For opioid-dependent individuals, recovery efforts begin with a period of withdrawal that typically include discomfort from symptoms, possibly precipitating a return to drug use. The study described here investigated whether the provision of ancillary medications for opioid withdrawal symptoms affects treatment outcomes in 139 participants receiving buprenorphine in a 13-day detoxification trial. Outcome measures include the number of opioid-free urine samples collected and retention in treatment. Ancillary medications were provided to 70% of participants: 59% received medication for insomnia, 45% for anxiety, 40% for bone pain, 35% for nausea, and 28% for diarrhea. Findings indicate no difference in the number of opioid-free urine samples between the group receiving ancillary medication and the group who did not, although tests of specific ancillary medications indicate that those who received diarrhea medication had fewer opioid-free urines than those who did not (p = 0.004). Results also indicate that participants attended fewer days of treatment if they received anxiety, nausea, or diarrhea medication compared to no medication (all p values < .05).

Dissociation is regarded as a possible psychological mechanism in nonepileptic seizures (NES), although existing evidence for this is equivocal. It has been suggested that the contradictory findings in this area reflect the use of measures that conflate qualitatively distinct types of dissociation, and provide inadequate coverage of the aspects of dissociation most closely related to NES. The study described here addressed this shortcoming by measuring the occurrence of two different types of dissociation, ''detachment" (measured using the Cambridge Depersonalisation Scale) and ''compartmentalization" (measured using the Somatoform Dissociation Questionnaire), in patients with NES (n = 32) and epilepsy controls (n = 37). As predicted, patients with NES scored significantly higher on the measure of compartmentalization only; contrary to prediction, however, this difference was no longer significant when anxiety and depression were controlled for. The conceptual and methodological implications of the study are discussed.

Caring for Caregivers The Need: With the growth of the aged population, more adults with chronic illnesses and conditions require assistance in going about their daily living. More than 80 percent of this assistance is provided by informal caregivers, primarily family members. Surveys by the North Carolina Division of Aging and Adult Services indicate that roughly a quarter of North Carolinians reported they had cared for a family member or friend age 60 or older during the past month. Caregiving often takes a physical, emotional and financial toll on caregivers. Studies have shown that caregivers can be helped by a variety of interventions, including information and case assistance, education for self-care, skills training and access to other community services such as respite care, support groups and flexible workplace options.

Bé né fice d'un programme cognitivo-comportemental et pluridisciplinaire de prise en charge de la maladie d'Alzheimer sur l'anxié té du conjoint : é tude française ELMMA Beneficial effect of a cognitive behavioral and multidisciplinary program in Alzheimer Disease on spouse caregiver anxiety: French study ELMMA

Some but not all models of obsessive–compulsive disorder (OCD) emphasize the role of dysfunctional beliefs in the etiology and maintenance of this disorder. Clinical observations suggest that some OCD patients have prominent dysfunctional beliefs associated with their obsessions and compulsions, while other patients do not show this pattern. It is possible that dysfunctional beliefs play a role in only a

Research in the fields of psychology and educational sciences shows that positive emotions foster creativity and motivate people to try new things, while they actively pursue health and well-being in the absence of negativity. The action tendencies produced by negative emotions, on the other hand, powerfully dispose a person to a specific action (Fredrickson 2013). For instance, due to pressure and negative emotions such as anxiety, shame, guilt, and disappointment, bilinguals may give up using their heritage language, which may lead to a language shift. In this chapter, I survey existing proposals on emotional levels in sociolinguistics and family language policy, paying particular attention to the lack of studies on the role of negative and positive emotions in the process of home language maintenance and/or shift. I also focus specifically on anxiety as a negative emotion in transnational contexts, and its causes and effects.

Objective There have been conflicting reports on the relationship between thyroid function and mood between studies in subjects on T4 and the general population not on T4. We investigated this relationship in a large catchment area-based study. Design We analysed data on serum TSH levels and Hospital Anxiety and Depression Scale (HADS) scores from the HUNT 2 study (age ‡ 40 years). Following a test for interaction, analyses were performed separately in females on T4 (n ¼ 1265) and in people not on T4 (males n ¼ 9319 and females n ¼ 17 694). Results More females on T4 had high depression and anxiety scores than females not on T4 (depression 18AE4% vs. 13AE0%, P < 0AE001, anxiety 23AE4% vs. 18AE7%, P < 0AE001). In those not on T4, there was an inverse association between serum TSH and depression score in males (B coefficient ¼ -0AE61, 95% CI -0AE91 to -0AE24, P ¼ 0AE001) though not in females (B coefficient ¼ -0AE07, -0AE33 to 0AE19), and an inverse association between TSH and anxiety score in both genders (B coefficient for males ¼ 0AE68, 95% CI -1AE04 to -0AE32, P < 0AE001; females -0AE37, 95% CI -0AE67 to -0AE08, P ¼ 0AE01). In contrast, in females on T4, TSH was positively associated with both depression (B coefficient ¼ +0AE27, 95% CI 0AE02 to 0AE51, P < 0AE05) and anxiety (B coefficient ¼ +0AE29, 95% CI 0AE01 to 0AE56, P < 0AE05). Conclusions There is a different relationship between thyroid function and depression and anxiety in females on T4 compared with individuals with no thyroid disease. This group also has a higher prevalence of depression and anxiety.

We conducted a 3-wave, longitudinal study to examine the role of ethnic collective self-esteem and United States (U.S.) collective self-esteem on anxious-depressed symptoms over time among Asian and Latino immigrant-origin adolescents (n ϭ 171). Growth curve analysis revealed that anxious-depressed symptoms first decreased between 10th and 11th grade and then increased over time for both groups. Additionally higher levels of ethnic collective self-esteem were associated with lower levels of anxiousdepressed symptoms only for Asian adolescents. There was a differing pattern for U.S. collective self-esteem such that for Latino adolescents, higher U.S. collective self-esteem was associated with higher anxious-depressed symptoms, whereas for Asian adolescents there was an inverse relationship with anxious-depressed symptoms. The results expand the literature on ethnic and U.S. collective self-esteem and their link to mental health. Implications of the findings for research in general, and for counseling immigrant youth and families in particular, are discussed.

This study was meant to investigate the psychometric properties and clinical utility of the Lehrer Woolfolk Anxiety Symptom Questionnaire (LWASQ), an instrument for assessment of somatic, behavioral and cognitive aspects of anxiety. Confirmatory factor analysis on data from social phobics (n = 108), normal adults (n = 103) and normal adolescents (n = 650) showed that the three original factors were strongly replicated in each sample. The three subscales appeared to have high internal consistency, while data on convergent and divergent validity were satisfactory. In addition, the subscales did very well in discriminating between phobic patients and normals, and were able to detect treatment effects. In the discussion the instrument is compared with other self report measures of anxiety dimensions, like the Cognitive Somatic Anxiety Questionnaire (CSAQ) and the Worry-Emotionality Scale (WES). It is suggested that similar questionnaires, adjusted to the separate anxiety disorders, should be developed.

Over the course of natural history, countless animal species have evolved adaptive behavioral systems to cope with dangerous situations and promote survival. Emotional memories are central to these defense systems because they are rapidly acquired and prepare organisms for future threat. Unfortunately, the persistence and intrusion of memories of fearful experiences are quite common and can lead to pathogenic conditions, such as anxiety and phobias. Over the course of the last 30 years, neuroscientists and psychologists alike have attempted to understand the mechanisms by which the brain encodes and maintains these aversive memories. Of equal interest, though, is the neurobiology of extinction memory formation as this may shape current therapeutic techniques. Here we review the extant literature on the neurobiology of fear and extinction memory formation, with a strong focus on the cellular and molecular mechanisms underlying these processes.

The present study investigates and evaluates "attitude characteristics" which affects consumer buying behaviour of male cosmetics products in Pune city. A questionnaire was developed and distributed to Pune male consumers aged 20 to 50 years by using convenience sampling technique. The total sample consists of 156 respondents. Data was analyzed by using factor analysis in SPSS version 17.0. The study provides evidence and an insight on various variables used for analysis and reveals that self-esteem, anxiety, self presentation and conformity have given more significance by Pune men for purchasing male cosmetics products.

Background: During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were registered in medical and psychotherapeutic practices, counseling centers, and clinics. According to previous stud- ies, younger people and women seemed to be particularly affected. The aim of this study was to describe mental health problems of students and to draw consequences for the fur- ther handling of pandemics and other crises. Method: Stu- dents at the University of Heidelberg, a typical German “full university,” were surveyed online using internationally com- parable screening instruments like the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ). In ad- dition, the students had the opportunity to describe in a nar- rative form their well-being and to make suggestions how to improve their situation. Results: Out of a population of 27,162 students who were contacted by email, 2,137 stu- dents completed the questionnaire. The salient finding is that according to the WHO-5 Well-Being Index, 72.2% of the
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respondents feel seriously impaired in their well-being. This corresponds to the finding that 75.8% of the respondents in the PHQ-D show indications of at least one syndrome diag- nosis. Depression was found in 41.8% of the respondents in the PHQ-D. Indications of moderate to severe and severe de- pressive syndromes were present in 31.8%. Signs of somato- form syndromes are found in 25.4% and of anxiety syn- dromes in 20.0%. 1,089 students gave narrative reports on how they were feeling and made suggestions for improve- ment. About 75% reported severely reduced well-being. Their main complaints were loneliness and depression and lack of recognition for their specific academic and life situa- tion during the pandemic. By far, the largest proportion of students supposed that their mental health issues were caused and/or intensified by the pandemic-related social contact restrictions. The vast majority of them made reason- able suggestions for controlled relaxation of contact restric- tions. Conclusions: Students suffer severely from the pan- demic-related social restriction. In respect to future pandem- ic outbreaks or other crises leading to social isolation, the dramatic consequences of social lockdowns should be taken into account. Under pandemic conditions, we especially should support persons lacking social networks.

Law firms seeking a competitive advantage in the marketplace would do well to consider that the positive psychological resources of firm lawyers are just as important to individual and organizational performance as their intellectual resources. There is growing evidence from the fields of positive psychology and positive organizational behavior that the resources of hope, optimism, self-efficacy and resilience shape the underlying attitudes and behaviors associated with increased performance. These resources may even buffer lawyers against the occupational hazards of the profession that cut against long-term success – hazards that include depression, anxiety, substance abuse and suicide. In this capstone I advocate for traditional law firm associate training programs to be enhanced to include the development of psychological capital (or “PsyCap”), a construct consisting of the components of hope, self-efficacy, resilience, and optimism. I discuss how policies that promote lawyer str...

There appear to be two forms of high self-esteem: secure high self-esteem (which is often linked with psychological health) and fragile high self-esteem (which is generally associated with poor psychological adjustment and impaired interpersonal relationships). Discrepant high self-esteem is a form of fragile self-esteem characterized by high explicit self-esteem and low implicit self-esteem. The present study examined whether discrepant high self-esteem was associated with narcissism and self-esteem instability in an undergraduate sample. Using multiple measures of implicit self-esteem, two basic findings emerged from the present study. First, participants with discrepant high self-esteem possessed the highest levels of narcissism. Second, participants with high explicit selfesteem and high implicit self-esteem displayed the most stable self-esteem. Findings are discussed in terms of secure and fragile high self-esteem.

The effect of adding a cognitive behavioral program to an intervention program in Positive Psychology was. For this purpose, 45 university students were measured by SWLS, PANAS, CES-D, BAI and HADS scales and assigned to one of two groups: a) intervention with positive psychology or b) intervention with more cognitive-behavioral positive psychology. Pre-post comparisons indicate that a Positive Psychology intervention significantly increases life satisfaction and positive affect and significantly decreases negative affect, depressive symptoms and anxiety symptoms (p < .05). Moreover, ANCOVA analysis show that the Cognitive-behavioral intervention does not contributed anything additional to the program of positive psychology in each of the variables measured (p > .05). In short, our findings suggest that it is possible to offer psychological assistance by providing tools from Positive Psychology that promote well-being and psychological health focusing on maximizing strengths within a small period intervention.

Sexual assault survivors with post-traumatic stress disorder (PTSD) were assessed for frequency of nightmares, measured retrospectively on the Nightmare Frequency Questionnaire (NFQ) and prospectively on nightmare dream logs (NLOG). Retrospective frequency was extremely high, averaging occurrences every other night and an estimated number of nightmares greater than ®ve per week. Test±retest reliability data on the NFQ yielded weighted kappa coef®cients of .85 (95% CI, .74±.95) for nights and .90 (95% CI, .83±.97) for nightmares. Correlations between retrospective and prospective nightmare frequencies ranged between .53 (P :001) for nights and .63 (P :001) for nightmares. Correlations between frequency and distress measures (anxiety, depression, post-traumatic stress) yielded coef®cients ranging from (r :28±.53). Compared with intrusive, cumbersome and time-consuming prospective measurements, the NFQ appears reliable, convenient, and equally useful in assessing nightmare frequency in a group of sexual assault survivors. Nightmare frequency, prevalence, distress and impairment are discussed. #

Despite the growing evidence that perfectionism is associated with adolescent psychological distress, few studies have investigated this relationship prospectively with measures designed for use in adolescent populations. In the present study, within a diathesis-stress framework, we investigated the extent to which perfectionism and acute life stress predict depression, anxiety and self-harm among adolescent school children (n ¼ 515) over a 6 month period (Time 1-Time 2). Socially prescribed perfectionism (SPP), self-oriented perfectionism-critical (SOP-critical) and the associated interactions with acute life stress differentially predicted anxiety, depression and self-harm. Acute life stress was an independent predictor of depression, anxiety and self-harm. SPP predicted depression and interacted with acute life stress to predict self-harm. SOP-critical and the SOP-critical by acute life stress interaction predicted anxiety. Self-oriented perfectionismstriving (SOP-striving) did not predict any of the Time 2 measures of distress. The dimensions of perfectionism are differentially associated with psychological distress. Tailored clinical interventions focused on adolescent perfectionism should offer promise in tackling psychological morbidity in adolescence.

Background: Violence against women has long been considered a hidden health burden. Questions about violence have not been included in health surveys; hence, little is known about prevalence and the consequences for health in the general population. No national study has been conducted in Norway. Aims: To estimate the prevalence of partner violence in Norway and the relationship between victimization and somatic health and depression and anxiety and post-traumatic stress symptoms. Methods: Data collection was performed by Statistics Norway. Among a random sample of women aged 20—55 years, 2,407 women returned the questionnaire (63.3%), of whom 2,143 were ever-partnered. Selected demographic characteristics were obtained from registers. Results: In total, 26.8% of 2,143 ever-partnered women had experienced any violence by their partner during their lifetime, and 5.5% in the year before the study. Low educational level, being unmarried, separated or divorced, currently being unemploye...

Deteriorative environmental conditions in environmental justice (EJ) communities not only post direct health risks such as chronic illnesses, but also cause emotional distress such as anxiety, fear, and anger among residents, which may further exacerbate health risks. This study applies a descriptive phenomenological method to explore and describe the emotional experience of residents living in Ironbound, a known EJ community located in Newark, New Jersey. Twenty-three residents participated in the study. Four essential themes regarding the residents' emotional experiences were elicited from 43 interviews: (1) being worried about the harmful effects of the surrounding pollution; (2) being distressed by the known historical pollution sources; (3) being frustrated by the unheard voices and/or lack of responses; and (4) being angered by the ongoing pollution sources. Participants not only expressed their emotions of worry, distress, frustration, and anger in detail but also described reasons or situations that provoked such negative emotions. Such detailed depictions provide insights into potential meaningful strategies to improve residents' psychological wellbeing by alleviating negative emotions and meaningfully engaging residents in developing, implementing, and enforcing environmental laws, regulations, and policies to achieve EJ goals.

Ethnopharmacological relevance: The essential oil (EO) from Cymbopogon citratus (DC) Stapf is reported to have a wide range of biological activities and is widely used in traditional medicine as an infusion or decoction. However, despite this widely use, there are few controlled studies confirming its biological activity in central nervous system. Materials and methods: The anxiolytic-like activity of the EO was investigated in light/dark box (LDB) and marble-burying test (MBT) and the antidepressant activity was investigated in forced-swimming test (FST) in mice. Flumazenil, a competitive antagonist of benzodiazepine binding and the selective 5-HT 1A receptor antagonist WAY100635 was used in experimental procedures to determine the action mechanism of EO. To exclude any false positive results in experimental procedures, mice were submitted to the rota-rod test. We also quantified some neurotransmitters at specific brain regions after EO oral acute treatment. Results: The present work found anxiolytic-like activity of the EO at the dose of 10 mg/kg in a LDB. Flumazenil, but not WAY100635, was able to reverse the effect of the EO in the LDB, indicating that the EO activity occurs via the GABA A receptor-benzodiazepine complex. Only at higher doses did the EO potentiate diethyl-ether-induced sleeping time in mice. In the FST and MBT, EO showed no effect. Finally, the increase in time spent in the light chamber, demonstrated by concomitant treatment with ineffective doses of diazepam (DZP) and the EO, revealed a synergistic effect of the two compounds. The lack of activity after long-term treatment in the LDB test might be related to tolerance induction, even in the DZP-treated group. Furthermore, there were no significant differences between groups after either acute or repeated treatments with the EO in the rota-rod test. Neurochemical evaluation showed no amendments in neurotransmitter levels evaluated in cortex, striatum, pons, and hypothalamus. Conclusions: The results corroborate the use of Cymbopogon citratus in folk medicine and suggest that the anxiolytic-like effect of its EO is mediated by the GABA A receptor-benzodiazepine complex.

We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national av...

Objectives Emotion regulation is an important transdiagnostic construct and one of the main and underlying dimensions in emotional disorders. This study aims to compare interpersonal and intrapersonal models of emotion regulation in explaining depression and anxiety symptoms in college students. Methods This is a cross-sectional study. Participants were 517 students of public universities in Tehran, Iran who were selected using multi-stage cluster sampling method. They completed the Emotion Regulation Questionnaire, Interpersonal Emotion Regulation Questionnaire, Difficulties in Emotion Regulation Scale, and short form of Symptom Checklist (SCL-25). Results Intrapersonal and interpersonal emotion regulation models had a significant role in explaining depression and anxiety symptoms, where the intrapersonal emotion regulation model had a significant and stronger effect in predicting depression and anxiety symptoms (P<0.01). Conclusion Both intrapersonal and interpersonal emotion regulation models have a role in explaining depression and anxiety symptoms and can be effective in predicting and treating emotional disorders.

Ultrasonic vocalization (USV) was found useful for differentiating fear and anxiety in rats. These affective states were established through a Pavlovian conditioning procedure. Danger stimulus, preceding unavoidable tail shock, elicited acute fear. Intertrial situational cues evoked anxiety. A safety signal (SS) indicating the omission of shock inhibited fear. Sustained 22-kHz USV characterized anxiety and was present between trials. A signal of danger resulted in immediate inhibition of vocalization, while a SS reversed this effect. These results are discussed in the context of three theories: Pavlovian, Bollesian and Konorskian. The anxiolytic drugs diazepam and buspirone (1 and 5 mg/kg) suppressed vocalization in the intertrial and SS periods. The reaction to the signal of danger remained complete inhibition of USV. Anxiogenic pentyletetrazole (1 and 5 mg/kg) enhanced intertrial vocalization, but did not affect its reoccurrence during the SS. Anxiogenic FG7142 (5 mg/kg) did not affect intertrial vocalization, but blocked its reappearance on the SS. It is suggested that the behavioral target of both anxiogenic drugs is different */pentyletetrazole supposedly exerts its anxiogenic effect by increasing situational anxiety, whereas FG7142 suppresses inhibition of fear.

Trabalho de pesquisa quantitativo realizado com 42 discentes de uma instituição pública de ensino superior, utilizando-se a técnica do Toque Terapêutico - Método Krieger-Kunz e aplicação de um questionário validado no Brasil para avaliar a ansiedade durante três sessões. Os sujeitos foram alocados em dois grupos: experimental (1), em que receberam a terapia complementar; e controle (2), em que foram submetidos a imitação da técnica sem intenção terapêutica. O objetivo foi identificar a influência gradativa desta terapia complementar de saúde no que se refere ao estado de ansiedade dos estudantes. A análise dos dados revelou uma redução estatisticamente significativa do estado de ansiedade em ambos os grupos, com pd&quot; 0,05.

Passive-Aggressive (Negativistic) Personality Disorder (NEGPD), listed in Appendix B of the DSM-IV, is not an officially recognized personality disorder. Its future as a discrete disorder is uncertain (Widiger, 2003). Yet, NEGPD occupies a role in some theoretical formulations of personality pathology (Millon & Davis, 1996), and many clinicians believe that passive-aggressive traits are not adequately represented by other PDs (Westen, 1997). In this study, 1158 psychiatric outpatients were assessed for Axis I and Axis II disorders. Thirty-five (3.02%) met criteria for NEGPD. Participants with NEGPD did not differ significantly from those without NEGPD on demographic variables. The internal consistency of the DSM-IV's seven NEGPD items was 0.50. Corrected itemtotal correlations for the 7 criteria averaged 0.27. Participants with NEGPD had higher rates of lifetime anxiety disorders, and almost 90% had an additional PD. An exploratory factor analysis suggested a twofactor solution that accounted for 43.4% of the variance. The first factor reflected the belief that life is unfair, while the second factor seemed to reflect modes of anger expression. A confirmatory factor analysis showed that the two-factor model fit the data better than a unidimensional model. We discuss implications of these results for the future of the NEGPD diagnosis. Passive-Aggressive (Negativistic) Personality Disorder (NEGPD) has a long history in the classification of mental disorders. In fact, descriptive features that typify the disorder have been depicted in significant detail by many prominent clinicians for nearly a century under a variety of headings (Millon & Radovanov, 1995).Years before World War II, clinical theorists portrayed diversely labeled "characters" and "dispositions" whose characteristics might now be classified under the passive-aggressive personality disorder designation (Millon, 1993).

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that affects both women and men. The aim of this study was to characterize and investigate the differences in terms of anxiety, depression, illness perception, and quality of life between female and male OSAS patients from a total of 111 patients (33 women and 78 men) who were recently diagnosed with OSAS in an outpatient clinic of a University Hospital in Portugal. They underwent a standardized protocol that included evaluation to assess of psychological morbidity (anxiety and depression -Hospital Anxiety and Depression Scale), illness representations (Brief Illness Perception Questionnaire), and quality of life (Sleep Apnea Quality of Life Index). The most significant differences between female and male OSAS patients result of apnea/hypopnea index (AHI), after controlling for body mass index (p 5 0.05); anxiety (p ¼ 0.000) and depression (p 5 0.005); consequences (p 5 0.005), identity (p ¼ 0.000), coherence (p 5 0.01), and emotional representation (p 5 0.005) of OSAS; and for daily functioning (p ¼ 0.000), emotional (p ¼ 0.001), and symptoms (p 5 0.05) domains of quality of life. Data suggest that women revealed more psychological morbidity associated with OSAS. Therefore, it seems extremely important to look at women as potential patients for sleep apnea and avoid looking up for a pattern of symptoms that rely on men as a norm to which women are compared.

Aim: Existing literature links poor sleep and anxiety symptoms in adolescents.This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness-based, multi-component group sleep intervention using sleep and anxiety as outcome measures.

Background: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ 2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.

We review data from our institution demonstrating the benefits of cardiac rehabilitation and exercise training on coronary risk factors, exercise capacity, behavioral characteristics, and quality of life in various subgroups of patients. In addition, we discuss our research in several other areas of preventive cardiology, including lipid disorders, hypertension, left ventricular hypertrophy, fish oils, and antioxidants. We believe that we are now in a very exciting era in which a multifactorial approach to the primary and secondary prevention of coronary artery disease is needed in order to further reduce morbidity and mortality rates.

The aim of our study was to examine psychosocial changes associated with participation in a camp for children with cardiac defects. We enrolled 29 children with cardiac defects aged from 8 to 18 years, along with their parents. Both the parents and the children completed measures of expectations for the camp and anxiety. Analyses of repeated measures indicated that levels of anxiety amongst the children decreased significantly at the end of camp when compared to its beginning. Levels of anxiety amongst the children were not statistically different at follow-up. Anxiety amongst the parents concerning the separation from their children also decreased at follow-up when compared to before the camp. Higher levels of anxiety reported by the children prior to the camp were associated with greater anxiety amongst the parents concerning the anticipated separation, more negative parental expectations of the camp, fewer experiences of separation from their children, and lower expectations by t...

Background: Existing studies suggest that music therapy can have favorable effects on hypertension and anxiety. We therefore set out to investigate the effect of Turkish classical music. Objectives: To investigate whether Turkish classical music has positive effects on blood pressures and anxiety levels in elderly patients. Design, setting and subjects: This was a randomized controlled trial performed on 60 hypertensive patients living in a local elderly home in Adana, Turkey. Methods: Following the completion of a socio-demographic form for each patient, Hamilton anxiety scale was applied. Thereafter, the subjects were randomly divided into two equal-size groups and were allowed to either listen to Turkish classical music (music therapy group) or have a resting period (control group) for 25 min. Outcome measures: The primary and secondary outcome measures were blood pressure and Hamilton anxiety scale scores, respectively. Results: The mean reduction in systolic blood pressure was 13.00 mmHg in the music therapy group and 6.50 mmHg in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 6.80-9.36). The median reductions in diastolic blood pressures were 10 mmHg both in the music therapy and control groups. The between treatment group difference was not statistically significant (Mann-Whitney U test, P = 0.839). The mean reduction in HAMA-A was 1.63 in the music therapy group and 0.77 in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 0.82-1.92). Conclusion: The study demonstrated that both Turkish classical music and resting alone have positive effects on blood pressure in patients with hypertension.

Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned. Methods. Psychometric properties of the HADS were assessed in six different groups of Dutch subjects (N l 6165) : (1) a random sample of younger adults (age 18-65 years) (N l 199) ; (2) a random sample of elderly subjects of 57 to 65 years of age (N l 1901) ; (3) a random sample of elderly subjects of 66 years or older (N l 3293) ; (4) a sample of consecutive general practice patients (N l 112) ; (5) a sample of consecutive general medical outpatients with unexplained somatic symptoms (N l 169) ; and (6) a sample of consecutive psychiatric outpatients (N l 491). Results. Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test-retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. Conclusions. The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a ' case-identifier ' for psychiatric disorder or depression.

Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well.

Understanding young adults&#39; anxiety requires applying a multidimensional approach to assess the psychosocial, behavioral, and cognitive aspects of this phenomenon. A hypothesized model of the relationships among coping style, thinking style, life satisfaction, social support, and selected demographics and anxiety among college students was tested using path analysis. A total of 257 undergraduate students aged 18-24 years completed an online survey. The independent variables were measured using the Multidimensional Scale of Perceived Social Support, the Brief Students&#39; Multidimensional Life Satisfaction Scale, the Brief COPE Inventory, the Positive Automatic Thoughts Questionnaire, and the Cognition Checklist-Anxiety. The outcome, anxiety, was measured using the Anxiety subscale of the 21-item Depression Anxiety and Stress Scale. Only negative thinking and maladaptive coping had a direct relationship with anxiety. Negative thinking was the strongest predictor of both maladapt...

DEPRESSION, SOCIAL ANXIETY, AND ATTACHMENT AS PREDICTORS OF THE USE AND QUALITY OF CYBER COMMUNICATION. Stefan E. LaTulip Old Dominion University, 2013 Director: Dr. Barbara Winstead This study examined the influence of depression symptoms, social anxiety symptoms, and adult attachment style on the use and the perceptions o f the quality of cyber communications with close friends, romantic partners, and family members. One hundred thirty-five individuals completed an initial survey, with sixty five o f the original group completing a follow-up survey five weeks later. Results indicated that anxious attachment was associated with a greater reported usage o f social networking sites, whereas avoidant attachment predicted less instant message use over time. Depression symptoms and avoidant attachment were generally associated with perceptions o f higher negativity and lower positivity with some of the target groups, where as social anxiety symptoms were generally associated with percep...

Plasma catecholamines and heart rate were determined in drug-free groups of anxious patients and normal controls before and 20 min after intramuscular injection of 0.01 mg/kg of 1/1000 diluted epinephrine. Levels of anxiety after the injection were determined via the State Anxiety Scale of State Trait Anxiety Inventory. Both groups showed substantial increases in plasma levels of epinephrine and norepinephrine and heart rate after the injection. However, there were no significant differences between anxious patients and controls on plasma catecholamines and heart rate before or after the injection and post injection levels of State Anxiety. The anxious subjects showed a significant correlation between post injection heart rate and State Anxiety.