STAI-trait Scores Research Articles

Effect of a homeopathic-complex medicine on state and trait anxiety and sleep disorders: a retrospective observational study

The primary objective of this open-label, retrospective, observational study was to examine change in indicators of anxiety changed after treatment period of at least 1 month with the homeopathic-complex medicine Datif-PC(®). A secondary objective was to describe the quantitative changes in the sleep pattern of the subjects included in the study. The study population consisted of 71 subjects suffering from mild to moderate anxiety, who were treated with a homeopathic-complex medicine. The subjects had attended at least 2 consultations during the year 2010, with the second visit taking place at least 30 days after the first baseline visit. At both visits, subjects were administered the State-Trait Anxiety Inventory (STAI)-Y questionnaire (consisting of trait and state subscales) to assess their level of anxiety. Sleep quality was assessed based on the subjects' self-reported number of hours slept and number of night-time awakenings, before and after treatment. Compared to baseline, the average (STAI)-state score at visit 2 decreased by more than 6 points, while the STAI-trait score decreased by more than 3 points. This was statistically significant (p<0.0001) for both subscales. These findings were stable in subgroup analyses (gender, age and anxiety level). The average number of hours slept per night increased significantly at visit 2 compared to baseline (from 5.1±1.1 to 5.56±0.9h, p<0.0001). A marked decrease in the average number of night-time awakenings was also observed at the second visit (-42%, p<0.0001). This retrospective observational study suggests that treatment of anxiety and sleep disorders with Datif-PC(®) can produce notable improvements even in a short period of time. Furthermore, the observed effects were not affected by sex, age or baseline anxiety. Further controlled, randomized studies are justified.

The Quality of Life and Psychological Status of Mothers of Hospitalized Pediatric Oncology Patients

This study compares the quality of life (QoL) and psychological status of mothers of children with cancer with those of mothers of children without cancer. One hundred hospitalized children and their mothers, as primary caregivers, were included in this study. Fifty mothers with healthy children were enrolled as the control group. A children and mother query form was used to obtain demographical data. The disease histories were extracted from patient records. QoL was measured with the Medical Outcomes Study 36-item Short Form Survey (SF-36) and the State-Trait Anxiety Inventory (STAI) in order to assess the psychological symptoms of the mothers in the study and in the control groups. The mean age of the caregivers was 35.93 ± 8.27 years, whereas the mean age of the mothers in the control group was 39.72 ± 6.88 years. The general health, vitality, social functioning, and mental health scores from the SF-36 and the STAI-trait scores were significantly poorer among the mothers of children with cancer as compared with the scores of the mothers of children without cancer (P < .05). Significant negative correlations were found between the age of the children, the age at diagnosis, and the SF-36 subscores for physical functioning, physical role, and pain (P < .05). The mothers of children with cancer, who require hospital care, have poorer QoL and psychological health than the mothers of healthy children. These results suggest that the current system for treating cancer in Turkish children should also include close monitoring of the care-giving mothers’ QoL and psychological health.

Evaluation of trait anxiety as predictors of psychological distress and low HRQL among breast cancer patients.

e19568 Background: Cancer patients frequently experience multiple and co-occurring problems due to their illness and therapies. Only few studies have suggested the contribution of specific psychological factors during cancer therapy. We have focused on trait anxiety, which is a general tendency to exhibit anxiety, as an important factor when considering psychological distress in breast cancer patients. Methods: A total of 157 women who visited the outpatient breast cancer clinic between October 2007 and December 2009 participated in this study. All patients that were referred to a medical oncologist were asked to complete five questionnaires (STAI, HADS, EORTC QLQ-C30, BR23, and KKSI) at baseline, three month, and six month follow up. STAI-Trait score were divided into two groups with a median cut off point (41). Then, we performed one-way ANOVA to determine the STAI-Trait scores as independent variables for possible predictors of psychological distress and low HRQOL. Results: Our response rate was 99 percent (156/157 patients). The ANOVA results showed a statistically significant difference in low role functioning, cognitive functioning, emotional functioning, social functioning, future perspective and high fatigue score, which were high STAI-Trait scores when compared to the low STAI-Trait scores (p<. 01). Patients who had a high trait anxiety were found to have a low HRQOL compared to those with a low trait anxiety. Conclusions: In conclusion, out results suggest that patients with a high trait anxiety are at risk of a low HRQOL, and trait anxiety could be used to screen and identify patients at the highest risk of experiencing psychological distress during cancer therapy. No significant financial relationships to disclose.

The levels of stress, depression and anxiety of parents of disabled children in Turkey

Background. Parents of disabled children experience some special problems in their lives. It is reported that the parents of disabled children experience a very high level of stress.Objectives This study aims to determine the situations in which the parents experience higher levels of stress; to investigate the relation between the levels of stress, depression and anxiety.Material and methods. This cross-sectional study was conducted with parents whose children attend a Special Education and Rehabilitation Centre. The total number of parents was 156 and 127 (81.4%) of them voluntarily participated in this study. A questionnaire form, consisting of questions regarding the socio-demographic characteristics of disabled children and of their parents, was given to the participants. Additionally, the participants were asked to score 10 possible stressful situations (financial problems, relations with other people, having limited free time, not to be able to participate in social activities, etc.) on a scale of 0–10 points. Moreover, psychometric scales such as Beck Depression Inventory (BDI) and Spielberger State Trait Anxiety Inventory (STAI) were applied to the participants.Results. The mean BDI (SD) score was found to be 14.9 (10.9). The mean STAI-state and STAI-trait scores were 55.1 ± 12.2 and 48.6 ± 8.8, respectively. Among the stressful experiences, the parents gave the highest points to ‘attitudes of society towards disabled people’, ‘having limited free time’ and ‘financial problems’ (Top three situations). In multiple analyses, it was found that by employing the BDI there was a relation between financial problems (β: 0.32, p < 0.01), a decrease in relations with other people (β: 0.21, p < 0.05), having limited free time (β: − 0.19, p < 0.05) and insufficiency of physical structures (β: 0.21, p < 0.05). The relations between financial problems (β: 0.31, p < 0.01) and being an individual who has close relations with disabled person other than his/her parents (β: 0.27, p < 0.01) were defined employing the STAI-state as effective variables. ‘Negative attitudes of society towards disabled people’ (β: 0.29; p < 0.01) were defined employing the STAI-trait as the only effective variable.Conclusion. Financial problems are the most important factors that affect the psychology of the parents of disabled people. Social programmes that support the parents in respect of both financial matters and home-care facilities should be set up.

Analysis of factors associated with increased psychological distress in new outpatients at the breast clinic.

Abstract Abstract #3110 Objective: To determine how psychological characteristics, subjective symptoms, and a family history of breast cancer affect the mood states of outpatients with mammary gland complains at the first hospital visit.&amp;#x2028; Participants and methods: Written consent to participate in the study was provided by 242 outpatients with mammary gland complains at Kitasato University hospital from November 2004 to January 2007. Participants either visited our hospital directly, or were referred here from another clinic. Participants were asked to complete questionnaires determining scales of the following: trait anxiety (State-Trait Anxiety Inventry-Trait; STAI-Trait), negative emotion suppression (Courtauld Emotional Control Scale; CECS), life stress events (Life Experiences Survey; LES), and mood states (Profile of Mood States; POMS) and return them either by mail or at the time of the next clinical examination. In addition, we examined subjective symptoms (lump, pain, abnormal nipple discharge, or deformed nipple) and family history of breast cancer based on answers to the interview sheet filled out by patients on their first visit to the hospital. We excluded 45 patients who submitted incomplete answers, 38 who did not reply, and 5 who were considered to be ineligible for other reasons. The analysis covered a total of 154 patients (age (years); mean=49.94, SD=12.22). Approval for this study was granted by the Institutional Review Board of Kitasato University School of Medicine and Hospital.&amp;#x2028; Results and conclusion: We performed multiple regression analysis (forced entry method) to assess how mood states (POMS score) are affected by the following factors: age at the time of first visit, trait anxiety (STAI-Trait score), emotional suppression (CECS score), number of life stress events (LES total score), number of negative evaluations of life stress events (LES balance score), subjective symptoms, and a family history of breast cancer. We obtained a significant model (adjusted R2=0.558, p&amp;lt;0.01) in which trait anxiety, emotional suppression, number of life stress events, and the standard partial regression coefficient of subjective symptoms were found to be statistically significant (beta=0.618, 0.111, 0.181, 0.118; p&amp;lt;0.05, respectively). This suggests that mood states at the first visit are less positive when patients have high trait anxiety, emotional suppression, many life stress events, and subjective symptoms. In particular, trait anxiety had a particularly large impact on mood states, indicating the importance of psychological assistance. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3110.

34th Annual Scientific Meeting of the Association of Paediatric Anaesthetists of Great Britain and Ireland, 8?10 March 2007, Manchester. The effect of videotaped preoperative information on parental anxiety during anaesthetic induction for elective paediatric procedures

Introduction: It has long been recognised that parents of children scheduled for elective surgery experience high levels of pathological anxiety (1). Providing parents with information about anaesthesia, surgery and postoperative recovery has been identified as a tool for reducing anxiety (2–4). The purpose of this study was to determine whether audiovisual information, describing the process of undergoing and recovering from anaesthesia, could reduce anxiety levels and desire for information in parents before their child's induction of anaesthesia. Methods: The study was approved by our local ethics committee. 111 Parents were recruited into this study. Of these 56 were randomised to a control group and 55 to an intervention group. All parents completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire on admission to hospital on the day of surgery and then again just before accompanying their child to the anaesthetic room. This is a tool for assessing preoperative anxiety and need for information, which has previously been validated in the parents of children presenting for surgery (5). In addition to the normal preoperative preparation, parents randomised into the intervention group watched a short 8 min information video after completing the first questionnaire. The video illustrated the events and procedures surrounding a child's admission to hospital for day-case surgery, including the induction of anaesthesia. Results: There was no statistically significant difference in child demographics, type of surgical procedure, parental demographics, parental experience or STAI-Trait scores between the two groups (P > 0.1). A repeated measures ANOVAfor APAIS scores revealed a significant group × time interaction for all three measures, Anxiety Scale (F (1,109) = 6.2; P < 0.05), Need for Information Scale (F (1,109) = 7.7; P < 0.01) and total score (F (1,109) = 11.1; P < 0.001). Further analysis revealed that the intervention group demonstrated a reduction in anxiety (effect size 0.47), need for information (effect size 0.53) and total scores (effect size 0.63) as measured by the APAIS, compared with controls (Figure 1). Figure 1Open in figure viewerPowerPoint APAIS scores: means and standard error bars for anxiety, desire for information and total, pre and postvideo. Discussion: We postulated that audiovisual information has a role in parental education and reducing parental anxiety before paediatric surgery. However few studies have been carried out examining the efficacy of audiovisual information and all published studies have been carried out in institutions in the USA. Our study is the first to examine the usefulness of videotaped information in a childrens hospital in the UK. In this study we demonstrated that a preanaesthetic educational videotape can reduce parental anxiety before paediatric day case surgery. Our study also suggests that an information video may reduce a parents desire for information. However as the APAIS score does not formally measure the effectiveness of information transfer we cannot discount the possibility that the reduced desire for information is a result of an expectation bias or may have been produced by an overly intimidating video. We have also demonstrated that the cost of making an effective information video need not be prohibitive. Our video was produced with the aid of our medical photography department and the final cost was £800 ($1.487), (€1.170). Conclusions: Providing parents with an information video depicting the process of undergoing and recovering from anaesthesia and surgery results in a significant reduction in their anxiety and may reduce their desire for information. Future studies should examine the effect of audiovisual information on anxiety in children before surgery. References 1 Thompson N, Irwin MG, Gunawardene MS et al. Preoperative parental anxiety. Anaesthesia 1996; 51: 1008–1012. 2 McEwen AW, Caldicott LD, Barker I. Parents in the anaesthetic room parents and anaesthetists view. Anaesthesia 1995; 50: 368. 3 Shirley PJ, Thompson N, Kenward M et al. Parental anxiety before elective surgery in children. A British perspective. Anaesthesia 1998; 53: 956–959. 4 Lee A, Chui PT, Gin T. Educating patients about anaesthesia: a systematic review of randomized controlled trials of media based information. Anesthesia and Analgesia 2003; 96:1424–1431. 5 Miller KM, Wysocki T, Cassady JF et al. Validation of measures of parents’ preoperative anxiety and anesthesia knowledge. Anesth and Analg 1999; 88: 251–257.

Valerian for anxiety disorders

Anxiety disorders are very common mental health problems in the general population and in primary care settings. Herbal medicines are popular and used worldwide and might be considered as a treatment option for anxiety if shown to be effective and safe. To investigate the effectiveness and safety of valerian for treating anxiety disorders. Electronic searches: The Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) searched on 04/08/2006, MEDLINE, Lilacs. References of all identified studies were inspected for additional studies. First authors of each included study, manufacturers of valerian products, and experts in the field were contacted for information regarding unpublished trials. Randomised controlled trials (RCTs) and quasi-randomised trials of valerian extract of any dose, regime, or method of administration, for people with any primary diagnosis of general anxiety disorder, anxiety neurosis, chronic anxiety status, or any other disorder in which anxiety is the primary symptom (panic disorder, obsessive compulsive disorder, social phobia, agoraphobia, other types of phobia, postraumatic stress disorder). Effectiveness was measured using clinical outcome measures and other scales for anxiety symptoms. Two review authors independently applied inclusion criteria, extracted and entered data, and performed the trial quality assessments. Where disagreements occurred, the third review author was consulted. Methodological quality of included trials was assessed using Cochrane Handbook criteria. For dichotomous outcomes, relative risk (RR) was calculated, and for continuous outcomes, the weighted mean difference (WMD) was calculated, with their respective 95% confidence intervals. One RCT involving 36 patients wih generalised anxiety disorder was eligible for inclusion. This was a 4 week pilot study of valerian, diazepam and placebo. There were no significant differences between the valerian and placebo groups in HAM-A total scores, or in somatic and psychic factor scores. Similarly, there were no significant differences in HAM-A scores between the valerian and diazepam groups, although based on STAI-Trait scores, significantly greater symptom improvement was indicated in the diazepam group. There were no significant differences between the three groups in the number of patients reporting side effects or in dropout rates. Since only one small study is currently available, there is insufficient evidence to draw any conclusions about the efficacy or safety of valerian compared with placebo or diazepam for anxiety disorders. RCTs involving larger samples and comparing valerian with placebo or other interventions used to treat of anxiety disorders, such as antidepressants, are needed.

Interactions among higher trait anxiety, sympathetic activity, and endothelial function in the elderly

Negative psychological characteristics have been recognized as independent risk factors of cardiovascular disease (CVD). The purpose of this study was to evaluate the influence of depression and anxiety on cardiac autonomic function and endothelial function in healthy elderly subjects. Forty-six healthy elderly volunteers (mean age 60.8 years) were enrolled in this study. Cardiac autonomic function was assessed by spectral analysis of heart rate variability (HRV) with the head-up tilt test. Brachial artery endothelium-dependent flow-mediated dilation (FMD) was measured using high-resolution ultrasound. A significant positive correlation was observed between the State and Trait Anxiety Inventory (STAI)-trait score as a parameter of anxiety and HRV sympathetic modulation in the supine position (baseline), and a significant negative correlation between this score and the head-up-induced HRV sympathetic response from the baseline. The STAI-trait score also showed a significant negative correlation with the percent change of FMD (%FMD). Analysis using structural equation modeling showed that higher trait anxiety reduced %FMD via abnormalities of sympathetic activity. On the other hand, psychometric parameters of depression were not associated with any HRV component or %FMD. These results suggest that there are specific interactions among higher trait anxiety, abnormalities of sympathetic activity, and endothelial dysfunction. This finding may be useful in clarifying the pathophysiological mechanism by which anxiety is associated with increased risks for atherosclerosis and CVD.

Studies on the psychosomatic functioning of ill-health according to eastern and western medicine 7. Psychoimmuno-endocrinological changes induced by Kampo medication and relaxation training.

Using the anxiety-affinitive constitution index (AACI) that we created, we measured the degree of the anxiety-affinitive constitution as an equivalent of ill-health for the study of psychoimmuno-endrocrinological changes induced by Kampo medication and relaxation training (RT). With 20 sixth-year Saga Medical School students (average age: 24.8 +/- 1.4) as the subjects, we obtained three results: (1) relaxation training produced lowered STAI trait and state anxiety scores and tended to transform the respiratory pattern from thoracic to abdominal; (2) Kampo medication generated lowered GHQ-30 total scores and lowered the depression factor scores for its symptom components; and (3) Kampo medication for overcoming blood stagnation induced lowered NK cell activity, whereas Kampo medication for providing a tonic effect on vital energy and enriching blood brought about elevated NK cell activity and blood cortisol concentration. These results strongly suggest that while Kampo medication alleviated psychological distress as demonstrated by lowered GHQ-30 scores, RT improved the respiratory pattern, as demonstrated by increased abdominal dominance. The utmost attention must be paid to the prolonged administration of drugs for overcoming blood stagnation because of their possible immunosuppressive action.