Studies on the psychosomatic functioning of ill-health according to Eastern and Western medicine 6. Psychosomatic characteristics of anxiety and depression.

Takeichi M, Sato T, Takefu M.

Department of Psychiatry, Saga Medical School, Japan.

In the accompanying paper "Psychosomatic Characteristics of Anxiety and the Anxiety-Affinitive Constitution (Provisional Term) in Medical Students," we suggest that an assessment of the relationship between anxiety and the state of thoracic-abdominal balance of breathing, and the creation of an anxiety-affinitive constitution index (AACI) derived from that assessment, will be indispensable for furthering research in the future. Using the tenets of Oriental psychosomatic medicine, we examined in this research medical students (N=104) from whom we had received fully-informed consent for the research in writing, and patients who met the DSM-IV diagnostic criteria for anxiety disorders (N=18) and major depressive episodes (N=20). We then identified their anxiety and depressive psychosomatic traits in accordance with an assessment of the relationship between anxiety and the state of their thoracic-abdominal balance of breathing, and the AACI derived from that assessment. We performed a multiple regression analysis with the STAI trait anxiety as the dependent variable, and the parameters of the somatic tests as the independent variables. We obtained the formula that AACI=-62.9 + 72.9 x the thoracic/abdominal respiratory movement ratio (the fractal dimension value for the thoracic respiratory curve/the fractal dimension value for the abdominal respiratory curve) + 22.5 x the horizontal eye movement (the fractal dimension value) + 2.4 x the dental indentation of the tongue (existence, 1; none 0). We then obtained data regarding a symptomatological, constitutional, and nosological, diagnosis of anxiety and depression based on the AACI values of the Student's t test calculated for the medical students and the anxiety disorder patients and patients with major depressive episodes, and a statistical analysis using ANOVA. We believe the AACI we created in this research will be very important and significant for the preventive treatment of lifestyle illnesses and stress-related diseases.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11527068&dopt=Abstract anxiety medicine




An anxiety, personality and altitude symptomatology study during a 31-day period of hypoxia in a hypobaric chamber (experiment 'Everest-Comex 1997').

Nicolas M, Thullier-Lestienne F, Bouquet C, Gardette B, Gortan C, Joulia F, Bonnon M, Richalet JP, Therme P, Abraini JH.

Laboratoire de Neurosciences Integratives, Universite Henri Poincare Nancy 1, Vandoeuvre-les-Nancy, France.

Extreme environmental situations are useful tools for the investigation of the general processes of adaptation. Among such situations, high altitude of more than 3000 m produces a set of pathological disorders that includes both cerebral (cAS) and respiratory (RAS) altitude symptoms. High altitude exposure further induces anxiety responses and behavioural disturbances. The authors report an investigation on anxiety responses, personality traits, and altitude symptoms (AS) in climbers participating in a 31-day period of confinement and gradual decompression in a hypobaric chamber equivalent to a climb from sea-level to Mount Everest (8848 m altitude). Personality traits, state-trait anxiety, and AS were assessed, using the Cattell 16 Personality Factor questionnaire (16PF), the Spielberger's State-Trait Anxiety Inventory (STAI), and the Lake Louise concensus questionnaire. Results show significant group effect for state-anxiety and AS; state-anxiety and AS increased as altitude increased. They also show that state-type anxiety shows a similar time-course to cAS, but not RAS. Alternatively, our results demonstrate a significant negative correlation between Factor M of the 16PF questionnaire, which is a personality trait that ranges from praxernia to autia. In contrast, no significant correlation was found between personality traits and AS. This suggests that AS could not be predicted using personality traits and further support that personality traits, such as praxernia (happening sensitivity), could play a major role in the occurrence of state-type anxiety responses in extreme environments. In addition, the general processes of coping and adaptation in individuals participating in extreme environmental experiments are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11543191&dopt=Abstract anxiety medicine




Depression and anxiety in people with inflammatory bowel disease.

Kurina LM, Goldacre MJ, Yeates D, Gill LE.

Unit of Health-Care Epidemiology, Institute of Health Sciences, University of Oxford, Old Road, Oxford OX3 7LF, UK.

STUDY OBJECTIVE: To determine whether depression or anxiety co-occurs with ulcerative colitis (UC) or Crohn's disease (CD) more often than expected by chance, and, if so, whether the mental disorders generally precede or follow the inflammatory bowel diseases (IBD). DESIGN: Nested case-control studies using a database of linked hospital record abstracts. SETTING: Southern England. MAIN RESULTS: Both depression and anxiety preceded UC significantly more often than would be predicted from the control population's experience. The associations were strongest when the mental conditions were diagnosed shortly before UC, although the association between depression and UC was also significant when depression preceded UC by five or more years. Neither depression nor anxiety occurred before CD more often than expected by chance. However, depression and anxiety were significantly more common after CD; the associations were strongest in the year after the initial record of CD. UC was followed by anxiety, but not by depression, more often than expected by chance and, again, the association was strongest within one year of diagnosis with UC. CONCLUSIONS: The concentration of risk of depression or anxiety one year or less before diagnosis with UC suggests that the two psychiatric disorders might be a consequence of early symptoms of the as yet undiagnosed gastrointestinal condition. The data are also, however, compatible with the hypothesis that the psychiatric disorders could be aetiological factors in some patients with UC. Most of the excess anxiety or depression diagnosed subsequent to diagnosis of IBD occurs during the year after IBD is diagnosed and the probable explanation is that the mental disorders are sequelae of IBD.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11553654&dopt=Abstract anxiety medicine




Life course outcomes of young people with anxiety disorders in adolescence.

Woodward LJ, Fergusson DM.

University of Canterbury, Christchurch, New Zealand.

OBJECTIVE: This study examined associations between the extent of anxiety disorder in adolescence (14-16 years) and young people's later risks of a range of mental health, educational, and social role outcomes (16-21 years). METHOD: Data were gathered over the course of a 21-year longitudinal study of a birth cohort of 1,265 New Zealand children. Measures collected included (1) an assessment of DSM-III-R anxiety disorders between the ages of 14 and 16 years; (2) assessments of mental health, educational achievement, and social functioning between the ages of 16 and 21 years; and (3) measures of potentially confounding social, family, and individual factors. RESULTS: Significant linear associations were found between the number of anxiety disorders reported in adolescence and later risks of anxiety disorder; major depression; nicotine, alcohol, and illicit drug dependence; suicidal behavior; educational underachievement; and early parenthood. Associations between the extent of adolescent anxiety disorder and later risks of anxiety disorder, depression, illicit drug dependence, and failure to attend university were shown to persist after statistical control for the confounding effects of sociofamilial and individual factors. CONCLUSIONS: Findings suggest that adolescents with anxiety disorders are at an increased risk of subsequent anxiety, depression, illicit drug dependence, and educational underachievement as young adults. Clinical and research implications are considered.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11556633&dopt=Abstract anxiety medicine




Self-efficacy, state anxiety, and cortisol responses to treadmill running.

Butki BD, Rudolph DL, Jacobsen H.

Southern Illinois University Edwardsville, 62026-1126, USA.

Social cognitive theory of Bandura hypothesizes that increases in self-efficacy act as a mechanism for anxiety reduction and lower biological stress reactions. Therefore, the purpose of the current study was to examine self-efficacy, anxiety, and cortisol responses to 20 minutes of treadmill running at 85% maximal heart rate and a control condition among 12 physically active males. For this study, self-efficacy, anxiety, and cortisol were measured prior to and 5 and 20 min. after exercise for individuals completing a 20-min. treadmill running activity or a 20 min. rest (control) activity. Repeated-measures analyses of variance showed significant condition by time interaction for self-efficacy and cortisol (ps <.05); the exercise group's self-efficacy and cortisol increased pre- to posttreatment. Moreover, the analysis of variance for anxiety yielded a main effect for time, with reductions in anxiety scores observed in both conditions. Correlational analyses showed that posttreatment cortisol levels were inversely correlated -.51 to self-efficacy scores and positively correlated .55 to anxiety scores. The correlation between self-efficacy and anxiety was not significant. These results provide partial support for the predicted relationships among self-efficacy, anxiety, and cortisol responses to treadmill running. Suggestions for research are provided.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11565921&dopt=Abstract anxiety medicine




Covert fears and anxiety in asthma and congenital heart disease.

Gupta S, Mitchell I, Giuffre RM, Crawford S.

Department of Psychology, Alberta Children's Hospital, The University of Calgary, Alberta, Canada.

AIM: To compare anxiety, fears and behavioural problems in children with asthma and children with congenital heart disease, and with the normative population. To also review the influence of maternal anxiety, time since diagnosis and severity of disease. DESIGN: Children administered Fear Survey Scale (FSSC-R) and Child Manifest Anxiety Scale (R-CMAS). Mothers given Child Behaviour Checklist (CBCL) and State Trait Anxiety Scale (STAI-S and STAI-T). Normative means and SDs compared with means and SDs for both medical groups. The mother's scores on the STAI-S and STAI-T scales were correlated with the child's scores on the FSSC-R and the R-CMAS. SETTING: Outpatient Asthma and Cardiology multidisciplinary Clinics at a tertiary care paediatric facility, Alberta Children's Hospital. SUBJECTS: Forty children with asthma (aged 6--17 years) were compared with 39 children with congenital heart disease. Intake questionnaires and interviews determined these children to be without obvious psycho-social problems. RESULTS: Children with asthma and children with congenital heart disease had more medical fears, and more physiological anxiety than normative samples. Increased maternal anxiety was correlated in both groups with increased child anxiety, medical fears and behavioural problems in the child. Similarly, increased severity of asthma or cardiac problems was associated with more physiological anxiety and more fears. Less time since diagnosis of the disease adversely affected social interactions in both groups of children. CONCLUSION: Physiological anxiety, medical fears and maternal anxiety are important issues requiring attention in asthma and cardiac disease, even in the absence of obvious psychosocial problems. There may be specific problems with a recent diagnosis of a chronic illness.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11437837&dopt=Abstract anxiety medicine




Is there a negative association between anxiety sensitivity and arousal-increasing substances and activities?

McWilliams LA, Asmundson GJ.

University of Regina, Saskatchewan, Canada.

Little research has addressed McNally's hypothesis [(1996). Anxiety sensitivity is distinguishable from trait anxiety. In: R. M. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 214-227). New York: The Guilford Press.] that anxiety sensitivity (AS) should be negatively associated with the use of arousal-increasing substances. In the present study, we examined the relationship between AS and the self-reported use of two widely available stimulants--nicotine and caffeine--and exercise frequency in a sample of 256 university students. A measure of trait anxiety was also incorporated within the design. The associations between use of both substances and levels of AS and trait anxiety were weak and nonsignificant. Although inconsistent with McNally's hypothesis, some significant findings were found when the lower-order components of AS (i.e., fears of physical, psychological, and publicly observable symptoms of anxiety) were examined. The associations between exercise frequency and the anxiety measures, indicating a negative relationship, were generally consistent with McNally's hypothesis. Implications of these findings are discussed with reference to future investigation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11442136&dopt=Abstract anxiety medicine




Social anxiety in college students.

Purdon C, Antony M, Monteiro S, Swinson RP.

Anxiety Treatment and Research Centre, St. Joseph's Hospital, Hamilton, Ontario, Canada. clpurdon watarts.uwaterloo.ca

Individuals with social phobia often hold erroneous beliefs about the extent to which others experience symptoms of social anxiety and the ways in which others evaluate people who appear to be anxious. The purpose of this study was to: (a) provide normative data on the frequency with which individuals in a nonclinical sample experience particular symptoms of social anxiety (e.g., sweating, shaking, etc.); (b) to examine how the perception of anxiety in others influences participants' immediate impressions of various personal characteristics (e.g., intelligence, attractiveness, etc); and, (c) investigate the relationship between social anxiety and perceptions regarding others who appear to be anxious. Eighty-one undergraduate students completed self-report measures of social anxiety and social desirability, and then rated the degree to which their impressions of various personal characteristics were influenced when another individual was perceived to be anxious. Results suggested that the vast majority of individuals experience symptoms of anxiety in social situations from time to time. In addition, individuals who themselves reported elevated social anxiety were more likely than individuals less socially anxious to judge others who appear anxious to have less strength of character and to be less attractive and more compassionate compared to others who do not appear anxious. Clinical implications of these results are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11442139&dopt=Abstract anxiety medicine




Fear and anxiety in patients awaiting coronary artery bypass grafting.

Koivula M, Paunonen-Ilmonen M, Tarkka MT, Tarkka M, Laippala P.

Department of Nursing Science, University of Tampere, Finland.

OBJECTIVE: The purpose of this study was to identify the prevalence of fear and anxiety in patients awaiting coronary artery bypass grafting and the factors associated with high fear and high anxiety. DESIGN: The survey included 240 patients placed on the waiting list for coronary artery bypass grafting at one hospital. SUBJECTS: Two hundred and seven patients completed the questionnaire. INSTRUMENTS: The Bypass Grafting Fear Scale, the State-Trait Anxiety Inventory, and the Hospital Anxiety and Depression Scale were used. RESULTS: Half of the patients experienced low fear and anxiety. Twenty-five percent had high fear, but only 5% had high anxiety. Patients who felt high fear were mainly women, had no vocational education, were on sick leave, were depressed, had a tendency towards anxiety, and had a short wait for operation. Patients who displayed medium or high anxiety were mostly under 55 years of age and had depression, but only low or no pain. CONCLUSIONS: The results facilitate better identification of predictors of high fear and anxiety as well as direct support and information for those patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11449217&dopt=Abstract anxiety medicine