State-Trait Anxiety Inventory Trait Research Articles

The Association Between Types of Chronic Diseases and Anxiety or Worry in Older Adults

Among several psychological problems, anxiety has been particularly accepted as a commonly seen disorder among older adults by several epidemiological studies around the world. Nevertheless, even though anxiety disorders are the most prevalent mental disorders among older individuals, there has not been much attention on some critical aging-related issues. Our research uncovers connections between many medical conditions and anxiety symptoms. The innovative aspect of our study is the evaluation of the use of extensive and validated measures for geriatric anxiety, trait anxiety, and worry, as well as associations between the number of diseases and types of diseases with those measures in a sample of older Turkish individuals living in their homes. The study is conducted with older adults (N = 246) living in their homes. The Geriatric Anxiety Inventory, the State-Trait Anxiety Inventory—Trait Form (STAI—T), and the Brief Version Penn State Worry Questionnaire (B-PSWQ) have been applied to them with their self-report of types of physical diseases. Results revealed that older adults with two or more diseases reported higher geriatric anxiety and worry than older adults with one disease or no disease. Regarding the types of diseases, older adults suffering from diseases of the digestive system, rheumatic and musculoskeletal diseases, neurological disorders, and urinary system diseases have higher geriatric anxiety, trait anxiety, and worry scores than the ones who have not. Considering the results of the present study, a combination of medical treatment and psychotherapy is essential.

Identifying emotional contributors to participation post-stroke

ABSTRACT Background Participation in daily activities is the ultimate goal of stroke rehabilitation. Emotional factors have been considered as contributors to participation, but associations between emotional factors and participation post-stroke have not been fully explored. Objective To investigate the extent to which emotional factors contribute to participation post-stroke. Methods 73 participants were included. Three participation outcomes were used as dependent variables in three models: (1) Stroke Impact Scale (SIS) Participation/Role Function, (2) Activity Card Sort (ACS), and (3) Reintegration to Normal Living (RNL). Main independent variables were six emotional factors: SIS Emotion Function (General emotion), Visual Analog Mood Scale energetic and happy subscales, Patient Health Questionnaire-9 (Depression), State-Trait Anxiety Inventory-Trait Anxiety Scale, and Apathy Evaluation Scale. Covariates of stroke severity and social support were included. Results Model 1 showed stroke severity (β = −0.300) and depression (β = −0.268) were significant contributors to SIS Participation/Role Function (R2 = 0.368, p < .05). Model 2 indicated that happiness (β = 0.284) and apathy (β = −0.330) significantly contributed to ACS total activity retention (R2 = 0.247, p < .05). Model 3 revealed that anxiety (β = −0.348), apathy (β = −0.303), stroke severity (β = −0.184), and social support (β = 0.185) were significant contributors to RNL total score (R2 = 0.583, p < .05). Conclusions Results suggested that emotional measures of apathy, depression, anxiety, and happiness, but not general emotion, were important contributors to participation post-stroke. These findings suggest that rehabilitation professionals should address individual emotional contributors to facilitate participation post-stroke.

Effects of the Kampo medicine Yokukansan for perioperative anxiety and postoperative pain in women undergoing breast surgery: A randomized, controlled trial.

Yokukansan (YKS) is a traditional Japanese herbal (Kampo) medicine prescribed for anxiety. In this randomized controlled trial, we compared the subjective assessment of anxiety using questionnaires and its objective assessment using salivary alpha-amylase concentrations in YKS and control (CNT) groups of women undergoing breast surgery. The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000028998), and the investigators were blinded to drug administration. One hundred patients who underwent breast cancer surgery were allocated to either the YKS or the CNT group. Finally, 35 and 42 patients in the YKS and CNT groups were analyzed, respectively. The YKS group received two 2.5 g doses of the medication before sleeping on the night before surgery and 2 h before inducing anesthesia, while the CNT group did not receive medication preoperatively. Patients answered two questionnaires, the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory, pre-and postoperatively as subjective anxiety assessments. As an objective anxiety indicator, salivary alpha-amylase levels were measured the day before, directly before, and the day after surgery (T3). In the YKS group, salivary alpha-amylase scores directly before operation were significantly lower than those on the day before surgery and at one day postoperatively (F [2,150] = 3.76, p = 0.03). Moreover, the Hospital Anxiety and Depression Scale-Anxiety and State-Trait Anxiety Inventory-Trait scores were significantly more improved postoperatively in the YKS group than in the CNT group (difference in Hospital Anxiety and Depression Scale-Anxiety: YKS, mean -2.77, 95% confidence interval [-1.48 --4.06], p <0.001, and CNT, -1.43 [-0.25--2.61], p = 0.011; and difference in State-Trait Anxiety Inventory: YKS group, -4.23 [-6.95--1.51], p = 0.0004; and CNT group, 0.12 [-2.36-2.60], p = 0.92). No side effects were associated with YKS. YKS may reduce perioperative anxiety in patients undergoing surface surgery.

Pareidolia in Parkinson's Disease and Multiple System Atrophy.

Pareidolia is a visual illusion of meaningful objects that arise from ambiguous forms embedded in visual scenes. Previous studies showed that pareidolias are frequently observed in patients with Parkinson's disease (PD) as well as dementia with Lewy bodies. However, whether pareidolias are useful for differentiating PD from other neurodegenerative parkinsonism disorders including multiple system atrophy (MSA) is unclear. The noise pareidolia test (NPT) was performed in 40 and 48 patients with PD and MSA, respectively. A receiver operating characteristic (ROC) curve analysis was used to evaluate sensitivity and specificity. Results of neuropsychological tests were also compared between patients with PD with and without pareidolias. Visual hallucinations were present in none of the subjects. Pareidolic response in the NPT was observed in 47.5% and 18.8% of patients with PD and MSA, respectively. The number of pareidolic responses in patients with PD was significantly larger compared with patients with MSA (P=0.001). ROC curve analyses showed the sensitivity and specificity at 33% and 98%, respectively. Among patients with PD, those with pareidolias demonstrated higher State-Trait Anxiety Inventory-state (P=0.044) and State-Trait Anxiety Inventory-trait (P=0.044) than those without pareidolias. Pareidolias can be found in patients with PD without visual hallucinations, and the pareidolia test may be a highly specific test for differentiating PD from MSA. Thus, anxiety may be associated with pareidolias in patients with PD.

Unveiling the relationship between autonomic involvement, fatigue, and cognitive dysfunction in early relapsing-remitting multiple sclerosis.

Fatigue is a common, yet disabling, symptom in patients with multiple sclerosis (PwMS). Fatigue has shown to be associated with self-reported autonomic nervous system (ANS) symptoms, particularly for cognitive fatigue; however, the question whether ANS involvement is related to cognitive impairment has never been addressed. We performed a study to unveil the complex relationship between fatigue, ANS symptoms, and cognitive impairment. We prospectively recruited early PwMS that were tested with Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS) and Composite Autonomic Symptoms Scale-31 (COMPASS-31) scale. We performed a comparison between fatigued and non-fatigued patients and between cognitive unimpaired and impaired patients. We evaluated the association of COMPASS-31, MFIS, BDI, STAI, and BICAMS scores, and the analysis was repeated for each scale's sub-scores. A multivariable analysis was performed to elucidate predictors of fatigue. Forty-four patients were recruited. Fatigued patients had higher COMPASS-31 total, orthostatic intolerance, secretomotor, and pupillomotor scores. No differences in fatigue and ANS symptoms were found between cognitive impaired and unimpaired patients. MFIS total score correlated with STAI state (p = 0.002) and trait (p < 0.001), BDI (p < 0.001), COMPASS-31 total (p < 0.001), orthostatic intolerance (p < 0.001), pupillomotor scores (p = 0.006). Multivariable analysis showed that BDI (p < 0.001) and COMPASS-31 (p = 0.021) predicted MFIS score. Sub-scores analysis showed that orthostatic intolerance has a relevant role in fatigue. ANS symptoms are closely related with fatigue. Orthostatic intolerance may have a predominant role. Cognitive impairment seems not to be associated with ANS symptoms.

Arterial stiffness in underweight and weight-restored anorexia nervosa.

Cardiovascular complications have been demonstrated in patients with anorexia nervosa (AN) in both the state of starvation and during weight restoration, however, the underlying mechanisms remain unclear. The current study aimed to assess arterial stiffness via carotid-femoral pulse wave velocity (cfPWV) in the acute and weight-restored states of AN. The study also aimed to determine the association between psychological distress and cfPWV. The sample included 37 participants; 10 participants with AN, 17 who were weight-restored (AN-WR; minimum body mass index >18.5 for at least 12months) and 10 healthy controls (HCs). cfPWV via applanation tonometry was conducted to assess arterial stiffness. Psychological distress was assessed using the depression anxiety stress scale (DASS-21) and the state-trait anxiety inventory (STAI). Between-group comparisons were performed to determine differences between groups, a two-stage hierarchical regression model was performed to determine the contribution of physiological and psychological variables on cfPWV and correlation analyses were also performed. Vascular stiffness was significantly increased in the AN and AN-WR groups, relative to HCs. The total DASS score was the only significant predictor of cfPWV across the sample. There were positive associations between cfPWV and depression, anxiety and stress, as assessed by the DASS. Furthermore, cfPWV was positively associated with STAI trait anxiety. Arterial stiffness was increased in individuals in the acute and weight-restored states of AN, demonstrating early signs of the development of arteriosclerotic cardiovascular disease. Increased arterial stiffness was associated with increased psychological distress, which may be a contributing mechanism to the increased cardiovascular risk in AN.

Behaviour is the Key in a Pandemic: The Direct and Indirect Effects of COVID-19-Related Variables on Psychological Wellbeing.

The aim of this study was to investigate the potential role of three COVID-19-related variables (i.e., risk perception, knowledge, and behaviour) on four indices of pandemic-related mental health (i.e., anxiety, depression, loneliness, and hopelessness). In total, 337 participants completed four self-report questionnaires: selected subscales of the World Health Organisation's COVID-19 Behavioural Insights Tool, UCLA Loneliness Scale, State-Trait Anxiety Inventory-Trait Scale, Center for Epidemiologic Studies Depression Scale, and Beck Hopelessness Scale. In addition to descriptive statistics and intercorrelations, structural equation modelling was used to compare three models of the potential role (predictor or moderator/mediator) that the three abovementioned COVID-19-related variables could play in psychological wellbeing. The results showed high levels of psychological distress among the current sample. Generally, better knowledge of COVID-19 and engaging in protective behaviours were found to be related to lower levels of psychological distress, whereas increased risk perception was found to be associated with increased feelings of loneliness, anxiety, and depression. It was also found that behaviour mediated the effect of knowledge on psychological wellbeing, suggesting that while publicising information about COVID-19 remains necessary, providing the public with a means to engage in protective behaviours is central for promoting psychological wellbeing.

The Differences of Anxiety Scores in the Pangkalan-I Defense Battalion Warriors, Belawan between the Pandemic Time COVID-19 and the Normal Period Before Pandemic

Background: COVID-19 has caused changes in people's living conditions and has brought harmful psychological effects such as anxiety. The military has an important role as a health service provider in particular and accelerates control in disasters such as COVID-19. Mental health in the rapid adaptation of the military is an important thing in carrying out its duties.&#x0D; Objective: This study is to determine the adaptability of the Belawan Defense Marine Battalion Soldiers in dealing with situations that have never been faced before.&#x0D; Methods: This study is a paired numerical comparative analytical study using a retrospective approach. By assessing the difference in the State-Trait Anxiety Inventory-State (STAI-S) score and also the State-Trait Anxiety Inventory-Trait (STAI-T) score during the COVID-19 pandemic and normal conditions before the pandemic, with the study population of Marine Defense Battalion Soldiers Base- I Belawan.&#x0D; Results: the median of the STAI-S score during the COVID-19 pandemic in the Belawan Defense Base-I Marine Battalion Soldier is 35 with a minimum value of 20 and a maximum value of 55. There is a significant difference between the STAI-S score during the COVID-19 pandemic and normal conditions at Belawan I-Base Defense Marine Battalion Soldiers (p &lt;0.001). There was no significant difference between the STAI-T score between the COVID-19 pandemic and the normal condition of the Belawan I-Base Marine Defense Battalion Soldiers (p = 0.45).&#x0D; Conclusion: There was a tendency for anxiety during the COVID-19 pandemic compared to normal conditions in the Belawan I Base Defense Marine Battalion soldier.

Measuring Prospective Imagery: Psychometric Properties of the Chinese Version of the Prospective Imagery Task.

ObjectiveProspective negative imagery is suggested to play an important role in the development and maintenance of anxiety and depression. The Prospective Imagery Task (PIT) was developed to assess prospective imagery. Given the importance of prospective imagery for mental health in the Chinese cultural context, our objective was to examine the psychometric properties of the PIT in a Chinese sample.MethodsThe instrument was validated among a sample of 1,372 Chinese individuals (mean age = 19.98, SD = 4.57; 35.2% male) who completed the PIT immediately following the Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory-Trait version (STAI-T).ResultsThe two-factor structure of the PIT was in line with the original study, with satisfactory reliability and positive correlations with the BDI-II and STAI-T scores. Latent profile analysis revealed a three-class pattern. The measurement invariance indicated that the instrument can be used among different age groups as well as among males and females.ConclusionThe Chinese version of the PIT is a reliable and valid tool to measure prospective imagery, and the positive subscale is meaningful for clinical psychology. Limitations and future research directions are discussed.

A brief scale of pathological worry that everyone already has

Worry is a central process in a wide range of psychopathological and somatic conditions. Three studies (N = 856) were used to test whether a subscale composed of five items of the most commonly used trait anxiety questionnaire, Spielberger’s State Trait Anxiety Inventory-Trait version (STAI-T), is appropriate to measure worry. Results showed that the subscale, named the Brief Worry Scale (BWS), had excellent internal consistency and temporal stability. Convergent and divergent validity were supported by correlation analyses using worry questionnaires and measures of anxious arousal and depression. The BWS was a particularly good predictor of the pathogenic aspects of worry, including worry perseveration in daily life (study 1), measures of clinical worry (study 2) and the uncontrollability of experimentally induced worry (study 3). Taken together, these studies demonstrate that the BWS might be a valuable scale for pathological worry, for which many researchers already have data.

The Investigation of Transdiagnostic Role of Obsessive Beliefs: Comparison of Clinical Groups Diagnosed with Obsessive Compulsive Disorder, Anxiety Disorders and Depression with University Students.

The present study aimed to investigate whether the dysfunctional obsessive beliefs are specific to obsessive-compulsive disorder (OCD) using three different clinical groups including OCD, depression, and anxiety and a control group of university students. The participants of the study comprised three patient groups with OCD (n=53), major depressive disorder (MDD, n=67), anxiety disorders (AD, n=73), and a group of university students (n=477). The short version of the Obsessive Belief Questionnaire (OBQ-20) was used to measure obsessive beliefs. The Semi-Structured Clinical Interviews for DSM-IV-TR (SCID-I), the Obsessive-Compulsive Inventory- Revised Form, the Beck Depression Inventory, and the State-Trait Anxiety Inventory-Trait Form were used to assess the severity of the symptoms. The scores of the three patient groups were significantly higher on the OBQ-20 as compared to the university students. It is noteworthy that the OBQ-20 scores did not significantly differ between the three patient groups except on the 'importance of thought' (ICT) subscale showing significantly higher scores in the group with OCD in comparison to the patients with depression and anxiety disorders. The results suggest that obsessive beliefs may have a transdiagnostic mechanism with a possible role in the etiology and maintenance of a broad range of different psychopathologies, except in relation to the 'importance and control' of thoughts. Investigating the common processes underlying different psychopathologies is important for the etiological explanation and future treatment of the disorders.

Depression and anxiety in mothers of home ventilated children before and during COVID-19 pandemic.

BackgroundDue to advances in technology, home ventilation in children has increased in recent years. The provision of proper care for a home‐ventilated (HV) child can have a strong impact on the lifestyle of caregivers. The aim of this study was to evaluate the depression and anxiety levels of the mothers of HV children during the current COVID‐19 pandemic and compare them to those of mothers of healthy peers.MethodsThis cross‐sectional study was conducted on HV children (n = 21) and a control group of healthy peers (n = 32) by means of a questionnaire completed by the mothers of the children of both groups. Psychometric scales, such as the Beck Depression Inventory (BDI), the State‐Trait Anxiety Inventory‐State (STAI‐S), and the State‐Trait Anxiety Inventory‐Trait (STAI‐T), were used to assess participants.ResultsDuring the pandemic signs of depression were present in 8 (38.1%) of the case group and 8 (25%) of the healthy control group. Comparison of the BDI scores from before and during the pandemic showed no difference between mothers of the HV children (p = .09). Scores for BDI and STAI‐T were higher in the case group than in the control group, whereas there was no significant difference in STAI‐S scores.ConclusionDepression and anxiety levels of mothers of HV children were found to be higher during the COVID‐19 pandemic. Economic, medical, and social support resources are needed to reduce levels of depression and anxiety and help mothers of those children dependent on technology.

A randomized controlled trial of a smartphone-based application for the treatment of anxiety

Introduction: Generalized anxiety disorder (GAD) is prevalent among college students. Smartphone-based interventions may be a low-cost treatment method. Method: College students with self-reported GAD were randomized to receive smartphone-based guided self-help (n = 50), or no treatment (n = 50). Post-treatment and six-month follow-up outcomes included the Depression Anxiety Stress Scales-Short Form Stress Subscale (DASS Stress), the Penn State Worry Questionnaire (PSWQ-11), and the State-Trait Anxiety Inventory-Trait (STAI-T), as well as diagnostic status assessed by the GAD-Questionnaire, 4th edition. Results: From pre- to post-treatment, participants who received guided self-help (vs. no treatment) experienced significantly greater reductions on the DASS Stress (d = −0.408) and a greater probability of remission from GAD (d = −0.445). There was no significant between-group difference in change on the PSWQ-11 (d = −0.208) or STAI-T (d = −0.114). From post to six-month follow-up there was no significant loss of gains on DASS Stress scores (d = −0.141) and of those who had remitted, 78.6% remained remitted. Yet rates of remitted participants no longer differed significantly between conditions at follow-up (d = −0.229). Conclusion: Smartphone-based interventions may be efficacious in treating some aspects of GAD. Methods for improving symptom reduction and long-term outcome are discussed.

Decreased anxiety after catheter ablation for paroxysmal atrial fibrillation is associated with augmented parasympathetic reactivity to stress.

BackgroundPsychological improvement after catheter ablation for atrial fibrillation (AF) has been reported, but its mechanism is unclear.ObjectiveThis study aimed to clarify the relationship between cardiac autonomic modification and psychological changes after catheter ablation for paroxysmal AF (PAF).MethodsThirty-five consecutive patients (60.5 ± 11.9 years; male, n = 24) with PAF treated by catheter ablation were enrolled. Autonomic activity and reactivity to stress and psychological status were measured before (baseline) and at 1 and 3 months after ablation. We assessed autonomic activity and reactivity to stress by measuring heart rate variability (HRV) at rest (Rest), and during (Task) and after (After) the execution of a task and assessed relationships between HRV parameters and psychological changes using the State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS).ResultsThe STAI state and trait scores significantly decreased at 3 months compared with baseline, whereas SDS scores essentially remained unchanged. The high-frequency (HF) response index (Task/Rest) and HF recovery index (After/Rest) were significantly higher than baseline at 3 months (0.40 [0.29–0.90] vs 1.30 [0.64–2.18], P = .007 for HF response index; 1.13 [0.92–2.19] vs 1.87 [1.19–2.97], P = .049 for HF recovery index). Reductions in STAI scores positively correlated with increments in the HF recovery index in the entire cohort as well as in 5 patients with recurrent AF.ConclusionsSome augmentation of parasympathetic reactivity to stress correlated with reduced anxiety, implying that cardiac autonomic modification plays roles in psychological improvement after catheter ablation for AF.

Risk factors associated with developing anxiety in Inuit adolescents from Nunavik

This study aimed to examine the relation between anxiety among the at-risk population of Inuit adolescents and diverse developmental risk factors including exposure to environmental chemicals, a subject of concern in Nunavik. Anxiety was assessed in 89 Inuit participants (mean age = 18.4 years; range = 16.2–21.9) with the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the State-Trait Anxiety Inventory (STAI). Potential risk factors for anxiety were documented at birth, 11 years of age and 18 years of age, including blood levels of chemicals (mercury, lead, PCBs) and nutrients, as well as age, sex, estimated IQ, drug and alcohol use, bullying, exposure to domestic violence, food insecurity, crowding and socio-economic status. Results showed that participants scored high on both measures of anxiety, particularly the SCARED, for which the mean score was above the clinical threshold. Multiple regression results show that significant risk predictors obtained from the SCARED scores were female sex (β = 0.32), higher current blood mercury concentration (β = 0.26), food insecurity (β = 0.26) and bullying experiences in the last year (β = 0.21). The significant predictors for the STAI trait anxiety were food insecurity (β = 0.25) and lower estimated IQ (β = −0.31), whereas food insecurity (β = 0.21), lower blood levels of vitamin E (β = −0.25) and higher cord blood mercury concentrations (β = 0.25) were found for STAI situational anxiety. Further regression analyses suggested that the adolescent-related variables were the most important risk factors. Our findings show that Inuit adolescents are at risk for anxiety via multiple contributing factors, particularly current exposure to mercury, food insecurity and female sex.

4191 The Role of Suggestibility and Trait Anxiety in Young Adult Alcohol Use

OBJECTIVES/GOALS: The purpose of this study was to investigate how suggestibility and social susceptibility relate to alcohol use in young adult non-dependent alcohol users, and the role of trait anxiety in this relationship. We hypothesized that greater trait anxiety would be associated with higher levels of alcohol misuse, and this would be mediated by suggestibility. METHODS/STUDY POPULATION: Study participants enrolled in the NIAAA screening and assessment protocol completed questionnaires on suggestibility, anxiety, and alcohol use. The Multidimensional Iowa Suggestibility Scale (MISS) is a 95-question self-report assessment of suggestibility. Trait anxiety is assessed with the State Trait Anxiety Inventory-Trait (STAI-T). Alcohol measures included the Alcohol Use Disorder Identification Test (AUDIT). Structured Clinical Interviews for DSM-IV or DSM-5 disorders were conducted, and non-dependent participants (N = 113) were considered. A median split was conducted (median age = 35.1 years), with the focus of this study on the younger individuals (N = 55). RESULTS/ANTICIPATED RESULTS: Initial analyses showed that suggestibility, alcohol misuse, and trait anxiety all had significant positive correlations with one another. To better understand the relationship of peer influence, specifically, with drinking and anxiety, MISS subscale of Peer Conformity was analyzed. MISS total score and Peer Conformity were positively correlated with AUDIT Total as well as STAI-T Score. STAI-T Score was additionally positively correlated with AUDIT Total (all p2 = 0.222). We also looked at Peer Conformity in place of MISS Total (R2 = 0.213). In both models, only suggestibility measures were significant predictors of harmful alcohol use (p&lt;0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: In young social drinkers, there were significant positive associations between suggestibility, risky alcohol use, and trait anxiety. These results suggest that suggestibility may be a modifiable risk factor for risky alcohol consumption. Future directions include using mediation models to explore the associations between suggestibility, anxiety, and alcohol misuse.

Caring for a Child with Phenylketonuria: Parental Experiences from a Eurasian Country.

Phenylketonuria (PKU) and mild hyperphenylalaninemia (HPA) are characterized by increased blood phenylalanine concentrations varying from mild to severe. Management of PKU was reported to be time consuming and burdensome for caregivers. This study intended to explore the experiences of families caring for a child with PKU/HPA in a country with a high PKU rate. The aim of this study was to compare parental well-being between parents of children with and without dietary restrictions and to explore the factors associated with parental psychological well-being. Participants were interviewed about their experiences, concerns, and challenges related to the disease by using a semistructured questionnaire. After the interview, parents filled out the Beck Depression Inventory and State-Trait Anxiety Inventory-Trait. This study highlighted the adverse psychological, financial, and social effects of the diagnosis and management of the disease regarding the lives of the families of children with PKU/HPA. Although parental anxiety scores of children with and without dietary restrictions were similar, depressive symptom scores were higher in parents of children with dietary restrictions. However, in multiple regression analysis, lower household income and absence of perceived social support were found to be independent factors associated with higher depressive symptom scores. Having a daughter diagnosed with PKU/HPA and lower household income were found to be factors associated with higher anxiety scores. This study revealed that income level, perceived social support, and gender of the child were factors associated with psychological well-being of parents caring for children with PKU/HPA. Health care professionals should identify the challenges faced by families and should be aware of risk factors associated with lower parental well-being to achieve better family adjustment and better health outcomes.

The Relationship of Theory of Mind and Attachment Characteristics with Disease Severity in Social Anxiety Disorder.

The aim of our study is to compare the attachment characteristics and the theory of mind abilities measured by the Eyes Test between social anxiety disorder (SAD) patients and healthy controls. Another aim of our study is to investigate the relationship between attachment characteristics, theory of mind abilities and disease severity in patients with SAD. 47 consecutive patients with SAD and 50 healthy controls were recruited for the study. Sociodemographic data form, SCID-I Structured Clinical Interview form Patient Version, Beck Depression Inventory (BDI), Reading Mind in the Eyes Test (Eye Test), Liebowitz Social Anxiety Scale (LSAS), Experiences in Close Relationship Inventory (ECR) and State-Trait Anxiety Inventory (STAI) were administered to all participants. The BDI, LSAS anxiety and avoidence, ECR and anxiety and avoidance, STAI state and trait anxiety scores of the SAD group were higher than the controls, but the Eyes Test scores were lower. It was observed that the Eyes Test score difference between the two groups survived when controlled for BDI and STAI state and trait anxiety scores. In the SAD group, both ECR anxiety and avoidance scores were associated with LSAS anxiety and avoidance scores. Eyes Test scores were associated with LSAS anxiety and avoidance scores. In regression analysis, it was observed that the Eyes Test, ECR anxiety and avoidance scores effected both the LSAS anxiety and the LSAS avoidance scores. In SAD patients, the theory of mind functions was impaired when compared to healthy controls, and this difference has been found to be independent of anxiety or depression levels. Attachment anxiety and avoidance dimensions have negative effects on SAD disease severity. The fact that the theory of mind ability is inversely related with SAD severity suggests that interventions to improve social cognition might have a potential to decrease the severity of disease in SAD.

Effectiveness of mindfulness-based cognitive therapy in patients with anxiety disorders in secondary-care settings: A randomized controlled trial.

The primary objective of this study was to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) in secondary-care settings where the vast majority of the patients have already undergone pharmacotherapy but have not remitted. Eligible participants were aged between 20 and 75 years and met the criteria for panic disorder/agoraphobia or social anxiety disorder specified in the DSM-IV. They were randomly assigned to either the MBCT group (n = 20) or the wait-list control group (n = 20). The primary outcome was the difference in mean change scores between pre- and post-intervention assessments on the State-Trait Anxiety Inventory (STAI). The outcome was analyzed using an intent-to-treat approach and a mixed-effect model repeated measurement. We observed significant differences in mean change scores for the STAI State Anxiety subscale (difference, -10.1; 95% confidence interval, -16.9 to -3.2; P < 0.005) and STAI Trait Anxiety subscale (difference, -11.7; 95% confidence interval, -17.0 to -6.4; P < 0.001) between the MBCT and control groups. MBCT is effective in patients with anxiety disorders in secondary-care settings where the vast majority of patients are treatment-resistant to pharmacotherapy.

Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial.

This randomized, placebo-controlled, crossover, and double-blind trial aimed to examine the possible effects of four weeks L-theanine administration on stress-related symptoms and cognitive functions in healthy adults. Participants were 30 individuals (nine men and 21 women; age: 48.3 ± 11.9 years) who had no major psychiatric illness. L-theanine (200 mg/day) or placebo tablets were randomly and blindly assigned for four-week administration. For stress-related symptoms, Self-rating Depression Scale, State-Trait Anxiety Inventory-trait, and Pittsburgh Sleep Quality Index (PSQI) scores decreased after L-theanine administration (p = 0.019, 0.006, and 0.013, respectively). The PSQI subscale scores for sleep latency, sleep disturbance, and use of sleep medication reduced after L-theanine administration, compared to the placebo administration (all p < 0.05). For cognitive functions, verbal fluency and executive function scores improved after L-theanine administration (p = 0.001 and 0.031, respectively). Stratified analyses revealed that scores for verbal fluency (p = 0.002), especially letter fluency (p = 0.002), increased after L-theanine administration, compared to the placebo administration, in individuals who were sub-grouped into the lower half by the median split based on the mean pretreatment scores. Our findings suggest that L-theanine has the potential to promote mental health in the general population with stress-related ailments and cognitive impairments.