Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

Background: Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

Methods: Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

Results: Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n?=?18) measured results showed a statistically significant improvement as compared to the control group (n?=?21) (time by treatment interaction): anxiety levels decreased (p?<?0.01), QoL and mood improved (p?<?0.05), while levels of pain and stress decreased (p?<?0.01).

Conclusions: Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.     

Attentional bias and anxiety in individuals with coronary heart disease

This study examined whether in an emotional Stroop task, individuals with coronary heart disease (CHD) would show greater attention towards the threatening words related to their disease than healthy persons, and if such an attentional bias is associated with anxiety. An emotional Stroop task with threatening words related to CHD as well as positive, negative and neutral words was administered to 35 individuals with CHD and 35 healthy controls. Additionally, the original Stroop task, the Beck anxiety inventory and the state-trait anxiety inventory were administered. The results indicated an attentional bias towards threatening words related to CHD in the individuals with CHD. They experienced higher interference than healthy participants from threatening words related to CHD but not from positive or negative words. Moreover, the level of interference was associated with their level of anxiety, and a vicious circle may exist in this association. In addition, results indicated a possible deficit of executive functioning among individuals with CHD. Attentional bias, as well as its association with anxiety, and an indication of deficit in executive functioning among individuals with CHD might be the risk factors for these individuals’ quality of life and for further development of their disease.     

Does sex moderate the relationship between anxiety and pain?

Objectives : Sex differences exist in the relationship between anxiety and pain, although findings are mixed. One reason could be because a number of anxiety measures have been used. Therefore, this study aimed to identify the core components within commonly used pain anxiety measures, and see whether these components are differentially related to sensation and pain thresholds in men and women.

Design, main outcome measures : One hundred and eighty-nine healthy adults (119 female) completed the Fear of Pain Questionnaire, Pain Catastrophising Scale, Pain Anxiety Symptoms Scale, Anxiety Sensitivity Index-3 and the Depression Anxiety Stress Scale. Thermal sensation and pain thresholds, mechanical sensation and pressure pain thresholds were also collected.

Results : A Principal Components Analysis of anxiety measures revealed three constructs: general distress, cognitive intrusion and fear of pain from injury/insult. Sex did not moderate the relationship between these anxiety constructs and sensation/pain thresholds. However, a significant main effect of sex was found to predict thermal pain thresholds.

Conclusion : Preliminary indications suggest that pain anxiety dimensions can be reduced to three core constructs, and used to examine pain sensation. However, sex did not moderate this relationship. Further research is required to establish the extent and strength of sex differences in the relationship between anxiety and pain.     

Predicting adolescent health complaints by personality and Behaviors

Abstract

In a sample of 97 male adolescents, individual differences in health complaints were predicted by personality traits and by self-reported health/risk behaviors. Anxiety and loneliness were measured at Times 1 and 2, and health locus of control, various behaviors and health complaints were assessed at the end of the two-year study. A causal model was specified, employing anxiety and loneliness as distal predictors, health locus of control and behaviors as proximal predictors of health complaints. It turned out that anxiety was the most powerful single predictor, and that loneliness exerted a direct effect on health locus of control and behaviors and an indirect effect on health complaints. Risk behavior as well as health behavior were related to complaints. Social integration facilitated not only health behavior but also risk behavior.     

Coping with dental treatment correlates of dispositional and domain specific monitoring and blunting

Abstract

Relations between coping style and several variables on an intermediary level were studied in a group of dentally anxious patients (N = 68) awaiting dental treatment. Monitoring was found to be positively related to the need of information: General dispositional monitoring was the best predictor of the need of information in case of more distant threat, whereas domain specific monitoring was the best predictor in case of imminent threat. Furthermore. dental trait anxiety was strongly related to early anticipatory tension, degree of anticipatory tension at several moments in time, and tension during treatment as perceived by the dentist, thereby overshadowing the weaker effects of coping style. Domain specific blunting was negatively related to desires for informational adaptations in the waiting room, and to question proneness as perceived by the dentist during treatment. It is concluded that, in order to study further effects of coping style, a sample homogeneous with respect to domain specific anxiety is needed.     

Sex differences in responding to rectal cancer symptoms

Many people who develop cancer symptoms wait inordinate amounts of time before seeking medical attention. Studies have found that symptom appraisal time–the time that passes before the individual concludes that their symptoms could be serious–accounts for most of the total delay time across subjects. It is thus important to understand the individual characteristics associated with slow recognition of dangerous symptoms. In this study, 62 patients (38 males) recently diagnosed with rectal cancer answered questions regarding the development of symptoms as well as their decisions and behaviors prior to seeking help. One subgroup of patients–males with the lowest scores on a measure of trait anxiety–took significantly longer to recognize the seriousness of their symptoms as compared to all other patients. This finding is discussed in the context of recent studies where the interaction of sex and negative affect is related to symptom reporting and other health-related behaviors.     

Cognitive processes in psychological adaptation to miscarriage: A preliminary report

Abstract

Twenty-two women who wished to continue their pregnancies were interviewed several months after their first miscarriage. Levels of anxiety and depression showed an extremely high degree of variability. Cognitive processes in the form of a search for meaning, mastery and self-enhancement hypothesised to be important in adaptation to negative events were assessed. Having an explanation for the miscarriage and the experience leading to a general reappraisal of values were associated with lower levels of intrusive thoughts. A belief in a medical cause was linked to lower anxiety. Women believed that neither they themselves nor their doctors could exert much influence over the outcome of future pregnancies. Stronger belief in personal control was associated with higher anxiety levels. There is a need to consider not only the emotional consequences of miscarriage but also the cognitive mediators influencing such responses and although based upon a small sample this study initiates that process.     

The effect of pre-treatment enquiries on child dental patient's post-treatment ratings of pain and anxiety

Abstract

The aim of this study was to attempt to replicate a study in adults: to determine whether pre-treatment enquiries about anxiety and pain in children, attending the dentist, influenced their subsequent reports of pain and anxiety immediately after treatment. One hundred and ninety five children aged from seven to 16, attending four Community Dental Clinics, were allocated at random to five groups. Before treatment the first group was asked questions about their dental anxiety, expectations and memories of pain. The second group was asked about dental anxiety and expectations of pain. The third group was asked only about dental anxiety; the fourth was asked only about pain. The fifth, the control group, was asked about none of these topics. All the children were asked after treatment to rate 1) their anxiety about dentistry and 2) their experience of pain in the treatment just completed. The children experienced less pain than they had expected. There were no differences between the groups in disruptiveness or in the amount of pain experienced. However, the children who were asked about both pain and dental anxiety (groups one and two) reported significantly less dental anxiety than the control group. These results are consistent with the conclusion that pre-treatment enquiries about both anxiety and pain have no effect on disruptiveness or the experience of pain but do reduce anxiety about dentistry.     

Coping variables as predictors of perioperative emotional states and adjustment

Abstract

Surgery, regardless of its kind and severity, can be regarded as a major stress situation for any patient. High preoperative emotional arousal may negatively influence adaptation during surgery and, consequently, rate of postoperative recovery. In a series of previous studies, our research group analyzed the influence of dispositional and actual coping on subjective and objective stress indicators before, during, and after surgery. The present study investigates the influence of the dispositional coping variables vigilance and cognitive avoidance on actual surgery-related coping, state anxiety, and indicators of intra- and postoperative adjustment. The sample consisted of 42 male and 42 female patients undergoing elective maxillofacial surgery under general anaesthesia. Dispositional coping was measured on the dimensions vigilance and cognitive avoidance with the Mainz Coping Inventory. Actual surgery-related coping was assessed by means of a newly constructed inventory containing items to measure the four dimensions avoidance, vigilance, positive restructuring, and seeking social support.

Self-reported state anxiety was differentiated according to the cognitive, affective, and somatic components. The patients' adaptation was assessed by measuring doses of the narcotic agents used for induction of anaesthesia, the intraoperative status, and the amount of postoperative (analgesic and psychotropic) medication. Significant effects of coping mode, gender, and time of measurement were observed on the cognitive, affective and somatic component of state anxiety, the indicators of intraoperative adaptation and on postoperative medication. Also, patients' actual coping behavior could partly be predicted by dispositional coping. Results indicate that actual coping behavior and gender should be taken into account when trying to predict adaptation and developing psychological preparatory intervention programs.     

The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

Objectives: To validate the Greek version of the State-Trait Anxiety Inventory (STAI) in a sample of cancer patients. Design: The scale was administered twice, with a 3-day interval, to 99 eligible patients with cancer. Together with the Greek version of STAI scale, the patients also completed the anxiety subscale from the Hospital Anxiety and Depression scale (HAD). Observations: Factor analysis yielded a three-factor solution, explaining 47.143% of the variance. Cronbach α for three scales was between 0.729 and 0.852. Inter-scale correlations were moderate-to-high and ranged from 0.282 to 0.563 (p < 0.0005, p < 0.005). The assessment of the relationships among the Greek STAI scales and HAD-Anxiety showed statistically significant correlations between them (r ranged between 0.428 and 0.596, p < 0.0005). The test/retest reliability of scale (Pearson's ‘r’), showed that the coefficient agreement ranged between 0.85 and 0.90 (p < 0.0005). Univariate analysis revealed significant correlations between female gender, metastasis, performance status, chemotherapy, mild opioids and low education level with increased anxiety. Conclusions: These results support that the Greek version of STAI is an instrument with satisfactory psychometric properties, and is a valid research tool for Greek cancer patients.