Trait Anxiety Research Articles

Resting state connectivity patterns associated with trait anxiety in adolescence

Anxiety symptoms occur more frequently during adolescence and early adulthood, increasing the risk of future anxiety disorders. Neuroscientific research on anxiety has primarily focused on adulthood, employing mostly univariate approaches, discounting large-scale alterations of the brain. Indeed adolescents with trait anxiety may display similar abnormalities shown by adults in brain regions ascribed to the default mode network, associated with self-referential thinking and rumination-related processes. The present study aims to explore resting-state connectivity patterns associated with trait anxiety in a large sample of young individuals. We analyzed the rs-fMRI images of 1263 adolescents (mean age 20.55 years) and their scores on anxiety trait. A significant association between trait anxiety and resting-state functional connectivity in two networks was found, with some regions overlapping with the default mode network, such as the cingulate gyrus, the middle temporal gyri and the precuneus. Of note, the higher the trait anxiety, the lower the connectivity within both networks, suggesting abnormal self-referential processing, awareness, and emotion regulation abilities in adolescents with high anxiety trait. These findings provided a better understanding of the association between trait anxiety and brain rs-functional connectivity, and may pave the way for the development of potential biomarkers in adolescents with anxiety.

Improving patient understanding of GEP test results (IMPARTER4): an RCT

ObjectiveExplaining gene expression profiling (GEP) test results to patients can be challenging. We examined the utility of two 8 min films about Oncotype DX and Prosigna to aid the knowledge...

Characterizing the functioning of the attentional networks in state and trait anxiety: the role of affective information

Characterizing the functioning of the attentional networks in state and trait anxiety: the role of affective information

The influence of affective temperaments on sleep quality in a general population sample. Data report from the CHRIS study.

The influence of affective temperaments on sleep quality in a general population sample. Data report from the CHRIS study.

Reduced symptoms of anxiety among professional caregivers facing cardiac arrest after simulation based training

Professional caregivers often suffer from post-traumatic stress disorder after intra-hospital cardiac arrest. The aim of our study was to describe long-term evolution of symptoms of anxiety among professional caregivers after a simulation-based training. Our study was a prospective, single-center pilot study conducted at Nancy-Brabois University Hospital. The sample included 56 professional caregivers, divided into two groups: 26 participants who underwent simulation-based training and 30 controls who did not participate during the study period. This sample size was determined based on the availability of participants and the exploratory nature of the pilot study. Each simulation involved a team of junior healthcare providers. Symptoms of anxiety and self-efficacy were assessed using standardized scales before, immediately after, and 3 months post-training. Control professional caregivers completed the same assessments without training. The symptoms of anxiety were assessed using the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire while self-efficacy was assessed by Cardiopulmonary Resuscitation Self-Efficacy Scale (CPR-SES). Nine simulation-based training sessions were conducted, each including a team of professional caregivers (one junior physician, one junior nurse, and one care assistant). There was no significant difference in symptoms of anxiety immediately after training. However, after 3 months, both state and trait anxiety significantly decreased, while self-efficacy improved among the professional caregivers who attended the simulation-based training. Our study shows sustained behavioral improvements in professional caregivers after simulation-based training, enhancing their self-efficacy in cardiac arrest management. Further research is needed to evaluate the longevity and necessity of repeated training sessions.

Effect of multimedia education on anxiety and pain in patients undergoing laparoscopic cholecystectomy: a Solomon four-group randomized controlled trial

Preoperative anxiety and postoperative pain pose significant challenges in surgical settings, often leading to various physical and psychological complications. This study aimed to assess the impact of multimedia education on anxiety levels and pain among candidates undergoing laparoscopic cholecystectomy. In a clinical trial employing Solomon’s four-group design, 80 candidates for laparoscopic cholecystectomy were enrolled. They were selected through convenience sampling and randomly allocated to four groups: intervention group with pre-test (E1), intervention group without pre-test (E2), control group with pre-test (C1), and control group without pre-test (C2). Multimedia education was administered to the intervention groups. Data were collected using the State-Trait Anxiety Inventory (STAI) for anxiety assessment and the Visual Analog Scale (VAS) for pain measurement, then analyzed using SPSS-22 software. Preoperative state anxiety levels in groups E1 and E2 were significantly lower compared to C1 and C2 (38.6 ± 7.32, 38.1 ± 8.83, 46.3 ± 11.57, and 45.8 ± 9.57, respectively; p = 0.006). However, there was no significant difference in state anxiety levels 24 h post-surgery nor in trait anxiety levels before and 24 h after surgery. Moreover, there was no significant difference in mean pain scores 24 h post-surgery among the groups. The findings indicate that multimedia education can effectively reduce preoperative anxiety in patients undergoing surgery. However, it did not significantly impact anxiety and pain levels post-surgery. Multimedia education may be considered as a supplementary approach to standard preoperative care protocols.

Holistic Healing Through Mindfulness: An Experimental Study Addressing Psychological Challenges Among Nurses Caring for Patients With COVID-19.

Purpose: This study aimed to evaluate the effect of mHealth-based mindfulness intervention on trait mindfulness, stress, anxiety, and depression among Registered Nurses caring for patients with COVID-19 in Jordan. Method: Using a pretest-posttest parallel controlled design, 102 nurses from the King Abdullah University Hospital were randomly assigned into experimental (n = 51) and control (n = 51) groups. The experimental group received 5 weeks of individual 30-min mindfulness intervention sessions via WhatsApp. The collected data included demographic information as well as baseline and postintervention scores from the Mindfulness Attention Awareness Scale and the Depression, Anxiety, and Stress Scale. Findings: Paired t-tests revealed that the experimental group demonstrated significantly lower levels of stress, anxiety, and depression, as well as higher trait mindfulness scores following the intervention. Independent t-tests indicated that, compared to the control group, the experimental group had significantly reduced depression and stress levels and increased trait mindfulness scores at the end of the intervention. Although anxiety scores were lower in the experimental group following the intervention, the difference between the groups was not statistically significant. Conclusion: This finding aligns with existing literature, which has reported similar outcomes in studies on mindfulness interventions. These studies highlight the potential of mHealth-based mindfulness intervention as a holistic approach to enhancing psychological well-being among nurses who care for patients with COVID-19. Trial Registration: Clinicaltrials.gov; ID: NCT06401252.

Using virtual reality to study spatial mapping and threat learning

Using spatial mapping processes to discriminate between threat and safety is crucial for survival. Little is known why some fail to discriminate during contextual conditioning. We used a virtual reality (VR) contextual conditioning paradigm to elucidate the effects of state and trait anxiety on contextual threat learning. Participants (n = 70) “picked” flowers in a VR environment. Dangerous zone flowers predicted an electric shock, while safe zone flowers did not. Between trials, participants completed a spatial memory task. Galvanic skin response (GSR) and State Trait Anxiety Inventory scores were recorded. Participants were considered learners for correctly identifying both zones. Non-learners, compared to learners, performed worse during the spatial memory task and demonstrated higher state anxiety scores and GSR. Learners showed higher skin conductance response (SCR) in the dangerous compared to the safe zone, while non-learners showed no SCR differences between zones. Results indicate state anxiety may impair spatial mapping, disrupting contextual threat learning.

The effectiveness of Melissa officinalis L. essential oil inhalation on anxiety and symptom burden of hemodialysis patients: a randomized trial study

BackgroundHemodialysis patients suffer from physical and mental symptoms for which aromatherapy might be useful. This study aimed to determine the effectiveness of Melissa officinalis L. (Lemon Balm) essential oil inhalation on anxiety and the burden of symptoms in hemodialysis patients.MethodsThis study is a randomized clinical trial with a pretest-posttest design. Sixty-eight hemodialysis patients were randomly divided into intervention (who underwent Melissa officinalis L. inhalation aromatherapy 3 times a week for one month) and control (who inhaled refined sweet almond oil) groups. The intervention in both groups was conducted during the hemodialysis session. The data were collected using the state-trait anxiety inventory and Dialysis Symptom Index. Data were analyzed through SPSS-25, using Mann-Whitney, Wilcoxon, t-tests and MANOVA.ResultsBefore the intervention, both groups were similar in terms of anxiety and symptoms burden (P > 0.05). However, after the intervention, a significant difference was found between the groups in terms of state and trait anxiety, and severity of constipation, nausea, vomit, diarrhea, swelling in legs, muscle cramps and shortness, worry, nervousness and anxiety, and trouble staying asleep. Moreover, after the intervention, a significant difference was observed between the groups regarding the prevalence of symptoms burden such as feeling anxious and having a dry mouth (P < 0.05).ConclusionMelissa officinalis L. essential oil inhalation aromatherapy reduced the symptoms burden and anxiety in hemodialysis patients. Given the effectiveness of aromatherapy in hemodialysis patients, it is suggested that healthcare workers should use this complementary and integrative health to reduce the anxiety and symptoms burden in hemodialysis patients.Trial registration RCT registryIranian Registry of Clinical Trials (IRCT) number: IRCT20191021045178N3; Registration date 27/04/2021.

The Effect of Electroencephalographic Biofeedback Therapy on Anxiety and Overall Well-being in Patients with Rectal Cancer.

This study aimed to investigate the effectiveness of electroencephalographic (EEG) biofeedback therapy in reducing anxiety levels and improving overall well-being among patients diagnosed with rectal cancer. A randomised controlled trial was conducted with 150 patients with rectal cancer who were randomly assigned to either the intervention group (n = 75) or the control group (n = 75). The intervention group received 16 sessions of EEG biofeedback therapy over 8 weeks, whereas the control group received standard care. Anxiety levels were assessed using the State-Trait Anxiety Inventory at baseline, post-intervention, 3-month follow-up, 6-month follow-up and 12-month follow-up. Secondary outcomes, including quality of life, sleep quality, treatment adherence, cortisol levels and heart rate variability (HRV), were also evaluated. The intervention group showed significant reductions in state anxiety (p < 0.001) and trait anxiety (p < 0.001) compared with the control group at all post-intervention time points. Significant improvements were also observed in the intervention group for quality of life (p < 0.001), sleep quality (p < 0.001), treatment adherence (p < 0.001), cortisol levels (p < 0.01) and HRV (p < 0.01). The effects were maintained at the 12-month follow-up. Electroencephalographic biofeedback therapy is an effective non-pharmacological intervention for reducing anxiety levels and improving overall well-being in patients with rectal cancer. The findings suggest that incorporating EEG biofeedback therapy into the standard care of patients with rectal cancer may enhance their psychological well-being, quality of life, sleep quality, treatment adherence, physiological stress responses and autonomic function. Long-term benefits were observed, indicating the sustainability of the intervention's effects. Further research is warranted to investigate the underlying mechanisms and potential applications of EEG biofeedback therapy in other cancer populations.

Relationship between temperamental dimensions and infant limb movement complexity and dynamic stability.

Infant temperament reflects behavioral responses to stimulation, while the motor system undergoes significant developmental changes throughout infancy, influenced in part by caregivers' mental well-being. This study examines the associations between temperament and motor system organization across three distinct social interaction tasks at 6 and 12 months of age. To account for the role of the caregiver's mental well-being, we also included maternal trait anxiety in our analysis. A longitudinal sample of 83 infants at 6 months and 59 infants at 12 months participated in three caregiver-infant tasks: book-sharing, playing with manipulative toys, and rattle-shaking. Infant limb movements were recorded using wearable accelerometers, and we applied Multidimensional Recurrence Quantification Analysis (MdRQA) to extract Entropy (reflecting motor system complexity) and Mean Line (reflecting motor system stability). Using mixed-effects models, we examined the predictive effects of task and temperament variables: Negative Affectivity (NEG), Positive Affectivity or Surgency (PAS), and Orienting and Regulatory Capacity (ORC). Our results suggest that Negative Affectivity measured at 6 months predicted increased motor system Entropy and Mean Line concurrently at 6 months as well as longitudinally at 12 months. Temperamental variables measured at 12 months of age did not predict infants' motor systems' complexity and stability at the same time point. At 12 months, task conditions modulated both Entropy and Mean Line, suggesting greater sensitivity to contextual differences later in infancy. Additionally, higher maternal trait anxiety (measured at 4 months) predicted decreased motor system Entropy and Mean Line at 12 months. Our results have implications for understanding the early developmental pathways of motor system organization, its relationship with temperament, and the influence of caregiver mental well-being on infant motor development.

The role of demographic and psychosocial factors in academic achievement: insights from a cross-sectional study on physiotherapy and rehabilitation students

BackgroundAcademic success is a multifaceted outcome influenced by various demographic and psychosocial factors. Understanding these determinants is essential for developing effective interventions, particularly in demanding disciplines such as physiotherapy and rehabilitation. This cross-sectional study examined the relationship between academic performance and demographic and psychosocial variables among undergraduate physiotherapy students.MethodsData on students’ age, gender, years of education, relationship status, parental status, monthly income, and residence status were collected. Academic success was assessed using grade point average (GPA). Psychosocial variables were measured using validated Turkish versions of the following scales: Rosenberg Self-Esteem Scale for self-esteem, Empathy Assessment Scale for empathy, Social Emotional Competence Questionnaire for social and emotional competence, Warwick-Edinburgh Mental Well-Being Scale for mental well-being, State and Trait Anxiety Inventory for anxiety, UCLA Loneliness Scale Short Form for loneliness, Adult Motivation Scale for motivation, and Satisfaction with Life Scale for life satisfaction. Statistical analyses, including Pearson and Spearman correlations, multiple linear regression, and independent t-tests, were conducted using SPSS 25.0.ResultsA total of 256 students (female/male = 187/69) participated in the study. Significant relationships were observed between GPA and gender, monthly income, anxiety levels, and loneliness levels. Multiple regression analysis revealed that 44.0% of the variance in GPA was explained by anxiety (R²=0.31, p < 0.001), loneliness (R²=0.11, p < 0.001), and gender (R²=0.02, p = 0.002). Female students outperformed their male counterparts in academic success (p < 0.05).ConclusionsThis study emphasizes the significant influence of demographic and psychosocial factors on the academic performance of physiotherapy students. Interventions aimed at reducing financial stress, anxiety, and loneliness may improve academic outcomes. Future research should explore these factors in diverse educational settings and over time to better support student success in healthcare education.Clinical trial numberNCT06534879 (registration date: 2024-07-30), retrospectively registered.

Chatbots in eyewitness interviews: perceived usefulness and ease of use drive intent to use conversational agent

Purpose This study aims to examine how lay persons’ perceived usefulness and ease of use of chatbots influence their intention to use one in an eyewitness interviewing setting, while considering trait anxiety, trust in police and prior experience in chatbots use. Design/methodology/approach Dutch citizens (N = 183) completed a survey consisting of scales measuring chatbot-related perceived usefulness, chatbot-related perceived ease of use, trait anxiety, trust in the police and prior experience in chatbot use. Findings Perceived usefulness and ease of use were found to significantly influence chatbot use intention during investigative interviews. Social anxiety moderated the relationship between ease of use and chatbot use intention, where higher anxiety reduced the likelihood of adoption. Trust in police and prior experience in chatbot use had no moderating effect. Research limitations/implications Psychological factors play an important part in using technological tools to collect information from eyewitnesses. Further research is needed to explore how other psychological factors and different levels of interaction with chatbots may affect their use in investigative contexts. Practical implications These findings address the importance of perceived use and social anxiety in improving chatbot integration in investigative interviews, enhancing resource efficiency in police work. Social implications This paper highlights that eyewitnesses might display individual preferences based on psychological determinants. Taking these into account may help improve reporting conditions and, therefore, reporting quality. Originality/value This study pioneers the application of the Technology Acceptance Model in the context of chatbot-aided eyewitness interviews, highlighting the crucial role of societal and psychological factors in technology acceptance within legal and investigative settings.

Does exposure to race-related stress lead to attention biases? Examining the moderating roles of anxiety and racial identity among Black adults.

Racism plays a deleterious role in Black Americans' mental health, yet little is known about the mechanisms through which racism may confer risk to mental health outcomes. One hypothesized yet untested mechanism through which racism may lead to negative mental health is increased attention bias to threat. Even less is known about individual difference factors that may exacerbate or ameliorate racism's effects, such as anxiety or racial identity. To address this gap in the literature, 214 Black adults were recruited online for an experimental study. Participants were randomly assigned to one (out of two) stress conditions: experimental, where they reflected on a racism experience (n = 102), or control, where they reflected on a nonracism stressor (n = 112). They also completed measures of general anxiety and racial centrality. Attention bias to threat was assessed using a dot-probe task, which compares reaction time to threat (i.e., angry) versus neutral faces. Although there was no overarching effect of racism exposure on general or Black-specific attention bias, there was a significant effect of racism on attention bias toward White angry faces such that those in the racism condition demonstrated lower bias than those in the control stress condition (t = -2.06, p = .04). Importantly, the effect of the racism manipulation depended on participants' level of anxiety and racial centrality. These unexpected results suggest that exposure to racism may lead to an avoidant attentional bias away from White threatening faces but that this process may be contingent on trait anxiety and racial centrality. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The effect of video-based multimedia information before amniocentesis on pain, anxiety, and pregnancy outcomes

Amniocentesis is the most commonly used invasive prenatal diagnostic test. This study aimed to investigate the effect of video-based multimedia information (MMI) on the anxiety and pain levels of patients undergoing amniocentesis. This randomized controlled study included all consecutive women aged 18–45 years scheduled for amniocentesis. Subjects were assigned to receive video-based MMI or standard written information. Anxiety levels were assessed pre-procedure and post-procedure using the State and Trait Anxiety Inventory-State (STAI-S). All patients underwent standard amniocentesis by the same perinatologists. After amniocentesis, Likert scale was used to evaluate the ease of the procedure and patient satisfaction, and a visual analog scale was used to evaluate pain. Pregnancy results and amniocentesis results were noted. Eighty-four patients were randomized to receive video-based MMI, and 76 were randomized to receive written information. The post-procedure STAI-S score was significantly lower in both the video group and the control group compared to the pre-procedure STAI-S score (47.8 ± 5.23 vs. 45.86 ± 5.02, 95% CI: [2.38–1.52], p < 0.001, and 46.75 ± 7.35 vs. 44.82 ± 6.85, 95% CI: [2.33–1.51], p < 0.001). The satisfaction rate of the video group was significantly higher than controls (69.05% vs. 48.68%, p = 0.01). Procedure pain, ease of procedure, and pregnancy outcomes were similar for both groups (p > 0.05). Performing video-based MMI before the amniocentesis procedure is associated with higher patient satisfaction than standard written information. Video-based MMI was not associated with reductions in pain and anxiety in patients undergoing amniocentesis.

The Psychophysiologic Stress and Salivary Cortisol and Alpha-Amylase Awakening Responses to Cross-Country Running Competitions in National-Level Female Athletes.

Aydemir, M, Makaracı, Y, Avcı, B, Ürkmez, YC, and Cintineo, HP. The psychophysiologic stress and salivary cortisol and alpha-amylase awakening responses to cross-country running competitions in national-level female athletes. J Strength Cond Res XX(X): 000-000, 2024-Cross-country running, characterized by diverse terrains and environmental conditions, primarily emphasizes individual performance, though team-oriented strategies are also used. This study aimed to examine psychophysiologic stress, anxiety, and race performance of elite female athletes during national cross-country running competitions. Twelve elite-level female cross-country runners were recruited to undergo psychophysiologic state using salivary cortisol and alpha-amylase levels (pre- and postrace) across 2 consecutive rounds of varying difficulty and significance (round 1 and final round). In addition, cortisol and alpha-amylase awakening responses (CAR and AAAR), and state anxiety (State and Trait Anxiety Inventory-I) were assessed on both precompetition and competition days during each round. The findings revealed significant increases in precompetition day AAAR, pre- and postrace cortisol, and postrace alpha-amylase levels in the final round compared with those in round 1 (p < 0.05). Mean race time was also faster in the final round than in round 1 (p < 0.05). Pre- and postrace cortisol levels were correlated with race time in round 1 (r = 0.554; r = 0.594), but not in the final round (p > 0.05). Increased cortisol emerged as a potential indicator of race difficulty and predictors of success in cross-country running. Coaches and athletes may benefit from monitoring cortisol levels to optimize performance during competitions with fluctuating conditions. Further research using saliva analysis as a noninvasive tool for assessing psychophysiologic parameters surrounding competition is warranted in larger samples across various endurance sports, though the data presented here provide a unique view of these responses.

Cerebrospinal fluid interferon-γ and development of depression in multiple sclerosis.

Cerebrospinal fluid interferon-γ and development of depression in multiple sclerosis.

Examining the roles of working memory and trait anxiety on math achievement in children with ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) demonstrate deficits across academic domains including underachievement in math. Proposed models of math skill development suggest that math difficulties may be associated with both neurocognitive (e.g., working memory) and socioemotional factors (e.g., anxiety). Extant literature indicates a 25% co-occurrence rate between ADHD and anxiety, as well as a strong link between neurocognitive deficits in working memory and ADHD symptomology. However, it remains unclear how both trait anxiety and working memory uniquely or jointly relate to underachievement in math in children with ADHD. The sample comprised 275 clinically evaluated children ages 8-13 (Myears = 10.36, SD = 1.44; 106 girls; 69% White/non-Hispanic) with and without ADHD. Serial conditional effects models were utilized to (a) quantify the magnitude of math underachievement in children with ADHD relative to peers without ADHD and (b) determine the extent to which these impairments are uniquely or jointly related to child self-reported trait anxiety and/or working memory abilities. The serial path analysis indicated that children with ADHD exhibited large magnitude deficits in math achievement relative to peers without ADHD (d = -0.76; β = -.34, 95% CI excludes 0.0). Furthermore, the ADHD/math achievement relation was uniquely accounted for by its shared association with working memory, whereas self-reported trait anxiety was not a significant predictor of math achievement. Together, ADHD status and working memory accounted for 65% of the variance in math achievement (R2 = .65). These findings suggest that math difficulties in children with ADHD are largely associated with neurocognitive factors such as working memory and do not appear to be associated with the frequency/severity of trait anxiety symptoms. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Development of the Leisure Activity Scale for young adults: Reliability and validity.

Previous studies have documented the beneficial effects of leisure activities on mental health. However, limited methods or scales are available to measure leisure activities for the evaluation of mental health or the intervention of mental disorders, and data on the therapeutic benefits of leisure activities for mental health are scarce. Furthermore, few studies have investigated the effects of leisure activities on the mental health of young individuals. Therefore, we developed the Leisure Activity Scale (LAS; a 7-item, 5-point scale) to assess the leisure activities of young adults, and aimed to confirm its reliability and validity. This study involved 551 Japanese participants aged 18-25 years and was conducted through an online survey from September to November 2022. Reliability of the LAS was assessed through internal consistency analysis. To determine convergent and discriminant validity, the LAS was compared with various scales measuring psychometric properties, including depression, anxiety, work fatigue recovery, resilience, neuroticism, emotion regulation, well-being, and ill-being. Factor analysis indicated that the 7-item LAS was the most appropriate measure for use in mental health (Cronbach's α coefficient = 0.756). Total LAS7 scores positively correlated with recovery experience, resilience, emotion regulation, and well-being, and negatively correlated with state anxiety. These were all weak correlations, with correlation coefficients of less than 0.3. Total LAS7 scores did not correlate with trait anxiety, neuroticism, or ill-being. Our results demonstrated the reliability of the LAS, but its convergent validity was insufficient. The LAS can comprehensively assess leisure activities, although further improvement regarding its validity is needed.

Indicators of improved emotion behavior in 6–14-year-old children following a 4-week placebo controlled prebiotic supplement intervention at home with a parent

BackgroundIn this double-blind placebo-controlled randomised intervention we investigated the potential benefits of a prebiotic supplement on children’s well-being in a home setting. The primary aim was to determine if this supplement could effectively reduce anxiety, improve mood, and enhance cognitive function, similar to findings in young adults.MethodsFifty-three healthy children, aged 6 to 14, participated in an 8-week trial. The trial consisted of three testing time points; day zero marked the baseline measurement (T1) followed by a 28-day supplement intervention period during which they consumed 5.5 g of the prebiotic galactooligosaccharides (GOS) daily under parental guidance. Endline measures (T2) were conducted on the last day of supplement consumption, with a final follow-up testing session (T3) on day 56. Primary outcomes were trait anxiety using a questionnaire and emotional behavior in a dot-probe task on responses to positive and negative images. Secondary outcomes encompassed depression levels, cognitive function tests, and dietary intake recorded in a 4-day food diary. Additionally, we explored whether parents’ emotional behavior had an impact on children’s responses.ResultsWhile our statistical analysis did not reveal significant effects of GOS, there were noteworthy trends. Trait anxiety levels decreased over time in both groups, with a more pronounced decrease in the GOS group (after intervention, p =.090; after follow-up, p =.031). The GOS group exhibited reduced negative emotional responses compared to the placebo group (p =.105), and post-trial depression levels decreased in the GOS group over time (p =.015). Although parental emotional responses correlated with various emotional outcomes in children, they did not influence the intervention effects.ConclusionsThese findings suggest positive trends in line with our hypotheses, however further investigation with greater statistical power would be beneficial.Trial registrationRetrospectively registered on https://clinicaltrials.gov/ [NCT06258135] on February 6, 2024.