State-Trait Anxiety Index Research Articles

Correlates of anxiety and depression in chronic lymphocytic leukemia (CLL) survivors.

153 Background: CLL is an indolent lymphoma effecting aging populations. Early stage patients are assigned to active surveillance and only 10% of patients require treatment at diagnosis. Active surveillance for CLL may increase susceptibility to anxiety and depression, resulting in enhanced comorbidities and reduced quality of life. However, little is known about the prevalence and risk factors of anxiety and depression in CLL. Methods: 125 CLL patients that were treatment naïve (n = 86) or previously chemotherapy-treated (n = 39) completed anxiety and depression questionnaires (State Trait Anxiety Index (STAI) and Center for Epidemiologic Studies Depression (CES-D)). Multivariable linear regression was used to examine associations with STAI/CES-D score. Logistic regression was used to examine clinically meaningful anxiety and depression, using validated cut points of 40 for the STAI and 16 (or on antidepressants) for the CES-D. All models included treatment status (treatment naïve vs. treated), age, gender, ECOG grade, time since diagnosis, education, & disease stage. Results: Patients had a median age of 65, were mostly male (60.8%), Caucasian (96%), well educated (55% ≥ college), and had low stage CLL (66% stage 0) and good performance status (67% ECOG 0). 20 and 24% of patients had clinically meaningful anxiety or depression (11% had both). Treatment and time since diagnosis were not associated with anxiety or depression. Older age was associated with better STAI and CES-D scores (STAI β = -0.34 (95%CI -0.52, -0.17) CES-D β = -0.27 (95%CI -0.42, -0.12)), and each 1 year increase in age was associated with a 9% decrease in odds of anxiety and a 7% decrease in odds of depression (OR 0.91(95%CI 0.86, 0.96) OR 0.93 (95%CI 0.88, 0.98) respectively). An ECOG grade of 3 or 4 was a significant predictor of increased depression risk (OR 2.84 (95%CI 1.03, 7.82)) and worse CES-D scores (β = 4.69 (95%CI 8.09, 1.29)) but not of anxiety. Conclusions: Anxiety and depression are common among CLL patients. Poor performance status was associated with more depression while older age was associated with less anxiety and depression. Future studies should investigate potential interventions for anxiety and depression in younger CLL patients.

Does a Brief Mindfulness Exercise Improve Outcomes in Upper Extremity Patients? A Randomized Controlled Trial.

Mindfulness-based interventions are useful in reducing psychologic distress and pain intensity in patients with chronic pain. However, most mindfulness-based interventions are resource-intensive, lengthy, and not feasible for busy orthopaedic surgical practices. The purpose of this study was to determine if a 60-second personalized mindfulness-based video exercise is (1) associated with improved pain intensity, emotional distress, and state anxiety compared with an attention placebo control (a time-matched educational pamphlet about pain and stress); and (2) feasible and acceptable for patients with upper extremity injury in an orthopaedic practice. This was a single-center, single-blind randomized controlled trial of the mindfulness-based video exercise (60 seconds duration, free online) versus an attention placebo control (an educational pamphlet about pain and stress presented to patients to read over 60 seconds). One hundred forty-nine patients presenting for a new or followup appointment at the office of one of two orthopaedic hand and upper extremity outpatient surgical practices at an urban academic hospital were invited to participate between September 2016 and December 2016. Of 149 patients screened, 125 patients were randomized and completed a demographic questionnaire, the Numeric Rating Scale to assess pain intensity, the State Anxiety subscale of the State Trait Anxiety Inventory to assess state anxiety, and Emotion Thermometers to assess anxiety, anger, and depression before and after the interventions. Postintervention, patients also completed the Client Satisfaction Questionnaire Scale-3 to assess the acceptability. A mean score of 21 or higher is considered acceptable. Feasibility was determined based on number of patients approached who refused participation. The intervention was defined as feasible if refusal rate was lower than 25%. Analysis of covariance was used to test comparative improved pain intensity on the NRS, psychologic distress on the Emotion Thermometers, and state anxiety on the State Anxiety Subscale of the State Trait Anxiety Index after controlling for respective baseline scores. A 1-point minimal clinically important difference (MCID) was used on the NRS for pain intensity. Adjusted for the baseline means, compared with patients who received the attention placebo control, patients who participated in the mindfulness-based video exercise demonstrated improved pain intensity (mindfulness-based video exercise: 3.03 ± 0.12; control: 3.49 ± 0.12; mean difference: 0.46 [0.12-0.80]; p = 0.008); state anxiety (mindfulness-based video exercise: 32.35 ± 0.59; control: 35.29 ± 0.59; mean difference: 2.94 [1.29-4.59]; p = 0.001); anxiety symptoms (mindfulness-based video exercise: 1.49 ± 0.19; control: 2.10 ± 0.19; mean difference: 0.61 [0.08-1.14]; p = 0.024); depression (mindfulness-based video exercise: 1.03 ± 0.10; control: 1.47 ± 0.11; mean difference: 0.44 [0.15-0.73]; p = 0.004); and anger (mindfulness-based video exercise: 0.76 ± 0.12; control: 1.36 ± 0.12; mean difference: 0.60 [0.26-0.94]; p = 0.001). However, the observed differences in pain intensity were below 1 point on the NRS, which is the MCID established in patients with chronic pain. No MCID is available for the other measures. The mindfulness-based video exercise was feasible based on a dropout rate of 0%, and acceptability reached the medium range with similar scores in both groups (mindfulness-based video exercise: 20.70 ± 5.48; control: 20.52 ± 6.42). A 60-second mindfulness-based video exercise is feasible to implement and acceptable to patients in busy orthopaedic practices. This video exercise is also effective in improving momentary pain, anxiety, depression, and anger in this population, but it is unclear whether these improved pain and distress levels are meaningful to patients who present with low levels of pain and psychologic distress. Future studies should seek to discern whether the improved pain and distress levels we observed are clinically important or whether the intervention delivers larger effects in subgroups of patients experiencing greater pain intensity and if the improved pain and distress levels are durable. Such studies might also assess cost-effectiveness, because this mindfulness-based tool takes little time and few resources to use, and the effects and durability of multiple sessions of a mindfulness-based video exercise. Level II, therapeutic study.

Abstract OT2-05-03: Does minocycline mitigate chemotherapy induced neuroinflammation? A phase II randomized placebo controlled study

Abstract Background: Many breast cancer (BC) patients, particularly those who receive chemotherapy (chemo), experience affective symptoms and cognitive changes that can negatively impact their quality of life. Causal links between inflammatory mediators and the development of depressive-like behavior and cognitive defects, have been established in mouse models, including studies by our group showing increased microglial activation following chemo (A.C DeVries et al). Microglia are resident immune cells of the brain, which release proinflammatory cytokines when activated. Doxorubicin (DOX) induces microglial activation in the brain. Minocycline, a second generation tetracycline, has been shown to suppress inflammation by inhibiting microglial activation in CNS disease models. We hypothesize that (1) chemo activates microglia in the brains of women being treated for BC, which can precipitate or exacerbate depression, anxiety and cognitive deficits and (2) Minocycline administration during neoadjuvant or adjuvant chemo will prevent chemo-induced microglial activation and will reduce affective and cognitive symptom burden. Trial Design: This is a single center, Phase II, double blinded randomized study of minocycline (100 mg twice a day) vs placebo twice a day in women with BC receiving DOX-based or other chemo for BC. Pts will be randomized to either oral minocycline or placebo for up to a 1 week loading period plus chemo treatment period and an optional subsequent 2 week period. Eligibility Criteria: Women diagnosed with BC stages I-III initiating first line adjuvant or neoadjuvant chemo. Aims: (1) to evaluate symptoms related to anxiety and depression and cognitive changes during and after chemo completion (2) to evaluate markers of neuro inflammation as assessed by blood based inflammatory cytokines and central markers of inflammation and microglia activation using 1 F-Fludeoxyglucose and 11C-PK11195 positron emission tomography. Primary endpoints are changes in Center for Epidemiological Studies Depression Scale (CES-D) and State Trait Anxiety Index (STAI) from baseline to end of study after minocycline vs placebo intervention. Secondary endpoints are changes in cognitive function during chemo using validated cognitive testing including N-Back Test, Behavioural Rating Inventory of Executive Function (BRIEF) and the Multifactorial Memory Questionnaire Ability Scale (MMQ). Statistical Methods: Primary analysis for efficacy will be intention-to-treat. The main objective is to preliminarily evaluate the effect of minocycline on chemo-induced depressive symptoms in terms of changes in CES-D and STAI scores. Mixed models will be used to evaluate cognitive function changes. A sample size of 23 per group, will give 80% power to detect an effect size of 0.74 standard deviation (SD) difference between the 2 groups at significance level of 0.10 based on a 2 sided two-sample t-test. From our experience, attrition of less than 20% is expected for studies in this patient population in our center, and to account for this, we plan to recruit up to 60 patients. 16 of 46 evaluable pts have been accrued to date. Accrual started in January 2016. Funded by Pelotonia grant from The OSUCCC. Contact: Study PI: Maryam.lustberg@osumc.edu Citation Format: Boutrid H, Reinbolt R, Knopp M, Williams N, VanDeusen J, Sardesai S, Noonan A, Flora L, Gleich E, Pan X, Berger M, Vargo C, Wesolowski R, Ramaswamy B, DeVries AC, Lustberg M. Does minocycline mitigate chemotherapy induced neuroinflammation? A phase II randomized placebo controlled study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-05-03.

A randomised trial of early palliative care for maternal stress in infants prenatally diagnosed with single-ventricle heart disease.

Children with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge. Infants were randomised to receive early palliative care - structured evaluation, psychosocial/spiritual, and communication support before surgery - or standard care. Among 56 eligible mothers, 40 enrolled and completed baseline surveys; 38 neonates were randomised, 18 early palliative care and 20 standard care; and 34 postnatal surveys were completed. Baseline Beck Depression Inventory-II and State-Trait Anxiety Index scores exceeded normal pregnant sample scores (mean 13.76±8.46 versus 7.0±5.0 and 46.34±12.59 versus 29.8±6.35, respectively; p=0.0001); there were no significant differences between study groups. The early palliative care group had a decrease in prenatal to postnatal State-Trait Anxiety Index scores (-7.6 versus 0.3 in standard care, p=0.02), higher postnatal Brief Cope Inventory positive reframing scores (p=0.03), and a positive change in PedsQL Family Impact Module communication and family relationships scores (effect size 0.46 and 0.41, respectively). In conclusion, these data show that mothers of infants with single-ventricle disease experience significant depression and anxiety prenatally. Early palliative care resulted in decreased maternal anxiety, improved maternal positive reframing, and improved communication and family relationships.

Correlation of occupational stress with depression, anxiety, and sleep in Korean dentists: cross-sectional study

BackgroundThis study aimed to investigate the degree of occupational stress and the clinical mental state of dentists. In addition, we investigated the correlation of occupational stress with depression, anxiety, and sleep among dentists in Korea.MethodsA cross-sectional survey on 231 dentists was conducted using the Doctor Job Stress Scale, Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Index (STAI), and Pittsburgh Sleep Quality Index (PSQI). Correlation of occupational stress with mental health was investigated by adjusted multiple regression analysis.ResultsThe scores of CES-D, STAI, and PSQI revealed a significant correlation with the Doctor Job Stress Scale (t = 3.93, P < 0.0001; t = 4.05, P < 0.0001; t = 4.18, P < 0.0001, respectively). In particular, patient factors and clinical responsibility/judgment factors were significantly associated with depression (t = 2.80, P = 0.0056; t = 4.93, P < 0.0001, respectively), anxiety (t = 2.35, P = 0.0195; t = 5.11, P < 0.0001, respectively), and sleep (t = 3.78, P = 0.0002; t = 4.30, P < 0.0001, respectively), whereas work factors were not associated with any mental health state.ConclusionsThis study confirms that dentists as professions experience more severe mental states. For successful mental health care among dentists, stress management focusing on interpersonal relationship with patients and responsibility as an expert rather than the intensity of work should be considered.

Exposure to Simulated Mortality Affects Resident Performance During Assessment Scenarios.

The utility of simulated mortality remains controversial in the literature. We therefore sought primarily to determine whether there was a difference in performance for residents exposed to varying levels of simulated mortality during training scenarios. As a secondary objective, we also sought to determine whether their self-reported anxiety levels, attitudes toward, and engagement in the simulated encounters differed based on group assignment. Fifty junior anesthesiology residents were randomized to one of the three simulation cohorts. The residents were broken into groups that either always experienced simulated patient survival (never death), always experienced simulated mortality (always death), or had a variable result based on performance (variable death). All residents experienced 12 identical training simulations with only the predetermined outcome as the variable. Residents were brought back 6 weeks after initial training for four assessment scenarios and subsequently rated on nontechnical skills and anxiety levels. Residents in the always and never death groups showed no difference in nontechnical skills using the Anesthetists' Nontechnical Skills Score before and after the simulations. Residents in the variable death group, however, had improved nontechnical skill scores when brought back for the assessment (45.2 vs 41.5 and 42.9 respectively, P = 0.01). Although all three groups had higher State-Trait Anxiety Index scores from baseline after training, only the always death group had higher anxiety scores during the assessment (43 vs 37 vs 37 P = 0.008). We found that participants who experienced simulated mortality that was variably delivered, and more directly related to performance, performed better on later assessment scenarios.

First trimester antenatal depression and anxiety: prevalence and associated factors in an urban population in Soweto, South Africa.

Depression and anxiety in the antenatal period are of public health concern given potential adverse effects for both mother and infant. Both are under-researched in the first trimester of pregnancy, especially in Africa. We examine the prevalence of first trimester antenatal depression and anxiety in a cohort of South African women and investigate associated risk factors. Data were collected from 946 women (2014-2016) in the Soweto First 1000 Days Cohort, a prospective pregnancy cohort in Soweto, South Africa. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale with a score of ⩾13 indicating probable depression. Anxiety was assessed using the short form of the State-Trait Anxiety Index with a score ⩾12 indicating probable anxiety. Prevalence of antenatal depression was 27% [95% confidence interval (CI) 24.2-29.8] and anxiety 15.2% (95% CI 12.9-17.5). Factors associated with antenatal depression and anxiety were predominantly relationship- and family-centred. Women who perceived that their partner made life harder for them had three-fold increased odds for depression [(odds ratio (OR) 3.33 [2.28-4.85] P<0.001], whereas those with family stressors had almost double the odds for depression (OR 1.78 [1.22-2.59] P=0.003) and anxiety (OR 1.75 [1.44-2.69] P=0.0011). Antenatal depression and anxiety are common in the first trimester of pregnancy, and partner and family relationship stressors are central. Longitudinal analysis is needed to determine if this is a phase of adjustment to pregnancy or onset of persistent symptomology. Early intervention may have secondary preventative effects and should involve the partner and family.

The effect of a preanaesthesia clinic consultation on adult patient anxiety at a tertiary hospital in Kenya: a cohort study.

Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction. To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward. Fifty one adult patients with 28 patients in anaesthesia clinic (AC) group and 23 in the ward (W) group were sequentially recruited from both the surgical, gynaecology and antenatal outpatient clinics and the wards. The patient's State Trait Anxiety Index (STAI) was taken once the patient was booked for theatre. The patients then had a preanaesthesia evaluation either in the preanaesthesia outpatient clinic (PAC) or in the wards. Another STAI score was taken in the preoperative area in theatre on the day of surgery. The difference in the change of STAI scores in both groups was then analysed. Fifty one adult patients were recruited with 28 in the AC group and 23 in the W group. The majority of patients were female (n=38). Statistically significant difference was seen in the reduction of the anxiety scores between the clinic group 2.143 (C.I=1.384-2.902) and ward group 0.74(C.I=0.17-1.31) with a p value=0.0051.There was also significant difference in reduction in anxiety scores within ward group in the patients with no prior anaesthetic experience having a greater reduction than those with prior anaesthetic experience. There were no other significant differences between the two groups. Patients evaluated in the anaesthesia clinic had a greater reduction in their anxiety but it was not as much as hypothesised which may be due to the multi-factorial nature of preoperative anxiety. A larger multicenter study is recommended to increase generalizability to the population.

Neuro emotional technique effects on brain physiology in cancer patients with traumatic stress symptoms: preliminary findings.

The purpose of this study was to characterize the neurophysiological and clinical effects that may result from the neuro emotional technique (NET) in patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that self-regulatory processing of traumatic memories would be observable as physiological changes in key brain areas after undergoing the NET intervention and that these changes would be associated with improvement of traumatic stress symptoms. We enrolled 23 participants with a prior cancer diagnosis who expressed a distressing cancer-related memory that was associated with traumatic stress symptoms of at least 6months in duration. Participants were randomized to either the NET intervention or a waitlist control condition. To evaluate the primary outcome of neurophysiological effects, all participants received functional magnetic resonance imaging (fMRI) during the auditory presentation of both a neutral stimulus and a description of the specific traumatic event. Pre/post-comparisons were performed between the traumatic and neutral condition, within and between groups. Psychological measures included the Impact of Event Scale (IES), State Trait Anxiety Index (STAI), Brief Symptom Inventory (BSI)-18, and Posttraumatic Cognitions Inventory (PTCI). The initial fMRI scans in both groups showed significant increases in the bilateral parahippocampus and brainstem. After NET, reactivity in the parahippocampus, brainstem, anterior cingulate, and insula was significantly decreased during the traumatic stimulus. Likewise, participants receiving the NET intervention had significant reductions (p<0.05) compared to the control group in distress as measured by the BSI-18 global severity index, anxiety as measured by the STAI, and traumatic stress as measured by the IES and PTCI. This study is an initial step towards understanding mechanistic features of the NET intervention. Specifically, brain regions involved with traumatic memories and distress such as the brainstem, insula, anterior cingulate gyrus, and parahippocampus had significantly reduced activity after the NET intervention and were associated with clinical improvement of symptoms associated with distressing recollections. This preliminary study suggests that the NET intervention may be effective at reducing emotional distress in patients who suffer from traumatic stress symptoms associated with a cancer-related event.

Pharmacy Student Anxiety and Success With Objective Structured Clinical Examinations

Objective. To evaluate whether a relationship exists between the degree of student state-anxiety and pass rates on moderate-to-high stakes objective structured clinical examinations (OSCE). Methods. Third-professional year (P3) students were assessed using the Speilberger State-Trait Anxiety Index (STAI) three weeks prior to their first moderate-to-high stakes OSCEs. Students' OSCE station pass rates, individual station analytical scores, and the overall pass rate for the class were compared with student responses on STAI surveys to measure their association. Results. Seventy-three students (100%) provided consent to participate in the research; 64 (87%) sufficiently completed the STAI survey. Degree of student state-anxiety or train-anxiety was not associated with any of the outcomes assessed in this study. Overall pass rate, individual station pass rates, and station analytical checklist scores were not inversely correlated with state- or trait-anxiety scores. Conclusions. Efforts to assist students in OSCE performance should focus on means other than reducing associated anxiety. Future research in this area should focus on what interventions beyond instruction could be put in place to help students be more successful during OSCEs.

How minimally invasive vestibular neurotomy for incapacitating Meniere’s disease improves dizziness and anxiety

Conclusion: Patients with incapacitating Meniere Disease (MD) suffer in their daily lives and activities because of the dizziness and anxiety induced by MD. Minimally Invasive Vestibular Neurotomy (MIVN) is a safe and effective surgical treatment for these individuals, and improved their dizziness and anxiety.Objectives: This study aimed to assess the state of dizziness and anxiety of patients with incapacitating MD and its improvement through MIVN.Method: A total of 118 patients with incapacitating MD who underwent MIVN in France and Japan were evaluated. The DHI (Dizziness Handicap Inventory), SAST (Short Anxiety Screening Test), and STAI (State Trait Anxiety Index) questionnaires were used to evaluate disequilibrium and anxiety.Results: The MIVN method appears safe and effective for patients with incapacitating MD. Pre-operative assessment results by DHI and SAST were significantly related to each other, and were influenced by lifestyle and profession. This prospective study showed that MIVN improved dizziness and anxiety in these patients.

Psychosocial aspects and temporomandibular disorders in dental students.

Dental students have high levels of anxiety that can affect not only academic performance but also increase the risk for other diseases. It is believed that the increase in the incidence of chronic orofacial pain in temporomandibular disorders (TMDs) may have an impact on the quality of life and general health of subjects. The aim of this study was to evaluate the prevalence of TMD in dental students and its association with general health, quality of life, and anxiety. Ninety students were evaluated by four questionnaires to determine the prevalence and sever-ity of TMD (Fonseca's questionnaire) and to quantify general health (General Health Questionnaire - GHQ), quality of life (World Health Organization Quality of Life - Brief version - WHOQOL-brief) and anxiety levels (State-Trait Anxiety Index - STAI). Approximately 58.9% of dental students presented TMD. Among the indicators of general health, psychologic stress (P = .010), distrust in their own performance (P = .012), and psychosomatic disorders (P = .020) showed a statistically significant difference with the presence of TMD. The four areas proposed in the questionnaire regarding quality of life, such as physical (P = .016), psychologic (P < .001), social (P = .045), and environmental (P = .017) factors also showed significant differences with the presence of TMD. A high prevalence of TMD was observed in dental students. In addition, some psychologic domains are important psychosocial indicators associated with the presence of TMDs.

POSSIBILITIES OF ANXIETY-DEPRESSIVE DISORDERS TREATMENT IN PATIENTS WITH CHRONIC HEART FAILURE

Aim. To study the efficacy and safety of D-, L-gopantenic acid/Pantogam active in the complex treatment of congestive heart failure and coronary heart disease in patients with symptoms of anxiety-depressive disorder. Patients and methods. 82 patients with NYHA II-III heart failure, anxiety and depression were enrolled in the study. Material and methods. The severity of psychological disorders and the efficacy of 8-week therapy with Pantogam active were assessed using Hamilton Depression Rating Scale (HDRS), Hospital Anxiety and Depression Scale (HADS), State Trait Anxiety Index (STAI), and Clinical Global Impression (CGI) Scale. The quality of life was evaluated using the Short Form 36 (SF-36) Health Survey. Global improvement or change of psychological symptoms by CGI Scale were considered as efficacy criteria. Standard diagnostic tools, i.e., echocardiography and 24-hour Holter monitoring, were applied as well. Results. 8-week treatment with Pantogam active of patients with heart failure and depression greatly reduces the severity of anxiety-depressive disorders, improves physical activity tolerance and vegetative regulation of heart rhythm, and decreases heart rate in supraventricular and ventricular arrhythmias. Conclusions. In heart failure patients, anxiety-depressive disorders are accompanied by significant disturbances of heart rhythm vegetative regulation, development of supraventricular and ventricular arrhythmias, physical activity intolerance, increased hospital admission rate, and decreased quality of life. 8-week treatment with Pantogam active due to its bimodal action significantly improves these symptoms and the quality of life.

Resilience in the First Episode of Major Depressive Disorder

Aim: Resilience refers to the human ability to adapt to tragedy, trauma, adversity, and significant stressors. Recently, resilience has been defined as a potentially modifiable factor that can be improved through intervention. Here, we examined resilience during a 3-month period as patients experienced their first episode of major depressive disorder (MDD). We hypothesized that despite MDD, resilient people could recover from depressive states more quickly than less resilient people. Methods: Twelve patients experienced their first MDD episode and 21 healthy control individuals participated in the study. Data from the Hamilton Depression Rating Scale (HAM-D), S-H Resilience Scale (S-HRS), and State-Trait Anxiety Index (STAI) were collected at two time points. Time 1 was the first visit after registration and Time 2 was 12 weeks later. Based on the symptoms described by the HAM-D results, the MDD group was divided into MDD-remission and MDD-residual subgroups. Results: Compared with controls, patients showed significantly lower resilience (low scores for Factor-A, Factor-B, and total S-HRS). Moreover, total SHRS scores for the MDD-remission group increased significantly from the Time 1 to Time 2, while those in MDD-residual group did not change. No significant differences in STAI scores were observed between MDD-remission and MDD-residual groups at either time point. Conclusion: This is the first report to show that patients experiencing their first episode of MDD show low resilience, and that a resilience scale might be a good index for estimating recovery from depression.

Peer Mentoring During Practicum to Reduce Anxiety in First-Semester Nursing Students.

The clinical setting creates significant anxiety for students that can decrease their ability to learn. This quasi-experimental study examined whether nursing students who participate in peer mentoring during their first clinical experience (n = 18) experienced less anxiety than those in traditional clinical experiences (n = 19). Anxiety was measured using the standardized State Trait Anxiety Index and the Clinical Experiences Anxiety Form (CEAF). Data were analyzed using descriptive and nonparametric statistics. A significant decrease was demonstrated in clinical situation-specific anxiety, as measured by the CEAF, among students who were peer mentored as compared with students who were not. Peer mentoring shows promise as an effective strategy to reduce anxiety among novice nursing students. [J Nurs Educ. 2016;55(11):651-654.].

Prenatal exposure to very severe maternal obesity is associated with adverse neuropsychiatric outcomes in children.

Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and maternal concurrent symptoms of anxiety and depression. Prenatal maternal very severe obesity is a strong predictor of increased neuropsychiatric problems in early childhood.

Neuropsychiatric characteristics of GBA-associated Parkinson disease

Mutations in GBA1 are a well-established risk factor for Parkinson disease (PD). GBA-associated PD (GBA-PD) may have a higher burden of nonmotor symptoms than idiopathic PD (IPD). We sought to characterize the relationship between GBA-PD and neuropsychiatric symptoms. Subjects were screened for common GBA1 mutations. GBA-PD (n=31) and non-carrier (IPD; n=55) scores were compared on the Unified Parkinson Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), and the State-Trait Anxiety Index (STAI). In univariate comparisons, GBA-PD had a greater prevalence of depression (33.3%) versus IPD (13.2%) (p<0.05). In regression models controlling for age, sex, disease duration, motor disability, and MoCA score, GBA-PD had an increased odds of depression (OR 3.66, 95% CI 1.13–11.8) (p=0.03). Post-hoc analysis stratified by sex showed that, among men, GBA-PD had a higher burden of trait anxiety and depression than IPD; this finding was sustained in multivariate models. Among women, GBA-PD did not confer greater psychiatric morbidity than IPD. These results suggest that GBA1 mutations confer greater risk of neuropsychiatric morbidity in PD, and that sex may affect this association.

(182) Vulvodynia is not created equally: pain-related distress subgroups in vulvodynia

Women with vulvodynia exhibit elevated psychological distress associated with negative perceptions of pain compared to pain-free women, including catastrophizing, anxiety, and depression. Unclear from existing data is if women with vulvodynia experience similar levels of pain-related distress and pain sensitivity. Empirical classification of women with vulvodynia is needed in order to identify subgroups of women with vulvodynia who may better respond to specific treatments. Thus, the objective of this study is to identify unique subgroups of women with vulvodynia based on pain sensitivity measures and psychological distress. Baseline self-reported data from 131 patients with vulvodynia enrolled in the National Vulvodynia Registry were included in this analysis. Patients completed the Coping Strategies Questionnaire catastrophizing subscale, State Trait Anxiety Index, McGill Pain Questionnaire Affective Pain subscale, and the Beck Depression Index. Patients underwent standardized pain sensitivity testing of the vulvar vestibule and puborectalis muscles. Prior to conducting cluster analysis, raw scores for measures were transformed to z scores for standardization. We conducted an exploratory hierarchical agglomerative cluster analysis using Ward’s cluster method and squared Euclidean distances to identify unique subgroups based on distress and pain sensitivity measures. Based on the inspection of the agglomeration coefficients, a 2-cluster solution was derived: high distress (n=67) and low distress (n=64). Follow-up analyses of variance indicated significant subgroup differences on all psychological measures. No subgroup differences existed between any of the pain sensitivity measures. These data suggest that within this sample of women vulvodynia exist different phenotypes related to pain-related distress. The mechanisms underlying vulvodynia may differ in women with this condition. These data are consistent with data from other chronic pain conditions, including spinal pain, fibromyalgia, and whiplash. This work supports existing recommendations that vulvodynia providers should screen for and refer for distress management when indicated.

BIOFEEDBACK E ANSIEDADE NO ENSINO SUPERIOR: COMPARAÇÃO DA EFICÁCIA ENTRE DOIS PROGRAMAS BREVES

This study follows Biofeedback (BFB) efficacy in higher education student’s levels of anxiety research. Looking for easy access, short duration programs, we tried to compare two brief programs, with 5 and 8 sessions of BFB. 32 1st year students with high State-Trait Anxiety Index (STAI-Y2) values. Using Biofeedback 2000 x-pert, one group (n=11) underwent 8 sessions, another (n=9) did 5 and a third group (n=12) underwent no intervention. Results were compared at the end. A significant reduction of STAI Y-2 values was observed on both BFB groups (p=0.05 in the 5 session group, p=0.003 in the 8 session one). Significant differences were also found between the control group and the 8 BFB session group (p=0.001). These results suggest the relevance of using brief BFB programs in dealing with anxiety in Higher Education, albeit with some care considering the 5 session program. Future studies, especially in the Portuguese population, are necessary to strengthen these programs’ efficacy. Having a good cost/efficacy relationship, BFB programs appear as a valid option for intervention in anxiety. BRIEF BIOFEEDBACK IN HIGHER EDUCATION ANXIETY 61 www.sp-ps.pt

Anxiety State and ITS Psychosocial Consequences among Acne Vulgaris and Chronic Urticaria Patients in Abuja

&lt;p&gt;BACKGROUND/OBJECTIVE: the skin defines the essence of beauty and overall perceived attention within a social context. As such, there is a relationship between skin diseases and the extent of provoked emotional psychological disturbances and social concern that the sufferers do have. This study therefore seeks to ascertain levels of anxiety and their psychosocial consequences among sufferers of acne vulgaris and chronic urticaria in dermatological outpatient in Abuja-Nigeria.&lt;/p&gt;&lt;p&gt;MATERIALS/METHODS:&lt;strong&gt; &lt;/strong&gt;this study was a prospective, cross sectional study carried out on consecutive consented dermatological outpatients who had acne vulgaris (N = 62) and chronic urticaria (N = 31) over a period of nine months (June 2013-February 2014) and 50 apparently healthy control matched for age and sex were recruited into the study. Diagnosis of acne vulgaris and chronic urticaria were clinically made. Questions on State Trait Anxiety Index STAI (Y-1) form were used to determine their present feelings and level of perceived anxiety within the society as a result of acne vulgaris and chronic urticaria. Total STAI score greater than 54 suggests severe level of anxiety and univariate analysis of variance was used to determine relationship between anxiety and its social consequences. Data was keyed into and analysed with SPSS 20.&lt;/p&gt;&lt;p&gt;RESULTS:&lt;strong&gt; &lt;/strong&gt;ratio of male: female for subjects is 1:1.9 and 1:1.3 for controls while mean age in years ± Standard Deviation (SD) for subjects and controls were 29.02 ± (9.2) and 28.42 ± (8.3) respectively. There was sex and age match between subjects and controls. Also, there was observable moderate to severe anxiety among those that had acne vulgaris and chronic urticaria as compared to apparently healthy controls. Low self-esteem, inferiority complex, lack of self-confidence, and social withdrawal, were among the common social reactions noticeable among the subject group. Mean STAI score ± s.e (standard error) of subjects was significantly higher than that of the controls 49.7 ± 0.788 and 33.9 ± 1.255 respectively at t-test = 11.2 and p = 0.0001.&lt;/p&gt;&lt;p&gt;CONCLUSION:&lt;strong&gt; &lt;/strong&gt;acne vulgaris and chronic urticaria was highly associated with moderate to severe anxiety with attending social reactions when compared to apparently healthy controls.&lt;/p&gt;