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Anxious
Terms modified by Anxious Selected AbstractsAccessibility of causal explanations for future positive and negative events in adolescents with anxiety and depressionCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 3 2004Lisa J. Kagan Anxious and depressed adults' pessimism about future events has been shown to be underpinned by their ability to think of reasons why future events would or would not happen (see, e.g., Byrne and MacLeod, 1997). This study sought to extend this finding to adolescents by investigating the accessibility of explanations given for future events in adolescents with elevated anxiety and depression scores. A school sample of 11,17 year olds (N = 123) participated. Participants completed self-report measures of anxiety, depression and positive and negative affect. In addition they were given a set of potential future positive and negative events and asked to provide reasons as to why the events would (pro reasons) or would not (con reasons) happen. Anxious participants, relative to controls, generated significantly more pro relative to con reasons for negative events happening and showed a non-significant trend towards the opposite pattern for positive events. Depressed participants showed clear differences from controls in their pattern of accessible explanations for both negative events and positive events. Correlational analysis showed that positive and negative affect had differential relationships to positive and negative cognitions concerning future outcomes. The results suggest that the processes that underlie pessimism in depressed and anxious adults also operate in relatively depressed and anxious adolescents.,Copyright © 2004 John Wiley & Sons, Ltd. [source] Interpersonal problems and emotional intelligence in compulsive hoardingDEPRESSION AND ANXIETY, Issue 9 2008Jessica R. Grisham Ph.D. Abstract There is some evidence that compulsive hoarding is associated with social impairment, which may contribute to poor functional outcomes among hoarding patients. In this study, individuals with compulsive hoarding (n = 30) were compared to nonhoarding anxious or depressed patients (n = 30) and nonclinical community participants (n = 30) with respect to clinical characteristics, interpersonal difficulties, and emotional intelligence. All participants were diagnosed using a semi-structured interview and completed self-report measures. Participants with compulsive hoarding endorsed more depression and schizotypal personality disorder symptoms than participants in both comparison groups. Hoarding participants also reported more interpersonal difficulties than community volunteers, but they did not differ significantly from nonhoarding participants with an anxiety or mood disorder. Multiple regression analyses demonstrated that hoarding-related beliefs were marginally related to increased interpersonal problems over and above the effect of depression and anxiety. The groups did not differ significantly with respect to emotional intelligence. Depression and Anxiety. © 2007 Wiley-Liss, Inc. [source] Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders,DEPRESSION AND ANXIETY, Issue 4 2008David Watson Abstract The Diagnostic and Statistical Manual of Mental Disorders,IV groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." The current mood and anxiety disorders reflect the logic of older models emphasizing the existence of discrete emotions and, consequently, are based on a fundamental distinction between depressed mood (central to the mood disorders) and anxious mood (a core feature of the anxiety disorders). This distinction, however, ignores subsequent work that has established the existence of a general negative affect dimension that (a) produces strong correlations between anxious and depressed mood and (b) is largely responsible for the substantial comorbidity between the mood and anxiety disorders. More generally, there are now sufficient data to eliminate the current rational system and replace it with an empirically based taxonomy that reflects the actual,not the assumed,similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching superclass of emotional disorders, which can be decomposed into three subclasses: the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia), and the bipolar disorders (bipolar I, bipolar II, cyclothymia). An empirically based system of this type will facilitate differential diagnosis and encourage the ultimate development of an etiologically based taxonomy. Depression and Anxiety 25:282,288, 2008. Published 2008 Wiley-Liss, Inc. [source] Portuguese version of Corah's Dental Anxiety Scale: transcultural adaptation and reliability analysisDEPRESSION AND ANXIETY, Issue 7 2007Li Wen Hu Ms.C. Abstract This study explores the psychometric properties of the Portuguese version of Corah's Dental Anxiety Scale (DAS), an instrument designed to assess the manifestations of dental anxiety. The DAS has been translated into several languages, but no adaptation and reliability analysis of the Portuguese version of the scale has yet been carried out. A total of 747 Brazilian undergraduate students participated in this study. The instrument proved to have good internal consistency and test,retest reliability. Furthermore, we observed that women are more anxious during dental treatment routines compared to men. Our findings suggest that the Portuguese version of DAS is a reliable instrument for assessing adults' dental anxiety traits, and can be used for both clinical and research purposes. Depression Anxiety 24:467,471, 2007. © 2006 Wiley-Liss, Inc. [source] Initial symptoms and reactions to trauma-related stimuli and the development of posttraumatic stress disorderDEPRESSION AND ANXIETY, Issue 2 2005Karin Elsesser Ph.D. Abstract We investigated laboratory and experimental variables as predictors of the development of posttraumatic stress disorder (PTSD). Evoked heart rate response to trauma-related pictures, attentional bias in the dot-probe task, and viewing time were assessed in 35 victims of a traumatic event and again after 3 months. Data was compared to 26 control participants. At first assessment trauma victims showed heart rate (HR) acceleration and controls showed HR deceleration to trauma-related material. The group of trauma victims improved clinically over time. Predictors of the number of PTSD symptoms after 3 months were re-experiencing (33% of the variance) and amplitude of the evoked HR reaction to trauma-related pictures (15%). The two variables were highly correlated. Trauma victims were also more anxious, viewed trauma-related pictures for a longer time, and had a longer reaction time in the dot-probe task (but no distinct attentional bias) than control participants. Results indicate that specific fear responses and re-experiencing contribute to the development of posttraumatic stress disorder. Depression and Anxiety 21:61,70, 2005. © 2005 Wiley-Liss, Inc. [source] Inactivation of the gene for the nuclear receptor tailless in the brain preserving its function in the eyeEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2007Thorsten Belz Abstract During embryogenesis, tailless, an orphan member of the nuclear receptor family, is expressed in the germinal zones of the brain and the developing retina, and is involved in regulating the cell cycle of progenitor cells. Consequently, a deletion of the tailless gene leads to decreased cell number with associated anatomical defects in the limbic system, the cortex and the eye. These structural abnormalities are associated with blindness, increased aggressiveness, poor performance in learning paradigms and reduced anxiousness. In order to assess the contribution of blindness to the behavioural changes, we established tailless mutant mice with intact visual abilities. We generated a mouse line in which the second exon of the tailless gene is flanked by loxP sites and crossed these animals with a transgenic line expressing the Cre recombinase in the neurogenic area of the developing brain, but not in the eye. The resulting animals have anatomically indistinguishable brains compared with tailless germline mutants, but are not blind. They are less anxious and much more aggressive than controls, like tailless germline mutants. In contrast to germline mutants, the conditional mutants are not impaired in fear conditioning. Furthermore, they show good performance in the Morris water-maze despite severely reduced hippocampal structures. Thus, the pathological aggressiveness and reduced anxiety found in tailless germline mutants are due to malformations caused by inactivation of the tailless gene in the brain, but the poor performance of tailless null mice in learning and memory paradigms is dependent on the associated blindness. [source] The effects of genetic and pharmacological blockade of the CB1 cannabinoid receptor on anxietyEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2002J. Haller Abstract The aim of this study was to compare the effects of the genetic and pharmacological disruption of CB1 cannabinoid receptors on the elevated plus-maze test of anxiety. In the first experiment, the behaviour of CB1-knockout mice and wild-type mice was compared. In the second experiment, the cannabinoid antagonist SR141716A (0, 1, and 3 mg/kg) was administered to both CB1-knockout and wild type mice. Untreated CB1-knockout mice showed a reduced exploration of the open arms of the plus-maze apparatus, thus appearing more anxious than the wild-type animals, however no changes in locomotion were noticed. The vehicle-injected CB1-knockout mice from the second experiment also showed increased anxiety as compared with wild types. Surprisingly, the cannabinoid antagonist SR141716A reduced anxiety in both wild type and CB1 knockout mice. Locomotor behaviour was only marginally affected. Recent evidence suggests the existence of a novel cannabinoid receptor in the brain. It has also been shown that SR141716A binds to both the CB1 and the putative novel receptor. The data presented here supports these findings, as the cannabinoid receptor antagonist affected anxiety in both wild type and CB1-knockout mice. Tentatively, it may be suggested that the discrepancy between the effects of the genetic and pharmacological blockade of the CB1 receptor suggests that the novel receptor plays a role in anxiety. [source] Dental trait anxiety and pain sensitivity as predictors of expected and experienced pain in stressful dental proceduresEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 6 2004Ulrich Klages A prevailing hypothesis suggests that exaggerated pain expectations in dentally anxious and pain-sensitive patients might usually be disconfirmed by a lower level of pain experienced during treatment. The present study was conducted to investigate whether this contention also holds during stressful dental procedures. Patients reporting high and low levels of dental fear and of pain sensitivity were compared in their expected and experienced pain and in the concordance between the two measures. Participants were 97 patients undergoing extraction and root canal treatment. The measuring instruments used were the Dental Anxiety Scale (DAS), the Pain Sensitivity Index (PSI), affective and sensory pain descriptor scales, and a numerical pain-intensity scale. The results demonstrated that patients, in general, expected more pain than they subsequently experienced. Subjects with a high DAS score both expected and experienced more pain than those with a low DAS score. Within the group of subjects with a high DAS score, those indicating high pain sensitivity expected and experienced more pain than their counterparts; additionally, only those reporting low pain sensitivity disconfirmed their high pain expectancies. The results suggest that during stressful dental procedures, patients indicating dental anxiety and pain sensitivity above median levels are especially at risk of stabilizing exaggerated pain expectations and dental fear. [source] A 3-year comparison of dental anxiety treatment outcomes: hypnosis, group therapy and individual desensitization vs. no specialist treatmentEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2002Rod Moore Outcomes of hypnotherapy (HT), group therapy (GT) and individual systematic desensitization (SD) on extreme dental anxiety in adults aged 19,65 yr were compared by regular attendance behaviors, changes in dental anxiety and changes in beliefs about dentists and treatment after 3 yr. Treatment groups were comparable with a static reference control group of 65 anxious patients (Dental Anxiety Scale ,,15) who were followed for a mean of nearly 6 yr. After 3 yr, 54.5% of HT patients, 69.6% of GT patients and 65.5% of SD patients were maintaining regular dental care habits. This was better than the 46.1% of the reference group, who reported going regularly to the dentist again within the cohort follow-up period, and 38.9% of a control subgroup with observation for 3 yr. Women were better regular attenders than men at 3 yr. Specialist-treated regular attenders were significantly less anxious and had more positive beliefs than regular attenders from reference groups. There were few differences between HT, GT and SD after 3 yr. It was concluded that many patients can, on their own, successfully start and maintain regular dental treatment habits with dentists despite years of avoidance associated with phobic or extreme anxiety. However, it also appears that these patients had less success in reducing dental anxiety and improving beliefs about dentists long-term than did patients who were treated at the specialist clinic with psychological strategies. [source] Anxiety and the True Beginner,False Beginner Dynamic in Beginning French and Spanish ClassesFOREIGN LANGUAGE ANNALS, Issue 2 2005Diana Frantzen Abstract: This study considered true beginners and false beginners in first-semester university French and Spanish classes to: (a) determine whether true beginners and false beginners differ in anxiety, grades, and plans to continue language study; and (b) identify classroom factors that foster anxiety or comfort. Students completed a questionnaire that included the Foreign Language Classroom Anxiety Scale (Horwitz, Horwitz, & Cope, 1986), MacIntyre and Gardner Anxiety Subscales (1989, 1994), demographic information, grade expectations, and open-ended questions. Randomly selected students were interviewed about their experiences in the courses. Statistical analyses revealed that (a) although neither group was terribly anxious, true beginners were significantly more anxious overall and during processing and output stages than false beginners; (b) true beginners expected and received lower grades than false beginners; and (c) significantly more true beginners than false beginners planned to continue studying the language. Comments on one written open-ended question and in the interviews pointed to the key role of the instructor in reducing anxiety. [source] SK3 K+ channel-deficient mice have enhanced dopamine and serotonin release and altered emotional behaviorsGENES, BRAIN AND BEHAVIOR, Issue 8 2008J. P. R. Jacobsen SK3 K+ channels influence neuronal excitability and are present in 5-hydroxytryptamine (5-HT) and dopamine (DA) nuclei in the brain stem. We therefore hypothesized that SK3 channels affect 5-HT and DA neurotransmission and associated behaviors. To explore this, we used doxycycline-induced conditional SK3-deficient (T/T) mice. In microdialysis, T/T mice had elevated baseline levels of striatal extracellular DA and the metabolites dihydroxyphenylacetic acid and homovanillic acid. While baseline hippocampal extracellular 5-HT was unchanged in T/T mice, the 5-HT response to the 5-HT transporter inhibitor citalopram was enhanced. Furthermore, baseline levels of the 5-HT metabolite 5-hydroxyindoleacetic acid were elevated in T/T mice. T/T mice performed equally to wild type (WT) in most sensory and motor tests, indicating that SK3 deficiency does not lead to gross impairments. In the forced swim and tail suspension tests, the T/T mice displayed reduced immobility compared with WT, indicative of an antidepressant-like phenotype. Female T/T mice were more anxious in the zero maze. In contrast, anxiety-like behaviors in the open-field and four-plate tests were unchanged in T/T mice of both sexes. Home cage diurnal activity was also unchanged in T/T mice. However, SK3 deficiency had a complex effect on activity responses to novelty: T/T mice showed decreased, increased or unchanged activity responses to novelty, depending on sex and context. In summary, we report that SK3 deficiency leads to enhanced DA and 5-HT neurotransmission accompanied by distinct alterations in emotional behaviors. [source] Common variations in the pretest environment influence genotypic comparisons in models of anxietyGENES, BRAIN AND BEHAVIOR, Issue 7 2005G. S. Izídio The behavioral characterization of rodent strains in different studies and laboratories can provide unreplicable results even when genotypes are kept constant and environmental control is maximized. In the present study, the influence of common laboratory environmental variables and their interaction with genotype on the results of behavioral tests of anxiety/emotionality were investigated. To this end, the inbred rat strains Lewis (LEW) and spontaneously hypertensive rats (SHR), which are known to differ for numerous emotionality-related behaviors, were tested in the open field (OF), elevated plus maze (EPM) and black/white box (BWB), while three environmental factors were systematically controlled and analyzed: (1) the experimenter handling the animal (familiar or unfamiliar); (2) the position of the home cage (top or bottom shelf of the rack) and (3) the behavioral state of the animal immediately before the test (arousal or rest). Experimenter familiarity did not alter the behavior of rats in the OF. Cage position, on the other hand, influenced the behavior in the OF and BWB, with rats housed in top cages appearing less anxious like than those housed in the bottom. In the BWB (but not in the OF), these effects were genotype dependent. Finally, the behavioral state of the animals prior to testing altered the results of the EPM in a strain-dependent manner, with some anxiety-related genotypic differences being found only among rats that were aroused in their home cages. This study showed that common variations in the laboratory environment interact with genotype in behavioral tests of anxiety/emotionality. Recognizing and understanding such variations can help in the design of more effective experiments. [source] Reduced aggression in AMPA-type glutamate receptor GluR-A subunit-deficient miceGENES, BRAIN AND BEHAVIOR, Issue 5 2004O. Y. Vekovischeva The importance of AMPA-type glutamate receptors has been demonstrated in neuronal plasticity and in adaptation to drugs of abuse. We studied the involvement of AMPA receptors in social interaction and anxiety and found that in several paradigms of agonistic behavior naïve male mice deficient for the GluR-A subunit- containing AMPA receptors are less aggressive than wild-type littermates. GluR-A deficient mice and wild-type littermates exhibited similar basic behavior and reflexes as monitored by observational Irwin's test, but they tended to be less anxious in elevated plus-maze and light-dark tests. Maternal aggression or male-female encounters were not affected which suggests that male hormones are involved in the expression of suppressed aggressiveness. However, testosterone levels and brain monoamines can be excluded and found to be similar between GluR-A deficient and wild-type littermates. The reduced AMPA receptor levels caused by the lack of the GluR-A subunit, and measured by a 30% reduction in hippocampal [3H]-S-AMPA binding, seem to be the reason for suppressed male aggressiveness. When we analyzed mice with reduced number of functional AMPA receptors mediated by the genomic introduced GluR-A(Q582R) channel mutation, we observed again male-specific suppressed aggression, providing additional evidence for GluR-A subunit-containing AMPA receptor involvement in aggression. [source] Medical tests: women's reported and preferred decision-making roles and preferences for information on benefits, side-effects and false resultsHEALTH EXPECTATIONS, Issue 4 2002Heather M. Davey BPsych (Hons) Abstract Objective, To determine women's preferences for and reported experience with medical test decision-making. Design, Computer-assisted telephone survey. Setting and participants, Six hundred and fifty-two women resident in households randomly selected from the New South Wales electronic white pages. Main outcome measures, Reported and preferred test and treatment (for comparison) decision-making, satisfaction with and anxiety about information on false results and side-effects; and effect of anxiety on desire for such information. Results, Overall most women preferred to share test (94.6%) and treatment (91.2%) decision-making equally with their doctor, or to take a more active role, with only 5.4,8.9% reporting they wanted the doctor to make these decisions on their behalf. This pattern was consistent across all age groups. In general, women reported experiencing a decision-making role that was consistent with their preference. Women who had a usual doctor were more likely to report experiencing an active role in decision-making. More women reported receiving as much information as they wanted about the benefits of tests and treatment than about the side-effects of tests and treatment. Most women wanted information about the possibility of false test results (91.5%) and test side-effects (95.6%), but many reported the doctor never provided this information (false results = 40.0% and side-effects = 31.3%). A substantial proportion said this information would make them anxious (false results = 56.6% and side-effects = 43.1%), but reported they wanted the information anyway (false results = 77.6% and side-effects = 88.1%). Conclusions, Women prefer an active role in test and treatment decision-making. Many women reported receiving inadequate information. If so, this may jeopardize informed decision-making. [source] Attachment style, affective loss and gray matter volume: A voxel-based morphometry studyHUMAN BRAIN MAPPING, Issue 10 2010Stefania Benetti Abstract Early patterns of infant attachment have been shown to be an important influence on adult social behavior. Animal studies suggest that patterns of early attachment influence brain development, contributing to permanent alterations in neural structure; however, there are no previous studies investigating whether differences in attachment style are associated with differences in brain structure in humans. In this study, we used Magnetic Resonance Imaging (MRI) and voxel-based morphometry (VBM) to examine for the first time the association between attachment style, affective loss (for example, death of a loved one) and gray matter volume in a healthy sample of adults (n = 32). Attachment style was assessed on two dimensions (anxious and avoidant) using the ECR-Revised questionnaire. High attachment-related anxiety was associated with decreased gray matter in the anterior temporal pole and increased gray matter in the left lateral orbital gyrus. A greater number of affective losses was associated with increased gray matter volume in the cerebellum; in this region, however, the impact of affective losses was significantly moderated by the level of attachment-related avoidance. These findings indicate that differences in attachment style are associated with differences in the neural structure of regions implicated in emotion regulation. It is hypothesized that early attachment experience may contribute to structural brain differences associated with attachment style in adulthood; furthermore, these findings point to a neuronal mechanism through which attachment style may mediate individual differences in responses to affective loss. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc. [source] Adaptation and communicative design.HUMAN COMMUNICATION RESEARCH, Issue 1 2001Patterns of interaction in truthful, deceptive conversations Two theoretical frameworks that examine the nature of adaptability and mutual influence in interaction, interpersonal deception theory and interaction adaptation theory, were used to derive hypotheses concerning patterns of interaction that occur across time in truthful and deceptive conversations. Two studies were conducted in which senders were either truthful or deceptive in their interactions with a partner who increased or decreased involvement during the latter half of the conversation. Results revealed that deceivers felt more anxious and were more concerned about self-presentation than truthtellers prior to the interaction and displayed less initial involvement than truthtellers. Patterns of interaction were also moderated by deception. Deceivers increased involvement over time but also reciprocated increases or decreases in receiver involvement. However, deceivers were less responsive than truthtellers to changes in receiver behavior. Finally, partner involvement served as feedback to senders regarding their own performance. [source] Beliefs and perceptions of Arab vitiligo patients regarding their conditionINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2010Khalid M. AlGhamdi MD Background, Patients' beliefs about their illness can result in positive and/or negative implications for the management of their disease. To examine the beliefs held by vitiligo patients about their condition and to explore the potential factors that might influence such beliefs. Methods, The illness perception questionnaire (IPQ) was translated into the particular regional language (Arabic) and administered to adult vitiligo patients visiting our Dermatology Department, from 2006 to 2008. Demographic and illness details were obtained. Results, We recruited 164 vitiligo patients (91 male subjects). The mean age was 27 years (SD = 13, range 15,57 years). It was believed that stress, altered immunity, and heredity were the cause of vitiligo by 33%, 26%, and 24% of the respondents respectively. Eighty-four percent and 28% believed in fate and evil eye as a cause of their illness respectively. Forty-two percent believed that their illness had a major effect on their lives and 44% believed that vitiligo had strongly affected the way others see them. For both beliefs, this was independent of the gender. Thirty-seven percent reported that they do not understand their illness. Six percent believed that their disease was contagious while 12% were not sure. Fifty-four and 57% reported feeling depressed and anxious respectively, because of their disease. This was more common in female patients (P = 0.019 and 0.031 respectively). Conclusion, Misconceptions and negative attitudes are widespread among vitiligo patients. The lack of disease-related understanding and the existence of anxiety and depression require targeted health education and psychosocial support. [source] Anxiety does not predict response to antidepressant treatment in late life depression: results of a meta-analysisINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2009J. Craig Nelson Abstract Objective Previous studies of mixed aged and older adult samples with major depressive disorder (MDD) reported reduced depression response in anxious patients, but a systematic review and analysis has not been performed. Our aim was to determine if anxiety predicts antidepressant response in previously identified placebo-controlled trials of second generation antidepressants for late-life depression. Method From a previous systematic review that identified ten randomized, placebo-controlled trials of community dwelling patients aged 60 or older with major depression, anxious patients were identified by a score ,7 on the anxiety/somatization factor of the Hamilton Depression Rating Scale (HDRS). Response was defined as 50% or greater improvement on the HDRS or the Montgomery Asberg Depression Rating Scale. A meta-analysis was performed using a random effects model to calculate Odds Ratios (OR). Results Data were available from eight trials having ten drug-placebo contrasts that included 2322 anxious and 1387 non-anxious patients. The odds ratio for response to drug compared to placebo in anxious patients was 1.57 (95% CI 1.15, 2.14; z,=,2.86, n,=,10, p,<,0.001), in non-anxious patients was 1.44 (95% CI 1.15, 1.80, z,=,3.21, n,=,10, p,<,0.001), and did not differ between groups. Pooled response rates to drug and placebo respectively were 49.4% vs 37.4% in anxious patients and 44.2 vs 35.5% in non-anxious patients. Conclusions In randomized, placebo-controlled trials, anxiety in late-life depression was not associated with decreased response to second generation antidepressants. Copyright © 2009 John Wiley & Sons, Ltd. [source] Assessment of health, well-being and social connections: A survey of women living in Western SydneyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2007Rhonda Griffiths RN CM B.Ed(Nursing) M.Sc(Hons) DrPH Strengthening the physical and social environment has been shown to support health and strengthen community action for health. In an attempt to improve the social factors that influence the health of individuals and the community, community interventions increasingly include strategies to build networks and social capital and develop resilience. This study was undertaken to identify the most appropriate strategies to strengthen friendships and the social support networks for women aged 18,39 years living in Villawood, an area of high disadvantage in South Western Sydney, Australia. Although the majority reported positively on their health, one-third reported feeling isolated, experienced low energy levels and felt unhappy and anxious over the past month. Women who described themselves as unemployed felt more isolated than women in home duties. Women who were employed or engaged in home duties had more contact with neighbours, and had more in common with their neighbours. Those who reported more contact with their neighbours perceived their mental healthlevel as being higher. These results indicate that community development initiatives should include consultation with the community and consider the needs of socially isolated groups and those with the poorest health status. [source] A study to assess the validity of clinical judgement in determining paediatric dental anxiety and related outcomes of managementINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2005R. D. HOLMES Summary. Objective. The aim of the present study was to determine the validity of subjective anxiety assessment and the outcomes of management of children receiving operative dental treatment. Setting., The study was conducted at the Departments of Sedation and Child Dental Health, Newcastle Dental Hospital, Newcastle upon Tyne, UK. Subjects and methods., One hundred children and adolescents aged between 8 and 15 years participated in the study. Clinicians subjectively allocated 50 children for treatment with local analgesia alone (low anxiety), and identified 50 children who had the potential to benefit from nitrous oxide and oxygen sedation (high anxiety). Participants then completed the State-Trait Anxiety Inventory for Children (STAIC), the Venham Picture Test (VPT) and the Child Fear Survey Schedule , Dental Subscale (CFSS-DS). A global rating scale classified behaviour during dental treatment. Results., State anxiety and dental fear prior to treatment were significantly higher in children allocated to receive inhalation sedation (P = 0·004 and P = 0·005, respectively). There was no significant difference in trait anxiety or post-treatment state anxiety between the two groups (P = 0·69 and P = 0·06, respectively). Only 11% displayed ,negative' behaviour during treatment: 82% of this group represented those allocated to receive sedation. Conclusion., Children receiving inhalation sedation were significantly more anxious prior to treatment than children receiving treatment with local analgesia alone. The findings support the subjective assessment of anxiety in children; however, objective anxiety measures may assist clinicians in identifying specific fears, which may ultimately aid patient management. [source] Symptom management for HIV-positive persons in NorwayINTERNATIONAL NURSING REVIEW, Issue 3 2004E. H. Bunch rn Abstract Purpose:, To record symptoms experienced by people with HIV/AIDS, and describe useful self-care strategies and how symptoms impact on daily life. Method:, A questionnaire was used with self-reported answers and descriptions of how symptoms impact on daily activities and suggestions for useful self-care strategies. Four hundred and twenty-two (n = 422) HIV-positive persons from seven sites in the USA and one site in Norway (n = 20) answered the questionnaire. Results:, In this article subjective symptom descriptions from the Norwegian sample are presented along with self-care strategies and their effectiveness. Findings revealed the Norwegian sample to be a little older, maybe less anxious and depressed, than participants in the larger study. This difference might be explained by the structure of the national social and health care system in Norway, where treatments, medications and social services are available to all citizens without cost. Respondents described a number of related symptoms as well as their subjective explanations of what triggered the symptoms. Most of the self-care strategies were learnt by trial and error. Recommendations:, Community health providers, nurses and physicians should become more knowledgeable about the symptoms that infected persons struggle with, as well as the impact these symptoms have on routine daily self-care activities and a person's quality of life. There is need for more research about helpful self-care strategies to assist HIV-positive persons to manage their symptoms and to disseminate these to community health providers and support groups for HIV infected persons. [source] Burnout and its correlates among nursing staff: questionnaire surveyJOURNAL OF ADVANCED NURSING, Issue 1 2008Mustafa N., lhan Abstract Title.,Burnout and its correlates among nursing staff: questionnaire survey Aim., This paper is a report of a study to determine the burnout level and its correlates in nurses. Background., Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. Method., The study was carried out at a university hospital in Turkey during May,June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88·2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. Findings., All the nurses were female, with a mean age of 30·6 (5·4) and a median age of 29 years. The mean score was 17·99(6·35) for the Emotional Exhaustion subscale, 5·72 (3·87) for the Depersonalization subscale and 19·83 (4·66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0·05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0·05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0·05). Conclusion., It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues. [source] Effects of Personality Style, Anxiety, and Depression on Reported Reasons for Smoking,JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2002Raquel R. Scheitrum This study examined the effects of personality style, anxiety, and depression on the reasons for smoking reported by active smokers. Type A individuals with high trait anxiety viewed smoking as a way to stimulate themselves, whereas Type B individuals claimed that they smoked in order to relax. No such relationship was found for smokers who were not anxious. Smokers who had a high degree of depressive symptomatology were more likely to smoke for stimulation than were smokers with a low degree of depressive symptomatology. These results support Warburton's theory (1988) that smoking is an active coping strategy maintained through nicotine's psychological benefits. [source] An exploratory study of anxiety in carers of stroke survivorsJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Nan Greenwood Aims and objectives., To investigate anxiety in informal carers of stroke survivors in the first three months after discharge. Background., Informal carers, also called caregivers, play a vital role in supporting stroke survivors. However, caring for stroke survivors can have adverse consequences amongst carers such as burden, stress and reduced quality of life. Emotional distress is also commonly reported but anxiety has received less attention than depression. Design., Prospective, longitudinal, descriptive study. Method., Forty-five carers completed the Hospital Anxiety and Depression Scale on two occasions , within one month and at three months after discharge from stroke and rehabilitation units. Results., Carers were more likely to have scores indicating anxiety than depression. In the first month, half the carers (51·1%) scored in the cut-off for anxiety and a third were in the cut-off for depression (31·1%). At three months, the picture was very similar with nearly identical proportions in the anxious and depressed categories (48·9% and 28·9%, respectively). Changes in numbers of cases of anxiety and depression and in mean anxiety scores were non-significant but there was a significant decrease in depression scores (p = 0·048). Fourteen carers (31·1%) at one month and eleven (24·4%) at three months fell into both anxious and depressed categories. Conclusions., Anxiety is a relatively neglected emotional outcome in stroke carers. Our study suggests anxiety is an important issue very early in caring whilst other research suggests it remains prevalent for many months. Given the significant role carers play in rehabilitation of stroke survivors, greater recognition of their emotional state is required. Further, longitudinal research with larger sample sizes from a range of geographical areas and improved understanding of factors associated with anxiety is needed. Relevance to clinical practice., Nurses working in the community are ideally placed to identify and support carers suffering from anxiety. [source] Internet-based cognitive behavioral therapy for tinnitusJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2004Gerhard Andersson Tinnitus is a common otological problem that is often resistant to surgical or medical interventions. In common with chronic pain, cognitive-behavioral treatment has been found to alleviate the distress and improve the functioning of tinnitus patients. Recently, a self-help treatment has been developed for use via the Internet. In this article, we describe the self-help program and apply it to a middle-aged woman with tinnitus. We report the case formulation, which was done in a structured interview, and the treatment interactions, which were conducted via e-mail. The self-help program was presented on Web pages, and weekly diaries were submitted to follow progress and give feedback. The treatment was successful with reductions of tinnitus-related annoyance and anxious and depressive mood. Implications for Internet administration of self-help treatment are discussed. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] Perspectives of parents and tutors on a self-management program for parents/guardians of children with long-term and life-limiting conditions: "a life raft we can sail along with" ,JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2008Julie Barlow The lay-led, community-based Supporting Parents Programme (SPP) aims to assist parents caring for children with long-term or life-limiting conditions through support and cognitive behavioral techniques. The value of the SPP from the perspectives of parent participants and tutors was examined in focus groups and telephone interviews. Data were analyzed using framework analysis. Parents perceived a commonality of emotions and practical issues, valued meeting similar others, felt less isolated, more positive, motivated, and more calm; some had found the "real me again." Changes were attributed to techniques learned. Parents were anxious of being cast adrift at the end of SPP. Tutors needed more support and additional training around child protection and confidentiality. © 2008 Wiley Periodicals, Inc. [source] Post-operative anxiety and depression levels in orthopaedic surgery: a study of 56 patients undergoing hip or knee arthroplastyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009Richard S. J. Nickinson Abstract Objective, To investigate the presence and rates of anxiety and depression in postsurgical patients. Methods, The Hospital Anxiety and Depression Scale was used to measure anxiety and depression levels. Patients completed the questionnaire on the day prior to surgery, then on each post-operative day up to and including their day of discharge. Statistical analysis using logistic regression was performed to determine whether any variables were risk factors for developing anxiety or depression. Fifty-six patients undergoing lower limb arthroplasty agreed to take part. Results, Post-operatively 17 patients became anxious prior to discharge. No variables were significant predictors of anxiety. Post-operatively 28 subjects (50%) became depressed at some point prior to discharge. Females were more likely to become depressed than males odds ratio (OR) = 3.48 [95% confidence interval (CI) 1.01,11.88]. Those who had had a previous lower limb arthroplasty were more likely to develop post-operative depression, OR = 3.92 (95% CI 1.05,14.6). Site of operation was not found to be significant, OR = 0.67 (95% CI 0.20,2.22). Age and anaesthetic method were not predictive of depression. The mean time point for development of depression was 2.43 days (SD = 1.40 days) and the time of deepest depression was 2.93 days (SD = 1.72 days). The mean length of depression was 1.93 days (SD = 1.21 days). The mean length of stay for depressed patients was 5 days (SD = 1.72), compared with 4 days for the non-depressed patients (SD = 1.62 days). Conclusion, The results suggest that post-operative depression does occur in orthopaedic surgery. The prevalence may be higher than that reported in other surgical specialities. These findings emphasize the need for evaluation of patients' psychiatric state post-operatively. [source] Psychological comorbidity and complexity of gastrointestinal symptoms in clinically diagnosed irritable bowel syndrome patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Antonina Mikocka-Walus Abstract Background and Aim:, The prevalence of psychological disorders is high in patients with irritable bowel syndrome (IBS) but their role in symptom reporting is uncertain. It is thus interesting whether the number of functional gastrointestinal disorders (FGID) determines the load of psychological comorbidity. The Rome III criteria have not been used to evaluate such a relationship as yet. Moreover, not many studies have examined the sensitivity of the Rome III criteria in detecting IBS. Our aims were therefore: (i) to determine whether those IBS participants with more FGID had a tendency to greater psychological comorbidity than those with fewer FGID; and (ii) to assess the performance of the Rome III criteria in detecting IBS versus the diagnosis of the gastroenterologist. Methods:, A cross-sectional survey of 32 consecutive outpatients with clinically diagnosed IBS was performed. The Hospital Anxiety and Depression Scale (HADS), the Short Form 12 Health Survey (SF-12), and the Rome III criteria questionnaire (BDQ-6) were administered. Multiple linear regression was conducted to detect associations among FGID, anxiety, depression and quality of life. Results:, Overall, 50% of participants were anxious and 12% were depressed. Forty-four percent of participants had >two FGID; however, the number of FGID did not correlate with scores for anxiety, depression or quality of life. Amazingly, only 50% (CI: 33,67) of participants clinically diagnosed with IBS met Rome III criteria for IBS. Conclusion:, Contrary to our expectations, a greater load of FGID did not correlate with a greater load of psychological comorbidity. Surprisingly, the Rome III criteria detected only 50% of clinical cases of IBS. [source] Injury risk in young people with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 1 2002J Sherrard Abstract Epidemiological studies have established injury as a major public health problem for young people in the general population, but minimal population-based injury information exists on those with intellectual disability (ID). The present study investigated risk factors for injury to subjects in the Australian Child and Adolescent Development (ACAD) programme, which is examining emotional and behavioural problems in young people with ID. Extensive biopsychosocial data for the ACAD programme were collected at two time intervals (i.e. 1990,1991 and 1995,1996). Carer report of medically attended injury over one year was collected for the first time period (1995,1996) on a sample of 465 ACAD subjects (aged 5,29 years) representative of young people with ID (IQ < 70) to determine risk factors for injury using the ACAD biopsychosocial data. Psychopathology [odds ratio (OR) = 3.4] epilepsy (OR = 2.4) and an overly sociable temperament (OR = 2.2) are associated with injury in young people with ID. Social and family factors had minimal influence on injury risk in this population. Those who are highly disruptive, self-absorbed, anxious, have problems relating socially, have communication disturbance or have attention deficit hyperactivity symptoms are particularly at increased risk for injury. The present study demonstrates a largely under-recognized public health problem of a high unintentional injury risk for young people with ID, and identifies substantial and important risk factors for injury. Injury prevention programmes, with a particular focus on those with highly disturbed behaviours or epilepsy, are warranted in this population. [source] Literature Review and suggested protocol for managing ultrasound soft markers for Down syndrome: Thickened nuchal fold, echogenic bowel, shortened femur, shortened humerus, pyelectasis and absent or hypoplastic nasal boneJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2007Article first published online: 10 MAY 200, M Bethune Summary Mid-trimester soft markers have been linked with Down syndrome and other aneuploidies. There are many other prenatal screening tests available with better detection rates for Down syndrome than the mid-trimester ultrasound. Many patients confronted with the diagnosis of a soft marker become anxious and may request a diagnostic test (amniocentesis) despite the associated risk of miscarriage. This is also despite the fact that most fetuses with an isolated soft marker are chromosomally normal. The management of a pregnancy with a soft marker must therefore be planned in a manner designed to minimize patient anxiety. Likelihood ratios can be used to modify a patient's ,prior risk' (based on age or prior screening tests) and create a new risk. This calculation may help identify a subset of patients suitable for further investigation. It has been proposed that ,negative' likelihood ratios can be used to reduce a patient's risk if no soft marker is found at a mid-trimester ultrasound. There remain concerns about this approach and further research is required before this approach enters common practice. The published work surrounding the management of thickened nuchal fold, echogenic bowel, shortened femur, shortened humerus, pyelectasis (renal pelvis dilatation) and hypoplastic nasal bone is reviewed. Each soft marker has different associations and individual management plans for each of these soft markers are presented. Although isolated single umbilical artery is not usually considered a soft marker of aneuploidy, a management plan for this common finding is also included. [source] | ||||||||||||||||||||||||||||||||||||||||||||||