Saúde mental de pais durante a pandemia da COVID-19 / Parental mental health during COVID-19 pandemic

OBJETIVO: Investigar a saúde mental de pais com filhos pequenos durante a pandemia de COVID-19. MÉTODOS: Foram utilizados questionários elaborados pelo Google Forms, no qual foram aplicados os dados sociodemográficos, e as escalas EADS-21, IES-R, PSQI-BR e WHOQOL-BREF. As análises estatísticas foram realizadas no software estatístico SPSS 21.0 para Windows. Para descrição da amostra, foram utilizadas análises descritivas. Em todos os testes, foi considerada a significância estatística de 0,05. Os 327 participantes foram divididos em três grupos: voluntários sem filhos (Grupo 1), com filhos entre 0 e 6 anos (Grupo 2) e com filhos de 7 anos ou mais (Grupo 3), dos quais todos eram residentes da região Sul do Brasil. RESULTADOS: Os grupos com maior vulnerabilidade em relação à sua saúde mental é o de participantes sem filhos e com filhos de 0 a 6 anos, com maiores escores para as escalas de depressão, ansiedade e estresse, e estresse pós-traumático, em comparação com o grupo com filhos de 7 anos ou mais. CONCLUSÕES: Mesmo que os dados mostrem que todos os grupos estão dentro da normalidade para as escalas aplicadas, faz-se necessário atentar para a saúde mental da população em maior sofrimento psíquico, seja a partir de estratégias desenvolvidas por profissionais de rede de saúde (SUS) e/ou da assistência social (SUAS), seja por projetos municipais/estaduais na busca pela promoção da saúde mental na rede.

OBJECTIVE: Explore the mental health of parents with young children during the COVID-19 pandemic. METHODS: We used questionnaires prepared by Google Forms, applying sociodemographic data, and also the EADS-21, IES-R, PSQI-BR and WHOQOL-BREF scales were applied. Statistical analyzes were performed using SPSS 21.0 statistical software for Windows. To describe the sample, descriptive analyzes were used. In all tests, a statistical significance of 0.05 was considered. Of the 327 participants, they were divided into three groups: volunteers without children (Group 1), with children aged 0 to 6 years (Group 2), and with children aged 7 or over (Group 3). All volunteers were residents from South of Brazil. RESULTS: The groups with the greatest vulnerability in relation to their mental health are those of participants without children and parents with children aged 0 to 6 years, with higher scores for the depression, anxiety and stress, and post traumatic stress symptoms, compared to parents with children aged from 7 years or more. CONCLUSION: even though the data show that all groups are within the normal range for the scales applied, it is necessary to pay attention to the mental health of the population in greater psychological distress, either from strategies developed by health professionals (SUS) and/or or social assistance (SUAS), either by municipal/state projects in the search for the promotion of mental health.

Changes in mental health during the COVID-19 crisis in Romania: A repeated cross-section study based on the measurement of subjective perceptions and experiences.

The coronavirus 2019 (COVID-19) pandemic has caused dramatic changes in the daily lives of Romanians, affecting their mental health. The COVID-19 pandemic has evolved at three significant peaks, which sequentially occurred on: April 29, 2020; September 18, 2020; and the third wave registered the highest severity on November 27, 2020. Little is known about the mental health changes during this phase of this pandemic. This study evaluated mental health levels in Romania at the end of the first wave of the pandemic and amidst the third and most severe wave. We administered a two-phase internet-based survey among 543 and 583 participants, respectively, recruited through snowball sampling at a 6-month interval. The IPAT Anxiety Scale measured anxiety, the Beck's Depression Inventory measured depression, and the Dissociative Experiences Scale measured dissociation. We observed no statistically significant differences in the number of participants with clinically relevant scores at either time point. In the first survey, 23.8%, 19.2%, and 32.6% reported being clinically anxious, clinically depressed, and showed clinical dissociation, respectively. Binary logistic regressions indicated that age, education level, and previous traumatic events were significantly associated with clinical levels of anxiety and depression. Moreover, multiple linear regression analysis reported a collective significant effect of gender, age, psychological impact, traumatic events, and dissociation on predicting high levels of anxiety and depression. Romanian adults' mental health status was affected during the COVID-19 pandemic, and it did not change 6 months after the first lockdown.

Ansiedade social: adaptação e evidências de validade da forma curta da Social Interaction Anxiety Scale e da Social Phobia Scale para o Brasil / Social anxiety: adaptation and evidence of validity of the short form of the Social Interaction Anxiety Scale and Social Phobia Scale for Brazil

OBJETIVO: A ansiedade social é um transtorno psicológico pouco publicizado, mas com importante distribuição epidemiológica. O presente estudo teve como objetivo adaptar para o contexto brasileiro as versões reduzidas da Social Interaction Anxiety Scale (SIAS) e da Social Phobia Scale (SPS) (SIAS-6 e SPS-6) e produzir evidências de validade. Essas escalas avaliam ansiedade em interações sociais e ansiedade social diante da possibilidade de escrutínio por outras pessoas, sendo complementares. MÉTODOS: Como são escalas com reconhecido uso internacional, a adaptação para o Brasil pode trazer contribuições para as investigações clínicas e científicas acerca do transtorno de ansiedade social. Foram realizados processos criteriosos para a adaptação (tradução, avaliação por juízes, retrotradução, avaliação pelo público-alvo) e conduzido um levantamento on-line com 1.049 pessoas, maiores de 18 anos, com média de idade de 25,98 anos (DP = 7,55). RESULTADOS: Utilizaram-se Análises Fatoriais Confirmatórias e, desse modo, constatou-se que os índices de ajuste produzidos são, em geral, adequados (SRMR < 0,04, CFI > 0,96, TLI > 0,94 e RMSEA < 0,05) e que os itens possuem cargas fatoriais adequadas (entre 0,441 e 0,837). As evidências de validade discriminante também se mostraram satisfatórias, conseguindo diferenciar grupos por renda e orientação sexual, como esperado pela literatura. CONCLUSÕES: Os resultados sugerem que as escalas são adequadas para uso no Brasil, tanto para uso em separado como para uso combinado, como fatores correlacionados.

OBJECTIVE: Social anxiety is a poorly publicized psychological disorder, but with an important epidemiological distribution. The present study aimed to adapt the reduced versions of the Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS) (SIAS-6 and SPS-6) to the Brazilian context and produce evidence of validity. These scales assess anxiety in social interactions and social anxiety in face of the possibility of scrutiny by other people, being complementary. METHODS: As they are scales with recognized international use, adaptation to Brazil can bring contributions to clinical and scientific investigations about Social Anxiety Disorder. Judicious processes for adaptation were carried out (translation, evaluation by judges, back-translation, evaluation by the target audience) and an online survey was conducted with 1,049 people, over 18 years of age with an average age of 25.98 years (SD = 7.55). RESULTS: Confirmatory Factor Analysis was used and, thus, it was found that the adjustment indexes produced are, generally, adequate (SRMR < 0.04, CFI > 0.96, TLI > 0.94 and RMSEA < 0.05) and that the items have adequate factor loads. Evidence of discriminant validity was also satisfactory, managing to differentiate groups by income and sexual orientation as expected by the literature. CONCLUSIONS: The results suggest that the scales are suitable for use in Brazil, both for separate use and for combined use, as correlated factors.

The effect of the waiting room's environment on level of anxiety experienced by children prior to dental treatment: a case control study.

BACKGROUND: In addition to visit purpose, one of the environmental factors that can cause anxiety prior to dental treatment includes the waiting room experience, specifically the amount of time spent awaiting treatment and the waiting room environment. The purpose of this study was to compare the effect of the waiting room's environment on the level of anxiety experienced by children in multisensory and traditional waiting rooms. METHODS: Case control study. Test group waited for treatment in a multisensory waiting room, which consisted of a lighting column that children could touch and climb; as well as, rhythmic music played on loudspeakers. Control group waited for treatment in a traditional waiting room. Study participants were asked to answer the "Venham Picture Test", a dental anxiety scale, while in the waiting room prior to entering the treatment room. Chi-squared, Fisher's Exact tests, and linear regression were utilized. A p-value less than 0.05 was considered statistically significant. RESULTS: No significant difference in dental anxiety scores was found between the test and control groups according to waiting room type (p > .05). Dental anxiety was significantly higher in patients who had longer waiting time prior to treatment (p = 0.019). In addition, dental anxiety was significantly associated with visit purpose (p < .001): children waiting for dental examination or those scheduled for dental treatment with conscious sedation were less anxious than children waiting for emergency treatment. CONCLUSIONS: A sensory adapted waiting room environment may be less important in reducing children's anxiety prior to dental treatment. Children's dental anxiety can be reduced by preventing emergency treatments, scheduling routine dental visits and decreasing waiting time. TRIAL REGISTRATION: TRN NCT03197129, date of registration June 20, 2017.

Nivel de ansiedad de los pacientes antes de ingresar a la consulta odontológica / Dental Anxiety Before a Dentist Appointment / Nível de ansiedade em pacientes antes de ingressar à consulta odontológica

Resumen Introducción: la ansiedad dental o miedo al tratamiento odontológico es una de las dificultades más frecuentes para el profesional, y esto puede tener un impacto considerable en la salud oral. El objetivo es evaluar el nivel de ansiedad de los pacientes que acudieron a las consultas en la clínica odontológica de una empresa privada de servicios odontológicos, en 2015. Materiales y métodos: estudio transversal en el que se utilizó la Escala de Ansiedad Dental de Corah Modificada (MDAS), y se interrogó sobre la ansiedad que generan los componentes de la consulta odontológica. Resultados: participaron un total de 297 adultos de los cuales 54.85 % fueron varones y la mediana de edad fue 28 años. Se obtuvo un bajo número de pacientes con ansiedad extrema (7.74 %), siendo el porcentaje más elevado para la inyección de anestésico local (85.52 %). El 17.85 % obtuvo un nivel de ansiedad elevada y el 17.85 % severa. El componente de la consulta odontológica que generó mayor nivel de ansiedad fue la extracción dental con 40.40 %. Conclusión: el paciente debe sentirse lo más relajado posible al ir a una consulta odontológica por lo que se necesitan charlas a los proveedores de salud dental acerca de las diferentes técnicas para disminuir la ansiedad dental del paciente.

Abstract Introduction: Dental anxiety or consulting fear to dentist appointment and/or dental treatment, is one of the most frequent problems to the professional which can have an impact to the oral health. The objective is to assess the level of anxiety in patients that attend to appointments in a dental clinic from a private company of dental care in the year of 2015. Materials and methods: The study design is cross-sectional, Corah's Modified Dental Anxiety Scale (MDAS) was utilized. And question were made about the components of dental services that generate dental anxiety. Results: The sample consisted of 297 adult patients, 54.85 % were males and middle age was 28. It was obtained a low number of patients with extreme anxiety (7.74 %) according to the questions; being the highest percentage for local anesthetic injection for dental treatment (85.52 %). A 17.85 % had a high level of anxiety and 17.85 % had a severe level of anxiety. The component that caused anxiety the most was tooth extraction with a 40.40 %. Conclusion: The patient must feel as relax as possible when going to a dentist appointment that is why would be needed to speak with care providers about different techniques to reduce dental anxiety on patients.

Resumo Introdução: a ansiedade dental ou medo ao tratamento odontológico, é uma das dificuldades mais frequentes para o profissional, que pode ter impacto na saúde oral. O objetivo é avaliar o nível de ansiedade dos pacientes que acudiram às consultas na clínica odontológica de uma empresa privada de serviços odontológicos, no ano 2015. Materiais e métodos: estudo transversal no qual utilizou-se a Escala de Ansiedade Dental de Corah Modificada (MDAS), e se interrogou sobre a ansiedade que geram os componentes da consulta odontológica. Resultados: participaram um total de 297 adultos dos quais 54.85 % foram homens e a idade média foi 28 anos. Obteve-se um número baixo de pacientes com ansiedade extrema (7.74 %), senda a porcentagem mais elevado para a injeção de anestésico local (85.52 %). O 17.85 % obteve um nível de ansiedade elevada e o 17.85 % severa. O componente da consulta odontológica que gerou maior nível de ansiedade foi a extração dental com 40.40 %. Conclusão: o paciente deve se sentir o mais relaxado possível ao ir a uma consulta odontológica pelo que precisam-se conversas aos provedores de saúde dental acerca das diferentes técnicas para diminuir a ansiedade dental do paciente.

An examination of the internal consistency and structure of the Statistical Anxiety Rating Scale (STARS).

The purpose of the current study was to examine the internal consistency and structure of the English version of the Statistical Anxiety Rating Scale (STARS). Participants were 202 (79% females) psychology undergraduates was recruited from James Cook University's Singapore (71%) and Australia (29%) campuses. Acceptable internal consistency reliabilities, ranging from .81 to .94, were found in this sample. Approximate fit indices suggest that a correlated six first-order factor model best describes the data in contrast to theoretical considerations suggesting that a six factor model with two correlated superordinate factors (i.e., statistics anxiety and attitudes toward statistics) best describes the data. Researchers are recommended to use part one of the STARS to assess statistics anxiety and part two to assess attitudes toward statistics.

Music Distraction Effectiveness in Dental Anxiety and Treatment Adherence in 6-Year-Old Children: A Randomized Clinical Trial / Efectividad de la Distracción Musical Sobre la Ansiedad Dental y Adherencia a Tratamiento en Niños de 6 Años: Ensayo Clínico Aleatorizado

ABSTRACT: Dental anxiety can be a barrier to following healthy behaviours. Musical distraction is an effective strategy to reduce dental anxiety and improve treatment adherence. The aim was to determine the effect of musical distraction on dental anxiety and treatment adherence in 6-year-old children. Multicenter randomized control trial with 176 children who were allocated into two parallel groups. One group received usual dental care (N 88), and the other was exposed to musical distraction during usual dental care (N 88). The primary outcome was dental anxiety and secondary was oral health status and oral health care behaviours. Both were assessed at baseline, discharged and six-month follow-up. Mid/high dental anxiety was exhibited by 16.1 % of the children. Musical distraction had no effect on dental anxiety levels in the experimental compared with the control group at any of the time points assessed. The size effect was 0.35 and 0.15 (Cliff's Delta) for baseline-discharge and 0.57 and 0.35 for baseline-six month. Only 47.7 % of the sample attended at 6-month follow-up. Dental anxiety is not prevalent in the sample and is not beneficially reduced by musical distraction. The educational actions of the dental care programme are not sufficient to attain permanent long-term changes in oral health behaviour.

RESUMEN: La ansiedad dental puede ser una barrera para seguir conductas saludables. La distracción musical es una estrategia efectiva para reducir la ansiedad dental y mejorar la adherencia al tratamiento. El objetivo fue determinar el efecto de la distracción musical sobre la ansiedad dental y la adherencia al tratamiento en niños de 6 años. Ensayo multicéntrico de control aleatorizado con 176 niños asignados a dos grupos paralelos. Un grupo recibió atención dental habitual (n 88) y el otro estuvo expuesto a distracción musical durante el cuidado dental habitual (N 88). El resultado primario fue la ansiedad dental y secundaria fue el estado de salud oral y las conductas de salud oral. Ambos fueron evaluados al inicio, dados de alta y seguidos durante seis meses. La ansiedad dental media / alta fue exhibida por 16,1 % de los niños. La distracción musical no tuvo ningún efecto sobre los niveles de ansiedad dental en el grupo experimental en comparación con el grupo control en ninguno de los momentos evaluados. El efecto del tamaño fue 0,35 y 0,15 (Cliff's Delta) para el inicio y el alta y 0,57 y 0,35 para el inicio y los seis meses de seguimiento. Solo el 47,7 % de la muestra asistió a los 6 meses de seguimiento. La ansiedad dental no prevalece en la muestra y no se ve beneficiada por la distracción musical. Las acciones educativas del programa de atención dental no son suficientes para lograr cambios permanentes a largo plazo en el comportamiento de salud oral.

Comparing Two Short Forms of the Hewitt-Flett Multidimensional Perfectionism Scale.

Hewitt and Flett's 45-item Multidimensional Perfectionism Scale is a widely used instrument to assess self-oriented, other-oriented, and socially prescribed perfectionism. With 45 items, it is not overly lengthy, but there are situations where a short form is useful. Analyzing data from four samples, this article compares two frequently used 15-item short forms of the Multidimensional Perfectionism Scale-Cox et al.'s and Hewitt et al.'s-by examining to what degree their scores replicate the original version's correlations with various personality characteristics (e.g., traits, social goals, personal/interpersonal orientations). Regarding self-oriented and socially prescribed perfectionism, both short forms performed well. Regarding other-oriented perfectionism, however, Cox et al.'s short form (exclusively composed of negatively worded items) performed less well than Hewitt et al.'s (which contains no negatively worded items). It is recommended that researchers use Hewitt et al.'s short form to assess other-oriented perfectionism rather than Cox et al.'s.

The Cyber Aggression in Relationships Scale: A New Multidimensional Measure of Technology-Based Intimate Partner Aggression.

The purpose of this study was to develop and provide initial validation for a measure of adult cyber intimate partner aggression (IPA): the Cyber Aggression in Relationships Scale (CARS). Drawing on recent conceptual models of cyber IPA, items from previous research exploring general cyber aggression and cyber IPA were modified and new items were generated for inclusion in the CARS. Two samples of adults 18 years or older were recruited online. We used item factor analysis to test the factor structure, model fit, and invariance of the measure structure across women and men. Results confirmed that three-factor models for both perpetration and victimization demonstrated good model fit, and that, in general, the CARS measures partner cyber aggression similarly for women and men. The CARS also demonstrated validity through significant associations with in-person IPA, trait anger, and jealousy. Findings suggest the CARS is a useful tool for assessing cyber IPA in both research and clinical settings.

Nivel de conocimientos del paciente sobre el cateterismo cardiaco y presencia de ansiedad y depresión / Level of knowledge of patients regarding cardiac catheterization in the presence of anxiety and depression

Resumen

Introducción: Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial. El cateterismo cardiaco es la prueba diagnóstica estándar de oro y para aplicarlo es necesario el apoyo educacional del equipo de salud hacia el paciente.

Objetivo: analizar el nivel de conocimientos del paciente adulto hospitalizado sobre el cateterismo cardiaco diagnóstico y la presencia de ansiedad y depresión.

Metodología: estudio transversal analítico que incluyó a 118 pacientes sometidos a cateterismo cardiaco por primera vez. Se construyó y se validó un instrumento cuya homogeneidad interna fue de 0.90 y que incluía una escala (Excelente, Bueno, Regular y Malo). Asimismo, se utilizó la Escala Hospitalaria de Ansiedad y Depresión, que está validada.

Resultados: La media de edad fue de 60 ± 14 años; 55% fueron hombres y 46% mujeres; el 40% tenía como escolaridad primaria; 57% tenía como ocupación hogar; el nivel de conocimientos fue regular en 56%, bueno en 9% y malo en 35%; hubo una relación entre ansiedad y depresión (chi cuadrada: p < 0.05).

Conclusión: los resultados analizados comprobaron la necesidad de orientación estandarizada por parte del personal de enfermería hacia el paciente.

Abstract

Introduction: Cardiovascular diseases are the leading cause of death worldwide. Cardiac catheterization is the gold standard test for diagnosis in the patient and, in order to perform it, the health personnel must provide sufficient educational support.

Objective: To analyze the level of knowledge of adults hospitalized for diagnostic cardiac catheterization, in presence of anxiety and depression.

Methods: Cross-sectional analytical study with 118 patients undergoing their first cardiac catheterization were included. It was designed and validated an instrument with an internal consistency of 0.90. This instrument included a scale (Excellent, Good, Fair and Bad). It was also used the Hospital Anxiety and Depression Scale, which is also validated.

Results: Mean age was 60 ± 14 years; 55% of patients were male and 46%, female; 40% had elementary school level; 57% were homemakers; the level of knowledge was regular in 56%, good in 9%, and bad in 35%; there was a relationship between anxiety and depression (chi-squared: p < 0.05). Conclusion: The results analyzed proved the need for standardized guidance from nurses to the patient.

[Anxiety in women undergoing surgical treatment of breast cancer]. / Trevoga u zhenshchin, prokhodiashchikh khirurgicheskoe lechenie raka molochnoi zhelezy.

AIM: To assess anxiety level and factors contributing to its development in patients undergoing surgical treatment for breast cancer. MATERIAL AND METHODS: The subjects of the study were 72 women, aged 20-80 years, with the diagnosis of primary breast cancer. The Basic Psycho-Oncological Documentation Scale (PO-BADO), the European Organization for Research, and the Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module (EORTC QLQ-C30; BR-23), the Hospital Anxiety and Depression Scale (HADS) were used. RESULTS AND CONCLUSION: The anxiety score showed negative correlation with EORTC QLQ-C30 'physical functioning', 'cognitive functioning', 'emotional functioning', 'global health status/quality of life' subscales (p≤0,002). Anxiety is a highly prevalent in women with breast cancer and has a marked negative impact, in particular on younger patients.

Relación entre Ansiedad Prequirúrgica e Intensidad del Dolor Postquirúrgico, Hospital Homero Castanier Crespo Azogues - Ecuador, 2016 / Descriptive Research: Relationship between Preoperative Anxiety and Postoperative Pain Intensity, Hospital Homero Castanier Crespo Azogues - Ecuador, 2016

INTRODUCCIÓN: La ansiedad es un mecanismo de defensa produciendo alteraciones somáticas y psíquicas, disminuyendo la capacidad de adaptación y reacción del organismo frente a un procedimiento médico. El objetivo fue determinar la relación entre la ansiedad prequirúrgica y la intensidad del dolor postquirúrgico en pacientes que fueron intervenidos quirúrgicamente. MÉTODOS: Se trata de un estudio analítico descriptivo que incluye a 200 pacientes que fueron sometidos a cirugía en noviembre-diciembre, 2016 en el Hospital Homero Castanier Crespo, que cumplieron con los criterios de inclusión, los datos se consignaron con la escala de ansiedad (STAI) que valoró la ansiedad prequirúrgica y la escala de valoración numérica para el dolor postquirúrgico a las 24 horas, se asoció las variables mediante medidas de correlación. Los datos fueron registrados y analizados en el programa PSPP versión 0.10.4-g50f7b7. RESULTADOS: La correlación entre ansiedad y dolor fue positiva (Rho de Spearman.34; p<0.05) mostrando que existe una relación entre la ansiedad y el dolor postquirúrgico en pacientes del Hospital Homero Castanier Crespo. (AU)

BACKGROUND: Anxiety is a defense mechanism that produces somatic and psychic alterations, reducing the capacity of adaptation and the reaction of the organism to a medical doctor. The aim was to determine the relationship between preoperative anxiety and the intensity of postoperative pain in patients who underwent surgery at the Homero Castanier Crespo Azogues Hospital - Ecuador, 2016. METHODS: This is a descriptive analytical study that includes 200 patients who underwent surgery in November-December, 2016 at the Homero Castanier Crespo Hospital, who met the inclusion criteria, data were recorded with the anxiety scale (STAI) Which assessed preoperative anxiety and the numerical rating scale for postoperative pain at 24 hours, the variables were associated by means of correlation measures. The data were recorded and analyzed in the program PSPP version 0.10.4-g50f7b7. RESULTS: The correlation between anxiety and pain was positive (Rho de Spearman 0.34, p: <0.05), showing that there is a relationship between anxiety and postoperative pain in patients at the Homero Castanier Crespo Hospital.(AU)

Influence of maternal anxiety on child anxiety during dental care: cross-sectional study.

CONTEXT AND OBJECTIVES:: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers' anxiety on their children's anxiety during dental care. DESIGN AND SETTING:: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS:: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS:: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION:: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children's anxiety. Dental procedures did not interfere with the mothers' anxiety, but caused positive feelings, whereas they affected the children more.

Influence of maternal anxiety on child anxiety during dental care: cross-sectional study / Influência da ansiedade materna na ansiedade infantil frente ao atendimento odontológico: estudo transversal

ABSTRACT CONTEXT AND OBJECTIVES: Anxiety is usually classified as a disorder of neurotic nature and is often related to contexts of stress, which may include worries, motor tension and autonomic hyperactivity. The aim of this study was to assess the influence of mothers’ anxiety on their children’s anxiety during dental care. DESIGN AND SETTING: Analytical cross-sectional study conducted at in a private dentistry school in the south of Brazil. METHODS: Convenience sampling was used. All mothers of children undergoing treatment were invited to participate in this study. Data to investigate anxiety related to dental treatment among the children were collected through applying the Venham Picture Test (VPT) scale. For the mothers, the Corah scale was applied. A self-administered sociodemographic questionnaire with questions about demographic, behavioral, oral health and dental service variables was also used. RESULTS: 40 mother-child pairs were included in the study. The results showed that 40% of the children were anxious and 60% of the mothers were slightly anxious. Local anesthesia was the procedure that caused most anxiety among the mothers, making them somewhat uncomfortable and anxious (60%). Family income higher than R$ 1,577.00 had an influence on maternal anxiety (75.6%). Maternal anxiety had an influence on child anxiety (81.3%). CONCLUSION: Most of the children showed the presence of anxiety, which ranged from fear of dental care to panic, inferring that maternal anxiety has an influence on children’s anxiety. Dental procedures did not interfere with the mothers’ anxiety, but caused positive feelings, whereas they affected the children more.

RESUMO CONTEXTO E OBJETIVO: A ansiedade é geralmente classificada como um transtorno de caráter neurótico, frequentemente relacionado a contextos de estresse variando entre preocupações, tensão motora e hiperatividade autonômica. O objetivo desta pesquisa foi avaliar a influência da ansiedade materna na ansiedade de seu filho durante o atendimento odontológico. TIPO DE ESTUDO E LOCAL: Estudo analítico transversal realizado em uma faculdade particular do sul do Brasil. MÉTODOS: Amostragem por conveniência foi utilizada. Todas as mães das crianças em tratamento foram convidadas a participar da pesquisa. A coleta dos dados para verificar a ansiedade relacionada com o tratamento odontológico nas crianças foi realizada a partir da aplicação da escala “Venham Picture Test” (VPT). Para as mães, foi utilizada a escala de Corah. Também se utilizou um questionário sociodemográfico autoaplicativo sobre variáveis demográficas, comportamentais, de saúde bucal e de serviço odontológico. RESULTADOS: Foram incluídos 40 pares de mães e crianças. Os resultados mostraram que 40% das crianças estavam ansiosas e 60% das mães estavam levemente ansiosas. A anestesia local foi o procedimento que causou mais ansiedade entre as mães, deixando-as um pouco desconfortáveis e ansiosas (60%). Renda familiar maior de R$ 1.577,00 influenciou a ansiedade materna (75.6%). A ansiedade materna influenciou a ansiedade das crianças (81.3%). CONCLUSÃO: A maioria das crianças apresentou ansiedade, o que variou do medo ao pânico ao atendimento odontológico, inferindo que a ansiedade materna tem influência na ansiedade dos seus filhos. Os procedimentos odontológicos não interferem na ansiedade das mães, atingindo mais as crianças, porém provocam sentimentos positivos.

A novel visual facial anxiety scale for assessing preoperative anxiety.

BACKGROUND: There is currently no widely accepted instrument for measuring preoperative anxiety. The objective of this study was to develop a simple visual facial anxiety scale (VFAS) for assessing acute preoperative anxiety. METHODS: The initial VFAS was comprised of 11 similarly styled stick-figure reflecting different types of facial expressions (Fig 1). After obtaining IRB approval, a total of 265 participant-healthcare providers (e.g., anesthesiologists, anesthesiology residents, and perioperative nurses) were recruited to participate in this study. The participants were asked to: (1) rank the 11 faces from 0-10 (0 = no anxiety, while 10 = highest anxiety) and then to (2) match one of the 11 facial expression with a numeric verbal rating scale (NVRS) (0 = no anxiety and 10 = highest level of anxiety) and a specific categorical level of anxiety, namely no anxiety, mild, mild-moderate, moderate, moderate-high or highest anxiety. Based on these data, the Spearman correlation and frequencies of the 11 faces in relation to the 11-point numerical anxiety scale and 6 categorical anxiety levels were calculated. The highest frequency of a face assigned to a level of the numerical anxiety scale resulted in a finalized order of faces corresponding to the 11-point numeric rating scale. RESULTS: The highest frequency for each of the NVRS anxiety scores were as follow: A0, A1, A2, A3, A4, A5, A7, A6, A8, A9 and A10 (Fig 2). For the six categorical anxiety levels, a total of 260 (98.1%) participants chose the face A0 as representing 'no' anxiety, 250 (94.3%) participants chose the face A10 as representing 'highest' anxiety and 147 (55.5%) participants chose the face A8 as representing 'moderate-high' anxiety. Spearman analysis showed a significant correlation between the faces A3 and A5 assigned to the mild-moderate anxiety category (r = 0.58), but A5 was ultimately chosen due to its higher frequency compared to the frequency of A3 (30.6% vs 24.9%)(Fig 3). Similarly, the correlation of the faces A7 and A6 was significantly correlated with moderate anxiety (r = 0.87), but A7 remained because of its higher frequency (35.9% vs 22.6%). Using frequency and Spearman correlations, the final order of the faces assigned to the categories none, mild, mild-moderate, moderate, moderate-high and highest anxiety levels was A0, A1, A5, A7, A8 and A10, respectively (Fig 4). CONCLUSION: The proposed VFAS was a valid tool for assessing the severity of acute [state] anxiety, and could be easy to administer in routine clinical practice.

[Characteristics of behavioral response of elderly women with high level of personal anxiety].

The results of studies of the behavioral response in 69 elderly women with normal and high levels of anxiety are presented in the article. Personal anxiety level was determined by «Integrative anxiety test¼. The indicators of strategies alteration for decision-making were assessed through a computer complex KPFK-99 «PSIHOMAT¼, which includes a test computer system «Binatest¼. It is found that more complex and structured programs of behavior are characteristic for women with normal levels of anxiety. The restriction tendency of adaptation opportunities of an organism, decrease in resistance to influence negative the stress - factors, and also tendency to doubts in correctness of a choice against any situation.

Children and adolescents who stutter: Further investigation of anxiety.

PURPOSE: Despite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood. METHODS: The RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering. RESULTS: All mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales. CONCLUSIONS: Experts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.

Anxiety is associated with higher levels of global DNA methylation and altered expression of epigenetic and interleukin-6 genes.

OBJECTIVES: Anxiety is associated with elevated levels of the inflammatory cytokine interleukin-6 (IL-6) and an increased risk for diseases with an inflammatory aetiology. In cancer, higher levels of IL-6 have been associated with increased expression of the epigenetic enzymes DNMT1 and Enhancer of Zeste Homolog 2 (EZH2). However, the relationship between IL-6 and DNA methyltransferases (DNMTs) and EZH2 expression has not previously been examined in anxious individuals. METHODS: Global DNA methylation levels were measured using the Methylflash Methylated DNA Quantification Kit and gene expression levels of the DNMT and EZH2 genes in anxious (n=25) and nonanxious individuals (n=22) were compared using quantitative real-time PCR. Specifically, we investigated whether global DNA methylation or aberrant expression of these genes was correlated with IL-6 mRNA and protein serum levels in anxious individuals. RESULTS: Anxious participants had significantly higher levels of global DNA methylation compared with controls (P=0.001). There were no differences in the mean mRNA expression levels of the DNMT1/3A/3B, EZH2 and IL-6 genes in anxious individuals compared with controls. However, the expression of DNMT1/3A, EZH2 and IL-6 genes increases with increasing Hospital Anxiety and Depression Scale-Anxiety scores in the anxious cohort only. Interestingly, IL-6 gene expression was correlated strongly with DNMT1/3A/3B and EZH2 expression, highlighting a potential relationship between IL-6 and important epigenetic regulatory enzymes. CONCLUSION: This study provides novel insight into the relationship between anxiety, epigenetics and IL-6. Moreover, our findings support the hypothesis that changes in DNA methylation profiles may contribute to the biology of anxiety.

An evaluation of the sociodemographic determinants of dental anxiety in patients scheduled for intra-alveolar extraction.

BACKGROUND: Studies on anxiety in patients having intra-alveolar extraction as well as the effect of patient's sociodemographic characteristics influencing level of associated anxiety are few in our environment. The aim of this study was to statistically analyze the sociodemographic determinants of dental anxiety in patients scheduled for intra-alveolar extraction. METHODS: A cross-sectional study was conducted among 93 consecutive patients attending the outpatient clinic of the Department of Maxillofacial Surgery, University of Benin Teaching Hospital for intra-alveolar extraction in the months of November and December 2013. An interview-based questionnaire, Corah Dental Anxiety Scale Revised (DAS-R), was administered to evaluate levels of dental anxiety. Sociodemographic characteristics of the subjects were recorded. Descriptive statistics and regression models were done with the independent variables (sociodemographic factors) and the dependent variable being the DAS-R. A P<0.05 was considered significant. RESULTS: The internal consistency of the scale used as determined by Cronbach alpha was 0.76. Mean DAS score was 8.12±2.58. Dental anxiety and age of subjects showed significant inverse relationship. Females had a higher mean DAS score (8.76) than the males (7.37) (P=0.006). Residence (urban/rural) was not statistically significant. Singles reported the highest DAS score (9.41) (P=0.006). The educational level attained was significantly related to dental anxiety (P=0.005). Those with secondary school education had the highest DAS score (9.26). Class V social status had the highest mean anxiety score (P=0.012). Stepwise linear regression showed that the best predictors for dental anxiety were sex (P=0.008) and marital status (P=0.026). CONCLUSION: This present study demonstrates that sex and marital status are the predictive factors for dental anxiety in the overall management of patients indicated for intra-alveolar extraction.

Attentional bias modulation by reappraisal in patients with generalized anxiety disorder: an event-related potential study

Affective states influence subsequent attention allocation. We evaluated emotional negativity bias modulation by reappraisal in patients with generalized anxiety disorder (GAD) relative to normal controls. Event-related potential (ERP) recordings were obtained, and changes in P200 and P300 amplitudes in response to negative or neutral words were noted after decreasing negative emotion or establishing a neutral condition. We found that in GAD patients only, the mean P200 amplitude after negative word presentation was much higher than after the presentation of neutral words. In normal controls, after downregulation of negative emotion, the mean P300 amplitude in response to negative words was much lower than after neutral words, and this was significant in both the left and right regions. In GAD patients, the negative bias remained prominent and was not affected by reappraisal at the early stage. Reappraisal was observed to have a lateralized effect at the late stage.