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Factorial structure of the State Trait Anxiety Inventory (STAI) for patients diagnosed with depression

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Abstract

Background: Despite being one of the questionnaires to assess anxiety more employed by mental health professionals, the State Trait Anxiety Inventory (STAI) has been criticized. The main criticism is that the possible existence of a set of items to assess depression would form an independent factor. Objective: The aim of this work is to evaluate the STAI factorization in a sample of patients diagnosed with depression. Method: We applied the Spanish adaptation of the STAI to 266 Spanish patients diagnosed with various depressive disorders. Results: Three underlying factors were identified in the exploratory factor analysis: state anxiety, positive trait anxiety and negative trait anxiety. Discussion and conclusion: The factorization did not confirm the presence of specific item sets for depression, pointed above as the main criticism of this questionnaire. Furthermore, the high values of the categorical alpha, both in the factor structure obtained and the theoretical subscales, are highly reliable indications for the use of the STAI in patients diagnosed with depression.

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... Anxiety: Anxiety is the tendency to see or react to different situations as more threatening (anxiety trait) or as a temporary period of duration and intensity characterized by tension, worry, and increased activity of the autonomic nervous system (anxiety state). In this study, anxiety was assessed with the Spanish version of the State-Trait Anxiety Inventory (STAI) [25], which measures anxiety status across 20 items with four options using a Likert-type response scale, which scores from 0 (not always) to 3 (a lot). ...
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Introduction: Complex Regional Pain Syndrome type 1 (CRPS-1) is defined as a group of sensory and motor disorders that occur as a result of traumatic tissue damage, such as fractures of the distal radius. Pain persistence induces supramedullary neuroplastic changes, resulting in a central sensitization syndrome, in which psychological, affective, and behavioral dimensions interact to amplify the experience of pain. The primary objective of this study was to quantify the relationship between the intensity and duration of perceived pain and psychological factors and quality of life in CS patients diagnosed with CRPS-1 after distal radius fracture. Materials and Methods: An observational descriptive, cross-sectional study using non-probability convenience sampling was conducted from January 27, 2023, to June 11, 2023. Pain intensity, kinesiophobia, anxiety, depression, hypervigilance, catastrophizing, perceived stress, and quality of life were measured. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 20.0 (IBM Co.), which included descriptive and normality analyses and multiple correlational regression strength calculation. Results: A total of 26 participants were selected: n=17 women (65.4%) and n=9 men (n=34.6%) with central sensitization diagnosed with CRPS-1 after distal radius fracture. Pain intensity correlated positively and strongly with kinesiophobia (TSK-11) (β=0.3697, t=2.760, p=0.014) and negatively with performance-related quality of life (β=-0.4778, t=-3.301, p=0.005). The correlation between pain duration correlated with depression was positive and very strong (β=0.7576, t=4.474, p<0.001). Conclusion: In patients with CRPS after a distal radius fracture who have been diagnosed with CS, pain intensity has been shown to have a positive association with levels of kinesiophobia, while pain duration is significantly related to elevated levels of depression.
... These authors concluded that items 2, 8,9,11,17,18 and 20 measure trait anxiety in its pure form. However, in other studies, factorial structures are not different from the factorial forms in healthy samples (Guillén-Riquelme & Buela-Casal, 2015) or in teenager samples (Silva, Hernández Medina, Jiménez Cruz, & Alvarado, 2016). However, in several samples high correlations between anxiety, stress and depression are observed using other questionnaires (e.g. ...
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Background/Objective: The State-Trait Anxiety Inventory (STAI) is one of the assessment instruments that are most widely used by psychologists around the world and is the seventh most broadly used by clinical psychologists in Spain. Although several short forms of the STAI have been developed since its creation, none are available for the Spanish general population. The aim of the present study was to develop and validate a short form of the STAI. Method: To achieve this, we administered the full STAI to 1,157 healthy adults, and 30 patients with generalized anxiety disorder. We conducted a discriminant analysis using such groups. Results: We obtained a selection of four items for state anxiety and four items for trait anxiety and compared it to other short forms through a confirmatory factor analysis. The short form obtained with the discriminant analysis showed the best fit for Spanish samples. Conclusions: these eight items can be used to facilitate the state and trait anxiety assessment.
... The lack of a comparable bias in clinical depression is puzzling since, as noted, clinically depressed individuals also show high anxiety levels. In addition, the subjective feelings of anxiety and depression are highly comparable among anxious and depressed individuals, as, similarly to the present study, self-report questionnaires often fail to distinguish between the two disorders (Andrade, Gorenstein, Vieira Filho, Tung, & Artes, 2001;Guillén-Riquelme & Buela-Casal, 2015). Moreover, anxiety disorders serve as risk factors for developing subsequent depression (e.g., Bittner et al., 2004;Kessler et al., 1996). ...
Article
Both anxiety and major depression disorder (MDD) were reported to involve a maladaptive selective attention mechanism, associated with bias toward negative stimuli. Previous studies investigated attentional bias using distractors that required processing as part of task settings, and therefore, in our view, these distractors should be regarded as task-relevant. Here, we applied a unique task that used peripheral distractors that presented emotional and spatial information simultaneously. Notably, the emotional information was not associated in any way to the task, and thus was task-irrelevant. The spatial information, however, was task-relevant as it corresponded with task instructions. Corroborating previous findings, anxious patients showed attentional bias toward negative information. MDD patients showed no indication of this bias. Spatial information influenced all groups similarly. These results indicate that anxiety, but not MDD, is associated with an inherent negative information bias, further illustrating that the two closely related disorders are characterized by different processing patterns.
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We examined whether math anxiety is related to a response inhibition deficit and, if so, whether it is a domain‐specific inhibition deficit in numerical tasks or a general inhibition deficit. Behavioral performance and electroencephalogram activity were recorded while 28 highly math–anxious (HMA) and 28 low math–anxious (LMA) individuals performed both a numerical and a non‐numerical Go/Nogo task. In the numerical task, single‐digit numbers were presented, and participants were asked to press a button if the number was even. In the non‐numerical task, letters were presented, and the button had to be pressed if the letter was a vowel. Nogo trials were answered less accurately and elicited larger Nogo‐N2 and Nogo‐P3 than Go trials in both tasks and both groups. Importantly, behavioral and brain response differences between tasks were only found in the HMA group. First, they were more error‐prone in numerical Nogo than in non‐numerical Nogo trials; and second, their Nogo‐N2 and N2d (Nogo–Go difference) were smaller in the numerical task than in the non‐numerical task. No differences were found in the LMA group. These results suggest that HMA individuals’ response inhibition is impaired specifically when dealing with numbers, which could contribute to their low achievement in math tasks.
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Anxiety disorders are a very common psychiatric pathology among young university students, and the strategies for its mitigation are limited to the consumption of anxiolytic substances. Adequate hydration is essential for staying healthy, as water is the main component of the human body and of several physiological processes. A state of dehydration, in addition to a negative water balance, has serious consequences on health status. We aimed to determine the association between the degree of anxiety and the level of hydration in Spanish university students. A cross-sectional, observational research study with a sample of 65 female university students was conducted. Over 90% of the study population shows anxiety levels above the 95th percentile. The individuals with anxiety above the 95th percentile showed a negative water balance. The consumption of coffee and herbal teas shows correlations with state anxiety and trait anxiety.
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The aim of study is to determine the possibility to reduce the level of anxiety as personality trait in the time of 22- month-long psychotherapeutic and educational group with using concepts of psychoorganic analysis – a relatively new branch of psychotherapy. The following concepts are used. Three relation forms: the unary form include a symbiotic relation level (undifferentiated sense of existence), the dual form is the binary and dialogic relation (“I am –YOU are”), the ternary form means the relation what is including a structure and the presence of the THIRD. The analysis and the evolution of three forms help to make sense of obstructive psychic occurrences in person. These occurrences are basis for life contracts, which have been protectively, but become troublesome in the lifetime. An activation of a micro–macro regulation is important in order the transformation of these occurrences. The evolution of three forms are the background for biodynamic work and the appropriate transformative intervention. The work of groups (36 participants in 2 groups) is managed from 8 psychotherapists and it is done following set instructions. Changes were evaluated 6 times with State-Trait Anxiety Inventory. The results show statistically significant reduction of the level of the trait anxiety of STAI-Y (p<.05) related to the group program and dynamic.
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Background:: Mood disturbances are implicated in the pathogenesis of fibromyalgia. The aim of this study was to assess the effect of different doses of melatonin on quality of life, mood status, pain, anxiety, and urinary cortisol levels in patients with fibromyalgia. Methods:: After a 10-day baseline period for the collection of data about participants' initial status, participants took different doses of melatonin for 10 consecutive days each, with placebo given during the 10 days either before or between melatonin doses. Participants' moods, quality of life, and pain levels were assessed using the Fibromyalgia Impact Questionnaire (FIQ), a Numerical Pain Scale (NPS), the State-Trait Anxiety Test (STAI), a Visual Analog Scale (VAS), and the Short Form-36 Health Survey (SF-36). Urinary cortisol levels were measured using enzyme-linked immunoassay. Results:: Doses of 9, 12, and 15 mg of melatonin were associated with decreases in the total score of the FIQ, NPS scores, and urinary cortisol levels. The State-Anxiety subscale of the STAI improved after the 12 mg dose. The scores on the VAS improved after the 9 mg dose. The dimensions evaluated in the SF-36 questionnaire improved after the 9 mg dose. Conclusion:: Melatonin improved mood, anxiety levels, and quality of life while decreasing cortisol levels in patients with fibromyalgia.
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Antecedentes El presente estudio tiene por objetivo: a) examinar la estructura interna del STAI en población dominicana; b) verificar la consistencia interna; c) obtener evidencias de validez de criterio correlacionando las puntuaciones del STAI con depresión, y d) comparar las puntuaciones del STAI en población general y hospitalaria, examinando su capacidad discriminativa. Método Para la validación del STAI se utilizó una muestra de 1,034 participantes constituida por población general (n = 792) y hospitalaria (n = 242) de Santiago de los Caballeros, República Dominicana. Resultados y conclusiones Los resultados avalan una solución factorial de 2 factores denominados ansiedad presente y bienestar. Esta solución da cuenta de adecuados índices de ajuste y consistencia interna aceptable y óptima. Por otra parte, los análisis de validez mediante comparación de grupos permiten corroborar que la escala distingue adecuadamente entre población general y psiquiátrica. Finalmente, se encuentran correlaciones fuertes entre la ansiedad y los niveles de depresión.
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