Anxiety and vagal control of heart rate.

Watkins LL, Grossman P, Krishnan R, Sherwood A.

Duke University, Department of Psychiatry and Behavioral Sciences, Durham, North Carolina, USA. watkins1 mailwa.acpub.duke.edu

OBJECTIVE: Prospective studies have demonstrated that anxiety predicts sudden cardiac death, but the mechanism underlying this increased risk is unclear. This study examined whether anxiety is associated with reductions in vagal control of heart rate in healthy volunteers. METHOD: Trait anxiety (T-ANX) was measured, using the Spielberger State-Trait Anxiety Inventory (STAI), in 93 healthy men and women 25 to 44 years of age. Power spectral analysis was used to measure two indices of vagal control: baroreflex control of heart rate (BRC) and respiratory sinus arrhythmia (RSA). RESULTS: High trait anxiety (T-ANX > 41, N = 23) was associated with significantly reduced vagal control of the heart, compared with low trait anxiety (T-ANX < 31, N = 22), as indicated by a 36% reduction in BRC (p< .001) and an 8% reduction in RSA (p<.05). Furthermore, T-ANX scores were negatively correlated with levels of BRC (r = -.30, p<.005), and levels of RSA (r = -.26, p <.05). CONCLUSIONS: These findings provide evidence that trait anxiety is associated with reductions in vagal control of the heart. Additional studies are needed to examine whether low vagal control is involved in the increased risk of sudden cardiac death associated with anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9710297&dopt=Abstract anxiety medicine




Childhood anxiety and memory functioning: a comparison of systemic and processing accounts.

Daleiden EL.

Department of Psychology, University of Tulsa, OK 74104, USA. eric-daleiden utulsa.edu

Information-processing models of childhood anxiety highlight the centrality of memory processes in the maintenance and intensification of anxiety. Recent advances in memory research allow for an increasingly fine-grained analysis of the relation between anxiety and memory. The relation between childhood anxiety and memory was examined in a sample of 160 high- and low-trait-anxious sixth through eighth grade children. Results indicated that anxiety predicted a memory bias toward negative relative to neutral information during conceptual but not perceptual tasks. Further, anxiety predicted a memory bias toward positive relative to neutral information on procedural tasks and a memory bias away from positive relative to neutral information on declarative tasks. These findings accent the complexity and multidimensionality of relations among childhood anxiety, the emotional valence of stimuli, types of cognitive processing, and memory systems in contributing to biases in children's memory functioning. Copyright 1998 Academic Press.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9514771&dopt=Abstract anxiety medicine




The role of anxiety and depression in fatigue and patterns of pain among subgroups of fibromyalgia patients.

Kurtze N, Gundersen KT, Svebak S.

North-Troendelag Research Institute, Steinkjer, Norway. nk ntforsk.no.

This study explored the relationship of anxiety and depression with two major symptoms of fibromyalgia, pain and fatigue, among fibromyalgia patients (N = 322). Due to collinearity between anxiety and depression scores, extreme groups were defined according to high versus low anxiety and depression scores. Two-thirds of the initial sample were excluded by this approach, which permitted a two by two factorial split-plot ANOVA for the assessment of main effects and the interaction of anxiety and depression upon pain and fatigue. Results stated independent, additive, effects of anxiety and depression upon levels of pain and fatigue, whereas interaction between anxiety and depression failed to significantly explain symptom differences among the participants. Correlational analyses indicated widespread pain among the low anxiety subgroups. In contrast, widespread pain was not indicated among anxious patients with low scores on depression. The findings support the hypothesis that (1) anxiety and depression are independently associated with severity of pain symptoms in fibromyalgia, and that (2) patients with high anxiety and low depression may communicate to the medical doctor in ways that involve a risk of diagnosing fibromyalgia when the criterion of widespread pain is not supported. These conclusions were confirmed by results from ANCOVAs that permitted more extensive control of collinearity among variables.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9617472&dopt=Abstract anxiety medicine




Positive and negative affect in the factor structure of the State-Trait Anxiety Inventory for Japanese workers.

Iwata N, Mishima N, Shimizu T, Mizoue T, Fukuhara M, Hidano T, Spielberger CD.

University of Occupational and Environmental Health, Institute of Industrial Ecological Sciences, Kitakyushu, Japan. ganta rose.med.uoeh-u.ac.jp

The factor structure of Form Y of the State-Trait Anxiety Inventory (STAI-Y) was examined with 1,862 Japanese adult workers (1,509 men, 353 women). The initial principal component analysis extracted three factors based on the scree test. All 20 state (S-Anxiety) and 20 trait (T-Anxiety) items had dominant salient loadings on the first factor, which reflected "over-all anxiety." The three factors identified by an oblique (promax) rotation were labeled "anxiety-absent," "state anxiety-present," and "trait anxiety-present." All 20 items with dominant salient loadings on the first oblique factor were clearly grouped on the basis of their content, indicating the absence of anxiety. The second and third oblique factors, defined almost entirely by the STAI-Y anxiety-present items, clearly reflected the state-trait distinction in this sample of Japanese workers.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9621742&dopt=Abstract anxiety medicine




[Anxiety disorders in general practice: frequency--treatment. A survey of the Aquitaine Sentinel Network]

[Article in French]

Martin C, Maurice-Tison S, Tignol J.

Laboratoire de Psychiatrie, l'Universite de Bordeaux II.

OBJECTIVE: This study, conducted in Aquitaine (Southwest France), was designed to assess both frequency and treatment of anxiety disorders in general practice patients. METHOD: The assessment was cross-sectional; a random sample of 312 patients was chosen and evaluated during the last week of Mai 1993, by 55 general practitioners who usually collaborate in the Aquitaine Sentinel Network, supported by the Department of Medical Statistics and Public Health of the University of Bordeaux. Anxiety disorders were assessed by the Composite International Diagnostic Interview and level of depression was self evaluated by the Beck Depression Inventory. The physicians reported current psychological and psychopharmacological treatments, and request for treatment of every patient tested. RESULTS: Frequency of anxiety disorders is concordant with available epidemiological data in French general population. There is no sex difference for anxiety disorders in this study, in opposition to what is known in the general population (2 = 1.47, p > .05). Women are more treated than men (drugs: chi(2) = 7.31 p < .01; psychotherapies: chi(2) = 7.58 p < .04) although they don't request for more treatment (chi(2) = .59 p M .05). Benzodiazepines and psychodynamic oriented therapies are the most used treatments for any anxiety disorders; specific treatments (antidepressive drugs, behavioral therapies) of anxiety are very rarely prescribed. CONCLUSION: This study shows the difference between the current theoretical knowledge in anxiety disorders, and the management of these disorders by the general practitioner. It suggests that patient's request, in opposition to what is often found in the literature, is not a determinant factor in treatment.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9622790&dopt=Abstract anxiety medicine




[Construction of a scale for college life anxiety and its reliability and validity]

[Article in Japanese]

Fujii Y.

Department of Educational Psychology, Faculty of Education, University of Tokyo.

The purpose of this study are to construct the College Life Anxiety Scale for measuring the level of college students' anxiety and to examine its reliability and validity. After collecting items about the anxiety in college life, factor analysis was performed on the data obtained from 2,782 college students. The result, firstly, showed that the College Life Anxiety Scale consisting of 30 items had three factors, which were daily life anxiety, test anxiety and college maladjustment. Secondly, it was indicated that the Scale had both high test-retest reliability and internal consistency (.82 and .84, respectively). It was also suggested that the Scale had high content, clinical, and criterion-related validities. In conclusion, the College Life Anxiety Scale is well able to measure the level of college students' anxiety in their usual life.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9626732&dopt=Abstract anxiety medicine




Anxiety and adipose essential fatty acid precursors for prostaglandin E1 and E2.

Mamalakis G, Kafatos A, Tornaritis M, Alevizos B.

Department of Social and Preventive Medicine, University of Crete, Iraklion, Greece.

OBJECTIVE: The purpose of the present study was to investigate the relation state and trait anxiety and adipose tissue essential fatty acid precursors for prostaglandins E1 and E2. METHODS: The sample consisted of 144 male and female Cretan adults, 23 to 69 years of age. Anthropometric and arterial blood pressure measurements were taken, and adipose tissue samples as well as data concerning general health habits were collected. Dietary data were collected using the weekly food frequency questionnaire and the 24-hour dietary recall method, while state and trait anxiety was assessed through the use of the Spielberger State-Trait Anxiety Inventory (STAI) and the Zung anxiety scale. RESULTS: State anxiety (STAI) related positively with sex (p < 0.0003) and negatively with adipose fat myristic acid (C14:0) (p < 0.004). Similarly, Zung trait anxiety related positively with sex (p < 0.0001) and negatively with adipose tissue myristic acid (C14:0) (p < 0.04). Spielberger trait anxiety related positively with adipose (LA + ALA)/(AA + EPA) ratio (p < 0.0002) and negatively with (C14:0) (p < 0.02) and dietary monounsaturated fat (p < 0.03). CONCLUSION: It appears that the positive relation between trait anxiety and adipose (LA + ALA)/(AA + EPA) ratio may stem from the inhibiting role of catecholamines on delta 6 and delta 5 desaturases.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9627909&dopt=Abstract anxiety medicine




The effects of animal-assisted therapy on anxiety ratings of hospitalized psychiatric patients.

Barker SB, Dawson KS.

Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA. sbbarker hsc.vcu.edu

OBJECTIVE: Animal-assisted therapy involves interaction between patients and a trained animal, along with its human owner or handler, with the aim of facilitating patients' progress toward therapeutic goals. This study examined whether a session of animal-assisted therapy reduced the anxiety levels of hospitalized psychiatric patients and whether any differences in reductions in anxiety were associated with patients' diagnoses. METHODS: Study subjects were 230 patients referred for therapeutic recreation sessions. A pre- and posttreatment crossover study design was used to compare the effects of a single animal-assisted therapy session with those of a single regularly scheduled therapeutic recreation session. Before and after participating in the two types of sessions, subjects completed the state scale of the State-Trait Anxiety Inventory, a self-report measure of anxiety currently felt. A mixed-models repeated-measures analysis was used to test differences in scores from before and after the two types of sessions. RESULTS: Statistically significant reductions in anxiety scores were found after the animal-assisted therapy session for patients with psychotic disorders, mood disorders, and other disorders, and after the therapeutic recreation session for patients with mood disorders. No statistically significant differences in reduction of anxiety were found between the two types of sessions. CONCLUSIONS: Animal-assisted therapy was associated with reduced state anxiety levels for hospitalized patients with a variety of psychiatric diagnoses, while a routine therapeutic recreation session was associated with reduced levels only for patients with mood disorders.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9634160&dopt=Abstract anxiety medicine




Why are depression and anxiety correlated? A test of the tripartite model.

Burns DD, Eidelson RJ.

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA.

L. A. Clark and D. Watson's (1991) tripartite model groups the symptoms of depression and anxiety into 3 components: nonspecific symptoms of general distress, which do not distinguish depression and anxiety; physiologic arousal, which is relatively unique to anxiety; and anhedonia (or low positive affect), which is unique to depression. Structural equation modeling was used to test this model with self-report data from 3 different samples: outpatients seeking treatment for mood disorder, anxiety disorder, or both (n = 483) outpatients seeking treatment for substance abuse (n = 453), and college students (n = 516). The tripartite model did not fit any of the sample covariance matrices, because the nonspecific symptoms of depression and anxiety could not be adequately represented by a single General Distress factor. An alternative model, in which the Anhedonia and Nonspecific Depression factors loaded on a second-order Depression factor, while the Somatic Arousal and Nonspecific Anxiety factors loaded on a second-order Anxiety factor, produced an excellent fit in all the groups. The Nonspecific Depression and Nonspecific Anxiety factors were the most valid and specific indicators of depression and anxiety, respectively. Anhedonia and Somatic Arousal were significantly less valid measures of depression and anxiety. The implications of these findings are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9642884&dopt=Abstract anxiety medicine