Search results for: influence of covid-19 on anxiety

Authors: María Isabel Núñez-Peña, Macarena Suárez Pellicioni

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In the present study, we used event-related potentials (ERP) to address the question of whether high (HMA) and low math-anxious (LMA) individuals differ on a complex addition verification task, which involved both carrying and non-carrying additions. ERPs were recorded while seventeen HMA and seventeen LMA individuals performed the verification task. Groups did not differ in trait anxiety or gender distribution. Participants were presented with two-digit additions and were asked to decide whether the proposed solution was correct or incorrect. Behavioral data showed a significant Carrying x Proposed solution x Group interaction for accuracy, showing that carrying additions were more error prone than non-carrying ones for both groups, although the difference non-carrying minus carrying was larger for the HMA group. As for ERPs, a P2 component larger in HMA individuals than in their LMA peers was found both for carrying and non-carrying additions. The P2 was followed by a sustained negative slow wave at parietal positions. Because the negative slow waves are thought to reflect the updating of working memory, these results give support to the relationship among working memory, math performance and math anxiety.

Keywords: math anxiety, carrying, working memory, P2

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Authors: W. Phokhwang-Just, A. Saraketrin, P. Thongpet, J. Udomkitpipat, J. Kaewsakulthong

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The more people get older and live longer, the more health problems they may have. This cross-sectional study aims to study a correlation between death anxiety, quality of life, and self-esteem as well as factors affecting these variables in the elderly living in Surat Thani Province, Thailand. Of 382 elderly people, who were proportionally sampled from 19 districts in Surat Thani Province, 256 (67%) already returned the questionnaires. The Thai version of Templer’s Death Anxiety, Quality of Life (WHO-BREF), and of Rosenberg’s Self-Esteem Questionnaires were employed. The result showed that the samples had a mean age of 72 years old, 53% were female, 62% were married, 61% graduated with primary-school, and 61% had at least one chronic disease Approximately, 19% of them had 3 diseases. The quality of life (QOL), self-esteem (SE), and death anxiety (DA) of samples were in moderate (n= 91, mean = 86.89, SD = 15.47), high (n = 138, mean = 29.33, SD=4.77), and low level (n= 85, mean = 6.23, SD= 3.65), respectively. The QOL was not significantly different between male and female as well as among different marital status. The female elderly had more DA and less SE than male (t= 2.095, df = 83; t =-3.258, df =135, respectively, p < 0.05). The female elderly, who were separated or widow, had a higher level of DA than did the married elderly (LSD: p < 0.05). The married elderly had a higher level of SE than did the separated, widowed (Tukey HSD, LSD: p < 0.05), or single elderly (LSD: p < 0.05). The more diseases the elderly got, the lower level of QOL they had (r = -0.335, p < 0.05). The QOL was significantly correlated with SE (r =0.434, p < 0.05), but not significantly related to DA (r = -0.200, p = 0.069). The lower level of SE the elderly had, the higher level of DA they become (r = -2.71, p < 0.05). In order to promote the QOL, the SE of the elderly should be enhanced. Consequently, the DA can be minimized. Healthcare providers should provide care that promotes QOL, SE, and reduces DA of the elderly, especially those, who are female, single, and separated or widowed as well as those, who have more diseases than the others

Keywords: death anxiety, quality of life, self-esteem, elderly

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Authors: Beatriz Delgado

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Although social anxiety is one of the most prevalent disorders in adolescents and causes considerable difficulties and social distress in those with the disorder, to date very few studies have explored the impact of social anxiety on academic adjustment in student populations. The aim of this study was analyze the effect of social anxiety on school functioning in Secondary Education. Specifically, we examined the relationship between social anxiety and self-concept, academic goals, causal attributions, intellectual aptitudes, and learning strategies, personality traits, and academic performance, with the purpose of creating a causal-explanatory model of academic performance. The sample consisted of 2,022 students in the seven to ten grades of Compulsory Secondary Education in Spain (M = 13.18; SD = 1.35; 51.1% boys). We found that: (a) social anxiety has a direct positive effect on internal attributional style, and a direct negative effect on self-concept. Social anxiety also has an indirect negative effect on internal causal attributions; (b) prior performance (first academic trimester) exerts a direct positive effect on intelligence, achievement goals, academic self-concept, and final academic performance (third academic trimester), and a direct negative effect on internal causal attributions. It also has an indirect positive effect on causal attributions (internal and external), learning goals, achievement goals, and study strategies; (c) intelligence has a direct positive effect on learning goals and academic performance (third academic trimester); (d) academic self-concept has a direct positive effect on internal and external attributional style. Also, has an indirect effect on learning goals, achievement goals, and learning strategies; (e) internal attributional style has a direct positive effect on learning strategies and learning goals. Has a positive but indirect effect on achievement goals and learning strategies; (f) external attributional style has a direct negative effect on learning strategies and learning goals and a direct positive effect on internal causal attributions; (g) learning goals have direct positive effect on learning strategies and achievement goals. The structural equation model fit the data well (CFI = .91; RMSEA = .04), explaining 93.8% of the variance in academic performance. Finally, we emphasize that the new causal-explanatory model proposed in the present study represents a significant contribution in that it includes social anxiety as an explanatory variable of cognitive-motivational constructs.

Keywords: academic performance, adolescence, cognitive-motivational variables, social anxiety

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz

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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Keywords: watching comedy movie, humor, pain, anxiety, nursing, care

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Authors: Japnoor Garcha, Andrew P. Smith

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There has been a significant increase in the prevalence and estimates of neurodevelopmental disorders specially autism spectrum disorders in the last decade. The literature has seen increasing research on understanding well-being and mental health. The current studies have focused on seeing the impact of mental health and well-being in autism spectrum disorders and ADHD both with and without a diagnosis. To further understand the association and interaction of well-being and mental health with autism and ADHD a survey was given to 560 secondary school students. The survey used the well-being process questionnaire, the autism spectrum quotient, the ADHD self-report scale, and the strengths and difficulties questionnaire. The analysis conducted using SPSS showed that there was a significant correlation between anxiety, depression, AQ and ADHD. Anxiety and depression were also significantly correlated with all well-being and SDQ variables. The regression analysis showed that anxiety was significantly associated with positive well-being, negative well-being, emotional problems and prosocial behaviour whereas depression was significantly associated with positive well-being, negative well-being, physical health, flourishing, conduct problems, emotional problems and peer problems. This interaction led to the formation of a combined variable to see what impact the variables of anxiety, depression, AQ and ADHD would have coupled together. Further analysis showed that the combined variable was significantly correlated with all outcome variables. The regression analysis showed that the Combined variable was significantly correlated with emotional problems, and hyperactivity, stress, negative coping, psychological capital and sleepiness.

Keywords: AQ, adhd, sdq, well-being, combined variable

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Authors: Juanita Morris

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The purpose of this study will examine the mediating relationships between the theories of intelligence, mathematics anxiety, gender stereotype threat, meta-cognition and math performance through the use of eye tracking technology, affecting student perception and problem-solving abilities. The participants will consist of (N=80) female graduate students. Test administered were the Abbreviated Math Anxiety Scale, Tobii Eye Tracking software, gender stereotype threat through Google images, and they will be asked to describe their problem-solving approach allowed to measure metacognition. Participants will be administered mathematics problems while having gender stereotype threat shown to them through online images while being directed to look at the eye tracking software Tobii. We will explore this by asking ‘Is mathematics anxiety associated with the theories of intelligence and gender stereotype threat and how does metacognition and math performance place a role in mediating those perspectives?’. It is hypothesized that math-anxious students are more likely affected by the gender stereotype threat and that may play a role in their performance? Furthermore, we also want to explore whether math anxious students are more likely to be an entity theorist than incremental theorist and whether those who are math anxious will be more likely to be fixated on variables associated with coefficients? Path analysis and independent samples t-test will be used to generate results for this study. We hope to conclude that both the theories of intelligence and metacognition mediate the relationship between mathematics anxiety and gender stereotype threat.

Keywords: math anxiety, emotions, affective domains fo learning, cognitive underlinings

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Authors: G. A. Ravishankar, A. Ramakrishna

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Melatonin (MEL) and Serotonin (SER), also known as [5-Hydroxytryptamine (5-HT)] are reported to be in a range of plant types which are edible. Their occurrence in plants species appears to be ubiquitous. Their presence in high quantities in plants assumes significance owing to their physiological effects upon consumption by human beings. MEL is a well known animal hormone mainly released by the pineal gland known to influence circadian rhythm, sleep, apart from immune enhancement. Similarly, SER is a neurotransmitter that regulates mood, sleep and anxiety in mammals. It is implicated in memory, behavioral changes, scavenging reactive oxygen species, antipsychotic, etc. Similarly Role of SER and MEL in plant morphogenesis, and various physiological processes through intense research is beginning to unfold. These molecules are in common foods viz banana, pineapple, plum, nuts, milk, grape wine. N- Feruloyl serotonin and p-coumaroyl serotonin found in certain seeds are found to possess antioxidant, anti-inflammatory, antitumor, antibacterial, and anti-stress potential apart from reducing depression and anxiety. MEL is found in Mediterranean diets, nuts, cherries, tomato berries, and olive products. Consumption of foods rich in MEL is known to increase blood MEL levels which have been implicated in protective effect against cardiovascular damage, cancer initiation and growth. MEL is also found in wines, green tea, beer, olive oil etc. Moreover, presence of SER and MEL in Coffee beans (green and roasted beans) and decoction has been reported us. In this communication we report the occurrence of indole amines in edible plants and their implications in human health.

Keywords: serotonin, melatonin, edible plants, neurotransmitters, physiological effects

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Authors: Nashi Khan, Amina Khalid

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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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Authors: Steven M. Sanders, April T. Berry, David W. Hollingsworth

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Previous research has shown that veterans have higher rates of mental health concerns compared to non-veteran populations. A potential risk factor for the development of mental health concerns (i.e., depression & anxiety), particularly in Black veterans, is psychological inflexibility. Psychological inflexibility, a component of Acceptance & Commitment Therapy (ACT), is a process by which behavior is expressed in ways that attempt to control emotional and psychological reactions to uncomfortable stimuli and situations rather than by direct contingencies or personal values. The present study explored the relationship between psychological inflexibility, symptoms of depression, and symptoms of anxiety in a sample of 131 Black veterans. Results demonstrated that Black veterans who endorsed psychological inflexibility also endorsed higher levels of both depression and anxiety symptomology. These findings indicate the deleterious consequences of experiencing psychological inflexibility, which could be treated through ACT.

Keywords: psychological flexibility, veteran, black, psychological distress

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Authors: Lindsey Giunta

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This review examines the current literature regarding the impact of COVID-19 on academic functioning and anxiety in children and adolescents. The objective was to determine the ways in which the pandemic affected youth mental health and academics, in addition to the extent that these factors were transformed as a result of the worldwide state of affairs. Twenty papers were selected and reviewed, and data showed long term consequences in youth mental health resulting from the current pandemic. The COVID-19 pandemic and its associated lockdowns led to disrupted childhood education, and data showed that the growth of cognitive executive functions was impacted to varying degrees dependent upon geographic location. The literature recommends supplemental education on the national level, as well as mental health promotion within communities and schools.

Keywords: pandemic, children, adolescents, anxiety, academic functioning

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Roger G. Pagente Jr.

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This study seeks to investigate the language learning experiences of the thirty-nine AB-English majors who were selected through fish-bowl technique from the 157 students enrolled in the AB-English program. Findings taken from the diary, questionnaire and unstructured interview revealed that motivation, learners’ belief, self-monitoring, language anxiety, activities and strategies were the prevailing factors that influenced the learning of English of the participants.

Keywords: diary, English language learning experiences, self-monitoring, language anxiety

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Authors: Muhammed Kök & Adem Kantar

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Learning a foreign language can be affected by various factors such as age, aptitude, motivation, L2 disposition, etc. Among these factors, masculine gender roles stress (MGRS) that male learners possess is the least touched area that has been examined so far.MGRS can be defined as the traditional male role stress when the male learners feel the masculinity threat against their traditionally adopted masculinity norms. Traditional masculine norms include toughness, accuracy, completeness, and faultlessness. From this perspective, these norms are diametrically opposed to the language learning process since learning a language, by its nature, involves stages such as making mistakes and errors, not recalling words, pronouncing sounds incorrectly, creating wrong sentences, etc. Considering the potential impact of MGRS on the language learning process, the main purpose of this study is to investigate the mediating role of MGRS on the relationship between the EFL learners’ self-disclosure and English class anxiety. Data were collected from Turkish EFL learners (N=282) who study different majors in various state universities across Turkey. Data were analyzed by means of the Bootstraping method using the SPSS Process Macro plugin. The findings show that the indirect effect of self-disclosure level on the English Class Anxiety via MGRS was significant. We conclude that one of the reasons why Turkish EFL learners have English class anxiety might be the pressure that they feel because of their traditional gender role stress.

Keywords: masculine, gender role stress, english class anxiety, self-disclosure, masculinity norms

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Authors: Annie Devault

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Mindfulness-based interventions (MBI) can be beneficial for the well-being of children. MBIs offered for children in contexts of vulnerability (poverty, neglect) report positive results in terms of emotion regulation and cognitive flexibility. Anxiety is a common issue for children living in a vulnerable context. It has a negative impact on children’s attention span, emotional regulation and self-esteem. The MBI (12 weeks) associated with this research has been developed for a total of 30 children suffering from anxiety (7 to 9 years old) and receiving services from a community center over the last seven years. The first objective is to describe in details the content of the mindfulness-based intervention. The second purpose is to document what helps and what hinders the practice of mindfulness for children living in a context of vulnerability. A special attention will be given to the importance of the way that the intervention is offered and the principles that are followed by the practitioners. Perceived effects of the intervention on children were collected through an individual semi-structured interview with each child at the end of the program. Parents were also interviewed to have their point of view on the effect of their children’s participation in the group. Anxiety was measure with the Beck youth pre-post and at follow up (2 months). Qualitative analysis of the interviews with children showed that most of them mentioned that the program helped them become calmer, more confident, less scared and more able to deal with difficult emotions. Almost all of them reported having used the material provided to them to practice at home. This result has been confirmed by parents. They reported that their child had gained confidence and were better at verbalizing emotions. Children also grew calmer, even though all anxiety was not gone. They would have liked more material to practice at home. The quantitative instrument used to measure anxiety did not corroborate the qualitative interviews about anxiety. Discussion will question the use of this questionnaire for children who have important cognitive limitations. Discussion will also report the importance of the personalized contact with children, along with other consideration, to enhance the adherence of children and parents. The MBI seems to have benefited children in different ways, which is corroborated by most parents. Since the sample was limited, we will need to continue documenting its effects with more children and parents. The major strength of this research is to have reported the subjective perspectives of children on their experience of mindfulness.

Keywords: anxiety, mindfulness, children, best practices

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Authors: Bo Yan, Amy Y. M. Chow

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Bereavement is recognized as a universal challenging experience. It is important to gather research evidence on protective factors in bereavement. Hope is considered as one of the protective factors in previous coping studies. The present study aims to add knowledge by investigating hope at the first month after death to predict psychological symptoms altogether including complicated grief (CG), anxiety, and depressive symptoms at the seventh month. The data were collected via one-on-one interview survey in a longitudinal project with Hong Kong hospice users (sample size 105). Most participants were at their middle age (49-year-old on average), female (72%), with no religious affiliation (58%). Bayesian Structural Equation Modeling (BSEM) analysis was conducted on the longitudinal dataset. The BSEM findings show that hope at the first month of bereavement negatively predicts both CG and anxiety symptoms at the seventh month but not for depressive symptoms. Age and gender are controlled in the model. The overall model fit is good. The current study findings suggest assessing hope at the first month of bereavement. Hope at the first month after the loss is identified as an excellent predictor for complicated grief and anxiety symptoms at the seventh month. The result from this sample is clear, so it encourages cross-cultural research on replicated modeling and development of further clinical application. Particularly, practical consideration for early intervention to increase the level of hope has the potential to reduce the psychological symptoms and thus to improve the bereaved persons’ wellbeing in the long run.

Keywords: anxiety, complicated grief, depressive symptoms, hope, structural equational modeling

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Authors: S. Bagur, S. Verger, B. Mut

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Early childhood intervention (ECI) is the set of actions aimed at children aged 0-6 years with special needs, the family, and the environment that aim to improve child development and family well-being. Socio-educational intervention with children with disabilities and their families should be understood through the principles of family-centered practice (FCP). The multidisciplinary team of professionals carries out the intake, assessment, and intervention, understanding that families may experience mental health problems, parental role incompetence, or feelings of exclusion. This study examines the relationship between caregivers' levels of anxiety and depression and child development during the fostering and assessment phase. The design is quantitative, non-experimental, and cross-sectional. The sample consisted of 135 family members (78.5% female, 21.5% male) users of child development services in the Balearic Islands (Spain). Three questionnaires were completed: Anxiety and Depression Scale, Child Behavior Checklist (CBCL 1½-5), and sociodemographic questionnaire. The main results show that parents of children with special needs score higher on anxiety than on depression. It should be noted that professional discipline is a variable to be taken into account in relation to parents' perception of the improvement of their child's development. In addition, there is an association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. In short, we propose a reflection on the application of FCP during the intervention, understanding the lack of professional training as a predictor of quality in early intervention. Likewise, future lines of research are proposed to improve early care practices.

Keywords: anxiety, depression, early childhood intervention, family

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Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

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Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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Authors: Usha Barahmand, Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: The association of epilepsy with several psychological disorders and reduced quality of life has long been recognized. The present study aimed at comparing the personality profiles, quality of life and symptomatology of anxiety and depression in patients with epilepsy and healthy controls. Materials and Methods: Forty seven patients (29 men and 18 women) with diagnosed epilepsy participated in this study. Forty seven healthy controls who matched the patients in age and gender were also recruited. The participants’ personality and psychological profiles were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), the Short-Form Health Survey (SF-36) and the HEXACO Personality Inventory (HEXACO-PI). Scoring algorithms were applied to the SF-36 produce the physical and mental component scores (PCS and MCS). Results: There were statistically significant differences in the total SF-36 score, anxiety, depression and stress scores of the DASS-21 between patients and controls. Anxiety, stress and depression scores significantly correlated inversely with the PCS and MCS. Data analysis showed that females had higher depression scores than males in both patients and controls, while males in both groups scored higher on stress. Patients’ personality scores were also different from those reported by controls on emotional, agreeableness and extroversion. Patients scored higher on emotionality, and lower on agreeableness and extraversion. Patients also scored lower on indices of quality of life. Regression analysis revealed that emotionality, anxiety, stress and MCS accounted for a significant proportion of the variance in severity of epileptic seizures. Conclusion: Stressful situations and psychological conditions as well as the personality trait of neuroticism were related to the occurrence of recurrent epileptic seizures.

Keywords: anxiety, depression, epilepsy, neuroticism, personality, quality of life, stress

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Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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Authors: Wenhsuan Lee, Yachi Chang, Yingyih Shih

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In clinical practices, it is common that while facing the unknown progress of their disease, palliative care patients may easily feel anxious and depressed. These types of reactions are a cause of psychosomatic diseases and may also influence treatment results. However, the purpose of palliative care is to provide relief from all kinds of pains. Therefore, how to make patients more comfortable is an issue worth studying. This study adopted the “bio-psycho-social model” proposed by Engel and applied spontaneous breathing training, in the hope of seeing patients’ psychological state changes caused by their physiological state changes, improvements in their anxious conditions, corresponding adjustments of their cognitive functions, and further enhancement of their social functions and the social support system. This study will be a one-year study. Palliative care outpatients will be recruited and assigned to the experimental group or the control group for six outpatient visits (once a month), with 80 patients in each group. The patients of both groups agreed that this study can collect their physiological quantitative data using an HRV device before the first outpatient visit. They also agreed to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” before the first outpatient visit, to fill a self-report questionnaire after each outpatient visit, and to answer the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire” after the last outpatient visit. The patients of the experimental group agreed to receive the breathing training under HRV monitoring during the first outpatient visit of this study. Before each of the following three outpatient visits, they were required to fill a self-report questionnaire regarding their breathing practices after going home. After the outpatient visits, they were taught how to practice breathing through an HRV device and asked to practice it after going home. Later, based on the results from the HRV data analyses and the pre-tests and post-tests of the “Beck Anxiety Inventory (BAI)”, the “Taiwanese version of the WHOQOL-BREF questionnaire”, the influence of the breathing training in the bio, psycho, and social aspects were evaluated. The data collected through the self-report questionnaires of the patients of both groups were used to explore the possible interfering factors among the bio, psycho, and social changes. It is expected that this study will support the “bio-psycho-social model” proposed by Engel, meaning that bio, psycho, and social supports are closely related, and that breathing training helps to transform palliative care patients’ psychological feelings of anxiety and depression, to facilitate their positive interactions with others, and to improve the quality medical care for them.

Keywords: palliative care, breathing training, bio-psycho-social model, heart rate variability

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Authors: Xiu Zhang

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The Merchant of Venice focuses on identity anxiety through the contract of “a pound of flesh” and refers to the economic, legal and religious issues related to identity. The development of the emerging capitalist economy in Venetian society prompted Shylock to become a usurer. The social identity of Shylock’s lender enabled him to use the power of money to consolidate the interdependent relationship with Christians and strive for his position and living space in Venetian society. However, there have long been economical and religious conflicts between Jews and Christians. Therefore, in order to take vengeance on Antonio and take his life, so as to revenge the whole Christian society, Shylock insists on taking a pound of Antonio’s flesh in the name of abiding by the contract and the law. The choice of “a pound of flesh” is essentially the representation of human materialization and commercialization under the background of the rise of capitalism and economic transformation. At the same time, it also symbolizes Shylock’s efforts and attempts to reshape himself and his racial identity.

Keywords: merchant of Venice, ethical choices, Shylock, a pound of flesh, identity anxiety

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Authors: Mehmet Bekmezci, Ismail Celik, Ismail Sahin, Ahmet Kiray, A. Oguz Akturk

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In this research, students’ scientific attitude, computer anxiety, educational use of the Internet, academic achievement, and problematic use of the Internet are analyzed based on different variables (gender, parents’ educational level and daily access to the Internet). The research group involves 361 students from two middle schools which are located in the center of Konya. The “general survey method” is adopted in the research. In accordance with the purpose of the study, percentage, mean, standard deviation, independent samples t--‐test, ANOVA (variance) are employed in the study. A total of four scales are implemented. These four scales include a total of 13 sub-dimensions. The scores from these scales and their subscales are studied in terms of various variables. In the research, students’ scientific attitude, computer anxiety, educational use of the Internet, the problematic Internet use and academic achievement (gender, parent educational level, and daily access to the Internet) are investigated based on various variables and some significant relations are found.

Keywords: scientific attitude, educational use of the internet, computer anxiety, problematic use of the internet, academic achievement

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Authors: Alexander N. Savostyanov, Tatyana A. Dolgorukova, Elena A. Esipenko, Mikhail S. Zaleshin, Margherita Malanchini, Anna V. Budakova, Alexander E. Saprygin, Yulia V. Kovas

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The present study compared spectral-power indexes and cortical topography of brain activity in a sample characterized by different levels of trait and mathematical anxiety. 52 healthy Russian-speakers (age 17-32; 30 males) participated in the study. Participants solved an error recognition task under 3 conditions: A lexical condition (simple sentences in Russian), and two numerical conditions (simple arithmetic and complicated algebraic problems). Trait and mathematical anxiety were measured using self-repot questionnaires. EEG activity was recorded simultaneously during task execution. Event-related spectral perturbations (ERSP) were used to analyze spectral-power changes in brain activity. Additionally, sLORETA was applied in order to localize the sources of brain activity. When exploring EEG activity recorded after tasks onset during lexical conditions, sLORETA revealed increased activation in frontal and left temporal cortical areas, mainly in the alpha/beta frequency ranges. When examining the EEG activity recorded after task onset during arithmetic and algebraic conditions, additional activation in delta/theta band in the right parietal cortex was observed. The ERSP plots reveled alpha/beta desynchronizations within a 500-3000 ms interval after task onset and slow-wave synchronization within an interval of 150-350 ms. Amplitudes of these intervals reflected the accuracy of error recognition, and were differently associated with the three (lexical, arithmetic and algebraic) conditions. The level of trait anxiety was positively correlated with the amplitude of alpha/beta desynchronization. The level of mathematical anxiety was negatively correlated with the amplitude of theta synchronization and of alpha/beta desynchronization. Overall, trait anxiety was related with an increase in brain activation during task execution, whereas mathematical anxiety was associated with increased inhibitory-related activity. We gratefully acknowledge the support from the №11.G34.31.0043 grant from the Government of the Russian Federation.

Keywords: anxiety, EEG, lexical and numerical error-recognition tasks, alpha/beta desynchronization

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Authors: Valerie Alexander, Amanda Gutierrez, Veronica Campbell, Dara Schwartz, B. Charles Tatum

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It has long been assumed that personality disorders (PD) originate in adolescence or early adulthood and that the maladaptive behaviors significantly attenuate over time. The Diagnostic and Statistical Manual of Mental Disorders-5 supports early onset of PD and views the pattern of behaviors as enduring and stable. The premise of this study is that PD may not always begin early in life, that behaviors may change over the lifespan, and that current treatment modalities may be beneficial in seniors. Self-injurious behaviors (SIB) exhibited earlier in life may, in older adults, be manifested in less overt high-risk behaviors but by refusal to take medication and get necessary medical treatment. Dialectical Behavioral Therapy is a well-known treatment modality for teaching emotional regulation and distress tolerance and thus reducing self-injurious behaviors yet very little has been studied about SIB and treatment in older adults. The population for this study was older adults, with a history of SIB, a PD, and depression and/or anxiety. Participants learned an adapted version of Dialectical Behavioral Therapy (DBT) as developed by DBT trained therapists. The results provided clinical potentials for the efficacy of DBT to reduce SIB, decrease depression and anxiety in the older adult population.

Keywords: anxiety, depression, dialectical behavioral therapy, personality disorders, self-harm behavior, treatment in older adults

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Authors: Yoonah Lee, Richard Kyung

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With technological advances in the computational biomedical field, the ability to measure neurotransmitters’ chemical imbalances that affect depression and anxiety has been established. By comparing the thermodynamics stability of amino acid supplements, such as glutamine, tyrosine, phe-nylalanine, and methionine, this research analyzes mood-regulating neurotransmitters, amino acid supplements, and antipsychotic substances (ie. Reserpine molecule and CRF complexes) in relation to depression and anxiety and suggests alternative complexes that are low in energy to act as more efficient treatments for mood disorders. To determine a molecule’s thermodynamic stability, this research examines the molecular energy using Avogadro, a software for building virtual molecules and calculating optimized geometry using GAFF (General Amber Force Field) and UFF (Universal Force Field). The molecules, built using Avogadro, is analyzed using their theoretical values and atomic properties.

Keywords: amino acids, anxiety, depression, neurotransmitters

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Authors: Ryotaro Ishikawa

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Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. Inflated responsibility attitude and interpretation are central beliefs in a cognitive model of OCD. This study aimed to develop a Japanese version of the Responsibility Attitude Scale (RAS-J) and Responsibility Interpretation Questionnaire (RIQ-J). 98 participants (OCD group = 37; anxiety control group = 24; healthy control group = 37) completed the RAS-J, RIQ-J and other measures to assess the validity of the RAS-J and RIQ-J. As a result of analysis, both scales had adequate concurrent validity, demonstrated by significant correlations with other measures of OCD, anxiety, and depression. Group comparison data using ANOVA with Bonferroni method indicated that RAS-J and RIQ-J scores for the OCD group not only differed from the nonclinical group, but also from the clinically anxious comparison group. In conclusion, this study indicated that the developed RAS-J and RIQ-J effectively measure responsibility attitude and responsibility interpretation in the Japanese population.

Keywords: obsessive-compulsive disorder, responsibility, cognitive theory, anxiety disorder

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Authors: Hsiao-Wen Tsai

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Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.

Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury

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Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

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