Anxiety in couples undergoing IVF: evidence from E-Freeze randomised controlled trial.

STUDY QUESTION: What are the risk factors and impacts of anxiety in women and men in heterosexual couples undergoing IVF as part of a randomised trial, with a delay in embryo transfer in one arm? SUMMARY ANSWER: Duration of infertility, ethnicity, and male partner's anxiety levels were associated with women's anxiety at the start of treatment, while initial anxiety score, partner's anxiety score at embryo transfer, ethnicity, and clinic location were associated with women's anxiety levels at embryo transfer; although women undergoing IVF were more anxious than their partners for slightly different reasons, their self-reported state anxiety was not associated with achieving clinical pregnancy, nor with switching from delayed frozen embryo transfer to fresh embryo transfer in an IVF trial. WHAT IS KNOWN ALREADY: Use of IVF treatment continues to rise and patients undergoing IVF are anxious. Participating in a randomised controlled trial (RCT) with uncertainty of arm randomisation might increase their anxiety, while a delay in treatment may add further to anxiety. STUDY DESIGN SIZE DURATION: A mixed methods study was conducted using data from the multi-centre E-Freeze RCT cohort conducted across 13 clinics in the UK from 2016 to 2019. A regression analysis on anxiety scores of couples undergoing the IVF trial and a qualitative analysis of participant questionnaires were performed. PARTICIPANTS/MATERIALS SETTING METHODS: Six hundred and four couples participating in the E-Freeze trial, who had at least one useable State-Trait Anxiety Inventory (STAI) State Anxiety subscale (STAI-S) standardised self-report questionnaire for at least one of the partners, were included in the study. STAI-S scores were measured at consent for trial (T1) and again at embryo transfer (T2). Linear and log-binomial regression were used to explore the association between characteristics and STAI-S scores, and the associations between STAI-S scores and non-compliance and clinical pregnancy, respectively. Responses to the open text question were qualitatively analysed inductively using content analysis. MAIN RESULTS AND THE ROLE OF CHANCE: Women's STAI-S scores at T1 (consent) were associated with their ethnicity, duration of infertility, and their male partner's STAI-S score at T1. Women's STAI-S scores at T2 (embryo transfer) were associated with their ethnicity, location of fertility clinic, their STAI-S score at consent, and their male partner's STAI-S score at embryo transfer. The adjusted coefficient (95% CI) for women's STAI-S scores at T2 was -4.75 (-7.29, -2.20, P < 0.001) for ethnic minority versus White, -2.87 (-4.85, -0.89, P = 0.005) for Scotland versus England, 0.47 (0.37, 0.56, P < 0.001) for each point increase in their own score at T1, and 0.30 (0.21, 0.40, P < 0.001) for each point increase in their male partner's score at T2. On average, women had higher STAI-S scores than men at both time points, and a larger increase of scores between the two time points. However, women's STAI-S scores were not associated with either non-compliance with trial allocation in the 'freeze-all' trial arm, or with chances of pregnancy. Both partners, but particularly women, described feeling anxious about the outcome of IVF, with women carrying the added worry of believing that feeling stressed might itself affect the outcome. Participants highlighted the important role of support from staff in helping them to manage their anxiety. LIMITATIONS REASONS FOR CAUTION: Data were not available on education level or social support, which might influence anxiety scores. Men's baseline characteristics were not collected. WIDER IMPLICATIONS OF THE FINDINGS: Identifying couples at increased risk of emotional distress may be improved by using standardised anxiety measures at the start of the fertility treatment. Women can be reassured that their self-reported state anxiety does not affect their chances of achieving clinical pregnancy through IVF, and this may help to reduce anxiety levels. The psychological wellbeing and experiences of couples undergoing IVF could be supported by patient-centred care: making information about the whole process of treatment and choices available to both partners in accessible formats; ensuring interactions with staff are kind and supportive; and acknowledging and addressing the different concerns of women undergoing IVF and their partners. STUDY FUNDING/COMPETING INTERESTS: This study was an NIHR HTA (National Institute for Health and Care Research Health Technology Assessment) funded study. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: ISRCTN registry: ISRCTN61225414.

Effect of neroli-flavored chewing gum on anxiety.

The aim of this study was to assess the effectiveness of neroli-flavored chewing gum in reducing anxiety. A single-blind, two-group study was conducted on 72 university students. Participants were randomly assigned to either the commercial neroli-flavored chewing gum (CNC) group or the natural hydro-distilled neroli-flavored chewing gum (NNC) group. The research instrument used was Spielberger's State-Anxiety questionnaire. While there was no significant difference in anxiety scores between the CNC and NNC groups before the intervention, a significant difference was observed in anxiety scores 20 min after the intervention. Within-group comparisons indicated statistically significant differences between pre-test and post-test values of anxiety in the NNC group. The results of this study suggest that natural hydro-distilled neroli-flavored chewing gum can reduce anxiety in university students.

Exercise and Anxiety.

Anxiety disorders are among the most commonly diagnosed mental health disorders in the United States - affecting over 40 million adults per year. Although anxiety disorders are commonly treated via psychotherapy and/or pharmacotherapy, there is also accumulating evidence to suggest that physical activity and exercise may play an important role in prevention and treatment. This chapter provides an extensive overview of literature examining the effects of physical activity, acute bouts of exercise, and chronic exercise training on several anxiety outcomes, primarily in adults. The collective evidence to date suggests that: (1) an acute bout of aerobic or resistance exercise generally results in reductions in state anxiety among adults with and without clinical anxiety disorders, (2) greater levels of physical activity are associated with fewer anxiety symptoms and a reduced likelihood of developing an anxiety disorder, (3) exercise training (aerobic and resistance) appears to reduce general anxiety symptoms in adults without a clinical anxiety disorder and adults with a chronic illness (e.g., cardiovascular disease) and may reduce disorder-specific symptoms of anxiety in adults with a clinical anxiety disorder. Although the collective body of evidence is promising, there is a need for additional well-designed and adequately powered randomized controlled trials, especially among adults with clinical anxiety disorders.

The mediating role of ego depletion in the relationship between state anxiety and academic procrastination among University students.

The issue of academic procrastination is highly prevalent among university students. It not only has a deterimental effect on students' academic performance but also poses a risk to their physical and mental well-being. Anxiety, as a negative emotion, has attracted researchers' attention in relation to academic procrastination. Research indicates a correlation between state anxiety and academic procrastination, but the underlying mechanisms that drive this association remain unclear. When individuals experience ego-depletion, it can lead to psychological exhaustion, subsequently leading to procrastination. Gender role conceptions, shaped by sociocultural and psychological mechanisms, have profound implications on individuals' cognition, emotions, and behaviors. This study primarily aims to explore the relationship between state anxiety and academic procrastination among university students, with a particularly focus on the mediating role of ego-depletion and the moderating role of gender. A survey using the State Anxiety Scale, Ego-Depletion Scale, and Irrational Procrastination Scale was administered to 3370 undergraduates. State anxiety shows positive correlations with ego depletion and academic procrastination (r = 0.665, p < 0.01; r = 0.491, p < 0.01), while ego depletion is also positively linked to academic procrastination (r = 0.500, p < 0.01). State anxiety serves as a positive predictor of academic procrastination, with a confidence interval of 95% [0.626, 0.696]; additionally, ego depletion partially mediates the relationship between state anxiety and academic procrastination, with a confidence interval of 95% [0.168, 0.251]. Gender acts as a moderator in directly predicting the impact of state anxiety on academic procrastination and in the latter stage of mediating the effect of ego depletion. State anxiety can significantly and positively predict academic procrastination among university students. Ego-depletion partially mediates the relationship between state anxiety and academic procrastination. The direct predictive effect of state anxiety on academic procrastination, as well as the mediating role of ego-depletion, is moderated by gender. This provides educators and university students themselves with reference for addressing the issue of academic procrastination.

Examination-related anticipatory levels of dehydroepiandrosterone and cortisol predict positive affect, examination marks and support-seeking in college students.

Dehydroepiandrosterone (DHEA) and cortisol release appear to have contrasting effects on stress perception during stressful tasks. This study aimed to investigate anticipatory examination stress in college students by considering DHEA, cortisol, psycho-emotional aspects and examination performance. Seventy-six students (66 females, 10 males; age range 18-25 years) provided saliva samples and completed questionnaires in two sessions 48 hours apart. During the second session, the students performed the examination. The questionnaires used were the State-Trait Anxiety Inventory, the Positive and Negative Affect Scale, and the Brief-Coping Orientation to Problems Experienced Inventory. DHEA, cortisol, anxiety and negative affect showed an anticipatory rise before the examination (all ps < 0.001). This rise of DHEA and cortisol was associated with lower positive affect (p = 0.001 and p = 0.043, respectively). However, only the DHEA anticipatory levels were linked to poorer examination marks (p = 0.020). Higher levels of the DHEA/cortisol ratio in anticipation of the examination were related to lower scores on the support-seeking strategy (p = 0.022). There was no association between DHEA and cortisol levels and anxiety, negative affect, active and avoidant coping strategies, or academic record. These results suggest that how DHEA and cortisol respond in anticipation of examination stress significantly impacts students' emotional well-being during examination periods and how they cope with stress. They also suggest that levels of DHEA in anticipation of an academic stressor have detrimental effects on stress management.

The impact of audiovisual information on parental anxiety levels prior to hypospadias surgery: A prospective single center cohort study.

BACKGROUND: Most parents have anxiety before a pediatric surgical procedure. Parental anxiety may impair the parents' ability to cope with new or stressful situations while their children are undergoing surgery. By effectively improving the education of parents regarding the diagnosis, treatment, and potential complications of hypospadias and surgical repair, it might be feasible to reduce their anxiety during this process. OBJECTIVE: To determine whether structured audiovisual information would reduce parents' anxiety levels compared to classic verbal information. MATERIAL AND METHODS: The diagnosis was made and, treatment options were explained, and State-Trait Anxiety Inventory Form - State Anxiety (STAI-I) forms were filled out by parents at the first consultation. In the second consultation, parents were divided into structured audio-visual-information (Group-1) and classic verbal information (Group-2) groups. Following these consultations, all parents in both groups filled out STAI-I again. Parents filled out the forms for the last time on the postoperative-14th-day and the results were compared. RESULTS: A total of 124 (51.2%) parents were informed with structured-audiovisual-informational material and 118 parents (48.8%) were informed with classic verbal information. First STAI-I scores were 57.65 ± 5.17 and 56.91 ± 5.28 for Group-1 and Group-2, respectively, and there was no difference between the groups (p = 0.709). The STAI-I scores after the second consultation were 44.82 ± 5.65 and 49.42 ± 2.81 for Group-1 and Group-2, respectively. Parental anxiety decreased in both groups following the second consultation. Notably, a statistically significant superiority was found between the groups in favor of Group-1 (p = 0.001). DISCUSSION: Parents whose children will undergo hypospadias surgery experience significant anxiety. We observed that informing patients adequately and in appropriate language using a suitable method was associated with less anxiety. Preoperative parental anxiety is influenced by several variables, including parent age, parent gender, child age, lack of knowledge, and concerns over complications or pain. Although we are unable to alter the factors of child age and parent gender, we can impact parents' concerns regarding postoperative pain and anesthesia by enhancing their comprehension of the procedure via providing them of sufficient and accurate information. CONCLUSION: Providing parents with structured audio-visual information about the preoperative and postoperative period before hypospadias surgery is associated with lower parental anxiety levels. Supplying structured audiovisual information regarding the preoperative and postoperative periods can help parents have an improved comprehension of the procedure and minimize their anxiety.

Household material hardship and distress among parents of children with advanced cancer: A report from the PediQUEST Response trial.

BACKGROUND: The prevalence and characteristics of household material hardship (HMH) in families of children with advanced cancer and its association with parent distress are unknown and herein described. METHODS: Parents of children aged ≥2 years with advanced cancer at five cancer centers completed baseline surveys as part of the PediQUEST Response trial. HMH (housing, energy, and food) was operationalized as binary (≥1 HMH domains), ordinal (zero, one, or two or more HMH domains), and housing based (none, nonhousing [food and/or energy], only housing, or housing + other). Associations between HMH and parent distress measured by the State-Trait Anxiety Inventory-State and the 10-item Center for Epidemiologic Studies Depression Scale were estimated via linear models adjusting for confounders. RESULTS: Among 150 parents, 41% reported ≥1 HMH (housing, 28% [only housing, 8%; housing + other, 20%]; energy, 19%; food, 27%). HMH was more prevalent among Hispanic, other non-White race, Spanish-speaking, and single parents and those with lower education (associate degree or less) or who were uninsured/Medicaid-only insured. Parents endorsing HMH reported higher anxiety (mean difference [MD], 9.2 [95% CI, 3.7-14.7]) and depression (MD, 4.1 [95% CI, 1.7-6.5]) scores compared to those without HMH. Distress increased with the number of hardships, particularly housing insecurity. Specifically, parents experiencing housing hardship, alone or combined, reported higher distress (housing only: anxiety: MD, 10.2 [95% CI, 1.8-18.5]; depression: MD, 4.9 [95% CI, 1.3-8.6]; housing + other HMH: anxiety: MD, 12.0 [95% CI, 5.2-18.9]; depression: MD, 4.8 [95% CI, 1.8-7.8]). CONCLUSIONS: HMH is highly prevalent in pediatric advanced cancer, especially among historically marginalized families. Future research should investigate whether interventions targeting HMH, particularly housing stabilization efforts, can mitigate parent distress. PLAIN LANGUAGE SUMMARY: In our cohort of parents of children with advanced cancer, household material hardship (HMH) was highly prevalent and significantly associated with higher parent distress. Housing hardship was the primary driver of this association. Families of children with advanced cancer may benefit from systematic HMH screening as well as targeted HMH interventions, especially stabilizing housing.

Bridging the Gap between Psychophysiological and Audiological Factors in the Assessment of Tinnitus: An EEG Investigation in the Beta Band.

BACKGROUND: Despite substantial progress in investigating its psychophysical complexity, tinnitus remains a scientific and clinical enigma. The present study, through an ecological and multidisciplinary approach, aims to identify associations between electroencephalographic (EEG) and psycho-audiological variables. METHODS: EEG beta activity, often related to stress and anxiety, was acquired from 12 tinnitus patients (TIN group) and 7 controls (CONT group) during an audio cognitive task and at rest. We also investigated psychological (SCL-90-R; STAI-Y; BFI-10) and audiological (THI; TQ12-I; Hyperacusis) variables using non-parametric statistics to assess differences and relationships between and within groups. RESULTS: In the TIN group, frontal beta activity positively correlated with hyperacusis, parietal activity, and trait anxiety; the latter is also associated with depression in CONT. Significant differences in paranoid ideation and openness were found between groups. CONCLUSIONS: The connection between anxiety trait, beta activity in the fronto-parietal cortices and hyperacusis provides insights into brain functioning in tinnitus patients, offering quantitative descriptions for clinicians and new multidisciplinary treatment hypotheses.

The Mental Game of Golf: Understanding Relationships Between Self-Efficacy, Fear of Failure, Competitive State Anxiety, and Flow.

Our purpose in this study was to investigate the relationship between self-efficacy, fear of failure, competitive state anxiety, and flow among elite golfers. We surveyed 375 elite golfers (N = 375; male = 187, female = 188) who were registered with the Korean Sports and Olympic Committee, and we analyzed their survey responses using descriptive statistics, confirmatory factor analysis, correlation analysis, and structural equation modelling. As expected, we found golf self-efficacy (GSE) to be significantly related to fear of failure (FOF). We also found FOF and competitive state anxiety (CSA) significantly related to flow. Finally, we verified a suspected hierarchical or mediating effect in these relationships such that we verified predictive relationships of flow as follows: GSE→FOF→CSA→Flow. These golfers' self-efficacy had a buffering effect of lowering their FOF and CSA in the pathway toward flow. A suggested implication of these findings is that to enhance a golfer's performance by minimizing interfering psychological factors, it is essential to boost their self-efficacy.

Exploring the role of mindfulness on obligatory exercise among young athletes: mediating roles of obsessive passion and cognitive state anxiety.

Introduction: In the current trend toward youthfulness and age reduction in competitive sports, the issue of obligatory exercise among young athletes is becoming more severe. This not only affects their physical and mental health but also hampers their future prospects in the sports world. While delving into the impact of mindfulness on the issue of obligatory exercise among young athletes, it reveals the mediating role of obsessive passion and cognitive state anxiety. Methods: This study is a cross-sectional research that employs convenience and snowball sampling methods. We selected 403 young athletes from several universities and high-level sports teams in the central-southern region of China as valid samples and used AMOS v.23 to construct a structural equation model to validate the hypotheses. Results: The research findings indicate a significant positive correlation between obsessive passion, cognitive state anxiety, and obligatory exercise. Furthermore, obsessive passion and cognitive state anxiety mediate the relationship between mindfulness and obligatory exercise. This implies that young athletes can better regulate their emotional state during training, manage training loads sensibly, and avoid issues with obligatory exercise through mindfulness training. Discussion: In conclusion, to enhance the cognitive levels of young athletes and reduce their obligatory exercise behaviors, national sports authorities and coaching teams should develop reasonable mindfulness training programs for athletes and encourage their participation in mindfulness training.

Rumination and Gender in the Relation Between Perceived Threat and State Anxiety During COVID-19.

OBJECTIVES: Perception of and subsequent responses to counter threats by disease, such as COVID-19, are essential for engagement in self-protective behaviors. But, associated increases in anxiety that accompany the threat of disease may negatively impact well-being. Therefore, identifying variables that may modulate the association between perceived threat from COVID-19 and anxiety is important. We conducted a study to examine the moderating roles of two subtypes of rumination (brooding and reflection) in the association between perceived threat from COVID-19 and state anxiety. Additionally, as both COVID-19 outcomes and the tendency to ruminate differ across genders, we explored gender as a second moderator. METHODS: Participants (N = 300; Men = 144) were recruited online in April 2020 and completed measures of state anxiety, brooding and reflective rumination, and perceived threat from COVID-19. RESULTS: Moderation regression analyses revealed that perceived threat and brooding were independently associated with increased state anxiety. Reflective rumination and gender, however, significantly moderated the relation between perceived threat and state anxiety. For men, reflective rumination strengthened the association between threat and anxiety. For women, reflective rumination weakened this association; women with the highest scores in reflective rumination also reported high state anxiety at low, medium, and high perceived threat levels. CONCLUSIONS: These findings illuminate gender differences in the relations between perceived threat, rumination, and experienced state anxiety during the pandemic.

Relationship between face recognition ability and anxiety tendencies in healthy young individuals: A prosopagnosia index and state-trait anxiety inventory study.

Developmental prosopagnosia (DP) is a condition that indicates the inability to recognize individuals by their faces from birth, without any history of brain damage. The assessment of face recognition ability and diagnosis of DP involve the use of face tests such as the Cambridge Face Memory Test (CFMT) and the Cambridge Face Perception Test, along with self-reported measures like the 20-Item Prosopagnosia Index (PI20). Face recognition accuracy is affected by anxiety. However, previous studies on the relationship between face recognition ability and anxiety have not used the PI20 measure. This study aimed to investigate the relationship between self-reported measures of face recognition ability and anxiety tendencies among healthy young individuals for DP diagnosis and its implications. We used a face recognition test, involving the PI20, CFMT, Visual Perception Test for Agnosia-Famous Face Test (VPTA-FFT), and State-Trait Anxiety Inventory (STAI). We assessed the performance of 116 Japanese young adults (75 females, median age of 20.7 years, with a standard deviation of 1.2). Subsequently, we conducted a statistical analysis to examine the relationship between the outcomes of the face recognition tests and STAI scores using Pearson correlation analysis and single correlation coefficients. The results showed a positive correlation between state anxiety and PI20 (r = 0.308, p = 0.007), and a weak positive correlation was also observed between trait anxiety and PI20 (r = 0.268, p = 0.04). In contrast, there was no correlation between CFMT and VPTA-FFT with respect to STAI. The results of the hierarchical multiple regression analysis also suggested that the correlation between the performance on the PI20 (self-report) and objective measures of face recognition performance (the CFMT and the VPTA-FFT) are driven by differences in anxiety. This study is the first to explore the relationship between face recognition abilities and anxiety using the PI20 self-report measure. There are implications for future research on the diagnosis of DP and the relationship between anxiety and face recognition.

The effect of yin yoga intervention on state and trait anxiety during the COVID-19 pandemic.

Introduction: Although some findings indicate that yoga can reduce stress and anxiety, many studies present mixed results. The potential of yoga interventions to alleviate anxiety, including the mechanisms and boundary conditions by which it does so, is an under-researched topic. Anxiety is often divided into "state anxiety" and "trait anxiety," the former being a temporary reaction to stressful events, while the latter is a more stable personality feature that responds to adverse situations or perceived threats. Materials and methods: This study investigates whether a yin yoga intervention delivered online reduces state anxiety immediately after each yoga session and whether the anxiety levels are significantly lower at the end of the 10-week yoga intervention than at the beginning of the study. We also predicted no effect of yin yoga intervention on trait anxiety. The study was conducted during the COVID-19 pandemic when participants (N = 48 Latvian women) experienced heightened anxiety levels. Results: This study shows that a ten-week online yin yoga intervention significantly reduced state anxiety in the intervention group compared with the control group. State anxiety levels also significantly decreased after each yin yoga session, providing more support for the anxiety-reducing effect of yin yoga. In contrast, yoga participation did not cause differences in trait anxiety between the control and intervention groups, even though trait anxiety decreased in the intervention group and increased in the control group over the study period. Conclusion: The positive effects of yin yoga on state anxiety indicate the potential of yin yoga intervention as a first-line treatment to control and reduce state anxiety, with possible additional effects on trait anxiety.

Effects of arginine vasopressin on human anxiety and associations with sex, dose, and V1a-receptor genotype.

RATIONALE: Arginine vasopressin (AVP) has dose- and sex-specific effects on social behavior, and variation in social responses is related to variation in the V1a receptor gene in animals. Whether such complexity also characterizes AVP effects on anxiety in humans, or whether V1a genotype is related to anxiety and/or AVP's ability to affect it, remains to be determined. OBJECTIVE: To test if AVP has dose-dependent effects on anxiety in men and/or women and if a particular allele within the RS3 promoter region of the V1a receptor gene is associated with anxiety and/or AVP effects on anxiety. METHOD: Men and women self-administered 20 IU or 40 IU intranasal arginine vasopressin (AVP) and placebo in a double-blind, within-subjects design, and State (SA) and Trait (TA) anxiety were measured 60 min later. PCR was used to identify allelic variation within the RS3 region of the V1a receptor gene. RESULTS: AVP decreased SA in men across both doses, whereas only the lower dose had the same effect, across sexes, in individuals who carry at least one copy of a previously identified "risk" allele in the RS3 promoter of the V1a receptor gene. Additionally, after placebo, women who carried a copy of the allele displayed lower TA than women who did not, and AVP acutely increased TA scores in those women. CONCLUSIONS: Exogenous AVP has modest sex- and dose-dependent effects on anxiety/affect in humans. Further, allelic variation in the V1a promoter appears associated with responsiveness to AVP's effects and, at least in women, to stable levels of anxiety/affect.

Intersubject representational similarity analysis uncovers the impact of state anxiety on brain activation patterns in the human extrastriate cortex.

The current study used functional magnetic resonance imaging (fMRI) and showed that state anxiety modulated extrastriate cortex activity in response to emotionally-charged visual images. State anxiety and neuroimaging data from 53 individuals were subjected to an intersubject representational similarity analysis (ISRSA), wherein the geometries between neural and behavioral data were compared. This analysis identified the extrastriate cortex (fusiform gyrus and area MT) to be the sole regions whose activity patterns covaried with state anxiety. Importantly, we show that this brain-behavior association is revealed when treating state anxiety data as a multidimensional response pattern, rather than a single composite score. This suggests that ISRSA using multivariate distances may be more sensitive in identifying the shared geometries between self-report questionnaires and brain imaging data. Overall, our findings demonstrate that a transient state of anxiety may influence how visual information - especially those relevant to the valence dimension - is processed in the extrastriate cortex.

Pre-scan state anxiety is associated with greater right amygdala-hippocampal response to fearful versus happy faces among trait-anxious Latina girls.

BACKGROUND: Unfamiliarity with academic research may contribute to higher levels of anticipatory state anxiety about affective neuroimaging tasks. Children with high trait anxiety display differences in brain response to fearful facial affect compared to non-anxious youth, but little is known about the influence of state anxiety on this association. Because reduced engagement in scientific research and greater mistrust among minoritized groups may lead to systematic differences in pre-scan state anxiety, it is crucial to understand the neural correlates of state anxiety during emotion processing so as to disambiguate sources of individual differences. METHODS: The present study probed the interactive effects of pre-scan state anxiety, trait anxiety, and emotional valence (fearful vs. happy faces) on neural activation during implicit emotion processing in a community sample of 46 preadolescent Latina girls (8-13 years). RESULTS: Among girls with mean and high levels of trait anxiety, pre-scan state anxiety was associated with greater right amygdala-hippocampal and left inferior parietal lobe response to fearful faces relative to happy faces. CONCLUSIONS: Anticipatory state anxiety in the scanning context may cause children with moderate and high trait anxiety to be hypervigilant to threats, further compounding the effects of trait anxiety. Neuroimaging researchers should control for state anxiety so that systematic differences in brain activation resulting from MRI apprehension are not misleadingly attributed to demographic or environmental characteristics.

A Short Form for Measuring Anxiety in Nursing Education.

Background and Purpose: Nursing education lacks an easily accessible, valid, and reliable short instrument to support researchers and instructors in quickly assessing student anxiety. The purpose of this research was to respond to this need by assessing the reliability and validity of a short-form anxiety instrument adapted from psychology which could measure state and trait anxiety. Methods: Using a one-group, repeated measures design, 51 sophomore level undergraduate nursing students had their state and trait anxiety levels measured at three time points over the course of a semester. Results: Results showed that the anxiety instrument was valid and reliable for use in nursing education with coefficient α ranging from .65 to .88. Conclusion: Future nurse researchers and educators should consider using the short-form anxiety instrument when a quick differentiation is needed to measure state and trait anxiety.

Design of Pediatric Outpatient Procedure Environments: A Pilot Study to Understand the Perceptions of Patients and Their Parents.

OBJECTIVE: To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces. BACKGROUND: Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted. METHODS: This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient's journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants' perceptions about four spaces-waiting, preprocedure, procedure, and recovery. RESULTS: Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups. CONCLUSIONS: Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.

Not realizing that you don't know: Fraction state anxiety is reduced by natural number bias.

BACKGROUND: Research has shown that mathematics anxiety negatively correlates with primary school mathematics performance, including fraction knowledge. However, recently no significant correlation was found between fraction arithmetic performance and state anxiety measured after the fraction task. One possible explanation is the natural number bias (NNB), a tendency to apply natural number reasoning in fraction tasks, even when this is inappropriate. Students with the NNB may not realize they are answering incorrectly. AIMS: The aim is to examine whether a misconception, namely the NNB, can influence students' fraction state anxiety. SAMPLE: The participants were 119 fifth- and sixth-grade students categorized as belonging to an NNB group (n = 60) or a No-NNB group (n = 59), according to their NNB-related answering profile on a fraction arithmetic task. METHODS: Group differences were examined for state anxiety and performance on a fraction and a whole number arithmetic task and self-reported trait mathematics anxiety. RESULTS: The NNB group reported lower fraction state anxiety than the No-NNB group, but there was no significant difference in trait mathematics anxiety. Furthermore, the NNB group reported lower fraction state anxiety than whole number state anxiety, while the opposite was true for the No-NNB group. CONCLUSION: The present study suggests that students' perceptions of their own performance influence their state anxiety responses, and students with a NNB may not be aware of their misconception and poor performance. Not taking into account qualitative differences in low performance, such as misconceptions, may lead to misinterpretations in state anxiety-performance relations.

The correlation between thrombolysis decision-making anxiety and decision-making duration among surrogate decision-makers of patients with acute ischemic stroke / 中华行为医学与脑科学杂志

Objective:To explore the anxiety level, influencing factors among surrogate decision-makers of patients with acute ischemic stroke during thrombolysis decision-making, and their correlation with decision-making duration.Methods:Acute ischemic stroke patients and their surrogate decision-makers who visited the Emergency Department of the First Affiliated Hospital of Zhengzhou University from September 2019 to December 2021 were selected as the research subjects.Sociodemographic data and disease related data of patients and surrogate decision-makers were collected.Surrogate decision-makers were evaluated with the state-trait anxiety inventory, decision participation expectation scale, Wake Forest physician trust scale, and perceived social support scale.SPSS 26.0 software was used for data processing.Pearson correlation analysis, Spearman correlation analysis and ridge regression analysis were used for statistical analysis.Results:The score of state anxiety of decision-makers was (49.47±9.04), and 18.2% (70/383) of decision-makers had a decision duration exceeding 15 minutes.The score of state anxiety of decision-makers was positively correlated with decision duration ( r=0.189, P<0.001). The influencing factors of state anxiety level of decision-makers included sociodemographic factors (age of decision-makers and patients, relationship between payers and patients, whether decision-makers bear the current medical expenses, type of medical insurance for patients), psychological factors (trust level in physicians, perceived social support), factors related to patient disease (numbers of stroke relapses, National Institutes of Health stroke scale scores for patients), characteristics of the decision-making process (whether patients participate in the decision-making process, and the role of decision-makers in the decision-making process) (all P<0.05). Conclusion:Most surrogate decision-makers experience anxiety.Medical staff should pay attention to the emotions of decision-makers and adopt appropriate communication skills when communicating with informed consent for thrombolysis, alleviate the anxiety of surrogate decision-makers, so as so reduce the decision-making duration.