Three phases of research in validating nursing diagnoses.

Whitley GG.

Northern Illinois University, School of Nursing, USA.

The purposes of this three-phase project consisting of concept analyses, nurse expert validation, and client validation were: identification of nursing definitions of anxiety and fear, validation of defining characteristics of the diagnoses by nurse experts, differentiation of the diagnoses by nurse experts, and validation of the nursing diagnosis anxiety by clients. The nurse expert sample consisted of 233 professional nurses, and the client sample consisted of 69 adult clients. Results include agreement on two critical defining characteristics of anxiety by nurse experts and clients, the differentiation of anxiety and fear by nurse experts, the suggestion of a fear-anxiety syndrome in the literature and by nurse experts and clients, and the suggestion by nurse experts that anxiety be defined using levels of anxiety. Recommendation for changes in the nursing diagnosis anxiety are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9170994&dopt=Abstract anxiety medicine




Overlap between dental anxiety and blood-injury fears: psychological characteristics and response to dental treatment.

Locker D, Shapiro D, Liddell A.

Faculty of Dentistry, University of Toronto, Ontario, Canada.

The relationship between dental anxiety and blood/body injury (BI) fears was examined in a sample of 1420 adults. Based on their responses to two mail questionnaires, they were classified into one of four groups: Group 1--neither dentally anxious nor BI fearful; Group 2--BI fearful only; Group 3--dentally anxious only; Group 4--both dentally anxious and BI fearful. Overall, only 16% of dentally anxious subjects were BI fearful while 31.6% of those with high levels of BI fears were dentally anxious. While subjects in Group 2 were more fearful of dentistry than those in Group 1, they were substantially less so than subjects in Groups 3 and 4. Moreover, even BI stimuli in the dental setting evoked lower levels of anxiety for subjects in Group 2 compared to Group 3 and 4. However, rates of fainting or near fainting experiences in the dental situation were similar for all three groups. Group 3 and 4 were similar in terms of fear evoking stimuli and patterns of anxiety response. Subjects in Group 4 had more agoraphobic symptoms and social interaction fears and had higher scores on the Anxiety Sensitivity Index and Speilberger Trait Anxiety Index. This suggests that Group 4 is comprised of individuals who are more likely to be multiphobic and exhibit generalized anxiety states. Although BI fears are a significant component of dental anxiety, their overall contribution is relatively small.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9193122&dopt=Abstract anxiety medicine




Depression and anxiety in young children of substance abusers.

Drucker PM, Greco-Vigorito C, Coil G, Moore-Russell M, Avaltroni J.

Division of Social Sciences, St. John's University, Staten Island, NY 10301, USA. drucker simcl.stjohns.edu

144 5- to 13-yr.-old children of substance abusers, enrolled in an expressive arts therapy program, were tested for depression on the Children's Depression Inventory and for anxiety on the Revised Children's Manifest Anxiety Scale prior to treatment. Total scores for anxiety were significantly higher for girls than for boys; however, total depression scores did not differ between boys and girls. Analysis of subscale scores on each of the tests indicated several sex differences. Age was positively correlated with certain symptoms of depression for boys but not for girls. Conversely, age was negatively correlated with certain symptoms of anxiety for boys but not for girls. When compared to known norms for these assessments, girls scored significantly higher on total Depression but not differently than normals on total Anxiety. Boys, however, scored significantly lower on total Anxiety but did not score differently than normals on total Depression. We interpreted these findings as indicating that young children of substance abusers may be at risk for certain symptoms of anxiety and depression following their parents' addiction. Also, these symptoms may be manifest differently by boys and girls of various ages.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9198371&dopt=Abstract anxiety medicine




At risk for anxiety: I. Psychopathology in the offspring of anxious parents.

Beidel DC, Turner SM.

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA.

OBJECTIVE AND METHOD: Children of parents with anxiety disorders, depressive disorders, mixed anxiety/depressive disorders, and no psychiatric disorder were assessed with semistructured interviews to determine rates of overall psychopathology and to determine specifically the presence of anxiety disorders. RESULTS: Children of the three "high-risk" groups were significantly more likely to have a diagnosable disorder (including anxiety disorders) than offspring of normal parents, but there were no differences among the children from the three parental diagnostic groups. However, when examined specifically for anxiety disorders, offspring of anxious parents were significantly more likely to have only anxiety disorders. Offspring of depressed or mixed anxious/depressed parents had a broader range of disorders and more comorbid disorders. Family socioeconomic status was related to the probability that a child would have a disorder. CONCLUSIONS: Anxiety disorders are common among offspring of anxious and depressed parents. However, when a parent has depression, children exhibit a broader range of psychopathology than when a parent has an anxiety disorder alone.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9204669&dopt=Abstract anxiety medicine




Generalized anxiety and depression. Assessment over 2 years after stroke.

Schultz SK, Castillo CS, Kosier JT, Robinson RG.

Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242, USA.

The authors examined the course of anxiety up to 2 years after stroke in relation to depressive symptoms, impairment in activities of daily living (ADLs), and social functioning. One hundred forty-two patients were evaluated at 3, 6, 12, and 24 months after stroke. Anxiety was associated with greater depression severity at all follow-up visits. Depression severity was associated with impairment in ADLs at followup; association of anxiety and impairment in ADLs was present only at the intake visit, with independent effects only for women. Women reported more symptoms of both anxiety and depression during the 2-year period. Younger patients reported more anxiety symptoms, but there was no difference between age-groups in depressive symptoms. Severity of anxiety was also related to higher depression scores at initial hospitalization, but not in the remainder of the 2-year period. In summary, anxiety is associated with increased severity of depressive symptoms and greater impairment in function primarily during the acute hospitalization period. Women and younger patients also may be more vulnerable to anxiety after stroke.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9209565&dopt=Abstract anxiety medicine




Unemployment, coping and psychological distress.

Smari J, Arason E, Hafsteinsson H, Ingimarsson S.

Faculty of Social Science, National University Hospitals, University of Iceland.

This study addressed the role of coping style in anxiety and depression of unemployed people. Two-hundred thirty-three people checking in at unemployment services participated. They filled in Carver, Scheier and Weintraub's (1989) coping measure (COPE), the Hospital Anxiety and Depression scale (HAD), gave information as to age, duration of unemployment and their appraisal of their situation. Four secondary dimensions of COPE were used in data analyses. Multiple regression analyses were undertaken with anxiety/depression as dependent and the coping variables as independent variables, with background/appraisal variables entered first. Coping variables added to the prediction of anxiety and depression over and above background/appraisal variables. For women Focus on Emotion as well as Avoidance was related to higher anxiety/depression scores (p < 0.01), whereas Reappraisal was related to lower anxiety/depression (p < 0.05). For men only Avoidance was related to anxiety/depression (p < 0.01). More Avoidance co-occurred with higher levels of anxiety as well as depression. The results are discussed with respect to possible intervention.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9210858&dopt=Abstract anxiety medicine