A rating instrument for anxiety disorders.
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Adolescent↗
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Results for “Test Anxiety Scale”
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A randomised placebo-controlled trial of a self-help Internet-based intervention for test anxiety.
Test anxiety is widespread and associated with poor performance in academic examinations. The Internet, not well-proven for the treatment of anxiety, should be able to deliver highly accessible Cognitive Behavior Therapy (CBT). This study sought to test the hypothesis that CBT, available on the Internet, could reduce test anxiety. Ninety university students were randomly allocated to CBT or a control program, both on the Internet. Before and after treatment, the participants completed the Test Anxiety Inventory (TAI), an Anxiety Hierarchy Questionnaire (AHQ), the Exam Problem-Solving Inventory (EPSI), the General Self-Efficacy Scale (GSES) and the Heim reasoning tests (AH) as a measure of test performance. Of the CBT and control groups 28% and 35%, respectively, withdrew. According to the TAI, 53% of the CBT group showed a reliable and clinically significant improvement with treatment but only 29% of the control group exhibited such a change. On the AHQ, 67% of the CBT group and 36% of the control group showed a clinically significant improvement, more than two standard deviations above the mean of the baseline, a change in favour of CBT. Both groups improved on the GSES, in state anxiety during exams retrospectively assessed, and on the AH tests. The improvement on the AH tests was probably a practice effect and not a reflection of a change in capacity for academic testing. This study thus supports use of CBT on the Internet for the treatment of test anxiety.
Adult↗
Pharmacology of human experimental anxiety.
This review covers the effect of drugs affecting anxiety using four psychological procedures for inducing experimental anxiety applied to healthy volunteers and patients with anxiety disorders. The first is aversive conditioning of the skin conductance responses to tones. The second is simulated public speaking, which consists of speaking in front of a video camera, with anxiety being measured with psychometric scales. The third is the Stroop Color-Word test, in which words naming colors are painted in the same or in a different shade, the incongruence generating a cognitive conflict. The last test is a human version of a thoroughly studied animal model of anxiety, fear-potentiated startle, in which the eye-blink reflex to a loud noise is recorded. The evidence reviewed led to the conclusion that the aversive conditioning and potentiated startle tests are based on classical conditioning of anticipatory anxiety. Their sensitivity to benzodiazepine anxiolytics suggests that these models generate an emotional state related to generalized anxiety disorder. On the other hand, the increase in anxiety determined by simulated public speaking is resistant to benzodiazepines and sensitive to drugs affecting serotonergic neurotransmission. This pharmacological profile, together with epidemiological evidence indicating its widespread prevalence, suggests that the emotional state generated by public speaking represents a species-specific response that may be related to social phobia and panic disorder. Because of scant pharmacological data, the status of the Stroop Color-Word test remains uncertain. In spite of ethical and economic constraints, human experimental anxiety constitutes a valuable tool for the study of the pathophysiology of anxiety disorders.
Anti-Anxiety Agents↗
Frequency and characteristics of anxiety among patients with Alzheimer's disease and related dementias.
The purpose of this study was to assess the cross-sectional prevalence and characteristics of anxiety among patients with Alzheimer's disease (AD), as compared with patients with frontotemporal dementia (FTD), patients with vascular dementia (VaD), and normal control subjects. The authors used the anxiety subscale of the Neuropsychiatric Inventory (NPI), an instrument with established reliability and validity, to compare patients. Patients were identified in a query of the UCLA Alzheimer's Disease Center database and included 115 patients with probable AD, 43 patients with VaD, 33 patients with FTD, and 40 normal, elderly control subjects. Descriptive statistics were generated, and partial correlations, controlling for Mini-Mental State Examination (MMSE) score, were performed between the anxiety subscale and other behavioral features as measured by the NPI and the Functional Activities Questionnaire (FAQ). Relationships between cognitive status (as indicated by MMSE score) and anxiety were explored. Anxiety was reported more commonly in patients with VaD and FTD than in patients with AD. These differences remained significant (P<0.01) in an analysis of variance (ANOVA) after adjusting for age, age at onset, educational level, and MMSE score. In AD, anxiety was inversely related to MMSE score (i.e., worse with more severe dementia), was more prevalent among patients with a younger age at onset (under age 65), and correlated with disability as measured by the FAQ score. These data suggest that anxiety is common among patients with diverse forms of dementia. In AD, anxiety is most common in those with more severe cognitive deterioration and an earlier age at onset.
Age of Onset↗
Hamilton Anxiety Rating Scale Interview guide: joint interview and test-retest methods for interrater reliability.
The Hamilton Anxiety Rating Scale (HARS) is the most widely used semistructured assessment scale in treatment outcome studies of anxiety. Interrater reliability coefficients for the HARS have been previously reported. However, differences in the way clinicians assess symptom severity may reduce reliability. A structured interview guide--The Hamilton Anxiety Rating Scale Interview Guide (HARS-IG)--was developed to standardize clinical probe questions and to minimize interrater variance. Joint-interview and test-retest methods of interrater reliability assessment were used in a group of 30 inpatients. Intraclass coefficient calculations revealed improved interrater agreement with the HARS-IG versus the HARS. The findings of this study demonstrate that the HARS-IG is a more reliable assessment instrument than the semistructured HARS and that it meets established standards of reliability assessment.
Adult↗
Comparative studies on the effects of the combination drug lorazepam plus diphenhydramine (Somnium) versus lorazepam on the noopsyche, thymopsyche and psychophysiology in nonorganic insomnia related to generalized anxiety disorder.
In a double-blind, parallel-group design study on hypnotic and anxiolytic effects of the combination drug Somnium (lorazepam 1 mg + diphenhydramine 25 mg) (SOM) as compared with 1 mg lorazepam (LOR) alone, daytime behavioral effects were studied in 44 patients with nonorganic insomnia related to a mild generalized anxiety disorder. After a placebo run-in phase of 1 week, they received active treatment for 4 weeks. Psychometric evaluations included 6 thymopsychic variables (somatic complaints, state anxiety, trait anxiety, self-rating anxiety and depression scale and adjective mood scale), 6 noopsychic variables (general, associative, numerical and total verbal memory; correct reproductions and errors-Benton visual memory test), 4 pupillary measures (pupillary diameter, latency, relative change in % and half recovery time in pupillary response) and 6 skin conductance measures (baseline, latency, ascending time, time to peak, skin conductance response and skin conductance response maximum). Multivariate statistical analysis of the thymopsyche demonstrated significant improvement after both compounds, with the combination drug significantly superior to its single component lorazepam. Also regarding noopsychic measures, Somnium was significantly superior to the single component lorazepam, as specifically verbal memory was improved after Somnium, while opposite changes occurred after lorazepam alone. Pupillary measures revealed no significant overall inter-drug differences, whereas skin conductance findings demonstrated that the combination drug Somnium was superior to the single component lorazepam also in regard to the anxiolytic effect at the autonomic nervous system level.
Adult↗
The hospital anxiety and depression scale.
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Anxiety Disorders↗
Anxiety: the state-trait model and the interaction model.
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Anxiety↗
Facilitating and debilitating test anxiety among college students and volunteers for desensitization workshops.
Administered the Alpert-Haber Achievement Anxiety Test (AAT) to 54 students who expressed interest in participating in a test anxiety desensitization workshop. In addition, 182 students from the general college population were tested. Results indicated that both the debilitating and facilitating (AAT) scales were higher for the self-referred volunteer group. These data indicate that these scales are useful in distinguishing self-referred volunteers for behavior modification workshops from a general college population. In addition, the scales of the AAT were correlated with the number of sessions attended by those students who enrolled in the desensitization groups. Results indicated no relationship between attrition and debilitating anxiety. There was a correlation of r = .318 p less than .15 between facilitating anxiety scores and number of sessions attended. It is suggested that facilitating anxiety can function as a measure of S's ego strength in predicting workshop attendance.
Anxiety↗
The effects of relaxation instructions and EMG biofeedback on test anxiety, general anxiety, and locus of control.
Examined the applicability of EMG biofeedback to alleviating subjectively experienced test-taking anxiety along with the effects of relaxation training on locus of control. The Achievement Anxiety Test (AAT) was administered to 271 freshman psychology students. Students whose scores indicated high levels of test anxiety were invited to participate. Twenty-seven volunteers were assigned randomly to three groups. Biofeedback (B) Ss received relaxation instructions and EMG biofeedback. Instruction-Control (IC) Ss received instructions alone. A second control group (C) received no treatment. Pre and post measures included the AAT, the State-Trait Anxiety Inventory (STAI), and the Rotter Locus of Control (I-E) Scale. Relaxation training involved eight half-hour sessions, two per week for 4 weeks. B and IC Ss changed significantly from pre to post on the anxiety measures. This was true for specific test-taking anxiety and for general anxiety. C Ss showed no change. On the I-E scale, only IC Ss showed a significant shift toward being more internal.
Adult↗
[New modification of the anxiety scale].
The shortcomings of Hamilton's anxiety scale are reviewed as are those by other authors. An anxiety scale is offered, characterized by less subjectivity of assessment grades. The scale consists of three sections: psychic manifestations of anxiety, somatic manifestations of anxiety, and mental disorders attending anxiety or triggered by it. The validity of the scale offered is supported by a high ratio of correlation with Hamilton's scale.
Anxiety↗
Does maternal serum screening for Down syndrome induce anxiety in younger mothers?
INTRODUCTION: To assess anxiety levels in mothers with low-risk pregnancies before and after offering routine serum screening. METHODS: A prospective study was carried out at the Kandang Kerbau Women's and Children's Hospital in Singapore from February 2000 to August 2000. We used standard statistical analysis and Spielberger's state-trait anxiety inventory (STAI) which consists of 40 items to assess anxiety. Anxiety levels were assessed at several stages: before serum screening counselling, after counselling but before serum screening, before the routine 20-week obstetrical screening ultrasound scan, and after ultrasound scan results were acknowledged four to six weeks later. As the STAI questionnaire has only been validated for an English-speaking population, only English-speaking women were recruited for the study. The subjects included 111 women between 15 to 20 weeks gestation that were randomly selected (without any risk factors) for serum screening counselling. RESULTS: Anxiety levels did not decline significantly after counselling by a trained nurse-counsellor. They were highest prior to counselling and were significantly higher compared to all other times in which anxiety was assessed. Anxiety levels were lowest after the serum screening and routine 20-week screening ultrasound scan results were acknowledged. They were also significantly lower compared to all other times in which anxiety was assessed. CONCLUSION: Anxiety before serum screening was not abnormally high and routine serum screening offered by trained nurse counsellors did not significantly increase maternal anxiety in mothers with low risk pregnancies.
Adult↗
Stress, anxiety, and cognitive interference: reactions to tests.
The nature of test anxiety and its relationships to performance and cognitive interference are analyzed from the standpoint of attentional processes. A new instrument to assess dimensions of reactions to tests is presented, and its psychometric properties are described. The scales of the Reactions to Tests questionnaire (Worry, Tension, Test-Irrelevant Thinking, Bodily Symptoms) were compared with regard to intellective performance and cognitive interference. The results were consistent with the idea that the problem of anxiety is, to a significant extent, a problem of intrusive thoughts that interfere with task-focused thinking. In the last of the three studies reported, it was shown that self- preoccupying intrusive thinking can be reduced by means of a task-focusing experimental condition. The studies suggest that the Reactions to Tests questionnaire may be useful in defining anxiety more sharply and improving understanding of how it relates to performance.
Attention↗
Relative interference on Logical Memory I Story A versus Story B of the Wechsler Memory Scale-revised in a clinical sample.
Prior research found Logical Memory I Story A and Story B of the Wechsler Memory Scale-Revised to be equivalent in difficulty, with no effect of administration sequence. Following clinical impression of many patients "freezing" on Story A and recovering on Story B, it was hypothesized that the presence of performance or test anxiety contributed to this phenomenon. Logical Memory scores and concurrent Minnesota Multiphasic Personality Inventory (MMPI) data from 85 clinical cases were examined. Participants were divided into 3 groups based on performance on the Logical Memory I stories: A < B (67%), A = B (15%), A > B (18%). There were no significant differences on Logical Memory I performance related to medical or neuropsychiatric history, age, or education. In support of the hypothesis, those patients who showed poorer performance on Logical Memory I Story A than on Story B had significantly higher T scores on the MMPI Social Anxiety scale as compared to the A > B group. No other MMPI differences were found.
Adult↗
Psychosocial effects of community noise: cross sectional study of school children in urban center of Skopje, Macedonia.
AIM: To assess noise exposure in school children in urban center in different residential areas and to examine psychosocial effects of chronic noise exposure in school children, taking into account their socioeconomic status. METHODS: We measured community noise on specific measurement points in residential-administrative-market area and suburban residential area. We determined the average energy-equivalent sound level for 8 hours (LAeq, 8 h) or 16 hours (LAeq, 16 h) and compared measured noise levels with World Health Organization (WHO) guidelines. Psychological effects were examined in two groups of children: children exposed to noise level LAeq, 8 h >55 dBA (n=266) and children exposed to noise level LAeq, 8 h <55 dBA (n=263). The examinees were schoolchildren of 10-11 years of age. We used a self-reported questionnaire for each child - Anxiety test (General Anxiety Scale) and Attention Deficit Disorder Questionnaire intended for teachers to rate children's behavior. We used Mann Whitney U test and multiple regression for identifying the significance of differences between the two study groups. RESULTS: School children who lived and studied in the residential-administrative-market area were exposed to noise levels above WHO guidelines (55 dBA), and school children who lived and studied in the suburban residential area were exposed to noise levels below WHO guidelines. Children exposed to LAeq, 8 h >55 dBA had significantly decreased attention (Z=-2.16; p=0.031), decreased social adaptability (Z =-2.16; p=0.029), and increased opposing behavior in their relations to other people (Z=-3; p=0.001). We did not find any correlation between socioeconomic characteristics and development of psychosocial effects. CONCLUSION: School children exposed to elevated noise level had significantly decreased attention, and social adaptability, and increased opposing behavior in comparison with school children who were not exposed to elevated noise levels. Chronic noise exposure is associated with psychosocial effects in school children and should be taken as an important factor in assessing the psychological welfare of the children.
Child↗
Attenuation of the hypothalamic-pituitary-adrenal axis responsivity to the Trier Social Stress Test by the benzodiazepine alprazolam.
Little is known about effects of commonly used anxiolytic drugs on psychologically evoked responses of two major stress systems, the hypothalamic-pituitary-adrenal (HPA) and the sympathetic-adrenal-medullary (SAM) axis. The purpose of the present study was to assess effects of the anxiolytic alprazolam on responses of the HPA and the SAM axes to a standardized psychosocial stress protocol, the Trier Social Stress Test (TSST). Forty-six healthy, non-smoking, non-medicated males, aged between 18 and 45 years, were invited once to the laboratory and received a single oral dose of 1mg alprazolam or placebo, respectively, 1h prior to the TSST. The secretion of ACTH, cortisol, epinephrine, norepinephrine as well as changes in heart rate, blood pressure, and psychological states (anxiety, wakefulness, good mood, calmness) in response to the TSST were measured. Subjects pre-treated with alprazolam showed a strongly blunted response of ACTH as well as total and free cortisol to the TSST. Whereas alprazolam-treated subjects displayed significantly lower systolic blood pressure immediately before the TSST, neither the secretion of epinephrine, norepinephrine nor changes of heart rate in response to the stress test differed from placebo-treated subjects. Regarding psychological parameters, alprazolam clearly decreased subjective ratings on the questionnaire scale "wakefulness" and increased ratings on the scale "good mood", whereas ratings on scales assessing "state anxiety" or "agitation" were not affected. In healthy subjects, we observed a dissociation of the effects of alprazolam on the endocrine and the autonomic response to psychosocial stress. The psychological responses seemed to be masked by sedative properties of alprazolam.
Adolescent↗
[Construction of an anxiety scale and its validation].
The purpose of this paper is to construct a new anxiety scale and to test its validity. For this aim, two inquiries were carried out. First, a preliminary questionnaire was given to 370 undergraduates and the data was analyzed by the oblique promax rotation method of factor analysis. Based on this result, ten subscales, each consisting of ten items, were established. Then, the validity of the new anxiety scale was examined by administering it to 456 normal adults and 132 psychopathic outpatients. Using the new anxiety scale, we could distinguish 76.2-79.4% psychopathics from normal group. And discriminations of psychopathy types were 72.7-94.1% success. The reliability of new scale was also examined; its theta reliability coefficients ranged from .713 to .876 and its test-retest reliability coefficients with three-week time interval ranged from .756 to .904.
Adult↗
Using hypnotherapy to overcome examination anxiety.
Eleven medical practitioners who had previously failed their fellowship examinations sought assistance in combating the anxiety that they felt had been responsible for their lack of success. They were seen individually for two, 50-minute sessions of hypnotherapeutic training designed to engender an increased confidence in their ability to overcome examination anxiety. Two outcome measures were used: the actual examination result and a face-valid attitude scale, the Examination Anxiety Thermometer. On the first of these, 10 of the 11 practitioners recorded passes, whereas on the second, 9 indicated an attitude change toward lower levels of test anxiety. Attention is drawn to the minimal expenditure of time involved in the treatment and the generalizability of the hypnotherapeutic technique to other areas of the practitioners' lives.
Anxiety↗