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.

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.

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.

Comparative Efficacy of Acute Exercise Intervention on Anxiety in Adolescents and Young Adults: A Network Meta-Analysis.

Acute exercise is a promising non-pharmacological therapy for alleviating anxiety. However, the effects of different types of acute exercise on anxiety in adolescents and young adults remain unclear. Therefore, our study aims to conduct a network meta-analysis to compare the effectiveness of various exercise interventions in improving anxiety in adolescents and young adults. We conducted an online literature search in five databases: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO. The search was conducted from inception to March 1, 2023, and was limited to English-language publications. Pairwise and network meta-analyses were performed using random-effects models. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was applied to rate the certainty of evidence. A total of 33 studies involving 1121 participants were included. The network meta-analysis results revealed that mind-body exercise was the most effective intervention for reducing anxiety in adolescents and young adults (SMD = -0.36, 95% CI: -0.70, -0.03, moderate certainty). Additionally, aerobic exercise (SMD = -0.16, 95% CI: -0.28, -0.03, high certainty) showed significant reduction in anxiety, while resistance exercise (SMD = -0.09, 95% CI: -0.33, 0.14, moderate certainty) and multicomponent exercise (SMD = -0.01, 95% CI: -0.59, 0.57, moderate certainty) did not show significant reduction in anxiety. Moderate certainty evidence suggests that acute mind-body exercise may be the most effective type of exercise for reducing anxiety in adolescents and young adults. Future research should focus on conducting more multi-arm randomized controlled trials to provide more direct evidence on the relative effectiveness of different exercise interventions.

SAI-CH-6: Development of a Short Form of the State Anxiety Inventory for Children At-Risk for Type 1 Diabetes.

OBJECTIVE: To develop a reliable and valid short form of the State Anxiety Subscale of the State-Trait Anxiety Inventory for Children (STAI-CH) in the Environmental Determinants of Diabetes in the Young (TEDDY) study. METHODS: A Development Sample of 842 10-year-old TEDDY children completed the STAI-CH State Subscale about their type 1 diabetes (T1D) risk. The best 6 items (three anxiety-present and three anxiety-absent) for use in a short form (SAI-CH-6) were identified via item-total correlations. SAI-CH-6 reliability was examined in a Validation Sample (n = 257) of children who completed the full 20-item STAI-CH State Subscale and then again in an Application Sample (n = 2,710) who completed only the SAI-CH-6. Expected associations between the children's SAI-CH-6 scores and country of residence, sex, T1D family history, accuracy of T1D risk perception, worry about getting T1D, and their parents' anxiety scores were examined. RESULTS: The SAI-CH-6 was reliable (α = 0.81-0.87) and highly correlated with the full 20-item STAI-CH State Subscale (Development Sample: r = 0.94; Validation Sample: r = 0.92). SAI-CH-6 scores detected significant differences in state anxiety symptoms associated with T1D risk by country, T1D family history, accuracy of T1D risk perception, and worry about getting T1D and were correlated with the child's parent's anxiety. CONCLUSION: The SAI-CH-6 appears useful for assessing children's state anxiety symptoms when burden and time limitations prohibit the use of the STAI-CH. The utility of the SAI-CH-6 in older children with and without chronic conditions needs to be assessed.

Better Understand to Better Predict Subjective Well-Being Among Older Greeks in COVID-19 Era: Depression, Anxiety, Attitudes Towards eHealth, Religiousness, Spiritual Experience, and Cognition.

Despite similarities with previous pandemics, the potential physical and psychosocial impact of COVID-19 on older adults is still little investigated in Greece. This study examines the intercorrelations between subjective well-being/life satisfaction, depression, state anxiety, global cognitive function, attitudes towards eHealth, religiousness and spiritual experience in older adults during COVID-19. Results revealed that statistically significant negative correlations exist between subjective life satisfaction and depressive symptomatology as well as with religiousness, a finding that can be explained by the COVID-19 externally imposed religious practice restrictions. Subjective life satisfaction was positively correlated with overall cognition as measured by Mini-Mental State Examination (MMSE). MMSE was also negatively correlated with state anxiety, depression, and attitudes towards eHealth use. The best predictors of subjective well-being is global cognition (as measured by MMSE) and depressive symptomatology (measured by GDS). The conclusions of this study underscore the need to examine in more detail psychological variables during COVID-19 and quality of life in older adults.

Surgery-related anxiety on geriatric patients undergoing total knee arthroplasty: a retrospective observational study.

BACKGROUND: The prevalence of anxiety in patients undergoing total knee arthroplasty (TKA) and its association with postoperative functions are well known; however, the levels of anxiety or anxiety-related characteristics are unknown. This study aimed to investigate the prevalence of clinically significant state anxiety in geriatric patients undergoing TKA for osteoarthritis (OA) of the knee and to evaluate the anxiety-related characteristics experienced by these patients pre- and post-operatively. METHODS: This retrospective observational study recruited patients who had undergone TKA for knee OA using general anesthesia between February 2020 and August 2021. The study participants were geriatric patients older than 65 years who had moderate or severe OA. We evaluated patient characteristics including age, sex, body mass index, smoking status, hypertension, diabetes, and cancer. We assessed their levels of anxiety status using the STAI-X which comprises 20-item scales. Clinically meaningful state anxiety was defined as a total score of 52 or higher. An independent Student's t-test was used to determine differences of STAI score between subgroups in terms of patient characteristics. And patients were asked to complete questionnaires, which assessed four areas: (1) the main cause of anxiety; (2) the most helpful factor in overcoming anxiety before surgery; (3) the most helpful factor in reducing anxiety after surgery; and (4) the most anxious moment during the entire process. RESULTS: The mean STAI score of patients who underwent TKA was 43.0 points and 16.4% of patients experienced clinically significant state anxiety. The current smoking status affect STAI score and the proportion of patients with clinically meaningful state anxiety. The most common cause of preoperative anxiety was the surgery itself. Overall, 38% of patients reported that they experienced the greatest level of anxiety when the surgeon had recommended TKA in the outpatient clinic. The trust in the medical staff before surgery and the surgeon's explanations after surgery helped the most in reducing anxiety. CONCLUSIONS: One in six patients before TKA experience clinically meaningful state anxiety, and about 40% of patients experience anxiety from the time they are recommended for surgery. Patients tended to overcome anxiety before TKA through trust in the medical staff, and the surgeon's explanations after surgery was found to be helpful in reducing anxiety.

The association between mechanical temporal summation, state anxiety at baseline, and persistent low back pain: a 12-month prospective cohort study.

BACKGROUND: Persons with acute low back pain (LBP) have a good prognosis for regaining function, while pain often persists. Neurobiological and psychosocial factors are recognized to amplify pain responses, as reported for central sensitization. This study investigated the combination of mechanical temporal summation (TS) chosen to characterize central sensitization and state anxiety representing a psychological factor and their association with persistent pain. METHODS: A longitudinal prospective cohort study including 176 participants aged between 18 and 65 with acute LBP was performed. The following independent variables were analyzed at baseline: The mechanical TS at the lower back, of whom the Wind-up ratio (WUR) was calculated, and the state anxiety level measured with the State and Trait Anxiety Inventory (STAI-S). The outcome pain intensity was assessed at baseline and 2,3,6 and 12 months after the onset of acute LBP with the Numeric Rating Scale 0-10 (NRS). Linear mixed models (LMM) were used to analyze the association of the independent variables with pain intensity over time. RESULTS: The mean baseline WUR was 1.3 (SD 0.6) for the right and 1.5 (SD 1.0) for the left side. STAI-S revealed a mean score of 43.1 (SD 5.2). Pain intensity was, on average, 5.4 points (SD 1.6) on the NRS and decreased over one year to a mean of 2.2 (SD 2.4). After one year, 56% of the participants still experienced pain. The LMM revealed a considerable variation, as seen in large confidence intervals. Therefore, associations of the independent variables (WUR and STAI-S) with the course of the outcome pain intensity over one year were not established. CONCLUSION: This investigation did not reveal an association of mechanical TS and state anxiety at baseline with pain intensity during the one-year measurement period. Pain persistence, mediated by central sensitization, is a complex mechanism that single mechanical TS and state anxiety cannot capture.

How nervous am I? How computer vision succeeds and humans fail in interpreting state anxiety from dynamic facial behaviour.

For human interaction, it is important to understand what emotional state others are in. Especially the observation of faces aids us in putting behaviours into context and gives insight into emotions and mental states of others. Detecting whether someone is nervous, a form of state anxiety, is such an example as it reveals a person's familiarity and contentment with the circumstances. With recent developments in computer vision we developed behavioural nervousness models to show which time-varying facial cues reveal whether someone is nervous in an interview setting. The facial changes, reflecting a state of anxiety, led to more visual exposure and less chemosensory (taste and olfaction) exposure. However, experienced observers had difficulty picking up these changes and failed to detect nervousness levels accurately therewith. This study highlights humans' limited capacity in determining complex emotional states but at the same time provides an automated model that can assist us in achieving fair assessments of so far unexplored emotional states.

Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19.

The present study aimed to investigate the mediating role of state anxiety in the relationship between the fear of COVID-19 and relationship happiness among married individuals. An additional aim of the study also tested the moderating role of joint family activities between state anxiety and relationship happiness. The study sample consisted of 1713 married individuals (1031 women and 682 men). The study findings showed both the significant direct associations among the studied variables and the mediating role of state anxiety in the relationship between fear of COVID-19 and relationship happiness. It also found that the path of state anxiety to relationship happiness among married individuals having family activities was significantly lower than those who did not. Directions for future research and application were discussed.

The Effect of Listening to Music Presurgery on the Anxiety Level of Individuals who are Planned for Urological Surgery: Randomized Controlled Study.

PURPOSE: This study aims to evaluate the effects of listening to music on preoperative anxiety levels in individuals planned for urological surgery. DESIGN: The study was a pretest-post-test randomized controlled study. METHODS: This research was conducted with 80 (intervention=40, control=40) individuals who applied to the urology clinic of a university hospital between September 2021 and February 2022 with surgery planned. The data were collected via the information form, state-trait anxiety inventory (STAI= STAI-S: state anxiety, STAI-T: trait anxiety), anxiety specific to surgery questionnaire (ASSQ). FINDINGS: The mean STAI-S scores for the pretest and post-test intervention group were 37.15 ± 8.04 and 34.67 ± 9.09; while scores for the control group were 36.23 ± 9.44 and 37.23 ± 9.78. While the difference in the intervention group was statistically significant (P = .006), there was no difference observed in the control group (P = .256). The pretest and post-test STAI-T mean scores for the intervention group were 39.73 ± 7.71 and 39.88 ± 8.22; the control group scores were 40.68 ± 4.91 and 41.25 ± 5.87; the difference between the intervention (P = .840) and control (P = .346) groups was not statistically significant. The pretest and post-test surgery-specific anxiety scale mean scores of the intervention group were 18.08 ± 4.52 and 16.55 ± 4.79; the control group were 20.50 ± 7.31 and 20.95 ± 7.69. While the difference in the intervention group was statistically significant (P = .011), no difference (P = .498) was determined in the control group. CONCLUSIONS: Individuals planned for urological surgery who listened to music for 30 minutes had reduced state and surgery-specific anxiety for 15 minutes after listening, however, this did not affect trait anxiety. The practice of listening to music before surgery may be recommended for individuals who are scheduled for urological surgery to reduce patient anxiety.

Threat-of-shock decreases emotional interference on affective stroop performance in healthy controls and anxiety patients.

Patients with anxiety disorders suffer from impaired concentration, potentially as a result of stronger emotional interference on attention. Studies using behavioural measures provide conflicting support for this hypothesis. Elevated state anxiety may be necessary to reliably document differences in emotional interference in patients versus healthy controls. The present study examines the effect of experimentally induced state anxiety (threat-of-shock) on attention interference by emotional stimuli. Anxiety patients (n = 36) and healthy controls (n = 32) completed a modified affective Stroop task during periods of safety and threat-of-shock. Results indicated that in both patients and controls, threat decreased negative, but not positive or neutral, emotional interference on attention (both p < .001). This finding supports a threat-related narrowing of attention whereby a certain level of anxiety decreases task-irrelevant processing.

Cognitive complaints mediate the influence of sleep disturbance and state anxiety on subjective well-being and ill-being in adult community volunteers: a cross sectional study.

BACKGROUND: Sleep disturbance, state anxiety, and cognitive complaints (CCs) have been recognized as important issues in public health. Although the mediating role of CCs has been proposed, their role in the relationships between sleep disturbance, state anxiety, and subjective well-being (SWB) and subjective ill-being (SIB) are not yet fully understood. This study used path analyses to investigate whether CCs mediate these relationships. METHODS: The study recruited 523 Japanese adult volunteers using convenience sampling. Participants completed the Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory (Form Y), Cognitive Complaints in Bipolar Disorder Rating Assessment, and Subjective Well-Being Inventory to evaluate sleep disturbance, state anxiety, CCs, and SWB and SIB, respectively. Path analyses were conducted to assess the mediating effects of CCs. RESULTS: The path analyses showed significant indirect associations of sleep disturbance and state anxiety with SWB (p = 0.024 and p = 0.012) and SIB (p < 0.001 and p < 0.001), respectively, mediated by CCs. Furthermore, there were significant indirect associations of sleep disturbance with CCs (p < 0.001), SWB (p < 0.001), and SIB (p < 0.001), via state anxiety, respectively. CONCLUSIONS: This study suggests that CCs mediate the associations of sleep disturbance and state anxiety with SWB and SIB, respectively, in adult community volunteers. To address SWB and SIB associated with sleep disturbance and state anxiety, evaluating CCs may be useful in public mental health. Our findings will encourage health care workers to assess CCs more systematically. Future studies may need to target CCs to develop interventions for SWB and SIB.

Predicting mental burnout among Israeli Home Front Command soldiers during the COVID-19 pandemic.

BACKGROUND: The present study examined personality, situational and organizational predictors of burnout during COVID-19 in a military setting, based on the salutogenic theory of health (Antonovsky, 1987). METHOD: Questionnaires were completed by 116 reserve Israeli Home Front Command medical staff (71% males). Background variables (e.g., gender), personality variables (self-efficacy and sense of coherence - SOC), situational variables (state-anxiety, self-rated health and sense of threat) and organizational variables (satisfaction with military's and government's handling of the COVID-19 crisis) were measured as predictors of burnout. RESULTS: Females had higher levels of state anxiety and burnout compared to males. Females also reported a lower level of satisfaction with the military's handling of the COVID-19 crisis than males. SOC and state anxiety were the only statistically significant predictors of burnout after controlling for sociodemographic variables. The entire model explained 59.4% of the burnout variance. CONCLUSION: In accordance with salutogenic theory, SOC is associated with active adaptation through use of generalized and specific resistance resources to avoid burnout in a stressful milieu. Psychological support, psychoeducation and simulation training are offered to increase manageability in crisis situations. LIMITATIONS: Following a large dropout rate due to being quarantined, the final sample size was much smaller than planned. Also, although previous longitudinal studies have found SOC to be a causal factor in burnout, the present cross-sectional design limits such conclusions.

Patient-Physician Concordance for Quantitative Formats and Treatment Options and the Relationship with State Anxiety.

Patient-physician concordance about topics discussed in a clinic visit is essential for effective communication but may be difficult to achieve in cancer care. We conducted a multicenter, observational study at two Midwestern oncology clinics. A sample of 48 English-speaking or Spanish-speaking women with newly diagnosed stage 0-3 breast cancer completed surveys before and after a visit with an oncologist. Patient-physician dyads were coded as concordant if both patient and physician follow-up self-reports agreed whether (or not) specific treatments were discussed (i.e., treatment option concordance; mastectomy, lumpectomy, hormone therapy, neoadjuvant, and adjuvant chemotherapy) and whether risk was described using certain quantitative formats (i.e., quantitative format concordance; percentages, proportions out of 100 and 1000, graphs, pictures, evidence from clinical studies, cancer stage). Agreement was determined using percent agreement and prevalence-adjusted bias-adjusted kappa (PABAK). Pearson's correlations were used to determine relationships between anxiety and each measure concordance. Percent concordance was higher for treatment concordance (73.3%) compared to quantitative format concordance (64.5%), and PABAK scores tended to be higher for treatment options (PABAK = .21-.78). Both treatment and quantitative format concordance were negatively associated with pre-visit state anxiety, but only treatment concordance was statistically significant (treatment: r = - .504, p = .001; quantitative format: r = - .096, p = .523). Our study indicates moderate patient-physician concordance in early breast cancer care communication and that patient anxiety may impact the ability for patients and physicians to agree on the content communicated in a clinic visit.

Pulling the Trigger: The Effect of a 5-Minute Slow Diaphragmatic Breathing Intervention on Psychophysiological Stress Responses and Pressurized Pistol Shooting Performance.

This study examined the effect of slow diaphragmatic breathing on psychophysiological stress responses and pressurized performance. Sixty-seven participants (40 female; Mage = 20.17 ± 2.77 years) were randomly assigned to either a diaphragmatic-breathing, paced-breathing, or control group. Participants completed a nonpressurized shooting task and then received instructions about a pressurized version. Next, the diaphragmatic group was told to breathe at 6 breaths/min, the paced group at 12 breaths/min, and the control group received no instructions. Following a 5-min intervention period, participants completed the pressurized task while performance was assessed. Psychophysiological stress responses (e.g., cognitive anxiety, heart rate) were recorded throughout. Results revealed that diaphragmatic breathing had mixed effects on stress responses, with some unaffected (e.g., heart rate) and others reduced (e.g., cognitive anxiety), and little effect on performance. Findings suggested that slow diaphragmatic breathing might not aid pressurized performance but could benefit psychological stress responses.

The role of death anxiety on marksmanship performance: a virtual reality simulator study.

Despite the well-established relationship between state anxiety and marksmanship performance, few efforts have examined the individual differences that affect the extent to which individuals experience state anxiety in combat situations. Thus, further studies are needed to increase the probability of mission accomplishment, which could ultimately serve to safely bring soldiers home. The present study examined how death anxiety, a trait-based difference affects state anxiety, which in turn affects shooting performance on a battlefield. In particular, we used a virtual reality simulator to create a realistic engagement setting in which simulated death anxiety is salient. On a sample of 99 active-duty enlisted men in the Republic of Korea Army, we found that death anxiety, and not trait anxiety, increased state anxiety, which in turn decreased marksmanship performance. Overall, the current findings highlight the role of death anxiety in combat situations. The practical implications and avenues for future research are also discussed.

Practical summarySoldiers encounter anxiety in threatening circumstances in which mortality is salient. We examined the role of trait death anxiety in combat situations using a virtual reality simulator. The results indicate that death anxiety increases state anxiety while decreasing marksmanship performance, which has important implications for the military.

Anxiety, resilience and local conditions: A cross-cultural investigation in the time of Covid-19.

The spread of Covid-19 is a worldwide phenomenon, unprecedented in modern times. Differences among countries in such matters are of interest as they provide a unique window to understand human behaviour and culture. The aim of this study is to examine cross-cultural differences in state anxiety, and any moderating role of resilience and social contact. Participants from three countries were recruited: Ireland (n = 449), Italy (n = 324) and Spain (n = 471). While these countries share many characteristics, it was anticipated that their experiences might differ because of pronounced differences in governmental measures and the local severity and history of the pandemic at the time of data collection. Results indicated that: (a) Resilience was negatively related to state anxiety both bivariately and multivariately; (b) number of hours outside per week did not predict state anxiety but was negatively correlated with fear of contagious diseases in the essential workers from the Irish sample; (c) national measures had a moderating role in the relationship between resilience and state anxiety; and (d) social contact, in terms of numbers of written, audio or visual interactions, was not a statistically significant predictor of state anxiety. These results may help to understand the adverse impact on mental health.

The relationship between information overload and state of anxiety in the period of regular epidemic prevention and control in China: a moderated multiple mediation model.

This study aimed to examine the relationship between information overload and individual state anxiety in the period of regular epidemic prevention and control and mediating effect of risk perception and positive coping styles. Further, we explored the moderating role of resilience. 847 Chinese participated in and completed measures of information overload, risk perception, positive coping styles, state anxiety, and resilience. The results of the analysis showed that information overload significantly predicted the level of individual state anxiety (ß = 0.27, p < 0.001). Risk perception partially mediate the relationship between information overload and state anxiety (B = 0.08, 95%CI = [0.05, 0.11]) and positive coping styles also partially mediate the relationship between information overload and state anxiety(B = -0.14, 95%CI = [-0.18, -0.10]). In addition, resilience moderated the mediating effects of risk perception (ß = -0.07, p < 0.05) and positive coping styles (ß = -0.19, p < 0.001). Resilience also moderated the effect of information overload on state anxiety (ß = -0.13, p < 0.001). These results offer positive significance for understanding the internal mechanism of the influence of information overload on individual state anxiety in the epidemic environment and shed light on how to reduce people's state anxiety during an epidemic.

During vigilance to painful stimuli: slower response rate is related to high trait anxiety, whereas faster response rate is related to high state anxiety.

A pathological increase in vigilance, or hypervigilance, may be related to pain intensity in some clinical pain syndromes and may result from attention bias to salient stimuli mediated by anxiety. During a continuous performance task where subjects discriminated painful target stimuli from painful nontargets, we measured detected targets (hits), nondetected targets (misses), nondetected nontargets (correct rejections), and detected nontargets (false alarms). Using signal detection theory, we calculated response bias, the tendency to endorse a stimulus as a target, and discriminability, the ability to discriminate a target from nontarget. Owing to the relatively slow rate of stimulus presentation, our primary hypothesis was that sustained performance would result in a more conservative response bias reflecting a lower response rate over time on task. We found a more conservative response bias with time on task and no change in discriminability. We predicted that greater state and trait anxiety would lead to a more liberal response bias. A multivariable model provided partial support for our prediction; high trait anxiety related to a more conservative response bias (lower response rate), whereas high state anxiety related to a more liberal bias. This inverse relationship of state and trait anxiety is consistent with reports of effects of state and trait anxiety on reaction times to threatening stimuli. In sum, we report that sustained attention to painful stimuli was associated with a decrease in the tendency of the subject to respond to any stimulus over time on task, whereas the ability to discriminate target from nontarget remains unchanged.NEW & NOTEWORTHY During a series of painful stimuli requiring subjects to respond to targets, we separated response willingness from ability to discriminate targets from nontargets. Response willingness declined during the task, with no change in subjects' ability to discriminate, consistent with previous vigilance studies. High trait anxious subjects were less willing to respond and showed slower reaction times to hits than low anxious subjects. This study reveals an important role of trait anxiety in pain vigilance.