Neuroendocrine Response to School Load in Prepubertal Children: Focus on Trait Anxiety

At the time of school-age, the most frequent stress stimuli are related to school environment and educational process. Anxiety may play a big role in coping with stressful situations associated with school load. To approach this issue, we performed a real-life study at school during the classwork. The sample consisted of 36 healthy children aged 10 years, which were divided to low and high trait anxiety group based on the median value of the anxiety score. The investigations were carried out in the classroom during a stress condition (final exams) and non-stress condition (without any exam). In the whole sample, the condition with exam was associated with higher cortisol and lower testosterone concentrations in saliva compared to the condition without exam. The activity of salivary alpha-amylase increased at the end of the exam. Anxious children showed higher concentrations of aldosterone and lower activity of alpha-amylase compared to children with low trait anxiety. Cortisol levels were higher in anxious children in the first morning samples before starting the lessons. Children with high and low trait anxiety did not differ in extraversion, neuroticism, as well as non-verbal intelligence and school success. Thus, the anxious children at school showed a more rapid decrease of anticipatory stress-induced cortisol concentrations, higher aldosterone levels, and lower alpha-amylase activities compared to non-anxious children. These changes, particularly high concentrations of aldosterone in children with high trait anxiety, may have an impact on their psychophysiological development.     

Level of anxiety and results of psychomotor tests in young soccer players of different performance levels

The aim of the current study is to determine how the level of state and trait anxiety differs between youth athletes of different performance levels and furthermore whether there are correlations between performance levels and psychomotor variables in the selected tasks. A sample of 97 boys, aged 11–12 years, practising soccer represented two groups: A – high performance level and B – lower performance level. Participants completed a state and trait anxiety inventory and performed selected psychomotor tests. The analyses demonstrated that the higher the levels of anxiety were, the shorter was the response time and more accurate were the responses in selected psychomotor tests. For the whole group, r = -0.224, p < 0.05, and for group B, r = -0.333, p < 0.05. Moreover, the findings showed a moderator effect of level (group A vs B) on reaction time, which was almost significant in state anxiety and significant in trait anxiety. For group B, trait anxiety was negatively related to reaction time (b = -0.002, SE = 0.001, t = -2.93, p = .004, 95% CI [-0.004, -0.001]). This means that the higher the trait anxiety was, the shorter was the reaction time in group B, but there was no significant effect in group A. The results of the study confirmed the negative correlation between the trait and state anxiety and reaction time. The higher the anxiety was, the shorter was the response time of child soccer players. Future research should determine whether athletes’ performance levels do affect performance under stress and replicate the study with different samples such as girls and different sport disciplines.     

Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose

There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale.

Design

Cross sectional study.

Participants and Controls

322 participants and 80 control participants.

Methods

State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality.

Main Outcome Measure

Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory.

Results

State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p<0.04), but similar for trait anxiety (p>0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls.

Conclusions

State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients.     

A tentative proposal on physiological polymorphism and its experimental approaches

The purpose of this paper is to propose a tentative concept of physiological polymorphism and experimental approaches to it. We think that the concept of physiological polymorphism is to categorize the diversified phenomena into various types with statistical methods and to explain the differences among the categorized types from the viewpoint of their physiological mechanisms. Furthermore, it is necessary to take into consideration the fact that physiological polymorphism is observed as a phenotype, and the phenotype results from a genotype modified by culture and environment. As an experimental approach, we studied the effects of gustatory stimulation by chocolate on the activities of the prefrontal area and found that the activities were increased in some cases and decreased in other cases. Therefore, to begin with, when we divided them into an "increasing group" and a "decreasing group," we found that the increasing group had many subjects of Type B and High anxiety, and the decreasing group had many subjects of Type A and Normal anxiety. By the chi-square test for independence, it was found that the ratio of "increase" and "decrease" was related to the trait anxiety and type A personality, respectively. Next, we divided the activities of the prefrontal area into Type A and Type B, as well as a high anxiety group and a low anxiety group. As a result, the Type B and high anxiety groups showed significantly increased activities, while the Type A and normal anxiety groups showed no changes in their activities. Consequently, this data enabled us to explain the difference in activities of the prefrontal area from the viewpoint of personality characteristics. To conclude, we were able to categorize diversified changes in the prefrontal area into certain types when a gustatory stimulus was applied, and to explain them by using personality characteristics (State Trait Anxiety Inventory, Type A behavioral pattern) that are commonly known for their reflection of genotypes.     

The relationships among trait anxiety, state anxiety and the goal performance of penalty shoot-out by university soccer players

The present study examined how the level of trait anxiety, which is a personality characteristic, influences state anxiety and penalty shoot-out performance under pressure by instruction. The high and low trait anxiety groups were selected by using Spielberger's Trait Anxiety Scale, with trait anxiety scores, and control and pressure conditions manipulated by instructions. The participants were two groups of eight university male soccer players. They individually performed 20 shots from the penalty shoot-out point, aiming at the top right and top left corner areas in the soccer goal. Each condition had 10 trials in a within-subject design. The dependent measures comprised the number of successful goals and the state anxiety scores under each instructional condition. The result showed a significant main effect of instruction. State anxiety scores increased more and the number of successful goals decreased more in high trait anxiety groups than in low trait anxiety groups under pressure instructional condition. These findings suggest that players with higher trait anxiety scores tend to experience increased state anxiety under a pressure-laden condition, and higher state anxiety interferes with goal performance.     

Fear Inhibition in High Trait Anxiety

Trait anxiety is recognized as an individual risk factor for the development of anxiety disorders but the neurobiological mechanisms remain unknown. Here we test whether trait anxiety is associated with impaired fear inhibition utilizing the AX+/BX- conditional discrimination procedure that allows for the independent evaluation of startle fear potentiation and inhibition of fear [1]. Sixty undergraduate students participated in the study - High Trait Anxious: n = 28 and Low Trait Anxious: n = 32. We replicated earlier findings that a transfer of conditioned inhibition for startle responses requires contingency awareness. However, contrary to the fear inhibition hypothesis, our data suggest that high trait anxious individuals show a normal fear inhibition of conditioned startle responding. Only at the cognitive level the high trait anxious individuals showed evidence for impaired inhibitory learning of the threat cue. Together with other findings where impaired fear inhibition was only observed in those PTSD patients who were either high on hyperarousal symptoms [2] or with current anxiety symptoms [3], we question whether impaired fear inhibition is a biomarker for the development of anxiety disorders.     

Trait anxiety affects the orofacial nociceptive response in rats

The aims of the present study were to assess the influence of: a) trait anxiety on orofacial pain; and b) orofacial pain on state anxiety. Forty-four rats were initially exposed to the free-exploratory paradigm for the evaluation of their anxiety profiles. In accordance to the parameter "Percentage of time in the novel side", the animals were considered as presenting high or low levels of trait anxiety when presenting values below the 1st quartile, or above the 3rd quartile, respectively. A week later, formalin-1.5% was injected into the upper lip of each animal. The behavioural nociceptive response, characterized by increased orofacial rubbing (OR), was quantified for 30 minutes, as follows: Total time OR (0-30 minutes: total pain), 1st phase OR (0-6 minutes: neurogenic pain), and 2nd phase OR (12-30 minutes: inflammatory pain). Immediately after this test, but still under the effect of formalin, the rats were submitted to the Elevated Plus-maze test (EPM). The results showed that the high trait anxiety individuals presented higher frequency of OR than the low trait anxiety ones, except during the neurogenic pain period. However, no correlation was found between OR frequency and levels of state anxiety presented on the EPM. In conclusion, the animals presenting higher anxiety profiles were the most susceptible to orofacial pain, nevertheless, orofacial pain did not influence state anxiety.     

Impaired Attentional Disengagement from Stimuli Matching the Contents of Working Memory in Social Anxiety

Although many cognitive models in anxiety propose that an impaired top-down control enhances the processing of task-irrelevant stimuli, few studies have paid attention to task-irrelevant stimuli under a cognitive load task. In the present study, we investigated the effects of the working memory load on attention to task-irrelevant stimuli in trait social anxiety. The results showed that as trait social anxiety increased, participants were unable to disengage from task-irrelevant stimuli identical to the memory cue under low and high working memory loads. Impaired attentional disengagement was positively correlated with trait social anxiety. This impaired attentional disengagement was related to trait social anxiety, but not state anxiety. Our findings suggest that socially anxious people have difficulty in disengaging attention from a task-irrelevant memory cue owing to an impaired top-down control under a working memory load.     

Influence of diet and physical exercise on plasma lipid concentrations in an homogeneous sample of young Spanish Air Force pilots

This study evaluates the influence of diet and physical exercise on plasma lipid concentrations — total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), and the TC:HDL-C ratio, in a homogeneous (age, sex and anxiety levels) group of young pilots divided into the following groups: A. uncontrolled diet and exercise programme; B. controlled diet and uncontrolled exercise programme; C. controlled diet and exercise programme (n=90). The dietary intake was a typical Mediterranean diet, which was supervised by the Flight Surgeon. The exercise was based on a physical training programme for pilots, directed by the Physical Training Officer. The State-Trait Anxiety Inventory test was performed to evaluate the anxiety levels. This test was supervised by a psychologist. The results showed a marked difference in all the lipid parameters studied between groups with an ad libitum diet versus groups with a controlled diet, this difference being demonstrated by TC and TG concentrations lower in the group with a controlled diet, than in the group with an ad libitum diet. A difference in HDL-C concentrations and TC :HDL-C ratio was found between groups with regular physical training (high HDL-C concentration and low TC:HDL-C ratio) versus groups with unlimited exercise (low HDL-C concentrations and high TC: HDL-C ratio). No differences in the state and trait of anxiety were found among any of the groups. Nevertheless, all the pilots showed a considerable increase in their anxiety state over their own anxiety trait.     

Psychological changes associated with self-regulatory treatments of irritable bowel syndrome

The psychological "side effects" of self-regulatory treatment (a combination of relaxation, thermal biofeedback, and cognitive therapy) for irritable bowel syndrome (IBS) were compared among 20 "successfully" treated patients, 12 "unsuccessfully" treated patients, and 9 patients who merely monitored symptoms for 12 weeks. Pretreatment and posttreatment scores on the Beck Depression Inventory, State-Trait Anxiety Inventory, and Psychosomatic Symptom Checklist were examined. "Successfully" treated patients had significant (p less than .01) reductions on all measures and significantly greater reductions on depression and state anxiety than the symptom monitoring group. Interestingly, the failures also showed a significant (p = .027) reduction in trait anxiety and no significant increases on other measures.     

Brain bioelectrical activity at a high anxiety level in humans

Brain bioelectrical activity was studied in 38 and 34 subjects with high and low levels of anxiety, respectively, by means of toposelective mapping of EEG spectral power and recording of P300 endogenous event-related auditory evoked potentials (EPs). Analysis of EEG spectra demonstrated, in the subjects with a high level of trait anxiety, a higher power of β₁ oscillations in the central-parietal areas of both hemispheres and the occipital area of the right hemisphere, as well as a higher power of θ and α oscillations in the frontal areas of both hemispheres and the central-parietal area of the left hemisphere. The occipital-frontal gradient of the spectral power of these rhythmic EEG components was altered in subjects with a high level of trait anxiety. Comparison of P300 cognitive auditory EPs in the subjects with high anxiety and in the control group showed that, in the former, the P300 EP amplitude and the habituation distortion (dishabituation) of the P300 EP amplitude were significantly higher in both hemispheres. This indicates that, at a high level of anxiety, the active directed attention was disturbed, which is confirmed by the results of neuropsychological examination, demonstrating reduced selectivity, concentration, and stability of attention in the Münsterberg test and Schulte’s test. The results of electrophysiological examination suggest that the malfunction of regulatory brain modulating systems is an important neurophysiological mechanism of attention pathology and disturbed adaptation in subjects with a high level of trait anxiety.     

The German Version of the Gaze Anxiety Rating Scale (GARS): Reliability and Validity

Objective

Fear of eye gaze and avoidance of eye contact are core features of social anxiety disorders (SAD). To measure self-reported fear and avoidance of eye gaze, the Gaze Anxiety Rating Scale (GARS) has been developed and validated in recent years in its English version. The main objectives of the present study were to psychometrically evaluate the German translation of the GARS concerning its reliability, factorial structure, and validity.

Methods

Three samples of participants were enrolled in the study. (1) A non-patient sample (n = 353) completed the GARS and a set of trait questionnaires to assess internal consistency, test-retest reliability, factorial structure, and concurrent and divergent validity. (2) A sample of patients with SAD (n = 33) was compared to a healthy control group (n = 30) regarding their scores on the GARS and the trait measures.

Results

The German GARS fear and avoidance scales exhibited excellent internal consistency and high stability over 2 and 4 months, as did the original version. The English version’s factorial structure was replicated, yielding two categories of situations: (1) everyday situations and (2) situations involving high evaluative threat. GARS fear and avoidance displayed convergent validity with trait measures of social anxiety and were markedly higher in patients with GSAD than in healthy controls. Fear and avoidance of eye contact in situations involving high levels of evaluative threat related more closely to social anxiety than to gaze anxiety in everyday situations.

Conclusions

The German version of the GARS has demonstrated reliability and validity similar to the original version, and is thus well suited to capture fear and avoidance of eye contact in different social situations as a valid self-report measure of social anxiety and related disorders in the social domain for use in both clinical practice and research.     

Sleep phenotyping in a mouse model of extreme trait anxiety

Background

There is accumulating evidence that anxiety impairs sleep. However, due to high sleep variability in anxiety disorders, it has been difficult to state particular changes in sleep parameters caused by anxiety. Sleep profiling in an animal model with extremely high vs. low levels of trait anxiety might serve to further define sleep patterns associated with this psychopathology.

Methodology/Principal Findings

Sleep-wake behavior in mouse lines with high (HAB), low (LAB) and normal (NAB) anxiety-related behaviors was monitored for 24 h during baseline and recovery after 6 h sleep deprivation (SD). The amounts of each vigilance state, sleep architecture, and EEG spectral variations were compared between the mouse lines. In comparison to NAB mice, HAB mice slept more and exhibited consistently increased delta power during non-rapid eye movement (NREM) sleep. Their sleep patterns were characterized by heavy fragmentation, reduced maintenance of wakefulness, and frequent intrusions of rapid eye movement (REM) sleep. In contrast, LAB mice showed a robust sleep-wake rhythm with remarkably prolonged sleep latency and a long, persistent period of wakefulness. In addition, the accumulation of delta power after SD was impaired in the LAB line, as compared to HAB mice.

Conclusions/Significance

Sleep-wake patterns were significantly different between HAB and LAB mice, indicating that the genetic predisposition to extremes in trait anxiety leaves a biological scar on sleep quality. The enhanced sleep demand observed in HAB mice, with a strong drive toward REM sleep, may resemble a unique phenotype reflecting not only elevated anxiety but also a depression-like attribute.     

The impact of anxiety-inducing distraction on cognitive performance: a combined brain imaging and personality investigation

Background

Previous investigations revealed that the impact of task-irrelevant emotional distraction on ongoing goal-oriented cognitive processing is linked to opposite patterns of activation in emotional and perceptual vs. cognitive control/executive brain regions. However, little is known about the role of individual variations in these responses. The present study investigated the effect of trait anxiety on the neural responses mediating the impact of transient anxiety-inducing task-irrelevant distraction on cognitive performance, and on the neural correlates of coping with such distraction. We investigated whether activity in the brain regions sensitive to emotional distraction would show dissociable patterns of co-variation with measures indexing individual variations in trait anxiety and cognitive performance.

Methodology/Principal Findings

Event-related fMRI data, recorded while healthy female participants performed a delayed-response working memory (WM) task with distraction, were investigated in conjunction with behavioural measures that assessed individual variations in both trait anxiety and WM performance. Consistent with increased sensitivity to emotional cues in high anxiety, specific perceptual areas (fusiform gyrus - FG) exhibited increased activity that was positively correlated with trait anxiety and negatively correlated with WM performance, whereas specific executive regions (right lateral prefrontal cortex - PFC) exhibited decreased activity that was negatively correlated with trait anxiety. The study also identified a role of the medial and left lateral PFC in coping with distraction, as opposed to reflecting a detrimental impact of emotional distraction.

Conclusions

These findings provide initial evidence concerning the neural mechanisms sensitive to individual variations in trait anxiety and WM performance, which dissociate the detrimental impact of emotion distraction and the engagement of mechanisms to cope with distracting emotions. Our study sheds light on the neural correlates of emotion-cognition interactions in normal behaviour, which has implications for understanding factors that may influence susceptibility to affective disorders, in general, and to anxiety disorders, in particular.     

Psychophysiological reactivity and personality traits of left- and right-handers during mental stress

The aim of the present study was to establish whether there is dependence of vascular reactivity to mental stress on the levels of neuroticism and anxiety in left- and right-handers. Thirty-two left-handed and 32 righthanded volunteers (16 males and 16 females in each group) between 18 and 30 years of age were studied. During mental stress both groups demonstrated a "standard" type of response, indicating an increase of the sympathetic-adrenal activity. In left-handers, however, the magnitude of the stress vascular reactivity was significantly higher (p<0.05) in comparison with that of right-handers. In left-handed females a moderate negative correlation between vascular reactivity and the levels of neuroticism (r = -0.39) and trait anxiety (r = -0.47, F = 4.04, p = 0.06) was established. In right-handed males a moderate positive correlation between neuroticism and vascular reactivity (r = 0.35) and significant positive correlation between trait anxiety and vascular reactivity (r = 0.60, F = 7.92, p = 0.01) was found. The results obtained show that vascular reactivity to mental stress is not influenced in a specific to left- and right-handers way by the levels of negative emotionality (neuroticism and trait anxiety).     

Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk

Previous studies have reported that trait anxiety (TA) affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA), medium TA (MTA) and low TA (LTA) groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT) that measures decision making under ambiguity and the Game of Dice Task (GDT) that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT.     

Pregnant Mothers with Resolved Anxiety Disorders and Their Offspring Have Reduced Heart Rate Variability: Implications for the Health of Children

Objective

Active anxiety disorders have lasting detrimental effects on pregnant mothers and their offspring but it is unknown if historical, non-active, maternal anxiety disorders have similar effects. Anxiety-related conditions, such as reduced autonomic cardiac control, indicated by reduced heart rate variability (HRV) could persist despite disorder resolution, with long-term health implications for mothers and children. The objective in this study is to test the hypotheses that pregnant mothers with a history of, but not current anxiety and their children have low HRV, predicting anxiety-like offspring temperaments.

Methods

The participants in this case-control study consist of 56 women during their first trimester and their offspring (15 male, 29 female). Women had a history of an anxiety disorder (n=22) or no psychopathology (n=34) determined using the Mini-International Neuropsychiatric Interview. The main outcome measures were indices of autonomic cardiac control including root mean square of successive differences (RMSSD) and high frequency (HF) variability. Children’s fearfulness was also assessed using the Laboratory Temperament Assessment Battery (Lab-TAB)-Locomotor Version.

Results

HRV was lower in women and children in the past anxiety group compared to controls. HRV measures for mothers and children were positively correlated in the anxiety group only. In all children, low HRV measures at 2-4 months were associated with a higher chance of fearful behavior at 9-10 months.

Conclusions

Pregnant women with previous but not current anxiety and their children have low HRV. Children with low HRV tend to show more fearfulness. These findings have implications for identifying children at risk of anxiety disorders and point to possible underlying mechanisms of child psychopathology.     

Impact of Working Memory Load on Cognitive Control in Trait Anxiety: An ERP Study

Whether trait anxiety is associated with a general impairment of cognitive control is a matter of debate. This study investigated whether and how experimentally manipulated working memory (WM) load modulates the relation between trait anxiety and cognitive control. This question was investigated using a dual-task design in combination with event-related potentials. Participants were required to remember either one (low WM load) or six letters (high WM load) while performing a flanker task. Our results showed that a high WM load disrupted participants'' ability to overcome distractor interference and this effect was exacerbated for the high trait-anxious (HTA) group. This exacerbation was reflected by larger interference effects (i.e., incongruent minus congruent) on reaction times (RTs) and N2 amplitudes for the HTA group than for the low trait-anxious group under high WM load. The two groups, however, did not differ in their ability to inhibit task-irrelevant distractors under low WM load, as indicated by both RTs and N2 amplitudes. These findings underscore the significance of WM-related cognitive demand in contributing to the presence (or absence) of a general cognitive control deficit in trait anxiety. Furthermore, our findings show that when limited WM resources are depleted by high WM load, HTA individuals exhibit less efficient recruitments of cognitive control required for the inhibition of distractors, therefore resulting in a greater degree of response conflict.     

Trait anxiety and neural efficiency of abstract reasoning: An fMRI investigation

Worries preoccupy the working memory capacity in anxious individuals, thereby affecting their performance during tasks that require efficient attention regulation. According to the attentional control theory (ACT), trait anxiety affects the processing efficiency, i.e. the effort required for task performance, more than the accuracy of task performance. We investigated the relation between trait anxiety and neural response for a reasoning task in healthy subjects. Functional magnetic resonance imaging (fMRI) was carried out on 22 healthy participants and blood oxygenation level dependent (BOLD) contrast estimates were extracted from a priori regions of interest (ROIs) that were earlier implicated in reasoning (i.e., bilaterally caudate head, globus pallidus, thalamus, prefrontal cortex [rostral, dorsal and ventral regions], inferior parietal lobule and middle occipital gyrus). Controlling for the effects of age, gender, state anxiety and depressive symptoms, for equivalent levels of task performance, trait anxiety of the participants was found to be associated with an increase in task related BOLD activation in right globus pallidus, left thalamus and left middle occipital gyrus. Our results suggest a reduced processing efficiency for reasoning in high trait anxiety subjects and provides important brain–behaviour relationships with respect to sub-clinical anxiety.