Attentional bias toward health-threat in health anxiety: a systematic review and three-level meta-analysis

Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = −0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.

Modulation of Auditory Perception Laterality under Anxiety and Depression Conditions

The objective of this work is to confirm the asymmetry in non-linguistic auditory perception, as well as the influence of anxiety-depressive disorders on it. Eighty-six people were recruited in the emotional well-being group, fifty-six in the anxiety group, fourteen in the depression group, and seventy-seven in the mixed group. In each group, audiograms were obtained from both ears and the differences were statistically analyzed. Differences in hearing sensitivity were found between both ears in the general population, such differences increased in people with anxiety-depressive disorders. When faced with anxiety-depressive disorders, the right ear suffered greater hearing loss than the left, showing peaks of hyper-hearing at the frequency of 4000 Hz in the anxiety subgroup, and hearing loss in the depression subgroup. In relation to anxiety, the appearance of the 4:8 pattern was observed in the right ear when the person had suffered acute stress in the 2 days prior to the audiometry, and in both ears if they had suffered stress in the 3–30 days before said stress. In conclusion, the advantage of the left ear in auditory perception was increased with these disorders, showing a hyperaudition peak in anxiety and a hearing loss in depression.

Posttraumatic Growth after the Fukushima Nuclear Disaster: Examination of Free Descriptions among Fukushima Residents Who Lived in the Evacuation Area

We examined the differences in the posttraumatic growth (PTG) free descriptions from clusters of Fukushima residents (evacuation and non-evacuation zones) who experienced the Great East Japan Earthquake, and the relationship between “recovery from radiation anxiety” and the PTG-free description classification in these regions. A mail survey was conducted in August 2016 among Fukushima residents aged 20–79 years for free descriptions of their PTG. Participants were then divided into the “no anxiety,” “recovered from anxiety,” and “unrecovered from anxiety” groups based on their “recovery from radiation anxiety.” Data from 786 responses were analyzed. The PTG-free descriptions were classified into eight categories. Among those who lived in the evacuation zone versus those in the non-evacuation zone, “relating to others” (non-evacuation zone: 11.9% vs. evacuation zone: 18.4%) and “appreciation of life” (non-evacuation zone: 2.7% vs. evacuation zone: 9.8%) were significantly higher, and “increased awareness of disaster prevention” (non-evacuation zone: 20.4% vs. evacuation zone: 8.0%) was significantly lower. In the evacuation zone, “renewed recognition of nuclear issues” was significantly lower than the expected value in the no anxiety group (3.1%) and significantly higher than the expected value in the recovered group (22.9%). Further studies are needed to build support measures and potentially aid in preparing for future disasters.

The effectiveness of preventive-behavioural therapy and cognitive anxiety group and student’s attention .

This study was performed with the purpose of determining the effectiveness of preventive- behavioural therapy and cognitive anxiety group and student’s attention. The population and sample of the study were 35 students of Azad University, East Tehran, which were selected randomly. The data collection method was the researcher-made field method. The research tools were the Beck Anxiety Inventory (BAI) and the video test. Through SPSS 23 software and using the Pearson correlation method, it was concluded that there was a direct relationship between therapy and training. Research tools were observed in the BAI. Based on the results of pre-test tests, none of the SBT and REDT methods led to a significant relationship between the level of anxiety and the attention of the respondents. The paper recommends that more comprehensive measurement tools are used in future research of a larger sample size. Keywords: Attention; Cognitive Behaviour; Effectiveness; Group Therapy; Students.

Evaluation of the dental anxiety levels of patients applying to the faculty of dentistry during the COVID-19 pandemic

Aim: The purpose of this study is to determine the levels of dental anxiety in patients who applied to the Necmettin Erbakan University Faculty of Dentistry during the COVID-19 outbreak and to evaluate the relationships of their anxiety levels to age, gender, education level, and the frequency of visits to dentists. Methodology: There were 320 participants, including 163 females (50.9%) and 157 males (49.1%), aged from 18 to 65 years or older, who had applied to the Necmettin Erbakan University Faculty of Dentistry. The Corah Dental Anxiety Scale (CDAS) was used to determine the levels of dental anxiety (non-anxiety, little anxiety, anxiety, over anxiety, and excessive anxiety) and the anxiety groups (low or high). Descriptive statistics were presented in percentages. Data were analyzed using t-tests and one-way ANOVA and chi-square tests, at a significance level of p = 0.05. Results: Among the participants, 38.1% were at the non-anxiety level, 44.1% had very little anxiety, 10.9% had anxiety, 5% had over anxiety, and 1.9% had excessive anxiety. With regard to the anxiety groups, 82.5% were in the low anxiety group, and 17.5% were in the high anxiety group. Age, education level, and frequency of visiting the dentist were not found to have any effects on dental anxiety (p > 0.05). However, the effect of gender with regard to dental anxiety was significant (p < 0.05), as females had higher dental anxiety levels than males. Conclusion: While the effect of gender was found to be important in terms of dental anxiety, age, educational status, and the frequency of visiting the dentist did not have significant effects on dental anxiety. Females had higher dental anxiety scores and levels than males. How to cite this article: Tunçdemir AR, Büyükerkmen EB, Savaş A. Evaluation of the dental anxiety levels of patients applying to the faculty of dentistry during the Covıd-19 pandemic. Int Dent Res 2021;11(Suppl.1):238-244. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.35 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

A-87 Regional Cerebral Blood Flow in Self-Reported Somatic Anxiety

Objective To identify regional cerebral blood flow (rCBF) differences between individuals who self-reported either low or high symptoms of somatic anxiety. Method Individuals who reported low levels of somatic anxiety (0-20th percentile;n = 8962,Mage = 39.2,39.2% female,62.6% Caucasian) and individuals who reported high levels of somatic anxiety (80-100th percentile;n = 6427,Mage = 40.9,39.0% female,69.5% Caucasian) were selected from a deidentified adult clinical outpatient database. Those with comorbid diagnoses were included. Significant differences (alpha = 0.001) were found for age [t(15387) = 6.3], and race [χ2(15) = 119.4] between groups and therefore were controlled. Results Significant rCBF differences were noted bilaterally in the frontal lobe [left: F(1,15,384) = 16.4; right: F(1,15,384) = 13.2] and motor-sensory strip [left: F(1,15,384) = 4.3; right: F(1,15,384) = 5.1]. Group means comparisons indicated higher perfusion in the frontal lobe of the high levels of somatic anxiety group. Lower perfusion was found in the motor sensory strip of the high levels of somatic anxiety group. No significant differences were found bilaterally in the cerebellum, limbic system, basal ganglia, vermis, or occipital, parietal, or temporal lobes. Conclusion Results indicated that individuals who report higher levels of somatic anxiety have higher perfusion in the frontal lobes and lower perfusion motor-sensory strip. Previous literature SPECT studies have found a link between individuals with panic disorder and increased activity in the right medial and superior frontal lobes. No research was found for anxiety in the motor-sensory strip. Limitations included the reliance on self-report measures of anxiety in place of clinical measures and the potential mediating effect of medication on somatic symptoms. Future research should examine perfusion in the motor-sensory strip, use clinical measures of anxiety, and control for mediation use.

Depression und Angst bei Glaukom

Glaucoma is considered a chronic disease that requires lifelong management. Chronic diseases are known to be highly associated with psychological disturbances such as depression and anxiety. There have also been many studies on association between anxiety or depression and glaucoma. The majority of these studies explained that the glaucoma diagnosis causes anxiety or depression. However, It is also necessary to evaluate whether the psychological disturbance itself affect glaucoma. Therefore, we investigated the association of anxiety and depression with glaucoma progression, and elucidate mechanisms underlying that. We included 251 eyes with open angle glaucoma who were followed up for at least 2 years in this retrospective case-control study. The Beck Anxiety Inventory (BAI) and Beck Depressive Inventory-II (BDI-II) were used to assess anxiety and depression in glaucoma patients. Patients were classified into groups (high-anxiety group; HA-G, low-anxiety group; LA-G, high-depression group; HD-G, low-depression group; LD-G) according to their score on the BAI or BDI-II (separately). In logistic regression analysis, disc hemorrhage, peak intraocular pressure (IOP) and RNFL thickness loss rate were significantly associated with high anxiety (p = 0.017, p = 0.046, p = 0.026). RNFL thinning rate and disc hemorrhage were significant factors associated with anxiety in multivariate models (p = 0.015, p = 0.019). Multivariate linear regression analysis showed a significant positive correlation between the rate of RNFL thickness loss and BAI score (B = 0.058; 95% confidential interval = 0.020–0.097; p = 0.003), and RNFL loss and IOP fluctuation (B = 0.092; 95% confidential interval = 0.030–0.154; p = 0.004). For the depression scale, visual field mean deviation and heart rate variability were significantly associated with high depression in multivariate logistic regression analysis (p = 0.003, p = 0.006). We suggest that anxiety increase the risk of glaucoma progression and they are also associated with IOP profile and disc hemorrhage.

Functional Measurement Applied to Engineering Students’ Test Anxiety Judgment for Online and Face-to-face Tests

<p style="text-align: justify;">This study explored the cognitive mechanism behind information integration in the test anxiety judgments in 140 engineering students. An experiment was designed to test four factors combined (test goal orientation, test cognitive functioning level, test difficulty and test mode). The experimental task required participants to read 36 scenarios, one at a time and then estimate how much test anxiety they would experience in the evaluation situation described in each scenario. The results indicate three response styles (low, moderate, and high-test anxiety) among the participants. The orientation and difficulty of each given exam scenario were the most critical factors dictating test anxiety judgments. Only the moderate test anxiety group considered the test mode to be a third relevant factor. The integration mechanism for Cluster 1 was multiplicative, while for Clusters 2 and 3, it was summative. Furthermore, these last two clusters differed in terms of the valuation of the factors. These results suggest that programs that help students to cope with test anxiety need to take into account the valuation and integration mechanism that students use to integrate different information in specific examination contexts, since the way students assess their internal and external circumstances can influence how they deal with evaluative situations.</p>

INITIAL CLINICAL PRESENTATION OF PEDIATRIC PATIENTS WITH PSYCHOLOGICAL DISORDERS FOLLOWING CONCUSSION

Background: There is limited evidence regarding the impact of pre-existing psychological disorders on the initial clinical presentation in pediatric patients following concussion. Hypothesis/Purpose: To examine differences in clinical symptom measures between pediatric patients with a history of depression and/or anxiety and no history of psychological disorder (PD) following a concussion. Methods: Data were prospectively collected from participants enrolled in the North Texas Concussion Network Registry (ConTex) between August 2015 and March 2020. Participants aged 5-18 years diagnosed with a concussion were included. Demographic variables and a range of clinical measures from initial presentation were reviewed, including SCAT-5 Symptom Log, Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder (GAD-7) scale, and Brief Resiliency Scale (BRS). Participants were separated into four groups based on self-reported prior diagnosis: depression, anxiety, depression+anxiety, and no PD. Results: A total of 1770 participants were included: 50 with depression, 82 with anxiety, 84 with both, and 1554 with no history of PD. There was no significant difference in age, sex, prior concussion history, or time to presentation between the depression and no PD group, or between the anxiety and no PD group. A significant difference was found between the depression+anxiety group and no PD group in the following variables: age (15.11±1.8 vs 13.68±2.61 years, p<0.001), prior concussion history (40.5% vs 23.9%, p=0.001), and time to presentation (31.47±25.82 vs 19.85±26.33 days, p=0.01). Additionally, there were more females in the depression+anxiety group than the no PD group (71.4% vs 47.8%, p<0.001). The depression, anxiety, and depression+anxiety groups had significantly higher rates of learning disorders than the no PD group (40%, 47.6%, 46.4% vs 16.4%, all p<0.001). A significant difference in SCAT-5 symptom severity scores between the depression, anxiety, and depression+anxiety groups compared to the no PD group was found. The PD groups all reported higher GAD-7 and PHQ-8 scores and lower BRS scores compared to the no PD group. The depression+anxiety group had the highest symptom severity, GAD-7, and PHQ-8 scores along with the lowest BRS score. Table 1.1 summarizes these significant findings. Conclusion: Differences were seen in participants with a history of depression and/or anxiety at initial clinical presentation, including history of learning disability, SCAT-5 symptom severity scores, and common screening tests for depression, anxiety, and resiliency compared to those without a history of PD. Understanding these differences at initial presentation may urge providers to engage multidisciplinary teams early in facilitating patient recovery. Tables/Figures: [Table: see text]

Post-stroke Anxiety Analysis via Machine Learning Methods

Post-stroke anxiety (PSA) has caused wide public concern in recent years, and the study on risk factors analysis and prediction is still an open issue. With the deepening of the research, machine learning has been widely applied to various scenarios and make great achievements increasingly, which brings new approaches to this field. In this paper, 395 patients with acute ischemic stroke are collected and evaluated by anxiety scales (i.e., HADS-A, HAMA, and SAS), hence the patients are divided into anxiety group and non-anxiety group. Afterward, the results of demographic data and general laboratory examination between the two groups are compared to identify the risk factors with statistical differences accordingly. Then the factors with statistical differences are incorporated into a multivariate logistic regression to obtain risk factors and protective factors of PSA. Statistical analysis shows great differences in gender, age, serious stroke, hypertension, diabetes mellitus, drinking, and HDL-C level between PSA group and non-anxiety group with HADS-A and HAMA evaluation. Meanwhile, as evaluated by SAS scale, gender, serious stroke, hypertension, diabetes mellitus, drinking, and HDL-C level differ in the PSA group and the non-anxiety group. Multivariate logistic regression analysis of HADS-A, HAMA, and SAS scales suggest that hypertension, diabetes mellitus, drinking, high NIHSS score, and low serum HDL-C level are related to PSA. In other words, gender, age, disability, hypertension, diabetes mellitus, HDL-C, and drinking are closely related to anxiety during the acute stage of ischemic stroke. Hypertension, diabetes mellitus, drinking, and disability increased the risk of PSA, and higher serum HDL-C level decreased the risk of PSA. Several machine learning methods are employed to predict PSA according to HADS-A, HAMA, and SAS scores, respectively. The experimental results indicate that random forest outperforms the competitive methods in PSA prediction, which contributes to early intervention for clinical treatment.