Showing papers on "Somatic anxiety published in 2007"

Psychometric Properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): Comparison to the State-Trait Anxiety Inventory (STAI).

Abstract: The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA; M. J. Ree, C. MacLeod, D. French, & V. Locke, 2000) was designed to assess cognitive and somatic symptoms of anxiety as they pertain to one's mood in the moment (state) and in general (trait). This study extended the previous psychometric findings to a clinical sample and validated the STICSA against a well-published measure of anxiety, the State-Trait Anxiety Inventory (STAI; C. D. Spielberger, 1983). Patients (N=567) at an anxiety disorders clinic were administered a battery of questionnaires. The results of confirmatory factor analyses (Bentler-Bonnett nonnormed fit index, comparative fit index, and Bollen fit index>.90; root-mean-square error of approximation /=.64), the STICSA was more strongly correlated with another measure of anxiety (rs>/=.67) and was less strongly correlated with a measure of depression (rs

Cortisol and stress responses during a game and practice in female collegiate soccer players.

Abstract: The purpose of this study was to compare the cortisol responses from a regular season game and a typical practice session in female National Collegiate Athletic Association Division I collegiate soccer players. Eighteen players were assigned to 2 groups, 10 starters and 8 nonstarters, depending on their playing time. Salivary cortisol concentration, as well as competitive sport anxiety (somatic and cognitive anxiety, self-confidence), was monitored before and after 1 regular season game and 1 typical practice session. Although salivary cortisol levels increased postgame for both starters (+250%) and nonstarters (+140%), they increased to a greater extent for the starters. Practice salivary cortisol did not significantly change (p > 0.05). Cognitive and somatic anxiety was greater pre- and postgame when compared with the pre- and postpractice scores, respectively. These data clearly demonstrate the psychological and physiological differences between soccer competition and practice in collegiate women. It appears that both physiological and psychological variables combine to contribute to the large stress hormone response to an actual competitive game.

Callous-Unemotional Behaviors in Young Girls: Shared and Unique Effects Relative to Conduct Problems.

Abstract: Among girls, little is known about the shared and unique associations that callous-unemotional (CU) behaviors and conduct problems have with aspects of emotional and behavioral dysregulation and with parenting practices. This study examined these associations using a large community-based sample of young girls (N = 990). The findings revealed that hyperactivity-impulsivity and negative emotionality were positively and uniquely associated with conduct problems, but not with CU behaviors, after controlling for co-occurring conduct problems. Conduct problems were also positively associated with both generalized anxiety and panic/somatic anxiety. In contrast, CU behaviors were negatively related to generalized anxiety problems after controlling for co-occurring conduct problems. The results also indicated that conduct problems were more closely associated with harsh punishment and low parental warmth among girls with low versus high CU behaviors.

Propiedades psicométricas de la versión española del Inventario de Ansiedad Competitiva CSAI-2R en deportistas

Abstract: Psychometric properties of the Spanish version of the Revised Competitive State Anxiety Inventory-2 with athletes. The aim of this work was to develop a Spanish adaptation of the Revised Competitive State Anxiety Inventory-2. The scale was translated and its psychometric properties were analyzed with data from a sample of 149 athletes. Exploratory and confirmatory factor analyses were performed which supported a 16-item CSAI-2R assessing the three hypothesised dimensions of anxiety: Somatic anxiety, Cognitive anxiety, and Self-confidence. Overall fit of the model was good with a value of .97 for Comparative and Non-Normed Fit Indexes, and .045 for Root Mean Square Error of Approximation. Cronbach alpha coefficients for the factors ranged from .79 to .83. It is concluded that this version shows adequate properties, in terms of its dimensionality and internal consistency. Guidelines are also provided for future research on its validity as a measure of state anxiety in competitive situations.

Efficacy of duloxetine for the treatment of generalized anxiety disorder: implications for primary care physicians.

Abstract: Objective: This study examined the efficacy and tolerability of duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine, for the treatment of patients with generalized anxiety disorder (GAD). Method: Patients were ≥ 18 years old and recruited from 5 European countries, the United States, and South Africa. The study had a 9-week, multicenter, randomized, double-blind, fixed-dose, placebo-controlled, parallel-group design. A total of 513 patients (mean age = 43.8 years; 67.8% female) with a DSM-IV–defined GAD diagnosis received treatment with duloxetine 60 mg/day (N = 168), duloxetine 120 mg/day (N = 170), or placebo (N = 175). The primary efficacy measure was the Hamilton Rating Scale for Anxiety (HAM-A) total score. Secondary measures included the Sheehan Disability Scale, HAM-A psychic and somatic anxiety factor scores, and HAM-A response, remission, and sustained improvement rates. The study was conducted from July 2004 to September 2005. Results: Both groups of duloxetine-treated patients demonstrated significantly greater improvements in anxiety symptom severity compared with placebo-treated patients as measured by HAM-A total score and HAM-A psychic and somatic anxiety factor scores (p values ranged from ≤ .01 to ≤ .001). Duloxetine-treated patients had greater functional improvements in Sheehan Disability Scale global and specific domain scores (p ≤ .001) than placebo-treated patients. Both duloxetine doses also resulted in significantly greater HAM-A response, remission, and sustained improvement rates compared with placebo (p values ranged from ≤ .01 to ≤ .001). The rate of study discontinuation due to adverse events was 11.3% for duloxetine 60 mg and 15.3% for duloxetine 120 mg versus 2.3% for placebo (p ≤ .001). Conclusion: The results of this study demonstrate that duloxetine 60 mg/day and 120 mg/day were efficacious and well tolerated and thus may provide primary care physicians with a useful pharmacologic intervention for GAD. Clinical Trials Registration: ClinicalTrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT00122824","term_id":"NCT00122824"}}NCT00122824.

Self-reported psychological states and physiological responses to different types of motivational general imagery.

Abstract: The aim of the present study was to examine self-reported psychological states and physiological responses (heart rate) experienced during different motivational general imagery scenarios. Forty competitive athletes wore a standard heart rate monitor and imaged five scripts (mastery, coping, anxiety, psyching up, and relax ation). Following each script, they reported their state anxiety and self-confidence. A significant increase in heart rate from baseline to imagery was found for the anxiety, psyching-up, and coping imagery scripts. Furthermore, the intensity of cognitive and somatic anxiety was greater and perceived as being more debilitative following the anxiety imagery script. The findings support Lang’s (1977, 1979) proposal that images containing response propositions will produce a physiological response (i.e., increase heart rate). Moreover, coping imagery enabled the athletes to simultaneously experience elevated levels of anxiety intensity and thoughts and feelings they perceived as helpful.

Competitive state anxiety and self-confidence: intensity and direction as relative predictors of performance on a golf putting task.

Abstract: This study considered relationships between the intensity and directional aspects of competitive state anxiety as measured by the modified Competitive Sport Anxiety Inventory-2(D) (Jones & Swain, 1992) in a sample of 12 experienced male golfers. Anxiety and performance scores from identical putting tasks performed under three different anxiety-manipulated competitive conditions were used to assess both the predictions of Multidimensional Anxiety Theory (MAT; Martens et al., 1990) and the relative value of intensity and direction in explaining performance variance. A within-subjects regression analysis of the intra-individual data showed partial support for the three MAT hypotheses. Cognitive anxiety intensity demonstrated a negative linear relationship with performance, somatic anxiety intensity showed a curvilinear relationship with performance, and self-confidence intensity revealed a positive linear relation. Cognitive directional anxiety illustrated a positive linear relationship with putting performance. Multiple regression analyses indicated that direction (42% of variance) was a better predictor of performance than intensity (22%).

Psychological factors predict patient satisfaction with postmastectomy breast reconstruction.

Abstract: Background: This prospective study examined the contribution of psychological factors to the prediction of patient satisfaction with postmastectomy breast reconstruction surgery. Methods: Women presenting for breast reconstruction were administered presurgical psychological inventories. Measures of affective distress, depressive symptoms, anxiety, somatization, and somatic preoccupation were obtained from standardized inventories. At 1-year (n = 295) and 2-year (n = 205) follow-up, subjects completed ratings of their satisfaction with both the general and aesthetic results of surgery. Results: After controlling for sociodemographic variables and both surgical procedure type and timing, multiple linear regression analyses indicated that at 1-year follow-up preoperative measures of affective distress, depression, somatization, and somatic anxiety predicted less general satisfaction with surgical outcome, while presurgical levels of affective distress, depression, anxiety, somatization, and somatic anxiety predicted decreased aesthetic satisfaction. At 2-year follow-up, only preoperative affective distress retained a significant association with lowered general satisfaction with reconstructive surgery. In addition, at 2-year reassessment, aesthetic quality of surgical outcome was inversely related to all the presurgical psychological variables. Conclusions: Affective distress and somatic preoccupation negatively influence patient satisfaction with both aesthetic and general outcomes associated with postmastectomy breast reconstruction. Presurgical psychological screening and counseling of selected women who are being considered for breast reconstruction may be advisable to enhance patient satisfaction with reconstructive surgery.

The role of achievement goal orientations and perceived ability upon somatic and cognitive indices of sport competition trait anxiety. A study of young athletes.

Abstract: Goal orientation theory and competence motivation theory were used to examine the relationships between young athletes' achievement goals and indices of somatic and cognitive trait sport competition anxiety. Included in these analyses were also the potential mediating and moderating role of the athletes' perceived competence in sport. We examined 136 young athletes aged 13 to 18 years involved in organized sport within a community in northern Norway. Whereas no association was found between an ego oriented achievement goal and indices of anxiety, multiple regression analyses revealed that both a high task goal orientation and high perceived sport competence predicted a reduced tendency to report cognitive anxiety when competing in sport. In addition, athletes who perceived their competence in sport as high were found to be less predisposed to experiencing somatic anxiety in the form of elevated physiological arousal when competing than those who doubt their competence. The results further showed that perceived competence did not mediate or moderate the relationships between achievement goal orientations and somatic and cognitive indices of trait sport competition anxiety. The findings suggest that being task oriented in sport as well as having a sense of being competent are important in order to prevent sport competitions giving rise to elevated cognitive anxiety in young athletes.

Role of pregabalin in the treatment of generalized anxiety disorder

Abstract: Generalized anxiety disorder (GAD) is a common, typically persistent, and disabling condition that is often not recognised, or treated in an evidence-based manner. Current pharmacological and psychological treatment approaches have a number of drawbacks, including a delay in onset of clinical effect, varying relative efficacy against psychological or somatic symptoms of anxiety, potentially troublesome adverse effects, and discontinuation symptoms on stopping treatment. Pregabalin is a structural analog of the inhibitory neurotransmitter gamma amino butyric acid (GABA) but is thought to exert its anxiolytic effects through binding in a state-dependent manner to the alpha-2-delta sub-unit of voltage-gated calcium channels in “over-excited” pre-synaptic neurones, reducing release of excitatory neurotransmitters such as glutamate and substance P. At fixed doses of 200 mg/day or greater, it has consistent proven efficacy in acute treatment of DSM-IV-defined GAD, with some evidence of an early onset of clinical effect, and of efficacy across psychological and somatic anxiety symptom clusters. A pregabalin dosage of 450 mg/day is efficacious in the prevention of relapse. There is at present no published direct comparison with an SSRI. The current known adverse effect profile and studies in healthy volunteers together suggest that pregabalin may have some tolerability advantages over benzodiazepines and venlafaxine, at least in short-term treatment.

Serotonin transporter gene influences the time course of improvement of "core" depressive and somatic anxiety symptoms during treatment with SSRIs for recurrent mood disorders.

Abstract: The short variant of the serotonin transporter gene (SERTPR) has been consistently associated with a poorer response to treatment with various selective serotonin reuptake inhibitors (SSRIs). Antidepressant response is not a unitary phenomenon, however, and we here hypothesized that the SERTPR effect could be specific to some types of symptomatology. The sample comprised 281 inpatients affected by mood disorders and treated for major depression with SSRIs. The total depressive scores for all patients were analyzed in previous reports, but symptomatologic clusters were not examined previously. The 21-item Hamilton Rating Scale for Depression (HAM-D) was administered to evaluate depressive symptoms at baseline and weekly over 6 weeks of treatment. All patients were genotyped for the SERTPR polymorphism. Compared with patients with the SERTPR l/l and l/s polymorphisms, s/s patients showed a selective and slower improvement of depressive “core” and somatic anxiety symptoms, but they did not differ from other patients regarding other symptomatologic clusters such as insomnia and motor retardation. These findings support the view that response to SSRIs is not a unitary phenomenon and that improvement of symptomatologic clusters as, at least in part, genetically driven. SERTPR may be hypothesized as concurrently participating to the activity of anatomic brain regions differentially involved in depression and somatic symptoms of anxiety; however, further studies are required to examine these complex interactions.

Effects of Coach and Parent Training on Performance Anxiety in Young Athletes: A Systemic Approach

Abstract: Coaches and parents play a major role in determining the consequences of sport participation in young athletes. This study focuses on the assessment of a systemic, empirically inspired intervention directed at coaches and parents. Parallel workshops derived in part from achievement goal theory were presented to the coaches and parents of 9 to 15 year old boys and girls participating in community-based basketball programs, and their effects were compared with a matched control condition. Multilevel analyses revealed significant Time x Condition interactions on all three subscales of the Sport Anxiety Scale-2 (SAS-2) and on a total anxiety score. Athletes in the intervention condition decreased in cognitive and somatic anxiety scores on the SAS-2, whereas athletes in the control condition exhibited increases in cognitive and somatic anxiety. Results suggest the potential efficacy of brief, economical interventions in enhancing the psychosocial impact of the youth sport environment.

Intensidad y dirección de la ansiedad competitiva y expectativas de resultados en atletas y nadadores

Abstract: This study describes the intensity and direction of pre-competitive somatic and cognitive state anxiety and self-confidence and relates them to expectations of results. A sample of 59 swimmers and track and field athletes completed the modified version (Jones and Swain, 1992) of the CSAI-2 prior to competing and recorded their predictions of the outcome of an event. Three different outcome expectancies groups were formed after comparing predicted performance with real performance. The studys descriptive results provided lower mean values in the intensity of anxiety than did previous studies on other types of sport and the correlation coefficient between the intensity and direction subscales was higher. Subjects who performed better in competitions than expected displayed less cognitive anxiety, less somatic anxiety and greater self-confidence and this group considered anxiety and self-confidence to be more facilitative than the other two groups did.

Pre-Competition Anxiety and In-Competition Coping in Experienced Male Swimmers:

Abstract: The purpose of the present study was to explore relationships between pre-competition anxiety and in-competition coping in swimmers. Thirty nine male swimmers with international competitive experience participated in the study (mean age 19.72 years; mean competitive experience 9.36 years). Participants completed a short measure of anxiety intensity and direction before the start of their event and a coping questionnaire after the completion of their event. Correlation analysis showed that intensity of cognitive anxiety had low to moderate negative correlations with approach coping strategies, and low to moderate positive relationships with avoidance coping strategies. Furthermore, somatic anxiety intensity had low to moderate positive relationships with avoidance strategies. Finally analysis of variance revealed that swimmers perceiving their anxiety states as facilitative reported more approach and less avoidance coping strategies than swimmers perceiving their anxiety states as debilitative. In accordan...

Prediction of Goal Orientation and Perceived Competence on Intensity and Direction of Precompetitive Anxiety among Adolescent Handball Players

Abstract: This study explored the main and interactive effects of goal orientations and perceived competence on intensity and direction of the symptoms of precompetitive cognitive and somatic anxiety. 109 handball players from 16 high school teams (M = 16.2 yr., SD = 1.5) participated. All were asked to complete the Task and Ego Orientation in Sport Questionnaire, Perceived Competence Questionnaire, and a modified version of the Competitive State Anxiety Inventory-2. Using separated multiple hierarchical regression analyses, direction of the symptoms of precompetitive somatic anxiety was predicted by perceived competence and interaction of ego orientation x perceived competence. Perceived competence and the interaction of ego orientation x task orientation x perceived competence were significant predictors of direction of the symptoms of precompetitive cognitive anxiety. The results suggest that perceptions of competence and task orientation moderate the relationship between ego orientation and direction of the symptoms of precompetitive anxiety.

Efficacy and tolerability of duloxetine treatment in elderly patients with major depressive disorder and concurrent anxiety symptoms.

Abstract: OBJECTIVE To compare the efficacy and tolerability of duloxetine 60mg/day versus placebo in treating elderly patients with major depressive disorder (MDD) and concurrent anxiety symptoms. METHODS Patients (>/=65) were randomized to eight weeks of treatment with duloxetine 60mg/day (n=207) or placebo (n=104). Anxiety measures were analyzed for all patients, by age ( /=75), and in patients having concurrent high anxiety (HAMD(17), item 10; Psychic Anxiety baseline score of 2, 3, or 4). Psychic Anxiety, Somatic Anxiety item 11, and the Anxiety/Somatization subscale were analyzed for all patients and subgroups by mean change from baseline to endpoint and repeated measures. Tolerability was assessed via treatment-emergent adverse events (TEAEs), and adverse events were reported as the reason for discontinuation. The analyses presented are primarily post hoc in nature. RESULTS Duloxetine produced significantly greater reductions than placebo in Psychic Anxiety (least-squares mean change: -0.62 vs. -0.18, p /=75 age groups for Psychic Anxiety, but only the <75 group for the Anxiety/Somatization subscale. Duloxetine-treated patients with high anxiety showed significant improvement compared with placebo-treated patients on Psychic Anxiety, Anxiety/Somatization subscale, the 17-item Hamilton Depression Rating Scale (HAMD(17)) total score, and several other measures. Duloxetine and placebo had similar TEAE rates and discontinuation rates due to adverse events. CONCLUSION Duloxetine (60mg/day) was efficacious and tolerable in elderly patients with MDD and concurrent anxiety symptoms.

Changes in some personality traits after recovery from alcohol dependence/abuse, anxiety and depression--results of a 5-year follow-up in a general population sample of women.

Abstract: The aim of this study was to analyse stability of and change in personality traits in a general population sample of women over 5 years. Specific questions were how personality traits changed after a first episode of alcohol dependence/abuse (ADA), anxiety or depression disorders and after remission of an episode. The study was based on data from a longitudinal general population-based survey titled, "Women and alcohol in Goteborg (WAG)". A total of 641 women were interviewed in 1990 or 1995 and re-interviewed after 5 years. Personality traits were assessed with the Karolinska Scales of Personality (KSP) and lifetime psychiatric diagnoses given according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd revised edition (DSM-III-R). Mean T-scores (KSP) for the general population sample were stable between initial assessment and follow-up 5 years later. Correlations between assessments were high for most KSP scores, indicating high individual stability. For women with resolved ADA, KSP scores were normalized to five scales at the follow-up assessment: somatic anxiety, muscular tension, monotony avoidance, social desirability and irritability. Women who recovered from anxiety disorders during the follow-up had decreased scores in somatic anxiety and muscular tension and increased scores in verbal aggression. Women who developed ADA during follow-up had increased scores on the scales impulsiveness and verbal aggression. Women who developed depression during follow-up had increased monotony avoidance. Personality traits were generally stable in this adult female population but some personality traits changed in association with changes in psychiatric disorders. This knowledge could be useful in evaluation of treatment needs and treatment outcome.

Competitive Anxiety in Lifesavers and Swimmers

Abstract: This study examined state and trait anxiety in competitive lifesavers and swimmers. The participants completed the SAS and the CSAI-2d before a training session and the CSAI-2d again before a competition. The competitive lifesavers were found to have lower levels of cognitive and somatic anxiety than competitive swimmers. Both groups were found to have lower levels of self-confidence but higher levels of somatic anxiety before a competition than before regular training sessions. Lifesavers found their levels of somatic anxiety to be more facilitative than the swimmers did. Both groups perceived that higher levels of self-confidence were more facilitative before competition than before training. Differences in the relationship between state and trait anxiety for swimmers and lifesavers were observed. The generally lower levels of cognitive and somatic state anxiety in lifesavers and their interpretation of somatic anxiety during competition would benefit their performance and decision making.

Residual anxiety symptoms in depressed primary care patients.

Abstract: Background The goal of this study was to characterize the burden of anxiety among residual depressive symptoms in naturalistic primary care settings. Methods A post-hoc analysis of a database comprised of naturalistically treated depressed patients across Canada was done. This bilingual (English and French), multi-center, randomized validation study was conducted in 47 primary care settings in four provinces of Canada. Patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text-Revision (DSM-IV-TR) criteria for a major depressive episode, in the context of a major depressive disorder (N=454) were enrolled. Eligible patients received open-label, flexible-dose antidepressant treatment. The analysis reported here was limited to patients whose depression severity was evaluated using the Hamilton Depression Rating Scale (HAMD-17) (n=205). Patients completing 8 weeks of open-label antidepressant treatment (n=157) were considered evaluable. As a proxy for anxiety symptoms, scores on 6 items from the HAMD-17 (psychological anxiety, somatic anxiety, gastrointestinal distress, fatigue, hypochondriasis, and insight into illness) were summed to arrive at a composite anxiety score, which was then used to calculate an anxiety ratio (with the composite anxiety score as the numerator and the total HAMD-17 score as the denominator). Results The composite anxiety ratio at baseline did not correlate with the probability of remitting at endpoint (p=0.534). After 8 weeks of antidepressant therapy, remitting patients evinced a statistically significant decrease in anxiety ratio (p=0.041). Moreover, an inverse correlation was noted between severity of anxious symptoms at endpoint and probability of remission (p=0.026). The burden of anxiety, presented as the anxiety ratio, was higher in non-remitting patients at endpoint (p=0.828). Conclusion Residual depressive symptoms represent ongoing illness activity in depression. Sharpening the focus of therapeutic interventions in the clinical environment calls for tracking and managing residual anxiety symptoms.

Measuring depressive symptoms in the naturalistic primary-care setting.

Abstract: Summary Background: The majority of individuals with major depressive disorder are diagnosed and treated in the primary-care setting. A quantifiable critical objective in the management of depression is to achieve and sustain full symptomatic remission. The HAMD-7 is a depression metric validated in both tertiary and primary-care settings. Methods: Herein, we further characterise the psychometric properties of the HAMD-7 in depressed patients treated in primary-care settings. Several cut-scores were evaluated for maximum agreement; diagnostic efficacy statistics with the original HAMD-7 items were also evaluated. We compared performance of the HAMD-7 in primary care to a previously characterised tertiary sample. Results: The depressive symptoms most frequently endorsed (≥ 70%) and most sensitive to change during antidepressant treatment in depressed primary-care patients were depressed mood, guilt, work and activities, psychic and somatic anxiety and fatigue. Limitations: This is a post hoc analysis of a primary-care database; assumptions regarding the definition of symptomatic remission in depression affect interpretation. Conclusion: Measurement-based care with the HAMD-7 quantifies the severity of commonly reported depressive items and their responsivity to treatment. The HAMD-7, inclusive of the suicide item, is capable of tracking symptom progress, with a validated remission cut-score.

Factorial structure of the Kuwait University Anxiety Scale in a large sample of college students: rejoinder.

Abstract: Recently a study by Lester of American college students found a different factor structure for the Kuwait University Anxiety Scale than studies with students from Arab countries. Thus, a large sample of college students (N=3064) was recruited from 10 Arab countries to examine the replicability of the factors previously extracted from the Kuwait University Anxiety Scale. Three factors, identified in the present sample, were compatible with those in the prior larger sample (N=9031). These were labeled Cognitive/Affective Anxiety, Subjective Anxiety or Nervousness, and Somatic Anxiety. The factorial pattern of the scale has been verified by both large samples.

Research Competitive Anxiety in Lifesavers and Swimmers

Abstract: This study examined state and trait anxiety in competitive lifesavers and swimmers. The participants completed the SAS and the CSAI-2d before a training session and the CSAI-2d again before a competition. The competitive lifesavers were found to have lower levels of cognitive and somatic anxiety than competitive swimmers. Both groups were found to have lower levels of self-confidence but higher levels of somatic anxiety before a competition than before regular training sessions. Lifesavers found their levels of somatic anxiety to be more facilitative than the swimmers did. Both groups perceived that higher levels of self-confidence were more facilitative before competition than before training. Differences in the relationship between state and trait anxiety for swimmers and lifesavers were observed. The generally lower levels of cognitive and somatic state anxiety in lifesavers and their interpretation of somatic anxiety during competition would benefit their performance and decision making.