Association of plasma tryptophan concentration with periaqueductal gray matter functional connectivity in migraine patients

Altered periaqueductal gray matter (PAG) functional connectivity contributes to brain hyperexcitability in migraine. Although tryptophan modulates neurotransmission in PAG projections through its metabolic pathways, the effect of plasma tryptophan on PAG functional connectivity (PAG-FC) in migraine has not been investigated yet. In this study, using a matched case-control design PAG-FC was measured during a resting-state functional magnetic resonance imaging session in migraine without aura patients (n = 27) and healthy controls (n = 27), and its relationship with plasma tryptophan concentration (TRP) was assessed. In addition, correlations of PAG-FC with age at migraine onset, migraine frequency, trait-anxiety and depressive symptoms were tested and the effect of TRP on these correlations was explored. Our results demonstrated that migraineurs had higher TRP compared to controls. In addition, altered PAG-FC in regions responsible for fear-cascade and pain modulation correlated with TRP only in migraineurs. There was no significant correlation in controls. It suggests increased sensitivity to TRP in migraine patients compared to controls. Trait-anxiety and depressive symptoms correlated with PAG-FC in migraine patients, and these correlations were modulated by TRP in regions responsible for emotional aspects of pain processing, but TRP did not interfere with processes that contribute to migraine attack generation or attack frequency.

Quality of Life and Anxiety in Age Macular Degeneration Patients: A Cross-Sectional Study

(1) Background: Chronic diseases affect patients’ quality of life. Age Macular Degeneration (AMD) is one of the most prevalent chronic ocular diseases. The study aims to measure the anxiety and quality of life related to vision in patients with AMD, as well as the relationship with other visual and demographic parameters. (2) Methods: Prospective cross-sectional study in AMD patients. Visual acuity (VA), contrast sensitivity (CS), line difference in the Colenbrander test, and the degree of pathology were measured. Other variables such as gender, age, and time from the diagnosis were also collected. Anxiety was measured with the Spielberger State-Trait Anxiety Inventory (STAI) and quality of life with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed. (3) Results: Patients with higher punctuation in Trait STAI showed lower punctuation in NEI VFQ-25 questionnaire (Spearman coefficient −0.415; p = 0.001). The variables VA, CS, and age were correlated to the quality of life. The relationship between trait anxiety and subscales of NEI VFQ-25 was significant for all subscales (p < 0.05), except for social functioning, peripheral vision, general vision, ocular pain, and driving. (4) Conclusions: AMD patients with higher levels of anxiety show a decrease in their quality of life. The quality of life of AMD patients depends on their VA and CS.

Threat Vigilance and Intrinsic Amygdala Connectivity

A well documented amygdala-dorsomedial prefrontal circuit is theorized to promote attention to threat (‘threat vigilance’). Prior research has implicated a relationship between individual differences in trait anxiety/vigilance, engagement of this circuitry, and anxiogenic features of the environment (e.g. through threat-of-shock and movie-watching). In the present study, we predicted that—for those scoring high in self-reported anxiety and a behavioral measure of threat vigilance—this circuitry is chronically engaged, even in the absence of anxiogenic stimuli. Our analyses of resting-state fMRI data (N=639) did not, however, provide evidence for such a relationship. Nevertheless, in our planned exploratory analyses, we saw a relationship between threat vigilance behavior (but not self-reported anxiety) and intrinsic amygdala-periaqueductal gray connectivity. Here, we suggest this subcortical circuitry may be chronically engaged in hypervigilant individuals, but that the amygdala-prefrontal circuitry may only be engaged in response to anxiogenic stimuli.

Pengaruh Konseling Online Menggunakan Teknik Desensitisasi Sistematis Terhadap Kecemasan Siswa Pada Saat Presentasi di SMPN 232 Jakarta

Penelitian ini bertujuan untuk mengetahui pengaruh teknik Desensitisasi Sistematis untuk mengurangi tingkat kecemasan siswa pada saat presentasi di SMPN 232 Jakarta. Penelitian ini menggunakan metode penelitian subjek tunggal dengan desain A-B. Subjek dalam penelitian ini adalah seorang siswa perempuan kelas VIII SMPN 232 Jakarta yang memiliki tingkat kecemasan tinggi pada saat presentasi berdasarkan hasil pengukuran kecemasan instrumen state and trait anxiety (STAI). Data yang diperoleh selama penelitian kemudian dianalisis dengan cara analisis dalam kondisi pada kondisi baseline (A) dan kondisi intervensi (B) serta dilakukan analisis antar kondisi baseline (A) dengan kondisi intervensi (B). Skor pada kondisi baseline cenderung stabil dan skor pada kondisi intervensi cenderung menurun. Skor kecemasan sebelum dilakukan intervensi adalah 121 (berada pada kategori tinggi) kemudian menurun menjadi 64 (berada pada kategori rendah) setelah diberikan intervensi. Hasil persentase overlap pada penelitian ini memperlihatkan bahwa teknik Desensitisasi Sistematis berpengaruh pada menurunnya tingkat kecemasan siswa pada saat presentasi.

Validation of a Computerized Version of the Trait Subscale of the Physical Appearance State and Trait Anxiety Scale in Mexican Preadolescents

Anxiety is a feeling of fear, dread or restlessness and can develop into a weight-related disorder. The objective was to analyze the psychometric properties of the trait anxiety subscale of the Physical Appearance State and Trait Anxiety Scale (PASTAS), as well as the invariance in Mexican preadolescents. The sample consisted of 604 participants, 285 female and 319 male, whose ages ranged between 11 and 12 years (M = 11.37; SD = 0.48). The questionnaire’s factor structure was analyzed using confirmatory factor analyses. The analyses show the viability and adequacy of a two-factor structure (weight and non-weight factors) both for the total sample and for the populations of male and female. The two-factor structure showed adequate reliability and validity fit indicators. The factor structure, the factor loadings and intercepts are considered invariant according to the variable sex; however, differences between female and male participants were found for levels of anxiety caused by physical appearance. In conclusion, the PASTAS can be considered a convenient instrument to assess the variables related to anxiety generated by one’s physical appearance, as well as allowing more participants to be quickly assessed.

Cognitive Hypnotherapy and EMDR: Two Effective Psychodynamic Therapies for the Rapid Reduction of Cognitive Anxiety

In the main research into cognitive anxiety has focused on the conscious mind. The aim of this chapter is to review two psychodynamic psychotherapies, cognitive hypnotherapy (CH) and eye movement desensitisation and reprocessing (EMDR). Both therapies focus on implicit or unconscious processes for the rapid relief of cognitive anxiety. The objective is to give credence to CH and EMDR both in the scientific and medical domains. The philosophy is concerned with changing negative cognitions and dysfunctional feelings through a process of desensitisation and reprocessing, utilising positive imagery. CH and EMDR were investigated in an intervention study with advanced pianists (n = 46). Participants were of mixed gender aged 18–26 and were randomly assigned to a therapy or control group. The therapy groups received two therapies of either CH or EMDR during a two week period between two concerts. Quantitative data were collected through the Spielberger State-Trait Anxiety Inventory. Results showed that both therapy groups (but not the control) experienced a significant reduction in state anxiety post-therapy and trait anxiety decreased significantly below baseline levels in the EMDR group. This chapter further reviews research into CH and EMDR documented through a case study allowing for qualitative assessment of the therapies where two sessions only were required to effect positive change.

The rosy future paradox: Positive future thinking without task relevance enhances negative biases and anxiety for aversive events

Expectations have an important role in guiding behavior and the interpretation of novel information, but can contain negative biases such as is the case in anxiety disorders. Positive future thinking may provide an accessible way to attenuate these negatively biases. However, much is still unclear about the optimal form of such positive interventions, and it is unknown if the effects go beyond subjective experience. Here, we used a positive future thinking intervention to adapt the way a stressful event is experienced. Participants imagined either task-relevant (N = 21) or irrelevant (N = 21) positive future events before being subjected to the Trier Social Stress Task, or did not receive the intervention (N= 20). We recorded resting state EEG during the anticipation and recovery phases of the TSST to assess intervention and trait anxiety related differences in the level of frontal delta-beta coupling, which is considered a neurobiological substrate of emotion regulation. Results show that the intervention reduces event-related stress and anxiety, and increases social fixation behavior and task performance, but only if future thinking is task relevant. Paradoxically, task-irrelevant positive future thoughts enhance negative perceptual biases and stress reactivity. This increase in stress reactivity in the task-irrelevant group was corroborated by the elevated levels frontal delta-beta coupling during event anticipation, especially for those with high trait anxiety. This suggests an increased demand for emotion regulation following the task-irrelevant intervention, possibly due to the contextual incongruence between positive imagery and the stressor. Together, these results show that positive future thinking can mitigate the negative emotional, behavioral and neurobiological consequences of a stressful event, but that it should not be applied indiscriminately. Task-relevant positive future thinking can be an accessible way to boost efficacy of exposure therapy for pathological anxiety, and can help people deal with negative anticipation in daily life.

The Efficacy of Downward Counterfactual Thinking for Regulating Emotional Memories in Anxious Individuals

Aversive autobiographical memories sometimes prompt maladaptive emotional responses and contribute to affective dysfunction in anxiety and depression. One way to regulate the impact of such memories is to create a downward counterfactual thought–a mental simulation of how the event could have been worse–to put what occurred in a more positive light. Despite its intuitive appeal, counterfactual thinking has not been systematically studied for its regulatory efficacy. In the current study, we compared the regulatory impact of downward counterfactual thinking, temporal distancing, and memory rehearsal in 54 adult participants representing a spectrum of trait anxiety. Participants recalled regretful experiences and rated them on valence, arousal, regret, and episodic detail. Two to six days later, they created a downward counterfactual of the remembered event, thought of how they might feel about it 10 years from now, or simply rehearsed it. A day later, participants re-rated the phenomenological characteristics of the events. Across all participants, downward counterfactual thinking, temporal distancing, and memory rehearsal were equally effective at reducing negative affect associated with a memory. However, in individuals with higher trait anxiety, downward counterfactual thinking was more effective than rehearsal for reducing regret, and it was as effective as distancing in reducing arousal. We discuss these results in light of the functional theory of counterfactual thinking and suggest that they motivate further investigation into downward counterfactual thinking as a means to intentionally regulate emotional memories in affective disorders.