are unaware of basic concepts of fever and stool of the infant. Foreign mothers with unwanted pregnancy and primary education seem to have more confusing concepts. Smoking mothers with psychopathological antecedents and who have not received breastfeeding present more anxiety. The matron significantly influences anxiety and acquired concepts.

Impact of Anxiety on the Satisfaction of Dental Implant Patients.

To study the influence of anxiety on dental implant patient satisfaction, and to explore if hemoglobin levels and the amount of body fat affected patient satisfaction. One hundred three partially edentulous patients (mean age 42.06 years) who had received dental implant therapy were enrolled in the study. Self-administered questionnaires were given to those patients to evaluate their level of satisfaction with implant treatment. The State-Trait Anxiety Inventory (STAI) self-reported questionnaire was used to determine anxiety levels. Hemoglobin levels (HB) were measured using an electronic hemoglobin meter, and body fat (BF) was measured using a special diagnostic scale. Statistical analysis was conducted using T-test to assess any significant differences between the groups. Pearson Correlation was used to measure the correlation between variables. Overall satisfaction for all patients was high (86.7%) for both STAI-trait and STAI -state anxiety groups. Highly significant differences in patient satisfaction were found between high and low STAI-state anxiety groups (p < 0.01). Patients with low STAI-state anxiety levels demonstrated significant negative correlations of many parts of patient satisfaction with HB levels and STAI-state scores. While for patients in the low STAI-trait anxiety group, the negative correlation was just with HB levels. For the patients with high STAI-state anxiety levels, a highly significant positive correlation was observed between many elements of patient satisfaction and BF and patient age. The results of this study indicated that patient satisfaction with dental implant treatment was high in all patients. STAI-state anxiety had a greater impact on patient satisfaction than did trait anxiety. HB levels negatively affected patient satisfaction in patients with low STAI-trait and STAI-state anxiety levels. BF positively affected patient satisfaction in patients with high STAI-state anxiety levels.

Effect of simulated patient death on emergency worker's anxiety: a cluster randomized trial.

ObjectiveSimulation-based teaching offers promising and diverse teaching possibilities. We aim to assess whether the death of the manikin increased anxiety amongst learner compared to similar simulation-based course where the manikin stays alive.MethodsWe conducted a cluster randomized study amongst multidisciplinary teams of emergency workers. Teams of physicians, nurses, and healthcare assistants were randomly assigned to participate in a simulation-based course where the simulated patient died (death group) or not (life group). We assessed anxiety at 1 month after the teaching using Spielberger STAI-state anxiety questionnaire. We compared reduction of anxiety when facing a life-threatening situation in both groups.ResultsWe included 25 teams for a total of 129 participants. We analysed 63 participants in the death group and 57 in the life group. Baseline characteristics were similar in both groups, including baseline anxiety (STAI-state score 39.6 (7.8) in the death group vs 38.6 (7.1) in the life group). We report a significant reduction in both groups 1 month after the training: 6.6 (7.8) vs 6 (8.0), mean difference 0.5 (−2.4; 3.4). At 3 months, we report a significant greater reduction of anxiety in the death group (mean difference 4 [0.1; 7.9]).ConclusionWe observed in our sample that unexpected simulated patient death did not increase anxiety amongst multidisciplinary emergency workers.

Reduced Pain and Anxiety with Music and Noise-Canceling Headphones During Shockwave Lithotripsy.

We assessed the effects of music and noise-canceling headphones (NCHs) on perceived patient pain and anxiety from extracorporeal shockwave lithotripsy (SWL). Patients with renal calculi scheduled for SWL were prospectively enrolled. All 89 patients between the ages of 19 and 80 years were informed about this study and then randomized into three groups: Group 1 (controls), no headphones and music; Group 2, music with NCHs (patients listened to Turkish classical music with NCHs during SWL); and Group 3, music with non-NCHs (patients listened to Turkish classical music with non-NCHs during SWL). Hemodynamic and respiratory parameters were recorded before and just after the SWL session. All patient visual analog scale (VAS) and State-Trait Anxiety Inventory (STAI) scores were recorded just after the SWL procedure. There were significant differences in VAS scores among the groups (5.1, 3.6, and 4.5, respectively, p < 0.001), including between Groups 2 and 3 (p = 0.018). There were also significant differences in STAI-State anxiety scores among the groups (43.1, 33.5, and 38.9, respectively, p = 0.001), including between Groups 2 and 3 (p = 0.04). Music therapy during SWL reduced pain and anxiety. Music therapy with NCHs was more effective for pain and anxiety reduction. To reduce pain and anxiety, nonpharmacologic therapies such as music therapy with NCHs during SWL should be investigated further and used routinely.