Trait Anxiety Inventory Research Articles

Study protocol for improving mental health during pregnancy: a randomized controlled low-intensity m-health intervention by midwives at primary care centers

BackgroundPregnancy-related anxiety and depression has received considerable attention worldwide. Mental health problems in pregnant women already since early weeks of gestation may have important consequences to the fetus. The necessity for more effective health care pathways, including some early interventions that reduce the overall burden of the childbearing situation appears a key factor for a successful birth and care of the baby. The few studies focalized in interventions, are focused on delivery and postpartum, without taking into account the whole maternity process. Current literature recommends the use of interventions based on new technologies for the treatment of mood disorders, already during the prenatal period. There have been scarce well-designed intervention studies that test technological low-intensity interventions by midwives to address pregnant women’s mental health, diminishing anxiety and depression during pregnancy.Methods/designAdult pregnant women (weeks 12–14 of gestation) will be recruited and screened from different primary care centers in Catalonia, Spain. Women who pass the initial mental screening will be randomly allocated to the relaxation virtual reality intervention or control group. The intervention aims to improve mental state of pregnant women during pregnancy, work through breathing, mindfulness and muscle relaxation techniques. Women in the control group will receive standard care offered by the public funded maternity services in Catalonia. The primary outcome measures will include the Edinburg Postnatal Depression (EPDS), State Trait Anxiety Inventory (STAI), Symptom Checklist-90 (SCL-90), and the Cambridge Worry Scale (CWS) instruments. Secondary outcome measures will include the Temperament and Character Inventory-Revised (TCI-R) and the Whooley and Generalized Anxiety Disorder-2 (GAD-2) questions. Routinary pregnancy monitoring measures will be also evaluated.DiscussionThis study aims to test the efficacy of a low-intensity, midwife-led e-health intervention based on new technologies to work on women’s anxiety and depression during pregnancy. We hypothesize that low-intensity mental health intervention during pregnancy, using an e-health (virtual reality) as a support tool, will be effective in reducing of anxiety, depressive symptoms, and improving satisfaction with pregnancy follow-up.Trial registrationClinical Trials ID NCT05756205.

SPECIAL ISSUE: Differentiating Successful from Less Successful Males and Females in a Group Relaxation/Biofeedback Stress Management Program

Managing stress in the post-COVID world requires a program that can efficaciously and cost-effectively address a large number of people who have differing experiences and needs and can also be adapted for internet presentation. The purpose of this paper is to share observations, collected over more than forty years, of group stress management training in university and community settings. The specific data reported are from a subgroup that is representative of the other groups. An in-person group stress-management program of 141 adults in community clinics with approximately 15 to 20 per group attended 10 training sessions across 5 weeks with pre-post personality measures. The group also documented 5 weeks of home practice, symptoms, and medication use. The average group improvement in well-being was 80%, following training in breathing, progressive muscle relaxation, autogenic training, visualization, quieting response, and alphagenics, with individual temperature biofeedback having been provided during the last 5 classes. A pre- to post-two-way analysis of variance (ANOVA) revealed that the Spielberger State-Trait Anxiety Inventory (STAI) trait anxiety and Eysenck Personality Inventory (EPI) neuroticism significantly decreased. EPI extraversion increased only in females. Males and females equally preferred autogenic training (55%). The most successful males and females were older, practiced more, reported greater increases in self-confidence, and attributed more of their success to the group and/or instructor. The success of a program may also be associated with excellent home practice compliance, being a part of a group, and increases in self-confidence/efficacy.

Inulin-type fructans and 2’fucosyllactose alter both microbial composition and appear to alleviate stress-induced mood state in a working population compared to placebo (maltodextrin): the EFFICAD Trial, a randomized, controlled trial

BackgroundThere is increasing interest in the bidirectional relationship existing between the gut and brain and the effects of both oligofructose and 2’fucosyllactose to alter microbial composition and mood state. Yet, much remains unknown about the ability of oligofructose and 2’fucosyllactose to improve mood state via targeted manipulation of the gut microbiota. ObjectivesWe aimed to compare the effects of oligofructose and 2’fucosyllactose alone and in combination against maltodextrin (comparator) on microbial composition and mood state in a working population. MethodsWe conducted a 5-wk, 4-arm, parallel, double-blind, randomized, placebo-controlled trial in 92 healthy adults with mild-to-moderate levels of anxiety and depression. Subjects were randomized to oligofructose 8 g/d (plus 2 g/d maltodextrin); maltodextrin 10 g/d; oligofructose 8 g/d plus 2’fucosyllactose (2 g/d) or 2’fucosyllactose 2 g/d (plus 8 g/d maltodextrin). Changes in microbial load (fluorescence in situ hybridization-flow cytometry) and composition (16S ribosomal RNA sequencing) were the primary outcomes. Secondary outcomes included gastrointestinal sensations, bowel habits, and mood state parameters. ResultsThere were significant increases in several bacterial taxa including Bifidobacterium, Bacteroides, Roseburia, and Faecalibacterium prausnitzii in both the oligofructose and oligofructose/2’fucosyllactose interventions (all P ≤ 0.05). Changes in bacterial taxa were highly heterogenous upon 2’fuscoyllactose supplementation. Significant improvements in Beck Depression Inventory, State Trait Anxiety Inventory Y1 and Y2, and Positive and Negative Affect Schedule scores and cortisol awakening response were detected across oligofructose, 2’fucosyllactose, and oligofructose/2’fucosyllactose combination interventions (all P ≤ 0.05). Both sole oligofructose and oligofructose/2’fuscosyllactose combination interventions outperformed both sole 2’fucosyllactose and maltodextrin in improvements in several mood state parameters (all P ≤ 0.05). ConclusionThe results of this study indicate that oligofructose and combination of oligofructose/2’fucosyllactose can beneficially alter microbial composition along with improving mood state parameters. Future work is needed to understand key microbial differences separating individual responses to 2’fucosyllactose supplementation.This trial was registered at clinicaltrials.gov as NCT05212545.

The impact of floatation therapy on body image and anxiety in anorexia nervosa: a randomised clinical efficacy trial

Body image disturbance and anxiety are core features of anorexia nervosa (AN), a psychiatric disorder with one of the highest mortality rates. This study examined the efficacy of a novel non-pharmacological treatment, floatation-REST (Reduced Environmental Stimulation Therapy) on body image disturbance and anxiety in inpatients with AN. This parallel group randomised controlled trial compared floatation-REST vs. care as usual in women and girls hospitalised for treatment of AN in Tulsa, Oklahoma, USA. Participants were randomised on a 2:1 ratio to receive eight, twice-weekly, 60-min floatation-REST sessions for 4 weeks, in addition to care as usual, or to receive care as usual. The primary outcome was the average change in body dissatisfaction from pre- to post-float as measured by the Photographic FigureRating Scale. The secondary outcome was the average change in anxiety from pre- to post-float as measured by the state version of the State Trait Anxiety Inventory. Longitudinal effects of floatation-REST on body dissatisfaction were also examined. All analyses were conducted using the intention-to-treat principle. Planned linear mixed models tested the effect of floatation-REST vs. care as usual. The trial was preregistered (clinicaltrials.govNCT03610451). Between March 16, 2018 and February 25, 2021, 133 participants were screened for eligibility, and 86 were consented. Eighteen were excluded after consent, for a final randomisation sample of 68 participants (45 floatation-REST; 23 care as usual). There were two session by condition interactions on body dissatisfaction (p=0.00026) and state anxiety (p<0.0001), such that the floatation-REST group exhibited acute (i.e., pre- to post-session) reductions in body dissatisfaction (floatation-REST group mean change (Δm)=-0.43; 95% CI-0.56 to-0.30, p<0.0001, Cohen's d=0.23), and acute reductions in anxiety (floatation-REST group Δm=-15.75; 95% CI-17.95 to-13.56, p<0.0001, Cohen's d=1.52); however, the care as usual group exhibited no significant changes. With regard to longitudinal results, there was a significant time by treatment interaction between baseline and immediately post intervention (p=0.012) and baseline and six-month follow up (p=0.0019). At immediately post intervention, there was a trending reduction in body dissatisfaction for the floatation-REST group (Δm=-0.41, 95% CI-0.86 to 0.03, p=0.068) and care as usual group (Δm=0.61; 95% CI-0.04 to 1.27, p=0.070). At six-months post-intervention, the floatation-REST group exhibited lower body dissatisfaction (Δm=-0.91; 95% CI-1.37 to-0.45, p=0.0020, Cohen's d=0.53) whereas the care as usual group reported no change in body dissatisfaction (Δm=0.35; 95% CI-0.28 to 0.98, p=0.96) relative to baseline. There were no adverse events related to the trial during the study. Our findings suggest that Floatation-REST decreased body dissatisfaction compared to care as usual acutely after each float session and at six-month follow-up. Floatation-REST has potential utility for the treatment of body image disturbance and anxiety in AN. These results may be limited by some generalisability concerns given the recruitment of a modest sample receiving inpatient treatment at a single site. The William K. Warren Foundation.

Nasal obstruction in adults: how it affects psychological status?

This study investigated the psychological status of patients with unilateral or bilateral complete nasal obstruction. The study included 49 consecutive cases of unilateral or bilateral complete nasal obstruction. In order to assess participants' personality traits, both groups completed the Personality Belief Questionnaire, State-Trait Anxiety Inventory form, Beck Depression Inventory and Beck Anxiety Inventory. The groups were similar in terms of demographic characteristics. Patients with unilateral or bilateral complete nasal obstruction had higher scores on all the psychological assessments compared with the healthy controls, except for the Beck Anxiety Inventory. Although all personality assessment scores were higher in patients, the only differences that were statistically significant were in the dependent, antisocial and avoidant personality trait scores. The psychological conditions of patients with structural deformities that cause nasal obstruction may be affected, and appropriate treatment should be provided to improve their symptoms and quality of life.

Effect of Cardiac Rehabilitation on the Psychological Changes in Post Myocardial Infarction Patients

Abstract Objectives To assess the effect of cardiac rehabilitation on the psychological changes in post myocardial infarction (MI) patients. Background Cardiac rehabilitation (CR) is a acceptable treatment strategy adding to the basic medical plan for the patients with coronary artery disease. Subjects and methods A prospective study that was conducted on 60 myocardial infarction patients and they were subdivided into 2 groups; group 1 included 30 myocardial infarction patients who underwent cardiac rehablitation and group 2: included 30 myocardial infarction patients who didn’t undergo cardiac rehablitation. All the included subjects underwent full history taking, full examination and echocradiography and psychological evaluation tests (state–trait anxiety inventory (STAI), Beck depression inventory (BDI) and hospital anxiety and depression scale (HADS)), before and after cardiac rehablitation. Results Comparison between the 2 groups regarding cardiac changes on follows up, there was significant difference between 2 groups regarding Left ventricular end diastolic diameter (LVEDD), Left ventricular end systolic diameter (LVESD) and ejection fraction (EF) (P-value = 0.0001, 0.0082 &amp; 0.0261). Comparison between the 2 groups regarding psychiatric changes on follows up revealed that there was significant difference as regard STAI, BDI and HADS (P-value = 0.0001, 0.0.0001 &amp; 0.0001). Conclusion Cardiac rehabilitation in post-MI patients could have beneficial effects on cardiac function without adversely affecting LV remodeling or causing serious cardiac complications. Participating in a cardiac rehablitation beneficially contributed to a decrease in depression and anxiety manifestations in post-MI patients. Abbreviations A-state: State-anxiety A-trait, Trait-anxiety; BDI: Beck depression inventory; BP: Blood pressure; CAD: Coronary artery disease; HADS: Hospital Anxiety and Depression Scale; HF: Heart failure; LVEF: Left ventricular ejection fraction; MI: Myocardial infarction; STAI: State–trait anxiety inventory

Daytime impulsiveness, attention, and learning in the restless legs syndrome.

Restless legs syndrome (RLS) is a sensorimotor condition characterized by disturbing sensations and the desire to move, often localized in the legs. Cognitive changes and impulsivity can be present in RLS, although the potential effect of commonly co-occurring attention-deficit/hyperactivity disorders (ADHD) or dopamine agonist (DA) use on these are unclear. Twenty-three RLS patients and 22 healthy controls were included. Rey Auditory Verbal Learning Test (RAVLT), Continuous Performance Test (CPT), Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), State and Trait Anxiety Inventory (STAI), and Adult Attention Deficit Self-Evaluation Scale (ASRS) were administered. Performance was compared between RLS patients and controls accounting for the presence of attention-deficit/hyperactivity disorder (ADHD) and DA use. Age, education, BDI, ESS, STAI, and ASRS scores were similar for control and RLS groups. Control and RLS groups performed similarly on auditory verbal learning and general attention tests. In the CPT, commission error was significantly higher and response time was significantly shorter in the RLS group compared to controls (p = .014 and p = .010, respectively). These significant differences persisted after adjusting for ADHD and DA usage. In this study, RLS patients were more impulsive than the healthy individuals independent of ADHD and DA use. However, learning and attention performances of the patients are not affected.

Anxiety Levels Among Emergency Unit Turkey Nurses During the Covid-19 Pandemic

The aim of the present study was to assess the anxiety level of nurses working in the emergency room during the COVID-19 pandemic. Nurses working at a hospital's emergency department between October 2, 2022, and November 15, 2022, participated in this descriptive study. Permission was obtained from the ethics committee, the institution, and the nurses prior to the study. The study's results were gathered using a face-to-face interview technique using a questionnaire—the State and Trait Anxiety Inventory. The data was analysed using the Shapiro-Wilk, Mann-Whitney U, and the Kruskal Wallis tests. According to the findings, the majority of the nurses were between the ages of 26 and 34, undergraduates, and female. The mean scores of the State and Trait Anxiety Inventory of the nurses were found to be 46.0±9.6-47.1±9.2, respectively. It was determined that gender, age, education level, number of people living together, chronic illness, working conditions and increased workload increased the state-continuity anxiety score. It was also determined that there was a significant relationship between working order, alcohol use, exposure to violence and the State-Trait anxiety score. It was concluded that nurses had moderate anxiety. It was determined that working conditions, prolonged working hours, and lack of personnel increased this level of anxiety. It is advised to assess emergency room nurses' anxiety levels, identify the variables that exacerbate anxiety, and take the required precautions.

Time to initiation of symptomatic treatment in untreated Parkinson disease in the Parkinson progression marker initiative cohort: A 10-year follow up

BackgroundInitiation of symptomatic therapy in Parkinson disease is a disease progression milestone, and its prediction is important. Previous studies were limited in duration and number of variables included in their predictive models. ObjectivesTo identify predictors of time to initiation of symptomatic therapy in patients with PD not on treatment, using a large pool of candidate variables from the Parkinson's Progression Markers Initiative dataset, analyzed at ten years. MethodsKaplan Meier survival curve was used to estimate time to initiation of symptomatic treatment. Potential predictors included 33 baseline clinical, imaging, biofluid, and genetic biomarkers. Univariate Cox regression was used for variable selection, significant predictors subsequently entering a multivariate Cox proportional hazard model, which was further reduced using the Akaike Information Criterion into a final reduced model. ResultsOf 425 participants with Parkinson's Disease, 406 initiated symptomatic therapy at last follow up. The outcome was censored for 4.5% of the sample. The risk of initiating symptomatic therapy was 65% (95%CI 60–70%) within the first year from enrollment. Predictors included dopamine transporter SPECT, the Movement Disorders Society Unified Parkinson Disease Rating Scale, and anxiety (State Trait Anxiety Inventory). ConclusionsBaseline dopamine transporter SPECT specific binding ratio was found to be the most impactful predictor for time to initiation of symptomatic therapy in this 10-year follow up analysis of the Progressive Parkinson Markers Initiative cohort, when treatment status was known for 95.5% of the sample.

A Pilot Study of Family-Integrated Care (FICare) in Critically Ill Preterm and Term Infants in the NICU: FICare Plus.

Family-integrated care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of an augmented FICare program, FICare Plus, in critically ill infants in the first few weeks of life. Resources were specifically developed for staff and parents to support earlier parental engagement in infant care. Infant health outcomes and standardized measures of parental stress, anxiety and parenting self-efficacy were also collected using standardized questionnaires: State -Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS: NICU), Perceived Parenting Self-Efficacy Tool and Family Centered Care Survey. The t-test or Wilcoxon rank-sum test were used to compare continuous variables, while the Chi-square or Fisher exact test were used for categorical variables, respectively. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in standard care (SC) and 24 in the FICare Plus group. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infants with no increase in adverse events and no increase in parental stress. Parents in the FICare Plus cohort felt confident to participate in their infant's care. The staff also found this model of care acceptable and well adopted. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrollment (87 (67-94) vs. 70.5 (66-86); p-value 0.22). However, the scores prior to discharge were lower in FICare Plus group (78 (71-90) vs. 63 (52-74.5); p-value 0.02). This pilot study showed that it is feasible and safe to implement family-integrated care in critically ill infants.

Can esophageal symptoms be associated with sleep disorders in esophageal rare diseases?. A prospective case-control study across achalasia, eosinophilic esophagitis and gastroesophageal reflux disease.

The association between sleep disorders and gastroesophageal reflux disease (GERD) has been the subject of several studies; however, quality of sleep has been under investigated in adult patients with eosinophilic esophagitis (EoE) and achalasia (Ach). This study aims to evaluate the prevalence of sleep disturbances in patients with EoE and Ach compared to GERD patients and their associations with esophageal symptoms. Thirty Ach patients and 20 EoE patients were consecutively enrolled and compared to a control group of 46 GERD patients. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (from 0 to 6) of esophageal symptoms, Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality, a SF-36 survey to investigate health-related quality of life (both physical (PCS) and mental (MCS) component scales), Beck Depression Inventory-II (BDI-II) and State Trait Anxiety Inventory (STAI) to assess the presence of depression and anxiety. The prevalence of sleep disturbances was 66.7% in Ach, 50% in EoE, and 60% in GERD patients (P=0.5). PCS and MCS significantly correlated with depression and anxiety levels. Ach patients showed significantly higher intensity-frequency scores of dysphagia for solids (Scheffè P<0.001) and liquids (Scheffè P<0.001) than EoE and GERD patients. No differences were found in the intensity-frequency scores of the esophageal symptoms among the three groups. There was a significant association between worst quality of sleep and higher intensity-frequency scores of regurgitation. Sleep disturbances are common with Ach and EoE, similar to GERD patients. Moreover, there is a significant association between regurgitation, a typical GERD symptom, and poor quality of sleep, independent from diagnosis.

Efficacy and safety of Lacticaseibacillus paracasei Lpc-37® in students facing examination stress: A randomized, triple-blind, placebo-controlled clinical trial (the ChillEx study)

Lacticaseibacillus paracasei Lpc-37 (Lpc-37) has previously shown to reduce perceived stress in healthy adults. The ChillEx study investigated whether Lpc-37 reduces stress in a model of chronic examination stress in healthy students. One hundred ninety university students (18–40 y) were randomized to take 1.56 × 1010 colony-forming units of Lpc-37 or placebo (1:1) each day for 10 weeks, in a triple-blind, parallel, multicenter clinical trial consisting of six visits: two screening visits, a baseline visit, and visits at 4, 8, and 10 weeks after baseline. The primary objective was to demonstrate that Lpc-37 reduces stress, as measured by the change in state anxiety from baseline to just before the first examination, after 8 weeks using the State Trait Anxiety Inventory (STAI-state). Secondary objectives aimed to demonstrate that Lpc-37 modulates psychological stress-induced symptoms and biomarkers related to mood and sleep. An exploratory analysis of fecal microbiota composition was also conducted. There was no difference between Lpc-37 and placebo groups in the change of STAI-state score (estimate 1.03; 95% confidence interval [CI]: -1.62, 3.67; p = 0.446). None of the secondary outcomes resulted in significant results when corrected for multiplicity, but exploratory results were notable. Results showed an improvement in sleep-disturbance scores (odds ratio 0.30; 95% CI: 0.11, 0.82; p = 0.020) and reduction in duration of sleep (odds ratio 3.52; 95% CI: 1.46, 8.54; p = 0.005) on the Pittsburgh Sleep Quality Index questionnaire after 8 weeks in the Lpc-37 group compared to placebo. A reduction in Bond Lader VAS-alertness was also demonstrated in the Lpc-37 group compared to placebo (estimate −3.97; 95% CI: -7.78, −0.15; p = 0.042) just prior to the examination. Analysis of fecal microbiota found no differences between study groups for alpha and beta diversity or microbiota abundance. Adverse events were similar between groups. Vital signs, safety-related laboratory measures, and gastrointestinal parameters were stable during the trial. In conclusion, probiotic Lpc-37 was safe but had no effect on stress, mood, or anxiety in healthy university students in this model of chronic academic stress. ClinicalTrials.gov: NCT04125810.

Pengaruh Kombinasi Aromaterapi Mawar dan Hipnoterapi terhadap Kecemasan Ibu Hamil saat Pemeriksaan Triple Eliminasi di UPTD Puskesmas Kuta II

Introduction: Pregnancy is a physiological process that almost every woman goes through. Pregnant women must have their pregnancies checked on a regular basis and receive integrated antenatal care. A laboratory examination, one of them is a triple elimination examination, as one of the minimum integrated antenatal service standards. Blood is drawn during the examination, which often causes anxiety in patients. Rose aromatherapy and hypnotherapy are non-pharmacological methods that can help patients relax and reduce anxiety. This study aimed at determining the effect of combining between rose aromatherapy and hypnotherapy on anxiety of pregnant women during triple elimination examination. Methods: This study was carried out at the UPTD. Kuta II Public Health Centre in November - December 2022, employing a pre-experimental research design with a one-group pretest-posttest design. Non-probability sampling was used, along with accidental sampling. The STAI (State Trait Anxiety Inventory) sheet was used to assess anxiety, and the Wilcoxon Sign Rank Test was used to analyze the data. Result: According to the study’s findings of 28 pregnant women, the average anxiety level before the intervention was 54.04, while the average anxiety level after the intervention was 26.50. Anxiety level analysis with Wilcoxon yielded a p-value (p-value = 0.000, α = 0.05), so H0 was rejected and Ha was accepted, indicating that there was an effect of combining between rose aromatherapy and hypnotherapy on anxiety of pregnant women during triple elimination examination at UPTD. Kuta II Public Health Centre. Suggestion: According to the findings of this study, the administration of a combination between rose aromatherapy and hypnotherapy can be used as a consideration in providing midwifery care to pregnant women, particularly those who will undergo blood tests.&#x0D; &#x0D; Keywords: aromatherapy, hypnotherapy, pregnant women, anxiety

Role of antenatal anxiety in the relationship between maternal exposure to nitrogen dioxide and small for gestational age: A birth cohort study

BackgroundBoth Nitrogen dioxide (NO2) exposure and antenatal anxiety have individually been associated with small for gestational age (SGA). Little is known, however, about whether there is effect modification of antenatal anxiety on NO2-related SGA. MethodsThe prospective birth cohort study included 1823 mother-newborn pairs in Guangzhou, China, from January 2017 to April 2020. Exposure to NO2 during the pre-conceptional and prenatal periods was estimated using an inverse distance weighted method. Antenatal anxiety was assessed by Trait Anxiety Inventory. SGA was determined by the Chinese gestational age- and sex-specific birthweight standards. Cox proportional hazards regression models was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for SGA as per 10 μg/m3 increase in NO2. Modifying effects of trait anxiety on NO2-related SGA were identified by stratified analyses, and three-dimensional response surface plots and two-dimensional heat maps. ResultsEach 10 μg/m3 increase in NO2 exposure during the third trimester was significantly associated with SGA risk among overall participants (HR = 1.221, 95 % CI: 1.014–1.471) and primipara (HR = 1.271, 95 % CI: 1.023–1.579). We found significant effect modification of anxiety level for NO2-related SGA in the third trimester (Pinteraction < 0.05). Pregnant women with higher levels of trait anxiety were more likely to deliver SGA newborns, particularly for those with high trait anxiety (HR = 1.781, 95 % CI: 1.007–2.945). Primiparous women were more susceptible. ConclusionsThis study provides evidence that antenatal trait anxiety may modify the effects of maternal NO2 exposure on SGA risk. The third trimester could be a critical window of susceptibility.

Investigating the association factors of acute postpartum pain: a cohort study

BackgroundLabor pain intensity is known to predict persistent postpartum pain, whereas acute postpartum pain may interfere with maternal postpartum physical, mental, and emotional well-being. Nevertheless, there is little research studying the association between labor pain intensity and acute postpartum pain. This study investigated the associations between labor pain intensity and psychological factors with acute postpartum pain.MethodsWe included women with American Society of Anesthesiologists (ASA) physical status II, having ≥ 36 gestational weeks and a singleton pregnancy. We investigated the association between labor pain intensity (primary exposure) and high acute postpartum pain at 0 to 24 h after delivery (Numeric Rating Scale (NRS) ≥ 3 of 10; primary outcome). Pre-delivery questionnaires including Angle Labor Pain Questionnaire (A-LPQ), Pain Catastrophizing Scale (PCS), Fear Avoidance Components Scale (FACS) and State Trait Anxiety Inventory (STAI) were administered. Demographic, pain, obstetric and neonatal characteristics were also collected accordingly.ResultsOf the 880 women studied, 121 (13.8%) had high acute postpartum pain at 0 to 24 h after delivery. A-LPQ total, PCS, FACS and STAI scores were not significantly associated with acute postpartum pain. Greater A-LPQ subscale on birthing pain (adjusted odds ratio (aOR) 1.03, 95% CI 1.01–1.05, p = 0.0008), increased blood loss during delivery (for every 10ml change; aOR 1.01, 95% CI 1.00–1.03, p = 0.0148), presence of shoulder dystocia (aOR 10.06, 95% CI 2.28–44.36, p = 0.0023), and use of pethidine for labor analgesia (aOR 1.74, 95% CI 1.07–2.84, p = 0.0271) were independently associated with high acute postpartum pain. “Sometimes” having nausea during menstruation before current pregnancy (aOR 0.34, 95% CI 0.16–0.72, p = 0.0045) was found to be independently associated with reduced risk of high acute postpartum pain.ConclusionsPre-delivery pain factor together with obstetric complications (shoulder dystocia, blood loss during delivery) were independently associated with high acute postpartum pain.Trial registrationThis study was registered on clinicaltrials.gov registry (NCT03167905) on 30/05/2017.

Psychometric Properties of the Polish Version of the Sports Anxiety Scale-2 (SAS-2).

The main aim of the study was to assess the psychometric properties of the Polish version of the Sports Anxiety scale-2 (SAS-2). The study covered 396 athletes, ages ranging from 18 years to 35 years. The task and ego orientation in sport questionnaire (TEOSQ) and State and Trait Anxiety Inventory (STAI) were used for validation of the scale. Cronbach's alpha for the somatic anxiety subscale was 0.88, for the worry subscale was 0.95, and for the concentration disruption was 0.86, respectively. The three-factor model and hierarchical model fits perfectly as CFI > 0.95, TLI > 0.95, and RMSEA < 0.08. Satisfactory results in measurement invariance show the use of the tool for any gender or athlete (high-performance, recreational) group. The internal consistency (α = 0.86-0.95) and the test-retest reliability (ICC = 0.87-0.90) were satisfactory. There was a statistically significant negative correlation between task orientation and total anxiety along with its three subscales, and a weak positive correlation between ego orientation and worry subscale. Meanwhile, a weak to moderate positive correlation was exhibited between total anxiety and its subscales with the STAI-T and STAI-S. Additionally, female, recreational, and female recreational athletes' groups had weak negative associations between worry and concentration disruption trait anxiety and task orientation, and a weak positive association between somatic anxiety and ego orientation.

Depression diagnosis based on electroencephalography power ratios.

Depression is a common mental disorder that impacts millions of people across the world. However, its diagnosis is difficult due to the dependence on subjective testing. Although quantitative electroencephalography (EEG) has been investigated as a promising diagnostic tool for depression, the associated results have proven contradictory. The current study determines whether the alpha/beta (ABR), alpha/theta (ATR), and theta/beta (TBR) ratios can serve as biological markers of depression. We used open-access EEG data from OpenNeuro to investigate power ratios in the resting state of 46 patients with depression and 75 healthy controls. Spectral data were extracted by fast Fourier transform at the theta band (4-8Hz), alpha band (8-13Hz), and beta band (13-32Hz). Neural network, logistic regression, and receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracies of each suggested index. Additionally, the cutoff point, sensitivity, specificity, positive predictive value, and negative predictive value at the maximized Youden index were compared for each variable. Decreased anterior frontal, frontal, central, parietal, occipital, and temporal ABR and decreased central and parietal TBR were observed in the depression group. The area under the curve of the ROC curves further revealed that these ratios could all effectively differentiate depression. In particular, the central, frontal, and parietal ABR exhibited high discrimination scores. Multiple logistic regression analysis demonstrated that the Beck Depression Inventory and Spielberger Trait Anxiety Inventory scores, as well as the probability of depression, increased with a decrease in the central ABR. Moreover, neural network analysis revealed that the global ABR was the most effective index for diagnosing depression among the three global EEG power ratios. The central, frontal, and parietal ABR represent potential biomarkers to differentiate patients with depression from healthy controls.

Hormone sensitivity predicts the beneficial effects of transdermal estradiol on reward-seeking behaviors in perimenopausal women: A randomized controlled trial

Depression is highly prevalent during the menopause transition (perimenopause), and often presents with anxious and anhedonic features. This increased vulnerability for mood symptoms is likely driven in part by the dramatic hormonal changes that are characteristic of the menopause transition, as prior research has linked fluctuations in estradiol (E2) to emergence of depressed mood in at risk perimenopausal women. Transdermal estradiol (TE2) has been shown to reduce the severity of depression in clinically symptomatic women, particularly in those with recent stressful life events. This research extends prior work by examining the relation between E2 and reward seeking behaviors, a precise behavioral indicator of depression. Specifically, the current study utilizes a randomized, double blind, placebo-controlled design to investigate whether mood sensitivity to E2 flux (“hormone sensitivity”) predicts the beneficial effects of TE2 interventions on reward seeking behaviors in perimenopausal women, and whether recent stressful life events moderate any observed associations. MethodParticipants were 66 women who met standardized criteria for being early or late perimenopausal based on bleeding patterns. Participants were recruited from a community sample; therefore, mood symptoms varied across the continuum and the majority of participants did not meet diagnostic criteria for a depressive or anxiety disorder at the time of enrollment. Hormone sensitivity was quantified over an 8-week baseline period, using within-subjects correlations between repeated weekly measures of E2 serum concentrations and weekly anxiety (State Trait Anxiety Inventory) and anhedonia ratings (Snaith-Hamilton Pleasure Scale). Women were then randomized to receive 8 weeks of TE2 (0.1 mg) or transdermal placebo, and reward-seeking behaviors were assessed using the Effort-Expenditure for Rewards Task (EEfRT). ResultsParticipants who were randomized to receive transdermal estradiol and who demonstrated greater anxiety sensitivity to E2 fluctuations at baseline, demonstrated more reward seeking behaviors on the EEfRT task. Notably, the strength of the association between E2-anxiety sensitivity and post-randomization EEfRT for TE2 participants increased when women experienced more recent stressful life events and rated those events as more stressful. E2-anhedonia sensitivity was not associated with reward-seeking behaviors. ConclusionPerimenopausal women who are more sensitive to E2 fluctuations and experienced more recent life stress may experience a greater benefit of TE2 as evidenced by an increase in reward seeking behaviors.

Personal Factors and the Overall Variability of Stuttering

Purpose: The initial diagnosis of stuttering is based on stuttering-like disfluencies. This approach fails to capture the variability in overt stuttering behaviors of persons who stutter across speaking tasks and over time. This preliminary study explored the relationships between day-to-day variability of stuttering and several commonly used self-report and behavioral outcomes used to diagnose and monitor stuttering in clinical and research settings. Method: Five adults who stutter participated in this study. All participants completed a demographic questionnaire; the Overall Assessment of the Experience of Stuttering, State, and Trait Anxiety Inventory; and the Brief Version of Unhelpful Thoughts and Beliefs About Stuttering (UTBAS), followed by six (i.e., twice weekly) online sessions where conversation and reading samples were video-recorded to determine stuttering frequency and severity. Participants also rated their stuttering severity, variability, stress, anxiety, and sleep on a 7-point Likert scale for each session. Results: No self-report measures correlated with stuttering frequency or severity measures determined at each twice-weekly online session. Positive correlations were observed between self-rated stuttering severity and stress, anxiety, and normal disfluencies. Stuttering variability across tasks and sessions was positively correlated with the one-time Overall Assessment of the Speaker's Experience of Stuttering (OASES) and UTBAS-6 scores. Conclusions: Stuttering frequency was found to vary to different degrees for individual participants, and preliminary data suggest that scores on standardized assessments such as the OASES and UTBAS-6 are predictive of stuttering variability. Objective data on stuttering frequency may not capture the entire experience of stuttering.

Relaxation and Performance During Microsurgical Learning

Introduction: Microsurgical learning is a difficult and stressful process, requiring self-control to achieve relaxation. The purpose of this study is to evaluate peripheral and central nervous system relaxation during microsurgical training. Methods: This cohort study included ten medical students with no previous experience in microsurgery. The somatic peripheral nervous system was evaluated by the force applied to a custom-designed microsurgical needle holder. The autonomic peripheral nervous system was assessed by a heart rate monitor. Central nervous system relaxation was evaluated by the State and Trait Anxiety Inventory scores. The quality of the anastomosis was graded by the Microsurgical Anastomosis Rating Scale (MARS10). These data were compared to a group of 5 senior microsurgeons who underwent a single assessment. Results: The time to complete the anastomosis and the force decreased significantly with training after only 2 weeks ( P &lt; .05). After 4 weeks of training, no statistical difference was observed between students and experts regarding force while the time of suture was still significantly different at 30 days ( P = .001). The maximum heart rate decreased significantly at 2 weeks ( P = .01). Anxiety scores decreased significantly between days 1 and 15 ( P = .002 and P = .036). The MARS10 score demonstrates that the quality of the suture increases significantly during the first 15 days ( P = .006). Conclusion: Peripheral and central nervous system relaxation as well as the quality of the microsurgical anastomosis increase significantly after only 15 days of learning. The force-sensing microsurgical needle holder offers a new tool for the evaluation of relaxation and can function as a learning aid.