Subjective Measures Of Anxiety Research Articles

Low salivary cortisol levels among socially anxious young adults: Preliminary evidence from a selected and a non-selected sample

We investigated salivary cortisol levels among socially anxious adults in two separate non-clinical samples using different participant designs. Study 1 examined salivary cortisol, heart rate, and subjective measures of anxiety in response to a self-presentation task in undergraduate students meeting DSM-IV criteria for social phobia. Adults with social phobia displayed significantly lower salivary cortisol compared to their non-socially phobic counterparts, despite being more anxious. Study 2 examined the relation between trait shyness and salivary cortisol in a different sample of undergraduate students who were not selected for individual differences in personality. High trait shyness was related to low salivary cortisol. We speculate that relatively low levels of salivary cortisol in socially anxious people may reflect how the adrenocortical system responds to social stress, allowing socially anxious individuals to cope and adapt to their environment.

The Effect of Mindfulness Training on Mood and Measures of Fatigue, Activity, and Quality of Life in Patients with Chronic Fatigue Syndrome on a Hospital Waiting List: A Series of Exploratory Studies

Three exploratory studies evaluated group mindfulness training (which aims to facilitate non-judgmental attention to present moment experience through the practice of meditation) in patients waiting for cognitive behaviour therapy for Chronic Fatigue Syndrome (CFS). The approaches used were based on Mindfulness Based Stress Reduction, and Mindfulness Based Cognitive Therapy. The first group showed that such training is acceptable to patients and that it results in significantly improved subjective measures of anxiety, and improvements in subjective levels of fatigue that approached significance, when compared to waiting list controls. A second uncontrolled study replicated the findings of the first study and also demonstrated an improvement in quality of life as measured by the Fatigue Impact Scale (FIS). More wide-ranging effects were demonstrated in the final study in which significant improvements in subjective levels of fatigue, anxiety, depression, quality of life and physical functioning were observed following the training programme. These effects were sustained for 3 months. Overall, the findings of the three exploratory studies indicate that MBSR/MBCT has potential for the treatment of patients with CFS.

Cerebral blood flow during anticipation of public speaking in social phobia: a PET study

Background The aim was to examine the neural correlates of anxiety elicited by the anticipation of public speaking in individuals with social phobia. Methods Positron emission tomography and 15O-water was used to measure regional cerebral blood flow in subjects with DSM-IV defined social phobia during anxiety anticipation. Heart rate and subjective anxiety were also recorded. While being scanned, subjects were speaking alone either before or after speaking in public. To evaluate anticipatory anxiety we compared individuals speaking alone before they were speaking in front of an audience with those who did the reverse. Results Heart rate and subjective anxiety measures confirmed anticipatory anxiety in social phobics who performed their private speech before their public. This was accompanied by enhanced cerebral blood flow in the right dorsolateral prefrontal cortex, left inferior temporal cortex, and in the left amygdaloid-hippocampal region. Brain blood flow was lower in the left temporal pole and bilaterally in the cerebellum in the anticipation group. Conclusions Brain regions with altered perfusion presumably reflect changes in neural activity associated with worry about anticipated public performance. We speculate that anticipatory anxiety in social phobics originates in an affect sensitive fear network encompassing the amygdaloid-hippocampal region, prefrontal, and temporal areas.

Agoraphobic avoidance and panic frequency as predictors of laboratory induced panic reactions

This study examined the importance of agoraphobic avoidance and frequency of panic as predictors of psychological and physiological responses of panic sufferers to a laboratory based provocation procedure. Psychophysiologic comparisons were made between 22 panic disorder patients and 15 controls, at baseline and across three periods of carbon dioxide gas inhalations (1, 3, 5%; balance oxygen). Subjective measures of anxiety, frightening cognitions and body sensations were obtained across the phases. Physiological measures of minute ventilation, breathing rate, tidal volume, end tidal CO 2 and heart rate were also obtained. Between group comparisons revealed significant differences between the groups on the subjective measures with no significant differences occurring on the physiological measures. Within group analyses revealed that pre-session questionnaire measures of agoraphobia avoidance and panic frequency predicted the degree of anxiety, frightening sensations and cognitions during baseline and 5% CO 2 inhalation. The results indicated that both self-reported agoraphobic avoidance and panic frequency are strong clinical predictors of psychological reactions of panic sufferers during laboratory provocation.

Patterns of psychophysiological change in the treatment of agoraphobia

Patterns of change and synchrony were studied in a group of 26 agoraphobics under-going a 12-week treatment program. Clinical, behavioral, physiological and subjective measures were taken at pre-, 4, 8 and 12 weeks of treatment and at 1-month follow-up. Clinically and statistically significant changes were found in all response systems and our results tentatively suggest that the order of change starts with behavioral and clinical measures followed by psychophysiological measures of which psysiological responsivity has the longest lag. Although the group as a whole changed synchronously, there was evidence of individual desynchrony between physiological and subjective measures of anxiety. The most common form this look was for SUDS to decline while heart rate increased. A closer look at desynchrony in the various time sequences revealed that both the form and occurrence of desynchrony vary according to phase of treatment and that time interval between assessment points might-be of crucial importance in the determination of synchrony-desynchrony.

Physiological and subjective measures of anxiety during flooding

Patterns of physiological arousal and subjective reports of anxiety were examined during individual sessions of imaginal flooding of five phobic subjects. A curvilinear pattern of increased, followed by decreased, arousal characterized changes in heart rate, respiration rate and subjective anxiety. Heart rate tended to reach its peak level before respiration rate and subjective anxiety. Intercorrelations between these measures were generally positive and significant. Comparisons between periods of high and low subjective arousal revealed a significantly greater correlation for low than for high arousal only for the subjective anxiety by respiration-rate correlation.

Habituation during exposure treatment: Distraction vs attention-focusing

To investigate the effects of distraction and attention-focusing during in-vivo exposure to feared stimuli, the responses of 16 obsessive-compulsives with washing rituals were studied. A cross-over design was employed in which 6 of the subjects underwent exposure with attention focusing on the first day followed by exposure with distraction on the second day. The remaining subjects received the reverse order. Habituation of both heart rate and subjective anxiety was observed under both conditions, the rate of habituation tending to remain constant throughout the 90-min exposure. Greater between-session habituation and greater synchrony between the psychophysiological and the subjective measures of anxiety was observed when attention-focusing preceded distraction. Since habituation and synchrony have previously been found to be positively related to treatment outcome, the present results suggest that treatment by exposure to feared stimuli may be more effective if attention-focusing is promoted.

Cognitive restructuring treatment: A controlled trial with anxious patients

Cognitive restructuring, modified systematic desensitization and a combined treatment (cognitive behaviour modification) were compared with a no-treatment control group, using a simple randomized design. Twenty seven general anxiety out-patients selected from the hospital waiting list were used as subjects. Assessments were made at the beginning and end of treatment, and at follow-up 1 month later. The assessments included two subjective anxiety measures, the Zung self-rating anxiety scale and fear thermometer scores, a behavioural anxiety measure, a measure of cognitive anxiety as estimated by a diary recording of thinking time, fear survey schedule scores and I/E scores. Cognitive behaviour modification was found to be a superior form of treatment, relative to the no-treatment control and the other active treatment groups as assessed by FSS intensity score. The cognitive behaviour modification group showed greater improvement than the cognitive restructuring group on the diary anxiety scores. The results also demonstrated a relationship between outcome and initial severity of condition. The higher the subjects' initial scores on neurotic symptoms and subjective anxiety level, the greater the degree of positive change after treatment. Moreover, subjects with high levels of internal control prior to treatment responded most to therapy.