STAI manual for the state-trait anxiety inventory

Assessment of Salivary Flow and Anxiety in Patients Rehabilitated with Implant-Supported Prostheses

Article

Full-text available

Jan 2019

Background: The aim of this study was to verify, through self-assessment questionnaires, the influence of implant-supported prosthesis in salivary flow and anxiety of patients rehabilitated with them. Materials and methods: Visual analog scale (VAS) questionnaire about xerostomia and State-Trait Anxiety Inventory were applied before (T1) and after 2 days (T2) and 3 weeks (T3) of prostheses installation. The study included patients rehabilitated with implant-supported prostheses containing three or more dental elements. A total of 17 patients were evaluated. Results: In VAS questionnaire, there was a significant increase in the difficulty of speaking and swallowing with dry mouth. The other VAS questions showed no statistically significant difference, indicating no changes in patients' salivary flow. Conclusions: It was concluded that the installation of implant-supported prostheses does not lead to major changes in patients' perception about their salivary flow and psychological state, causing no improvement or worsening in the characteristics evaluated.

Symptom-severity-related brain connectivity alterations in functional movement disorders

Article

Full-text available

Mar 2022

Background Functional movement disorders, a common cause of neurological disabilities, can occur with heterogeneous motor manifestations including functional weakness. However, the underlying mechanisms related to brain function and connectivity are unknown. Objective To identify brain connectivity alterations related to functional weakness we assessed network centrality changes in a group of patients with heterogeneous motor manifestations using task-free functional MRI in combination with different network centrality approaches. Methods Task-free functional MRI was performed in 48 patients with heterogeneous motor manifestations including 28 patients showing functional weakness and 65 age- and sex-matched healthy controls. Functional connectivity differences were assessed using different network centrality approaches, i.e. global correlation, eigenvector centrality, and intrinsic connectivity. Motor symptom severity was assessed using The Simplified Functional Movement Disorders Rating Scale and correlated with network centrality. Results Comparing patients with and without functional weakness showed significant network centrality differences in the left temporoparietal junction and precuneus. Patients with functional weakness showed increased centrality in the same anatomical regions when comparing functional weakness with healthy controls. Moreover, in the same regions, patients with functional weakness showed a positive correlation between motor symptom severity and network centrality. This correlation was shown to be specific to functional weakness with an interaction analysis, confirming a significant difference between patients with and without functional weakness. Conclusions We identified the temporoparietal junction and precuneus as key regions involved in brain connectivity alterations related to functional weakness. We propose that both regions may be promising targets for phenotype-specific non-invasive brain stimulation.

Predicting pain among female survivors of recent interpersonal violence: A proof-of-concept machine-learning approach

Article

Full-text available

Jul 2021
PLOS ONE

Interpersonal violence (IPV) is highly prevalent in the United States and is a major public health problem. The emergence and/or worsening of chronic pain are known sequelae of IPV; however, not all those who experience IPV develop chronic pain. To mitigate its development, it is critical to identify the factors that are associated with increased risk of pain after IPV. This proof-of-concept study used machine-learning strategies to predict pain severity and interference in 47 young women, ages 18 to 30, who experienced an incident of IPV (i.e., physical and/or sexual assault) within three months of their baseline assessment. Young women are more likely than men to experience IPV and to subsequently develop posttraumatic stress disorder (PTSD) and chronic pain. Women completed a comprehensive assessment of theory-driven cognitive and neurobiological predictors of pain severity and pain-related interference (e.g., pain, coping, disability, psychiatric diagnosis/symptoms, PTSD/trauma, executive function, neuroendocrine, and physiological stress response). Gradient boosting machine models were used to predict symptoms of pain severity and pain-related interference across time (Baseline, 1-,3-,6- follow-up assessments). Models showed excellent predictive performance for pain severity and adequate predictive performance for pain-related interference. This proof-of-concept study suggests that machine-learning approaches are a useful tool for identifying predictors of pain development in survivors of recent IPV. Baseline measures of pain, family life impairment, neuropsychological function, and trauma history were of greatest importance in predicting pain and pain-related interference across a 6-month follow-up period. Present findings support the use of machine-learning techniques in larger studies of post-IPV pain development and highlight theory-driven predictors that could inform the development of targeted early intervention programs. However, these results should be replicated in a larger dataset with lower levels of missing data.

Teacher Cognition about Sources of English as a Foreign Language (EFL) Listening Anxiety: A Qualitative Study

Article

Jan 2020

The anxiety that accompanies English-as-a-foreign-language (EFL) listening comprehension is difficult to detect and access. Such anxiety will prevent the students from actively and strategically participating in the listening process. This qualitative study aims to explore teachers' cognitions about the sources of students' anxiety during their EFL listening in the classroom in a Chinese tertiary context. The participants' cognitions were elicited through in-depth pre-observation interviews, consecutive classroom observations for one semester, and stimulated recall interviews after each classroom observation. The study found that 16 sources organized into four categories contributed to EFL listening anxiety, among which students' unfamiliarity with cultural backgrounds and topics in the category of input played a prominent role. Pedagogical implications for reducing EFL listening anxiety are also discussed.

Attention impairment in motor functional neurological disorders: a neuropsychological study

Article

Full-text available

Jul 2022
J NEUROL

Objective Our objective was to assess cognitive functioning across multiple cognitive domains using a standardised neuropsychological battery in patients with motor functional neurological disorders (mFND). Methods Thirty patients with clinically established mFND and 30 age-, sex- and education-matched control subjects underwent a thorough neuropsychological assessment evaluating (1) attention including processing speed, (2) executive functions including working memory, (3) short-term memory, (4) speech and language and (5) visuospatial functions. Performance validity tests (PVT) and self-report measures of depression, anxiety and cognitive complaints were included in the assessment. Only patients with valid test performance were included in the analysis. Results Three patients scored below the cut-off scores in PVT. Patients performed significantly worse than controls in the following areas: (1) the attention domain which included a slow processing speed (p = 0.005, Cohen’s d = 0.89), (2) executive functions (p = 0.01, Cohen’s d = 0.88) and (3) speech and language domains (p = 0.025, Cohen’s d = 0.77). Patients with mFND showed greater intra-individual variability in cognitive performance (p = 0.005, Cohen’s d = 0.94). Cognitive impairments were independent of depressive symptoms, which were higher in mFND patients. Conclusion This study revealed both subjective and objective cognitive impairment in patients with mFND. The neuropsychological profile in mFND was characterised primarily by attentional impairment including a slow processing speed and a high intra-individual variability in cognitive performance. Cognitive impairment was associated with a valid test performance, highlighting that the deficits observed were not likely to be explained by a lack of effort in the patient group. Attention is considered to play a key role in mFND pathophysiology, and the results suggest that such impairments are objectively measurable.

The complex syndrome of functional neurological disorder

Article

Jan 2022

Background Patients with functional neurological disorders (FND) often present with multiple motor, sensory, psychological and cognitive symptoms. In order to explore the relationship between these common symptoms, we performed a detailed clinical assessment of motor, non-motor symptoms, health-related quality of life (HRQoL) and disability in a large cohort of patients with motor FND. To understand the clinical heterogeneity, cluster analysis was used to search for subgroups within the cohort. Methods One hundred fifty-two patients with a clinically established diagnosis of motor FND were assessed for motor symptom severity using the Simplified Functional Movement Disorder Rating Scale (S-FMDRS), the number of different motor phenotypes (i.e. tremor, dystonia, gait disorder, myoclonus, and weakness), gait severity and postural instability. All patients then evaluated each motor symptom type severity on a Likert scale and completed questionnaires for depression, anxiety, pain, fatigue, cognitive complaints and HRQoL. Results Significant correlations were found among the self-reported and all objective motor symptoms severity measures. All self-reported measures including HRQoL correlated strongly with each other. S-FMDRS weakly correlated with HRQoL. Hierarchical cluster analysis supplemented with gap statistics revealed a homogenous patient sample which could not be separated into subgroups. Conclusions We interpret the lack of evidence of clusters along with a high degree of correlation between all self-reported and objective measures of motor or non-motor symptoms and HRQoL within current neurobiological models as evidence to support a unified pathophysiology of ‘functional’ symptoms. Our results support the unification of functional and somatic syndromes in classification schemes and for future mechanistic and therapeutic research.

Rural Nursing Theory: Past, Present, and Future

Chapter

Sep 2021

Mediating Effect of Coping Strategies between Personality and Anxiety during COVID-19

Article

Full-text available

Apr 2021

George Felix

Introduction: Several studies have highlighted the psychological consequences (anxiety, depression) of COVID-19 in India. However, the effect of personality on anxiety, mediated by coping, remains scarce. Method: For carrying out this study, 215 healthy, unmarried, educated Indian adults participated in an online form-based study comprising measures of personality (The Big Five Inventory-2-S), coping (Coping Inventory for Stressful Situations-21), and anxiety (State-Trait Anxiety Inventory-6). Results: Analyses were done after controlling gender, age, work, and family status. Negative-emotionality and emotion-oriented coping were the highest predictors of anxiety. A contradictory finding showed conscientiousness to predict and increase anxiety upon using coping strategies. Emotion-oriented coping mediated the relationship between negative-emotionality and anxiety. Open-mindedness had an insignificant total effect on anxiety but reduced it when mediated by emotion-oriented coping. Additionally, higher anxiety was reported in those who watched one hour or more of pandemic news per day. Conclusion: Emotion-oriented coping was found to be an ineffective strategy to alleviate anxiety in those with higher trait neuroticism. The flexibility provided by trait openness facilitated effective use of emotion-oriented coping in reducing anxiety.

The effect of perceived stress on anxiety and sleep quality among healthcare professionals in intensive care units during the coronavirus pandemic

Article

Jan 2021

The study aimed to explore the effect of perceived stress of healthcare workers on anxiety and sleep level in intensive care units during corona virus pandemic. The research was conducted in descriptive and cross-sectional types. The study was conducted between April 2020 and July 2020 at Atatürk University Research Hospital and Erzurum Regional Training and Research Hospital. In the research, it was aimed to reach all the healthcare professionals (260) working in intensive care units without selecting a sample. The data was collected by using the personal information form prepared by the researchers in line with the literature, Perceived Stress Scale, State-Trait Anxiety Inventory, and Vısual Analog Sleep Scale. Of the 210 participants, 75.4% were female, and 88.1% were nurses. The mean age of the participants was 27.04 ± 5.71 years, and 51.9% of the participants were 20–25 years old. The mean perceived stress, state anxiety, trait anxiety, and visual analog sleep scores were moderate and found as 29.9 ± 6.83, 43.09 ± 5.55, 46.15 ± 5.3, and 503.79 ± 134.24, respectively. In conclusion, a general picture of the psychological state of healthcare professionals in Turkey during the COVID-19 pandemic has been presented.

Anxiety and Perceived English and French Language Competence of Education Students

Article

Full-text available

Dec 2005

The authors examined manifest anxiety and perceptions of English and French language competence among Anglophone (n = 35), Francophone (n = 29), and Mixed-heritage (n = 34) elementary education (60%) and secondary education (40%) students (80% female) in their second, third, or fourth year of study at the Faculté Saint Jean (University of Alberta). Participants assessed their language competence differently in English and French. Francophone and Mixed-heritage students felt equally competent in the two languages, but Anglophone students reported much higher language competence in English. Manifest anxiety and self-assessments of language competence were related only among the Anglophone group, with high levels of manifest anxiety associated with both low self-assessments of French language competence and high self- assessments of English language competence—the two being correlated with each other.

Anxiety disorders and psychological evaluation: Instruments used in Brazil

Article

Full-text available

Oct 2020

Maria Luzinete Alves Vanzeler

Anxiety disorders are characterized by fear and anxiety disproportionate to the situation that triggers and persists beyond what is foreseen for the event. They cause harm to the individual due to the suffering produced, worsen the quality of life and impose social restrictions. Psychological assessment techniques can help an investigation and improve understanding of these disorders. This study aimed to investigate the instruments for anxiety assessment used in Brazil. Thus, a literature review was carried out, searching specialized textbooks, journals and indexed articles (in capes, lilacs, pubmed, mediline, scielo and academic Google) in order to describe the most used ones. At the end of this study, it was found that the instruments for assessing anxiety disorders can be divided into seven categories: The first includes instruments that assess anxiety as a global construct; the second evaluates psychiatric disorders; the third comprises instruments that assess specific anxiety disorders, taking into account symptomatic behaviors and thoughts or feelings; the fourth category covers instruments related to specific contexts, such as hospital or sports; the fifth category includes instruments for assessing specific characteristics related to anxiety, such as concern, irritability, among others; the sixth category, covers instruments for mental health assessment in general as complaints related to anxiety seen as screening and need for psychiatric care and; finally, the seventh category comprises the other instruments that did not fall into the previous categories. It was also verified that the most used tests in Brazil from 2000 to 2015 were: Anxiety Inventory (BAI), Hospital Anxiety and Depression Scale (HADS); State Trait Anxiety Inventory (IDATE); Hamilton Anxiety Scale; Social Phobia Inventory (SPIN). These instruments are adaptations of international instruments for use in Brazil.

Maternal long-chain polyunsaturated fatty acid status during early pregnancy: Association with child behavioral problems and the role of autonomic nervous system activity

Article

Full-text available

Nov 2020
CLIN NUTR

Background & aims The prenatal environment, including availability of critical nutrients, has a profound impact on offspring development. The present study examined the association between maternal long-chain polyunsaturated fatty acid (LC-PUFA) status during pregnancy and later child behavioral problems at the age of 5–6 years. In light of evidence of autonomic nervous system (ANS) dysregulation in some behavioral problems, study further tested if the above association is statistically mediated by cardiac ANS activity. Methods Data was collected as part of the Amsterdam Born Children and their Development-study and complete data were available for 1717 mothers and their offspring. Maternal LC-PUFA status was assessed during early pregnancy (mean gestation = 12.7, SD = 2.5 weeks) and quantified as levels of docosahexenoic acid (DHA), arachidonic acid (AA), eicosapentaenoic acid (EPA), as well as the ratio of n-6:n-3 fatty acids. Child emotional problems and peer problems (internalizing problems), as well as conduct problems and inattention/hyperactivity (externalizing problems), were assessed using the Strengths and Difficulties Questionnaire as rated by the mother and teacher at 5–6 years. Child cardiac respiratory sinus arrhythmia (RSA), pre-ejection period (PEP), and heart rate (HR) were utilized as measures of ANS activity at 5–6 years. Results The results confirmed an association between maternal LC-PUFA status and internalizing behavioral problems as rated by the mother, as shown for DHA (β = −0.11;p < 0.01), EPA (β = -0.22;p < 0.05), and n-6:n-3 LC-PUFA (β = 0.17;p < 0.01). Statistical mediation was only demonstrated for HR. No associations were observed between LC-PUFA status and externalizing behavioral problems. Conclusions The present results are consistent with a role of maternal LC-PUFA status in internalizing behavioral problems as rated by the mother. These results were not observed when problem behavior was rated by the teacher. Analyses did not yield strong evidence supporting ANS activity as a possible mediator in this relationship.

processing-of-emotional-facial-expressions-efe-in-paediatric-anxiety-are-child-faces-more-noteworthy-than-adult-faces

Article

Full-text available

Jun 2017

Anxiety is characterized by an increased attention toward threatening information. Anxious adults displayed such attentional biases in tasks involving both implicit and explicit evaluation of Emotional Facial Expressions (EFE). This study investigated whether anxiety can disturb these two levels of information processing in children processing emotional faces. Second, we also intended to examine whether anxious children exhibit comparable responses to adult and child EFE, as children are particularly confronted to peers’ faces in their daily life. To this aims, a sample of children with high levels of anxiety on SCARED and STAI-C scales were compared to healthy children ranging in age from 6 to 9 years. They performed a forcedchoice paradigm, consisting in judging the age (adult/child), the gender (male/female) and the emotion (anger/happiness) of faces presented one by one on a screen. For each condition, correct answers rates (CA) and Reaction Time (RT) were examined for anxious and non-anxious groups. Results showed that children performed generally more accurately for judging emotion as compared to age or gender. However, this effect was moderated by the face’s categories, as all children answered with higher accuracy to adult faces in the gender condition, and to children faces in the age condition, meaning they identify more accurately their peers but the sexual characters are more distinguishable on adult faces. All participants were more efficient to identify anger than happiness, but healthy children answered faster to adult angry faces in all conditions, while anxious children did not show this effect and processed more accurately anger on children faces as compared to adult ones. These results suggest that anxious children paid more attention to their peers’ disapproval, while non-anxious children focused rather on adults’ disapprobation. Further research might examine the role of the social standing and need of social approval in paediatric anxiety.

When we seek and share information about mental illness: The impact of threat appraisal, negative emotions, and efficacy

Article

Feb 2020
SOC SCI J

Jiyoung Lee

Mental illnesses (e.g., depression, stress, anxiety disorder) are prevalent in our everyday lives. It is important to explore how individuals cope with mental illness. Little is known, however, about the psychological mechanisms that motivate coping behaviors of mental illness. To address this gap, this study applied an extension of the extended parallel process model (E-EPPM) to examine how threat appraisals (e.g., severity and susceptibility), negative emotions (e.g., anxiety and fear), and coping appraisals (e.g., self-efficacy and response efficacy) show dynamic relationships on information seeking. Furthermore, the current study tests whether information seeking ultimately elicits intentions to spread information on social media. An online survey of adults aged over 18 years old (Mage = 32.40) recruited from Amazon Mechanical Turk (MTurk) was used for this study (N = 614). The structural equation modeling (SEM) results analyzed by AMOS statistical software indicated that anxiety was a strong predictor of coping appraisals and information seeking. Overall, anxiety increased information sharing intentions via self-efficacy and information seeking. Theoretical and practical ramifications are discussed.

Predictors for the Early Termination of a Psychological Intervention During Treatment with Assisted Reproductive Technologies [Prädiktoren für das vorzeitige Beenden einer psychologischen Inter- vention während einer reproduktionsmedizinischen Behandlung]

Article

Full-text available

Feb 2020

Introduction Assisted reproductive technologies are typically perceived by couples as being an emotional burden. The objective of the study “Positive Ausrichtung bei unerfülltem Kinderwunsch” [Positive adjustment in infertility] (PACI) is to examine the efficacy and acceptance of a smartphone-supported psychosocial intervention during infertility treatment. In this investigation, the early drop-out of study subjects from the study is of primary interest. The objective of the investigation was to find predictors for ending a psychological intervention prematurely. Materials and Methods There are data available from an eight-month randomised, controlled study in which 141 patients and their partners participated. Sociodemographic and fertility-related data were collected at the start of the study. The couples received the ScreenIVF questionnaire at two points in time. As part of a post-evaluation, a survey was conducted on the efficacy of the psychological online intervention. To analyse the data, a dyadic data structure was used in order to determine connections within the study subject couples between the selected stress indicators and the drop-out. In addition, a “risk score” as a possible predictor for the drop-out was tested. Results The descriptive observation of the sample indicates in this interim assessment that the study subjects recruited are less stressed patient couples. Actor–partner interdependence models indicate statistically significant connections between the stress indicators of anxiety, little social support and helplessness and an early drop-out. Conclusions The statistically significant effects found in this study with regard to the stress indicators in connection with drop-outs from psychosocial intervention studies indicate that it is advisable to continue to seek measures for people undergoing stressful medical treatments in order to motivate and support them and thus optimally utilise the opportunities of a medical treatment. The number of patients who endure their ART treatment may also increase as a result, which could lead in turn to increased patient satisfaction over the long term (and thus possibly to higher pregnancy rates).

The Effect of Pain Catastrophizing on Endogenous Inhibition of Pain and Spinal Nociception in Native Americans: Results From the Oklahoma Study of Native American Pain Risk

Article

Feb 2020

Background Conditioned pain modulation (CPM) is a task that involves measuring pain in response to a test stimulus before and during a painful conditioning stimulus (CS). The CS pain typically inhibits pain elicited by the test stimulus; thus, this task is used to assess endogenous pain inhibition. Moreover, less efficient CPM-related inhibition is associated with chronic pain risk. Pain catastrophizing is a cognitive-emotional process associated with negative pain sequelae, and some studies have found that catastrophizing reduces CPM efficiency. Purpose The current study examined the relationship between catastrophizing (dispositional and situation specific) and CPM-related inhibition of pain and the nociceptive flexion reflex (NFR; a marker of spinal nociception) to determine whether the catastrophizing–CPM relationship might contribute to the higher risk of chronic pain in Native Americans (NAs). Methods CPM of pain and NFR was assessed in 124 NAs and 129 non-Hispanic Whites. Dispositional catastrophizing was assessed at the beginning of the test day, whereas situation-specific catastrophizing was assessed in response to the CS, as well as painful electric stimuli. Results Situation-specific, but not dispositional, catastrophizing led to less NFR inhibition but more pain inhibition. These effects were not moderated by race, but mediation analyses found that: (a) the NA race was associated with greater situation-specific catastrophizing, which led to less NFR inhibition and more pain inhibition, and (b) situation-specific catastrophizing was associated with greater CS pain, which led to more pain inhibition. Conclusions Catastrophizing may contribute to NA pain risk by disrupting descending inhibition.

Oxytocin attenuates neural response to emotional faces in social drinkers: an fMRI study

Article

Full-text available

Aug 2021
EUR ARCH PSY CLIN N

IntroductionOxytocin is a key mediator of emotional and social behavior that seems to be of relevance for the development and maintenance of addictive behaviors. We thus investigated the effect of oxytocin on neural response and behavior during a face-matching task in a sample of social drinkers.Methods Thirteen social drinkers underwent a randomized double-blind placebo-controlled cross-over functional magnetic resonance imaging face-matching task with and without prior intranasal application of 24 international units oxytocin. Effects of oxytocin and task condition (faces, shapes) on brain activation and individual task performance were assessed.ResultsFace-matching compared to shape-matching trials resulted in higher brain activation in the bilateral amygdala, hippocampus and parts of the occipital gyri. Oxytocin application vs. placebo reduced activation in bilateral amygdala, parts of the frontal gyri, and the parietal lobe. Region of interest analyses indicated that the oxytocin-induced attenuation of amygdala response was specific to face-stimuli and associated with lower subjective alcohol craving, and a lower percentage of heavy-drinking days (defined as ≥ 5 standard drinks/day).Conclusion For the first time, we could show that a larger oxytocin-induced attenuation of amygdala response to fearful faces is associated with lower subjective craving for alcohol and percentage of heavy drinking days in social drinkers. Modulation of amygdala activation, induced by emotional stimuli, might represent a neurobiological substrate of oxytocin’s protective effects on drug seeking behavior.

Acute and Chronic Effects of Resistance Exercise Training Among Young Adults With and Without Analogue Generalized Anxiety Disorder: A Protocol for Pilot Randomized Controlled Trials

Article

Feb 2020

Objectives Recent meta-analyses support the chronic anxiolytic effects of resistance exercise training (RET) among women with diagnosed Generalized Anxiety Disorder (GAD). However, the effects of RET among those with subclinical, or analogue, GAD (AGAD) is unknown. The purpose of the pilot randomized controlled trial (RCT) detailed in this protocol was to quantify the acute and chronic effects of RET on signs and symptoms of GAD among young adults with and without AGAD. Methods This protocol details the full methods of two parallel, RCTs of an eight-week RET intervention compared to a wait-list control condition among young adults with and without AGAD. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire GAD subscale (≥6) and the Penn State Worry Questionnaire (≥45). The ecologically-valid RET was designed according to World Health Organization and American College of Sports Medicine guidelines. The primary outcome was AGAD status, assessed pre- and post-intervention. Secondary outcomes were assessed weekly. Two acute RET trials were nested within the design at pre- and post-intervention to determine response and change in response to a single bout of RET. Conclusions This pilot RCT examines the effect of an ecologically-valid RET intervention among young adults with subclinical levels of GAD. Given that GAD most often emerges during young adulthood, and young adults who display elevated subclinical symptoms are more likely to develop clinically significant psychopathology, investigating the effects of RET among individuals with emerging signs and symptoms of an anxiety disorder is particularly important. Trial registration ClinicalTrials.gov Identifier: NCT04116944.

Effect of selected play activities on preoperative anxiety level and fear among children undergoing abdominal surgeries

Article

Jan 2018

Trajectory and Predictors of Fatigue Among Chinese Immigrant and Chinese Canadian-Born Women in the Postpartum Period

Article

Feb 2020
J Obstet Gynecol Neonatal Nurs

Objective: To describe the proportion of women with improving or worsening symptoms of fatigue at 1, 3, 6, and 12 months after birth; to model the trajectory of fatigue across the first year after birth and identify baseline predictors (e.g., immigrant status) and time-varying predictors; and to describe the degree to which fatigue interferes with activities of daily living across the first year after birth among a cohort of Chinese immigrant and Chinese Canadian-born women. Design: Prospective cohort study. Setting: Toronto, Ontario, Canada. Participants: Chinese women who were recent immigrants (n = 244), nonrecent immigrants (n = 247), or Canadian born (n = 100). Methods: Women completed surveys at 1, 3, 6, and 12 months after birth. We measured fatigue with the use of the Multidimensional Assessment of Fatigue scale. Fatigue predictor variables were classified as baseline (e.g., immigrant status) or time varying (e.g., depression). We used latent growth curve modeling to examine fatigue trajectories and identify predictors over time. Results: Fatigue followed a nonlinear pattern: it improved from 1 to 6 months after birth and then worsened from 6 to 12 months after birth. Depression, anxiety, infant sleep characteristics, and breastfeeding problems, but not immigrant status, significantly increased risk for fatigue. Several daily activities were significantly influenced by fatigue, particularly early in the postpartum period as well as later, which showed a U-shaped relationship between fatigue and activities of daily living. Conclusion: Fatigue is common and persistent across the postpartum period. Modifiable risk factors related to mental health, infant sleep, and breastfeeding difficulties suggest that preventive strategies for maternal fatigue warrant further investigation.

The mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias

Article

Full-text available

Jan 2019

Context: The basis of anxiety disorders in cognitive and emotional fields can be effective in coping strategies to anxiety. Aims: This research aimed to investigate the mediating role of emotional distress tolerance in relationship between self-discrepancy with anxiety in people suffering from special phobias. Settings and Design: The present study was a correlational research with structural equation modeling. Materials and Methods: The statistical population of this study was all individuals suffering from specific phobia disorders in the 5th Azar Hospital in Gorgan City. The sample size selection, which was made by Loehlin method (2004), was 220 persons suffering from anxiety disorder referring to Psychiatric Clinics of 5 Azar Hospital in Gorgan City and was investigated by purposeful sampling. Data gathering tools included Distress Tolerance Scale, self-discrepancy questionnaire, and Spielberger State-Trait Anxiety Inventory. Statistical Analysis Used: The collected data were analyzed using structural regression equations using SPSS 18 and Amos 23 software. Results: The findings showed that the research model is fit and overall, 42% of the anxiety could be explained through emotional stress tolerance and self-discrepancy, and emotional distress tolerance has a mediating role in relationship self-discrepancy with anxiety. Conclusions: The results of this research emphasized the necessity of self-discrepancy as well as the role of mediator of emotional distress tolerance in anxiety in people suffering from special phobias, which can provide applied templates for improving the psychological state of anxious individuals with therapists and counselors.

Development and Validation of a Japanese Version of the Emotion Regulation Questionnaire for Children and Adolescents

Article

Full-text available

Jan 2020

Purpose: We developed a Japanese version of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) and examined its reliability and validity across three studies. Patients and methods: In Study 1, the Japanese version of ERQ-CA was developed and administered to 389 children aged 8-12 years. In Study 2, the questionnaire was administered to 1738 adolescents aged 12-18 years. In Study 3, utilizing a sample of 1300 children and adolescents, the test was administered twice over a period of four weeks in order to assess test-retest reliability. Results: In Study 1, the Japanese version of ERQ-CA showed the same factor structure as the original version, along with good internal consistency reliability and acceptable construct validity. In Study 2, the questionnaire's factor structure, internal consistency reliability, and construct validity were again confirmed. Finally, in Study 3, measurement invariance was tested across distinct age groups (8-11, 12-15, and 16-18 years), and the questionnaire had good test-retest reliability over a period of four weeks. Conclusion: The Japanese version of the ERQ-CA had good reliability and validity.

Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy

Article

Full-text available

Jan 2020

Psychological distress is a common consequence of breast cancer diagnosis and treatment and could further exacerbate therapy side effects. Interventions increasing treatment tolerance are crucial to improve both patients' quality of life and adherence to therapies. Virtual reality (VR) has emerged as an effective distraction tool for different medical procedures. Here, we assessed the efficacy of immersive and interactive VR in alleviating chemotherapy‐related psychological distress in a cohort of Italian breast cancer patients, also comparing its effects with those of music therapy (MT). Thirty patients were included in the VR group, 30 in the MT group, and 34 in the control group, consisting of patients receiving standard care during chemotherapy. Our data suggest that both VR and MT are useful interventions for alleviating anxiety and for improving mood states in breast cancer patients during chemotherapy. Moreover, VR seems more effective than MT in relieving anxiety, depression, and fatigue. The efficacy of virtual reality (VR) has been tested versus music therapy (MT) and a control group. The results of our study suggest that both VR and MT are useful interventions for alleviating anxiety and for improving mood states in breast cancer patients during chemotherapy. Moreover, the VR intervention seems more effective than MT in relieving anxiety, depression, and fatigue. Thus, despite its limitations, this study supports the continuous research on VR as a distraction intervention able to meet the global clinical need for effective nonpharmacologic adjuncts.

Cognitive behavioral therapy (CBT) anxiety management and reasoning bias modification in young adults with anxiety disorders: A real-world study of a therapist-assisted computerized (TACCBT) program Vs. “person-to-person” group CBT

Article

Full-text available

Jan 2020

Computerized cognitive behavioral therapy (cCBT) appears to be a therapeutic strategy that is as effective as person-to-person CBT in the treatment of adults and young people with anxiety disorders. The aim of our controlled study was to evaluate the following in young adult users affected by anxiety disorders: (1) the feasibility of our simple "prototype" of a therapist-assisted computerized cognitive behavioral therapy (TacCBT); and (2) the effectiveness of two different interventions-group CBT and TacCBT-in an "enriched" format for anxiety management and reasoning bias modification as compared to a control group. Psychopathology, global functioning, and cognitive flexibility were examined in 13 users undergoing TacCBT and compared to those receiving "person-to-person" group CBT (CBT Group, n = 25), which controlled for their psychopharmacological treatment. Users were included in the arms of our real-word study on the basis of their treatment preferences. Twelve subjects were included in a Treatment as Usual (TAU) group. Following the intervention, all groups showed a significant improvement in symptoms. Both CBT groups showed an improvement in cognitive flexibility with respect to TAU, in addition to a reduction of their reasoning overconfidence. Our preliminary results show the benefits of the TacCBT program and highlight its advantages.

Longitudinal changes of resting-state functional connectivity of amygdala following fear learning and extinction

Article

Jan 2020
INT J PSYCHOPHYSIOL

Altered functional connectivity of the amygdala has been observed in a resting state immediately after fear learning, even one day after aversive exposure. The persistence of increased resting-state functional connectivity (rsFC) of the amygdala has been a critical finding in patients with stress and anxiety disorders. However, longitudinal changes in amygdala rsFC have rarely been explored in healthy participants. To address this issue, we studied the rsFC of the amygdala in two groups of healthy volunteers. The control group participated in three fMRI scanning sessions of their resting state at the first visit, one day, and one week later. The experimental group participated in three fMRI sessions on the first day: a resting state before fear conditioning, a fear extinction session, and a resting state immediately after fear extinction. Furthermore, this group experienced scanning after one day and week. The fear-conditioning paradigm consisted of visual stimuli with a distinct rate of partial reinforcement by electric shock. During the extinction, we presented the same stimuli in another sequence without aversive pairing. In the control group, rsFC maps were statistically similar between sessions for the left and right amygdala. However, in the experimental group, the increased rsFC mainly of the left amygdala was observed after extinction, one day, and one week. The between-group comparison also demonstrated an increase in the left amygdala rsFC in the experimental group. Our results indicate that functional connections of the left amygdala influenced by fear learning may persist for several hours and days in the human brain.

Cannabidiol as a Treatment for Mood Disorders: A Systematic Review

Article

Dec 2019
CAN J PSYCHIAT

Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov , and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.

Psychosocial interventions for caregivers of individuals with autism spectrum disorder (ASD): a systematic review

Preprint

Full-text available

May 2016

Queralt Burgaya-Julià

Taking care of an individual with autism spectrum disorder (ASD) can be considered as a lifelong challenge. The demands of raising a child with ASD are associated with significant physical and mental health consequences for parents, including increased reports of emotional distress, reduced quality of life and higher caregiving burden than parents of typically developing children. In turn, the caregiver's mental health and family functioning impacts on the quality of care provided to the child. However, no systematic reviews have analysed the effects of psychosocial interventions in improving well-being in this population. The purpose of this review was to address whether psychosocial interventions are effective in improving caregivers' psychosocial well-being.

Per- and polyfluoroalkyl substances and psychosocial stressors have a joint effect on adverse pregnancy outcomes in the Atlanta African American Maternal-Child cohort

Article

Oct 2022

Background: African Americans (AAs) experience high rates of adverse pregnancy outcomes relative to Whites. Differential in utero exposure to environmental chemicals and psychosocial stressors may explain some of the observed health disparities, as exposures to per- and polyfluoroalkyl substances (PFAS) and experiences of discrimination have been linked to adverse birth outcomes. Few studies have examined chemicals and non-chemical stressors together as an exposure mixture, which may better reflect real-life exposure patterns. Here, we adapted methods designed for the analysis of exposure mixtures to examine joint effects of PFAS and psychosocial stress on birth outcomes among AAs. Methods: 348 participants from the Atlanta African American Maternal-Child cohort were included in this study. Four PFAS were measured in first trimester serum samples. Self-report questionnaires were administered during the first trimester and were used to assess psychosocial stress (perceived stress, depression, anxiety, gendered racial stress). Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to estimate the joint effects between PFAS and psychosocial stressors on gestational age at delivery and birthweight for gestational age z-scores. All models were adjusted for maternal education, maternal age, parity, and any alcohol, tobacco and marijuana use. Results: Our analytic sample included a socioeconomically diverse group of pregnant women, with 79 % receiving public health insurance. In quantile g-computation models, a simultaneous one-quartile increase in all PFAS, perceived stress, depression, anxiety, and gendered racial stress was associated with a reduction in birthweight z-scores (mean change per quartile increase = -0.24, 95 % confidence interval = -0.43, -0.06). BKMR similarly showed that increasing all exposures in the mixture was associated with a modest decrease in birthweight z-scores, but not a reduced length of gestation. Discussion: Using methods designed for analyzing exposure mixtures, we found that a simultaneous increase in in utero PFAS and psychosocial stressors was associated with reduced birthweight for gestational age z-scores.

Aim. This study aimed to examine the effect of open visiting hours on sleep quality, anxiety, and satisfac-tion of patients undergoing coronary artery bypass graft surgery (CABG).

Article

Full-text available

Jan 2019

Mohammad Imanipour

Effects of hydrogen water and psychological treatment in a sample of women with panic disorder: a randomized and controlled clinical trial

Article

May 2022

Research suggests that inflammation is an important mediator in the pathophysiology of anxiety disorders. In addition, women are more likely to develop an anxiety and depression disorder, in comorbidity with a wide spectrum of diseases related to the immune system. In recent years, hydrogen-rich water has emerged as a promising therapeutic strategy to prevent and intervene in stress-related disorders, due to its antioxidant and anti-inflammatory properties. The present study aims to analyze the effects of psychological treatment and a hydrogen-rich drink on the severity of anxiety and depression, pro-inflammatory cytokine levels, the cortisol awakening response, and general health state in a sample of women with panic disorder. This is a completely randomized, placebo-controlled study. The treatment group simultaneously received psychological treatment and 1.5 L of hydrogenated water for three months, compared to the control group that received psychological treatment and placebo. The results show that the treatment group was not significantly better than the control group. But there was a further reduction in measured pro-inflammatory cytokine scores, improving body pain and physical health. When between-group treatment effects were removed, psychological treatment significantly decreased measured variables, including cytokines and cortisol. The results support the presence of a maladaptive inflammatory process in women with panic disorder.

Wearing a Mask Shapes Interpersonal Space during COVID-19 Pandemic

Article

Full-text available

May 2022
BSRCCS

Social distancing norms have been promoted after the COVID-19 pandemic. In this work, we tested interpersonal space (IPS) in 107 subjects through a reaching-comfort distance estimation task. In the main experiment, subjects had to estimate the comfort and reach space between an avatar wearing or not wearing a face mask. We found that IPS was greater between avatars not wearing a mask with respect to stimuli with the mask on, while reaching space was not modulated. IPS increment in the NoMask condition with respect to the Mask condition correlated with anxiety traits, as shown with the State-Trait Anxiety Inventory, rather than with transient aspects related to the pandemic situation. In the control experiment, the avatars with a mask were removed to further explore the conditioning effect provided by the presence of the facial protection in the main experiment. We found a significant difference comparing this condition with the same condition of the main experiment, namely, the distances kept between avatars not wearing a mask in the main experiment were greater than those between the same stimuli in the control experiment. This showed a contextual adaptation of IPS when elements related to the actual pandemic situation were relevant. Additionally, no significant differences were found between the control experiment and the Mask condition of the main experiment, suggesting that participants had internalized social distancing norms and wearing a mask has become the new normal. Our results highlight the tendency of people in underestimating the risk of contagion when in the presence of someone wearing a mask.

Prenatal internalizing symptoms as a mediator linking maternal adverse childhood experiences with infant temperament

Article

Apr 2022
EARLY HUM DEV

Background Maternal adverse childhood experiences are known to significantly influence offspring development. However, mediators linking maternal early-life adversity with infant temperament remain largely unknown. Aims The current study investigated whether prenatal internalizing symptoms mediate the association between maternal adverse childhood experiences and infant temperament at two months. Maternal sensitivity/responsiveness during the postpartum period was also examined as a moderator of these associations. Study design We used a repeated-measures design, with self-report measures administered during pregnancy. Self-report and observational data were also collected at 2 months postpartum. Subjects The study included a community sample of 64 pregnant women and their infants. Outcome measures Participants completed measures assessing their early-life adversity and current depression/anxiety symptoms. At two months postpartum, mothers reported on their infant's temperament and participated in a parent-child interaction task designed to assess maternal sensitivity/responsiveness. Results and conclusions Maternal adverse childhood experiences indirectly predicted poor self-regulation during early infancy via prenatal internalizing symptoms. Maternal sensitivity/responsiveness was also found to moderate the association between maternal adverse childhood experiences and certain aspects of infant regulatory capacity and positive affectivity at two months. This research has implications for mental health screening procedures during pregnancy and the development of early intervention programs.

Exploring the Structure and Interrelations of Time-Stable Psychological Resilience, Psychological Vulnerability, and Social Cohesion

Article

Full-text available

Mar 2022

The current study explores the relationship between three constructs of high relevance in the context of adversities which have, however, not yet been systematically linked on the level of psychological dispositions: psychological vulnerability, psychological resilience, and social cohesion. Based on previous theoretical and empirical frameworks, a collection of trait questionnaires was assessed in a Berlin sample of 3,522 subjects between 18 and 65 years of age. Using a confirmatory factor analytical approach, we found no support for a simple three-factor structure. Results from exploratory structural analyses suggest that instead of psychological resilience and psychological vulnerability constituting two separate factors, respective indicators load on one bipolar latent factor. Interestingly, some psychological resilience indicators contributed to an additional specific latent factor, which may be interpreted as adaptive capacities, that is, abilities to adapt to changes or adjust to consequences of adversities. Furthermore, instead of evidence for one single social cohesion factor on the psychological level, indicators of perceived social support and loneliness formed another specific factor of social belonging, while indicators of prosocial competencies were found to form yet another distinct factor, which was positively associated to the other social factors, adaptive capacities and social belonging. Our results suggest that social cohesion is composed of different independent psychological components, such as trust, social belonging, and social skills. Furthermore, our findings highlight the importance of social capacities and belonging for psychological resilience and suggest that decreasing loneliness and increasing social skills should therefore represent a valuable intervention strategy to foster adaptive capacities.

Positive cognitive reappraisal is beneficial for women’s but not for men’s IGT decision-making

Article

Full-text available

Jun 2022
MOTIV EMOTION

Real-life decision-making involves a balance between emotion and cognition, a process that is mirrored in the Iowa Gambling Task (IGT). Previous studies suggest that negative emotion affects IGT performance, and that this effect may be moderated by gender. In the current study, we experimentally instructed the use of a strategy for ameliorating the incidental negative emotion induced by negative images while men and women solved the IGT. To do this, we asked 38 men and 38 women to either only look at negative images (non-reappraisal group) or to use positive cognitive reappraisal when facing these negative images (reappraisal group) to ameliorate the negative emotion associated with them while trying to solve the IGT. Both men and women in the reappraisal group successfully used positive reappraisal to decrease their negative emotion compared to the control, non-reappraisal group. Critically, we observed that women performed better in the reappraisal group compared with the non-reappraisal group, in the second half of the task (performance phase). Conversely, men performed worse in the reappraisal group compared to the non-reappraisal group in the second half of the task (performance phase). Finally, a multigroup analysis revealed a gender moderation of the direct and indirect effects of positive reappraisal on IGT performance, indicating that reappraisal benefited women’s IGT performance through the regulation of negative emotion. Conversely, for men, the decrease of negative emotion through reappraisal did not impact IGT performance. Our results demonstrate that while the use of positive reappraisal is useful to ameliorate negative emotions for men and women, positive reappraisal benefits women’s decision-making, and impairs men’s.

Improving care transitions with standardized peer mentoring: Evidence from intervention based research using randomized control trial

Article

Jan 2022
J OPER MANAG

We investigate how patients can co-create value when transitioning care between the hospital and home after a major life altering surgery such as kidney transplant. Collaborating with health care providers at a large U.S. hospital, we adopted an intervention-based research approach to develop a standardized peer-mentoring program where former patients mentor current patients for 30 days postdischarge. We assessed the impact of the program on patient anxiety and 30-day readmissions through a randomized control trial that recruited 80 transplant patients. Our analyses of patient anxiety indicated that patients in the treatment arm experienced 3.42 points greater decrease in anxiety score over 30 days, suggesting that care transitions using mentors decreases anxiety levels among patients. Our analyses of readmissions led to an unexpected but explainable result. We found that patients in the treatment arm were at 12.6 times greater risk of readmission during the first 30 days. Exploratory analysis suggests that increased readmission may have been due to patients reporting complications sooner, which allowed them to get treated earlier. Overall, our study informs healthcare operations on how to design effective transition of care programs using cost-effective resources and offers new insights on using patient-centric metrics.

Impaired differential learning of fear versus safety signs in obsessive‐compulsive disorder

Article

Full-text available

Oct 2021

Pavlovian learning mechanisms are of great importance both for models of psychiatric disorders and treatment approaches, but understudied in obsessive-compulsive disorder (OCD). Using an established Pavlovian fear conditioning and reversal procedure, we studied skin conductance responses in 41 patients with OCD and in 32 matched healthy control participants. Within both groups, fear acquisition and reversal effects were evident. When comparing groups, patients showed impaired differential learning of threatening and safe stimuli, consistent with previous research. In contrast to prior findings, differential learning impairments were restricted to fear acquisition, and not observed in the reversal stage of the experiment. As previous and present fear reversal experiments in OCD differed in the use of color coding to facilitate stimulus discrimination, the studies converge to suggest that differential learning of threatening versus safe stimuli is impaired in OCD, but manifests itself differently depending on the difficulty of the association to be learned. When supported by the addition of color, patients with OCD previously appeared to acquire an association early but failed to reverse it according to changed contingencies. In absence of such color coding of stimuli, our data suggest that patients with OCD already show differential learning impairments during fear acquisition, which may relate to findings of altered coping with uncertainty previously observed in OCD. Impaired differential learning of threatening versus safe stimuli should be studied further in OCD, in order to determine whether impairments in differential learning predict treatment outcomes in patients, and whether they are etiologically relevant for OCD.

Effect of depression and anxiety on human schedule performance

Article

Full-text available

Jul 2021

Two experiments examined the impact of depression and anxiety on the microstructure of human schedule responding. Human participants responded by pressing a computer key for points on a multiple random ratio (RR) random interval (RI) schedule. The RI schedule was yoked to the RR schedule in terms of reinforcement rate within subject. Overall response rates were higher on the RR compared to the RI schedule. In both experiments, the presence of psychometrically-measured depressive traits reduced overall levels of responding. Depressive traits also decreased within-bout responding, but increased levels of bout-initiation responding. These findings regarding the microstructure of responding were not noted for anxiety traits. These results suggest that depression impacts learning by working through a number of different mechanisms – both impacting the perceived value of the reinforcer, and possibly by creating a bias to attend and process external cues associated with reinforcement which are taken to control response-initiation rates.

Abnormal brain functional network dynamics in obsessive-compulsive disorder patients and their unaffected first-degree relatives

Article

Full-text available

Jun 2021
HUM BRAIN MAPP

We utilized dynamic functional network connectivity (dFNC) analysis to compare participants with obsessive-compulsive disorder (OCD) with their unaffected first-degree relative (UFDR) and healthy controls (HC). Resting state fMRI was performed on 46 OCD, 24 UFDR, and 49 HCs, along with clinical assessments. dFNC analyses revealed two distinct connectivity states: a less frequent, integrated state characterized by the predominance of between-network connections (State I), and a more frequent , segregated state with strong within-network connections (State II). OCD patients spent more time in State II and less time in State I than HC, as measured by fractional windows and mean dwell time. Time in each state for the UFDR were intermediate between OCD patients and HC. Within the OCD group, fractional windows of time spent in State I was positively correlated with OCD symptoms (as measured by the obsessive compulsive inventory-revised [OCI-R], r = .343, p<.05, FDR correction) and time in State II was negatively correlated with symptoms (r = À.343, p<.05, FDR correction). Within each state we also examined connectivity within and between established intrinsic connectivity networks, and found that UFDR were similar to the OCD group in State I, but more similar to the HC groups in State II. The similarities between OCD and UFDR groups in temporal properties and State I con-nectivity indicate that these features may reflect the endophenotype for OCD. These results indicate that the temporal dynamics of functional connectivity could be a useful biomarker to identify those at risk.

Anxiety, post-traumatic stress symptoms, and emotion regulation: A longitudinal study of pregnant women having given birth during the COVID-19 pandemic

Article

Apr 2021

The objectives of the present longitudinal study were to (i) understand the potential impacts of concern about the COVID-19 epidemic and containment measures (e.g. lockdown) on the psychological and emotional status of women during pregnancy and after childbirth, (ii) identify factors associated with these impacts, and (iii) to study the mothers’ coping strategies and protective factors. Data were collected during pregnancy (timepoint 1, during France's first period of lockdown from April 6th to May 11th, 2020) and then one month after childbirth (timepoint 2). At timepoint 1, 90 women completed a sociodemographic questionnaire, the Spielberger Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, and the Multidimensional Scale of Perceived Social Support. At timepoint 2, 26 women completed the City Birth Trauma Scale, the Interpersonal Emotional Regulation Questionnaire, and the Posttraumatic Growth Inventory. The relationship between social support and worry about the fetus/baby during the COVID-19 pandemic was statistically significant (Rho=- 0.21; p<0.05). Worry about the fetus/baby was also significantly correlated with the anxiety score (Rho=0.60; p<0.01) and the depression score (Rho= 0.37, p<0.01). When the study population was compared with a control sample of new mothers having given birth outside the lockdown period, we observed differences in the prevalence of anxiety but not in the prevalence of postpartum PTSD. Lastly, the relationship between posttraumatic growth and emotion regulation was not significant (Rho=0.29, p=0.16 for soothing; Rho=0.26, p=0.20 for social modeling; Rho=0.28; p=0.17 for perspective-taking; Rho=0.35; p=0.08 for enhancing positive affect). In view of the sample size and the statistical tests, this study should be considered as exploratory. Our present results open up opportunities for further research and suggest that a possible impact of COVID-19 must be considered when evaluating potential psychological disorders in the perinatal period.

Association between Symptoms of Psychological Distress and Cognitive Functioning among Adults with Coronary Artery Disease

Article

Dec 2020

Greater psychological distress is associated with cognitive impairment in healthy adults. Whether such associations also exist in patients with coronary artery disease (CAD) is uncertain. We assessed cognitive function in 496 individuals with CAD using the verbal and visual memory subtests of the Wechsler Memory Scale and executive functioning measured by the Trail Making Test parts A and B. We used a composite score of psychological distress derived through summation of Z‐transformed psychological distress symptom scales (depression, posttraumatic stress, anxiety, anger, hostility, and perceived stress) and scores for each individual psychological scale. Multivariable linear regression models were used to determine the association between memory scores (as outcomes) and the psychological distress scores (both composite score and individual scales). After adjusting for demographic and cardiovascular risk factors, a higher psychological distress score was independently associated with worse memory and executive functioning. Each standard deviation increase in psychological distress score was associated with 3% (95% CI 1% to 5%) to 5% (95% CI 3 to 7%) worse cognitive performance (higher Trail‐A and Trail B, and lower verbal and visual memory scores). Among individuals with CAD, a higher level of psychological distress is independently associated with worse cognitive performance. These findings suggest that psychological risk factors play a role in cognitive trajectories of persons with CAD. This article is protected by copyright. All rights reserved.

Impaired set-shifting in drug-naïve patients with borderline personality disorder: an event-related potentials study

Article

Feb 2021
J AFFECT DISORDERS

Background: Neurocognitive impairments might play a key role in the development of Borderline Personality Disorder (BPD), however, the pathophysiological mechanism underlying cognitive impairment of BPD is largely unknown. This study was aimed to examine the electrophysiological mechanism of deficits in set-shifting processing in patients with BPD. Methods: Twenty-seven drug-naïve patients with BPD and twenty-four healthy controls were recruited. Demographic variables and clinical characteristics of all subjects were collected. Behavioral data and event-related potentials (ERPs) were recorded when subjects were performing the task-switching paradigm, which was applied to investigate the set-shifting function. The P2, N2 and P3 components in the task-switching paradigm would be analyzed. Results: Patients with BPD had significantly higher level of impulsivity, depression and anxiety than healthy controls. When performing the switching task, the BPD group had lower P2 amplitude and higher N2 amplitude than the control group. In the BPD group, the P2 latency at Fz electrode in repeat task was correlated positively with the level of depression, and P2 latency at Pz electrode in repeat task and switch task both had significantly negative relationships with the the level of anxiety. Limitations: This cross-sectional designed study did not clarify the causal relationship of the electrophysiological characteristics and the development of BPD. Conclusions: Patients with BPD might have abnormal brain activities when overcoming the inhibition of current task and inhibiting the effects of prior task, and their top-down control function might be impaired. These findings provide some useful clues for the underlying pathophysiological mechanism of BPD.

Psychological effects of nurses and midwives due to COVID-19 outbreak: The case of Turkey

Article

Jul 2020
ARCH PSYCHIAT NURS

Purpose The study was carried out to determine the psychological impact levels of nurses and midwives due to the COVID-19 outbreak. Methods The research is planned in a descriptive type. Nurses and midwives working in any health institution in Turkey constituted the population of the research. The questionnaire form of the study was shared on social media tools between 01 and 14 April 2020 and a total of 758 nurses and midwives were included in the study sample. Personal Information Form, State-Trait Anxiety Inventory and Intolerance of Uncertainty Scale were used as data collection tools. Results Participants who attended the study were 56.9% of nurses and 43.1% of midwives. Approximately half of the nurses and midwives (48.8%) participating in our study contacted the patient with suspected COVID-19, and 29.8% provided care to the patient diagnosed with COVID-19. Nurses and midwives were scored 52.75 ± 9.80 for State Anxiety, 44.87 ± 7.92 for Trait Anxiety Inventory and 35.16 ± 9.42 for Intolerance of Uncertainty Scale. It has been determined that 54.5% of nurses and midwives have been making their lives worse since the outbreak started, 62.4% had difficulties in dealing with the uncertain situation in the outbreak, 42.6% wanted psychological support and 11.8% had alienated from their profession. It was determined that there was a difference between scale scores and difficulties in work, family and private life due to COVID-19. Conclusion As a result, it is seen that the midwives and nurses in our country have high psychological effects due to the COVID-19 outbreak.

Emotion regulation

Chapter

Apr 2020

In this chapter we include a brief review of the emotion-performance relationship literature. We then describe psychobiosocial states and their defining characteristics as conceptualized within the individual zones of optimal functioning (IZOF; Hanin, 2007) model as applied to emotion regulation. Finally, we introduce the multi-action plan (MAP; Bortoli et al., 2012) model, which has been developed for emotion and action regulation in the optimization of athletes’ performance. Some directions for future research are also proposed.

The influence of attachment styles on autonomic correlates of perspective-taking

Article

May 2020
BIOL PSYCHOL

This study examined the effects of attachment styles on physiological responses during a perspective-taking task. Sixty-eight participants were selected according to attachment styles. Physiological responses were assessed using skin conductance responses (SCRs) in the three attachment groups (secure, insecure-anxious and insecure-avoidant) during the presentation of attachment-based pictures (distress, comfort or neutral) in two different perspective-taking conditions: self perspective-taking (i.e. imagine how you would feel in the given situation) or other perspective-taking (i.e. imagine how that person could feel in this situation). In the self perspective-taking condition, insecure-anxious individuals displayed higher SCRs than secure individuals for distress pictures. In the other perspective-taking condition, insecure-anxious individuals showed higher SCRs than secure individuals for comfort pictures. The results also showed a strong negative association between self-reported perspective-taking tendencies and SCRs in secure individuals. The findings suggest that perspective-taking plays an important role in the modulation of physiological responses in reaction to attachment-related pictures, which varies according to attachment styles.

Sleep and Glycemia in Youth With Type 1 Diabetes

Article

Full-text available

Mar 2020
J Pediatr Health Care

Introduction Short sleep duration and quality are problems for many youth, and are associated with difficulties in executive function. Our purpose was to describe subjective and objective sleep characteristics and their associations with executive function, stress and coping, adjustment, and self-management in youth with type 1 diabetes (T1D). Method Youth with T1D (N = 40; mean age, 13.4 ± 1.9 years; 60% female; 77.1% non-Hispanic white; diabetes duration, 7.1 ± 4.6 years; and hemoglobin A1c, 8.2 ± 1.2%) wore an actigraph and a continuous glucose monitor for 3–7 days and completed questionnaires. Descriptive and bivariate analyses were conducted. Results Sleep variability was associated with stress and depressive symptoms, as well as more glucose variability. Consistent rest-activity rhythm timing was associated with fewer trait anxiety symptoms. Robust rhythms were associated with better diabetes self-management. Discussion Providers should routinely assess sleep habits in youth, especially those with T1D. Improving consistency in sleep timing and sleep duration may be a potential therapeutic target to improve diabetes clinical outcomes.

PREPARE: PreoPerative Anxiety REduction. One-Year Feasibility RCT on a Brief Psychological Intervention for Pancreatic Cancer Patients Prior to Major Surgery

Article

Full-text available

Mar 2020

IntroductionThe aim of the present paper is to establish feasibility and required power of a one-session psychological intervention devoted to increasing patient’s self-efficacy and awareness in dealing with anxiety symptoms before major pancreatic cancer surgery.Methods Parallel assignment RCT. All consenting patients listed for pancreatic major surgery during day-hospital visits (T0) between June 2017–June 2018 were assigned randomly in blocks of ten to a psychological intervention vs usual care group to be held the day before surgery (T1). The psychological intervention provided the patient the opportunity to increase self-efficacy in dealing with anxiety by talking with a psychologist about personal concerns and learning mindfulness based techniques to cope with anxiety.Results400 patients were randomized into the experimental vs. usual care group. 49 and 65, respectively, completed baseline and post-intervention measures. The dropout rate between day-hospital (T0) and pre-surgery intervention (T1) was high (74.5%) due to several management and organization pitfalls. The main outcome, perceived self-efficacy in managing anxiety, showed a significant increase in the intervention group compared to the control group (p < 0.001), and was related to a reduction in state anxiety (p < 0.001). The intervention group perceived also lower emotional pain (p = 0.03). A power analysis was performed to define the appropriate sample size in a definitive RCT.Conclusion Beneath the complexity in retaining patients along their trajectory in pancreatic surgery department, when they had the opportunity to follow a brief psychological intervention, most of them adhered, showing a significant reduction in preoperative emotional distress and less emotional pain perception after surgery. Even if results need caution because of the high attrition rate, we can infer that our psychological intervention has the potential to be proposed in surgical setting, being short, easy to learn and applicable to a wide range of patients.Clinical Trial RegistrationThe trial was registered on ClinicalTrials.gov (identifier: NCT03408002). The full protocol is available from the last author.

The influence of fear on risk taking: a meta-analysis

Article

Mar 2020

A common finding in the study of emotion and decision making is the tendency for fear and anxiety to decrease risk taking. The current meta-analysis summarises the strength and variability of this effect in the extant empirical literature. Our analysis of 136 effect sizes, derived from 68 independent samples and 9,544 participants, included studies that experimentally manipulated fear or measured naturally varying levels of fear or anxiety in both clinical and non-clinical samples, and studies measuring risky decision making and risk estimation. A multilevel random effects model estimated a small to moderate average effect size (r = 0.22), such that fear was related to decreased risky decision making and increased risk estimation. There was also high heterogeneity in the effect sizes. Moderator analyses showed that effect sizes were greater when risk tasks used tangible (e.g. monetary) outcomes and when studies used clinically anxious participants. However, there also remained considerable variability in effect sizes, the sources of which remain unknown. We posit several potential factors that may contribute to observed variability in this effect for future study, including factors concerning both the nature of fear experience and the risk taking context.

Associations between latent trait negative affect and patterns of food‐intake among girls with loss‐of‐control eating

Article

Full-text available

Feb 2020

Objective: Momentary negative affect (NA) has been shown to predict eating patterns in the laboratory, yet, more stable mood states have not been studied in relation to eating patterns in the laboratory among youth at high risk for binge-eating disorder and obesity. Method: One-hundred-eight adolescent girls (14.5 ± 1.7 years) with BMI between the 75th-97th percentile who reported loss-of-control (LOC)-eating completed measures of trait anxiety and depressive symptoms. Food-intake patterns were measured from a laboratory test meal (9,385 kcal). Latent factor analysis of depressive symptoms and trait anxiety was used to compute latent trait NA. Multivariate general linear models predicted total energy, snacks, and macronutrient intake from trait NA, adjusting for age, race, height, lean-mass, and percentage fat-mass. Results: Trait NA was significantly positively related to total energy-intake, and, specifically, snacks, sweet snacks, and percentage sweet fats (ps ≤ .03), and negatively related to percentage protein consumed (p = .04). Discussion: Expanding on affect theory, trait NA may relate to palatable food-intake among girls with LOC-eating. Further data are needed to determine whether those with LOC-eating and trait NA are at heightened risk for the development of binge-eating disorder and obesity.

Wayfinding Strategy and Gender – Testing the Mediating Effects of Wayfinding Experience, Personality and Emotions

Article

Full-text available

Jan 2020

Background: Individual differences have been seen to play a key role in spatial orientation. Gender implications have been previously described but little is known about how other variables, such as wayfinding anxiety, emotional difficulties and wayfinding experience can mediate this relationship. Methods: A group of 269 participants were involved in this study and completed questionnaires on their self-reported allocentric orientation strategy, wayfinding experience and satisfaction with the ability for wayfinding. Emotional outcomes were also investigated: spatial and trait anxiety, neuroticism, difficulties in emotion regulation, and personal safety. First, a principal component analysis was conducted and the studied variables were grouped into four components: outdoor wayfinding experience, wayfinding-related fear, emotional difficulties, and effective wayfinding skill. Afterwards, structural equation modelling was performed, using the MPLUS statistical program. Results: The results showed that gender constitutes a predictor for using an effective wayfinding skill and for feeling wayfinding-related fear. However, outdoor wayfinding experience, wayfinding-related fear and emotional difficulties did not mediate the relationship between effective wayfinding skill and gender. Conclusion: These results highlight the differential contribution of gender in the emotions that are experienced during spatial orientation and emotions that are related to other types of situations. The limitations, strengths and theoretical implications of the proposed model are discussed. Further investigation is needed in order to understand the role of emotions in spatial orientation.

To attend, or not to attend: Examining caregiver intentions and study compliance in a pediatric, randomized controlled trial

Article

Jan 2020

Background/Aims The Intent to Attend is a brief questionnaire recommended by the National Research Council to address dropout concerns and improve prediction of missing data in clinical trials, although implementation has been very limited. As a formative study in pediatric research, the relationship between caregiver intentions and study compliance was investigated in a 180-day trial of dietary supplementation of preterm toddlers. Treatment effect estimation in the context of missing data was also explored. Methods Study compliance (i.e. study completion, supplement adherence, and diary completion) was tracked over three study visits. Baseline questionnaires asked caregivers about intentions concerning study completion via the Intent to Attend, screened for mental health symptoms (depression, trait anxiety), and captured family demographics. Simple and multiple logistic regression models were built to examine associations between caregiver intent and compliance outcomes. The Intent to Attend was also employed as an auxiliary variable to account for missing data within mixed models estimating the treatment effect on the primary outcomes. Results Of the 316 caregiver–child dyads included, 95% of caregivers with low intentions had a child complete the study, but only 87% of caregivers with high intentions had a child complete the study. Low intentions to complete the study were associated with a more than 60% lower odds of study non-completion, but the confidence interval included the null (odds ratio: 0.36; 95% confidence interval: 0.11, 1.20). No effect measure modification by caregiver mental health, child sex, or annual income was detected. Income was the only significant predictor of study non-completion; the lowest income group was almost four times more likely to be study non-completers compared with the highest income group, even after adjustment for child sex and caregiver mental health (adjusted odds ratio = 3.59, 95% confidence interval: 1.38, 9.31). When using Intent to Attend as an auxiliary variable, similar results were obtained when compared with the original treatment effect estimates on the primary outcomes. Conclusion Contrary to prior adult studies, there is no clear relationship between caregiver intentions and study compliance. Findings elucidate the complexities of caregiver–child interactions during pediatric trial participation.

STAI manual for the state-trait anxiety inventory

No full-text available

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