Psychometric properties of the Brazilian version of the Athlete Burnout Questionnaire (ABQ) in a sample of young and adult athletes

Abstract Aims: This study investigated the psychometric properties of the Brazilian version of the Athlete Burnout Questionnaire (ABQ). Methods: Participants were five hundred and nineteen young and adult athletes who responded to the ABQ and Competitive State Anxiety Inventory-2R. Data analysis was conducted through Confirmatory Factor Analysis (CFA), Cronbach's alpha, Composite reliability, average variance extracted, multigroup analysis, and Pearson's correlation (p<0.05). Results: The results of the CFA confirmed the structure with three dimensions (Physical and emotional exhaustion (PEE), reduced sense of sports accomplishment (RSSA), and sports devaluation (SD) [χ²/gl=2.92; CFI=.92; TLI=.91; RMSEA=.06]. Internal consistency was satisfactory (>.70). External validity revealed a positive correlation between PEE (r=.14) and RSSA (r=.23) with somatic anxiety and a positive correlation of PEE (r=.15), RSSA (r=.30), and SD (r=.14) with cognitive anxiety. Further, all dimensions of burnout had negative correlations with the self-confidence (r=.17-.23). In the factor invariance analysis, satisfactory data were found in the model's fit, establishing good factor loadings, variance/covariance, and residuals in both age groups (up to 18 years and over 18 years) and genders (men and women). Conclusion: It was concluded that the Brazilian version of the ABQ is satisfactory for the application of possible studies involving burnout syndrome in the Brazilian sports context in different group extracts.

Respuesta autonómica cardiovascular al estrés mental inducido por la prueba de cálculo aritmético / Autonomic cardiovascular response to mental stress induced by the arithmetic computation test

Introducción: El estrés mental agudo, así como los estados de ansiedad inducidos para influenciar la reactividad psicofisiológica en jóvenes sanos, aportan cambios en los patrones nerviosos que pueden ser medidos mediante la variabilidad de la frecuencia cardiaca. Objetivo: Determinar las diferencias en los parámetros lineales del balance autonómico cardiovascular en individuos jóvenes en estado basal y durante la prueba de cálculo aritmético. Métodos: Se realizó un estudio cuasi-experimental, sin grupo control de tipo antes y después, en el Laboratorio de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba. Población y muestra de 10 sujetos. Se registró el trazado electrocardiográfico (5 min) durante el reposo y luego durante la prueba de cálculo aritmético. Resultados: Existieron diferencias significativas entre ambos estados en las variables frecuencia cardiaca (p = 0,005); mínima (p = 0,007); máxima (p = 0,005); intervalo RR (p = 0,005); stress index (p = 0,028); índice simpático (p = 0,005); bajas frecuencias (p = 0,005); relación LF/HF (p = 0,005); RMSSD (p = 0,007); NN50 (p = 0,008); pNN50 (p = 0,005); índice parasimpático (p = 0,005) y altas frecuencias (p = 0,005). El estrés mental provocó una disminución parasimpática y un predominio simpático uniforme en todos los sujetos participantes en el estudio. Conclusiones: Durante el estrés mental inducido por la prueba de cálculo aritmético la dinámica lineal de la respuesta autonómica cardiovascular experimenta un aumento en la actividad simpática y una disminución del tono parasimpático, traduciendo una respuesta adaptativa en la regulación de la función cardiovascular por el sistema nervioso autónomo(AU)

Introduction: Acute mental stress and states of anxiety induced to influence psychophysiological reactivity in healthy young people, result in changes in nervous patterns which may be measured in terms of heart rate variability. Objective: Determine the differences in linear parameters for autonomic cardiovascular balance in young individuals at baseline and during the arithmetic computation test. Methods: A non-observational quasi-experimental before-after study without a control group was conducted at the Basic Biomedical Sciences Laboratory of the University of Medical Sciences of Santiago de Cuba. The study population and sample was 10 subjects. The electrocardiographic tracing (5 min) was recorded at rest and then during the arithmetic computation test. Results: Significant differences were found between the two states as to the variables heart rate (p = 0.005), minimum (p = 0.007), maximum (p = 0.005), RR interval (p = 0.005), stress index (p = 0.028), sympathetic index (p = 0.005), low frequencies (p = 0.005), LF/HF ratio (p = 0.005), RMSSD (p = 0.007), NN50 (p = 0.008), pNN50 (p = 0.005), parasympathetic index (p = 0.005) and high frequencies (p = 0.005). Mental stress caused a parasympathetic reduction and uniform sympathetic predominance in all the subjects participating in the study. Conclusions: During the mental stress induced by the arithmetic computation test, the linear dynamic of the autonomic cardiovascular response experiences an increase in sympathetic activity and a reduction in parasympathetic tone, displaying an adaptive response in cardiovascular function regulation by the autonomous nervous system(AU)

Instrumentos de avaliação da ansiedade da criança hospitalizada / Instrumentos de evaluación de ansiedad de niños hospitalizados / Anxiety assessment tools in hospitalized children

Resumo Objetivo Identificar na literatura os instrumentos existentes para a avaliação da ansiedade em crianças hospitalizadas. Métodos Trata-se de uma revisão integrativa. As buscas foram realizadas de janeiro a maio de 2017 nas seguintes bases de dados: PubMed, LILACS e CINAHL, com os descritores anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale e test anxiety scale. Resultados Após a seleção, foram analisados 33 artigos, sendo identificados dez instrumentos para a avaliação da ansiedade da criança. Oito instrumentos utilizaram a Escala de Likert nas respostas, um empregou a escala analógica de um a dez e o único instrumento que utilizou uma estratégia lúdica, o desenho dirigido, foi o Child Drawing: Hospital. Conclusão Recomenda-se a tradução, adaptação transcultural e validação do instrumento CD:H. Este estudo visa contribuir para o conhecimento dos enfermeiros pediatras no manejo da ansiedade da criança em unidades pediátricas, a fim de diminuir seu sofrimento emocional durante a hospitalização.

Resumen Objetivo Identificar en la literatura los instrumentos existentes para evaluar la ansiedad de niños hospitalizados. Métodos Se trata de una revisión integradora. Las búsquedas se realizaron de enero a mayo de 2017 en las siguientes bases de datos: PubMed, LILACS y CINAHL, con los descriptores anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale y test anxiety scale. Resultados Luego de realizar la selección, se analizaron 33 artículos, en los que se identificaron diez instrumentos para evaluar la ansiedad de niños. Ocho instrumentos utilizaron la escala de Likert en las respuestas, uno empleó la escala analógica de uno a diez y el único instrumento que utilizó una estrategia lúdica, el dibujo dirigido, fue el Child Drawing: Hospital. Conclusión Se recomienda la traducción, adaptación transcultural y validación del instrumento CH:H. Este estudio tiene el objetivo de contribuir para el conocimiento de los enfermeros pediatras en el manejo de la ansiedad de los niños en unidades pediátricas, a fin de reducir su sufrimiento emocional durante la hospitalización.

Abstract Objective Identify existing tools for the assessment of anxiety in hospitalized children in the literature. Methods An integrative review was undertaken. The searches took place from January to May 2017 in the following databases: PubMed, LILACS and CINAHL, using the descriptors anxiety, hospitalized child, inpatients, children, emotional responses, emotional manifestation, emotional reactions, validation studies, manifest anxiety scale and test anxiety scale. Results After the selection, 33 articles were analyzed, in which 10 child anxiety assessment tools were identified. Eight instruments used the Likert scale in the answers, one used the analogue scale from one to ten and the only instrument that used a playful strategy, directed drawing, was the Child Drawing: Hospital. Conclusion The translation, cross-cultural adaptation and validation of the CD:H is recommended. This study aims to contribute to pediatric nurses' knowledge in the management of child anxiety in pediatric wards, with a view to reducing their emotional suffering during hospitalization.

Evaluation of Child Anxiety Prior to Dental Care by Means of Modified Venham Picture Test, RMS Pictorial Scale and Facial Image Scale Tests

Abstract Objective: To evaluate child anxiety prior to dental care; to compare the results obtained by applying different anxiety tests and to assess whether anxiety is related to age or gender, and to identify which test children find to be more attractive and easier to understand. Material and Methods: The research was performed with 30 children of both genders and age group of 4-9 years distributed into Group 1 = children aged 4, 5 and 6 years and Group 2 = children aged 7, 8 and 9 years. Modified Venham Picture Test (VPT), RMS Pictorial Scale (RMS-PS) and Facial Image Scale (FIS) were the anxiety evaluation tests used. For statistical analysis, the Shapiro Wilk Normality test, Spearman correlation and the Independent Proportions test were used. Results: Modified VPT identified 70% anxiety-free children, RMS-PS 90%, and FIS 87%. RMS-PS and FIS scores had moderate correlation (51%). Regarding age groups, no significant difference was found between proportions of group 1 and group 2. According to gender, in 11 girls, the modified VPT test identified 3 (27%) with some anxiety degree; RMS-PS test identified 1 (9%) and FIS test 2 (18%). In 19 boys, modified VPT test identified 6 (32%) with some anxiety degree; RMS-PS test identified 2 (11%) and the FIS test 2 (11%). The test that was the easiest to understand was the modified VPT (54%) and regarding attractiveness, modified VPT and RMS-PS presented similar results, 40% each. Conclusion: All three tests were able to identify anxiety prior to dental care. The evaluation of results showed that the more the children could identify themselves with the test, the more they found it to be easy and attractive.

Effects of mindfulness-based stress reduction combined with music therapy on pain, anxiety, and sleep quality in patients with osteosarcoma

Objectives: To evaluate the effects of mindfulness-based stress reduction (MBSR) combined with music therapy (MT) on clinical symptoms in patients with osteosarcoma. Methods: Patients diagnosed with osteosarcoma were assessed for eligibility. A total of 101 patients were ultimately randomized into the intervention and control groups. Both groups received routine care. Eight sessions of MBSR and MT psychotherapy were conducted in the intervention group, while the control group received no psychological intervention. Patients were assessed regarding pain, anxiety, and sleep quality at two distinct stages: before and after the intervention. Results: There were no significant differences in sociodemographic and clinical parameters between the intervention and control groups at baseline. The intervention program significantly alleviated psychological and physiological complications in patients with osteosarcoma. Specifically, the study revealed that 8 weeks of the combined MBSR/MT intervention effectively reduced pain and anxiety scores and improved the quality of sleep in patients. Conclusion: MBSR combined with MT significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for patients with osteosarcoma.

Body dysmorphic disorder in patients attending a dermatology clinic in Nigeria: sociodemographic and clinical correlates

Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.

Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory / A informação no pré-operatório reduz a ansiedade pré-operatória em pacientes com câncer submetidos à cirurgia: utilidade do Inventário Beck de Ansiedade

Abstract Background and objectives: Preoperative instruction is known to significantly reduce patient anxiety before surgery. The present study aimed to investigate the effects of preoperative education on the level of anxiety of cancer patients undergoing surgery using the self-reported Beck anxiety inventory. Methods: This study is a short-term observational study, including 72 female patients with a diagnosis of endometrial cancer who were scheduled to undergo surgical treatment under general anesthesia. During the pre-anesthetic consultation 15 days before surgery, one group of patients (Group A, n = 36) was given comprehensive information about their scheduled anesthetic and surgical procedures, while the other group of patients (Group B, n = 36) did not receive any information pertaining to these variables. The Beck anxiety inventory, blood pressure and heart rate were evaluated before and after the preoperative education in Group A. In Group B, these parameters were evaluated at the beginning and at the end of the consultation. Results: The hemodynamic values were lower in the group that received preoperative education, in comparison with the group that did not receive preoperative education. Educating the patients about the procedure resulted in a reduction in the levels of anxiety from mild to minimum, whereas there was no change in the group that did not receive the preoperative education. This latter group kept the same level of anxiety up to the end of pre-anesthetic consultation. Conclusions: Patient orientation in the preoperative setting should be the standard of care to minimize patient anxiety prior to surgery, especially for patients with cancer.

Resumo: Justificativa e objetivos: A informação transmitida no pré-operatório é conhecida por reduzir de modo significativo a ansiedade do paciente antes da cirurgia. O presente estudo teve como objetivo investigar os efeitos da orientação pré-operatória sobre o nível de ansiedade de pacientes com câncer submetidos à cirurgia, utilizando o inventário Beck de ansiedade. Métodos: Estudo observacional de curto prazo, incluindo 72 pacientes do sexo feminino com diagnóstico de câncer endometrial, programadas para receber tratamento cirúrgico sob anestesia geral. Durante a consulta pré-anestésica, 15 dias antes da cirurgia, um grupo de pacientes (Grupo A, n = 36) recebeu informações abrangentes sobre seus procedimentos anestésicos e cirúrgicos, enquanto o outro grupo de pacientes (Grupo B, n = 36) não recebeu qualquer informação referente a essas variáveis. O inventário Beck de ansiedade, a pressão arterial e a frequência cardíaca foram avaliados antes e após a transmissão de informações ao Grupo A. No Grupo B, esses parâmetros foram avaliados no início e no final da consulta. Resultados: Os valores hemodinâmicos foram menores no grupo que recebeu informação pré-operatória, em comparação com o grupo que não recebeu informação pré-operatória. Informar os pacientes sobre o procedimento resultou em uma redução dos níveis de ansiedade de leve a mínimo, enquanto não houve mudança no grupo que não recebeu informação pré-operatória. Esse último grupo manteve o mesmo nível de ansiedade até o final da consulta pré-anestésica. Conclusões: A orientação do paciente no período pré-operatório deve ser o atendimento padrão para minimizar a ansiedade dos pacientes antes da cirurgia, especialmente os pacientes com câncer.

Doença inflamatória do intestino: impacto no score da qualidade de vida, depressão e ansiedade em pacientes atendidos em um centro de atendimento terciário no Brasil / Inflammatory bowel disease: impact on scores of quality of life, depression and anxiety in patients attending a tertiary care center in brazil

ABSTRACT BACKGROUND: Inflammatory bowel disease frequently affects patients at working age, compromising their quality of life in several levels: physical, psychological, familial and social. Few studies have evaluated the impact of Inflammatory bowel disease on quality of life, anxiety and depression in Brazilian patients. OBJECTIVE: Evaluate quality of life and its correlation with psychological aspects of patients with inflammatory bowel disease through the Inflammatory Bowel Disease Questionnaire and Hospital Anxiety and Depression Scale. METHODS: Cross-sectional study; Inflammatory Bowel Disease Questionnaire, Short Form-36 and Hospital Anxiety and Depression Scale were applied to consecutive outpatients in a tertiary referral center for inflammatory bowel disease. Harvey-Bradshaw Index and Truelove scores were used to evaluate Crohn's disease and ulcerative colitis activity. Sample calculation: 113 patients for a significance level of 5%, power of 90% and a correlation coefficient of at least 0.3 between scales. Statistical analysis: Student-t test, Pearson and Spearman correlations. RESULTS: One hundred twenty patients participated in the study; mean age: 41.7 years; female: 58.3%; Crohn's Disease: 69 patients. No low scores for quality of life were found across the four Inflammatory Bowel Disease Questionnaire domains; the Short Form-36 showed low scores in physical limitations (47.2±42.4) and emotional aspects (49.8±43.4); Hospital Anxiety and Depression Scale score presented a mean of 9.5±2.7 for anxiety and 8.7±2.0 for depression. Quality of life was decreased and Hospital Anxiety and Depression Scale did show increased indices of anxiety and depression, in both diseases only when clinically active. CONCLUSION: Inflammatory Bowel Disease Questionnaire and Hospital Anxiety and Depression Scale showed that outpatients of a tertiary care center for inflammatory bowel disease in Brazil presented good quality of life. The worst quality of life was associated with the intensity of the disease activity.

RESUMO CONTEXTO: A doença inflamatória do intestino afeta frequentemente os pacientes em idade de trabalho, comprometendo a qualidade de vida em vários níveis: físico, psicológico, familiar e social. Poucos estudos avaliaram o impacto da doença inflamatória do intestino na qualidade de vida, ansiedade e depressão em pacientes brasileiros. OBJETIVO: Avaliar a qualidade de vida e sua correlação com os aspectos psicológicos dos pacientes com doença inflamatória intestinal através do Questionário da Doença Inflamatória do Intestino e da Escala de Ansiedade e Depressão Hospitalar. MÉTODOS: Foi realizado um estudo transversal, com uma amostra de pacientes consecutivos, nos quais foram aplicados os questionários de perguntas fechadas sobre Qualidade de Vida através dos questionários: Inflammatory Bowel Disease Questionnaire, Short Form Health Survey 36; e ansiedade e depressão: Hospital Anxiety and Depression em suas versões validadas para a língua portuguesa praticada no Brasil. Foram aplicados em pacientes ambulatoriais consecutivos em um centro de referência terciária para doença inflamatória intestinal. Os índices Harvey-Bradshaw Index e Truelove foram utilizados para avaliar a doença de Crohn e a atividade da colite ulcerativa. Cálculo da amostra: 113 pacientes para um nível de significância de 5%, força de 90% e um coeficiente de correlação de pelo menos 0,3 entre as escalas. Análise estatística: teste Student-t, correlações Pearson e Spearman. RESULTADOS: Cento e vinte pacientes participaram do estudo; idade média: 41,7 anos; feminino: 58,3%; doença de Crohn: 69 pacientes. Não foram encontrados escores baixos para a qualidade de vida nos quatro domínios do questionário da Inflammatory Bowel Disease; O Short-Form-36 mostrou baixa pontuação em limitações físicas (47,2±42,4) e aspectos emocionais (49,8±43,4); O índice da escala Hospital Anxiety and Depression apresentou uma média de 9,5±2,7 para ansiedade e 8,7±2,0 para depressão. A qualidade de vida foi diminuída e a Hospital Anxiety and Depression mostrou índices aumentados de ansiedade e depressão, em ambas as doenças somente quando clinicamente ativo. CONCLUSÃO: O questionário da Inflammatory Bowel Disease e a Escala de Hospital Anxiety and Depression mostraram que os pacientes ambulatoriais de um centro de cuidados terciários para doença inflamatória do intestino no Brasil apresentaram boa qualidade de vida. A pior qualidade de vida foi associada à intensidade da atividade da doença.

Can the elite slalom kayaker's performance be correlated with anthropometric, nutritional, genetic, psychological as sleep traits?

Abstract AIMS The aims of this study were to investigate and characterize the anthropometric, nutritional, genetic, psychological and sleep variables of slalom kayakers, and to verify the correlation of these variables with the slalom kayakers' performance. METHODS Ten elite Brazilian team slalom kayakers participated of this study. Nutritional analysis was made by the Food Record (three days), 24 Hour Dietary Recall and Food Frequency Questionnaire. The ACE I/D, AGTMet235Thr, ACTN3R577X and BDKRB2+9/-9 were genotyped for genetic profile. The Profile of Mood States (POMS) and Sports Competition Anxiety Test (SCAT) were applied to investigate the psychological variables. The Pittsburgh Sleep Quality Index (PSQI), Epworth Sleep Scale (ESS) and Morningness-eveningness questionnaire (MEQ) were used for sleep traits analysis. Performance trials were performed on a white-water course with 24 gates, and finish time was considered as the variable related to performance. RESULTS Significant correlations were obtained between Performance Time Trial and %Fat (r=0.77), Energy (r=-0.75), Protein (r=-0.76), Carbohydrate (r=-0.72), Vitamin B6 (r=-0.87), Vitamin A (r=-0.82), Thiamine (r=-0.77), Riboflavin (r=-0.71), Magnesium (r=-0.86) and Phosphorus (r=-0.74) intake, besides the Fatigue mood domain (r=0.73) and the SCAT score (r=0.67). Athletes genotyped with the I, T, R and +9 alelle also presented better performances. CONCLUSIONSIn summary, the novel results provided by this study reinforce the necessity of considering several aspects during athlete development in order to achieve better performance in competitions.

Avaliação da sensibilidade da Escala Psicossocial de Aparência Facial na paralisia facial periférica / Evaluation of the sensitivity of the Psychosocial Scale of Facial Appearance in peripheral facial paralysis

RESUMO Objetivo Investigar a sensibilidade e consistência interna do instrumento a partir da comparação com os resultados dos instrumentos de avaliação funcional facial, escala de House-Brackmann (HBS) e Sistema de Graduação Facial, e implicações psicossociais a partir da aplicação da Escala Hospitalar de Ansiedade e Depressão (HADS). Método Pesquisa aprovada pelo comitê de ética em pesquisa, sob o protocolo nº. 196.977 e 230.982. A avaliação da sensibilidade do questionário foi realizada por meio de entrevistas fechadas em sujeitos adultos com PFP, sendo 38 selecionados para essa etapa. A análise estatística foi realizada para cada uma das etapas deste estudo, os dados foram digitados em Excel®, analisados pelos programas SPSS versão 17.0 para Windows e AMOS versão 22.0 para Windows®. Resultados Participaram 38 sujeitos, entre 19 e 78 anos, com predominância de paralisia idiopática (44,7%). Os resultados do Alfa de Cronbach mostraram uma consistência interna forte entre os grupos temáticos e as questões, no entanto a análise fatorial confirmatória alerta para questões cuja relação de causa entre os grupos temáticos foi fraca, como nos casos das questões 5 e 6 do grupo temático Aspectos Funcionais da Face, questão 17 dos Aspectos Sociais e questão 23 dos Aspectos Emocionais. Conclusão Essa pesquisa constituiu os primeiros passos para o subsídio e respaldo de um instrumento que investiga os aspectos psicossociais associados à PFP, sendo possível a elaboração de questões e ordenação em grupos temáticos. Porém, faz-se necessária a continuidade de estudos para a efetivação dos processos de validação.

ABSTRACT Purpose To investigate the sensitivity and internal consistency of the Psychosocial Scale of Facial Appearance (PSFA) based on the comparison between its results and those from other facial functional assessment instruments: House-Brackmann scale (HBS) and Facial Grading System - and the psychosocial implications measured by the Hospital Anxiety and Depression Scale (HADS). Methods The study was approved by the Research Ethics Committee of the aforementioned Institution under protocols no. 196.977 and 230.982. Thirty-eight adult individuals with Peripheral Facial Palsy (PFP) were submitted to closed interviews in order to evaluate the sensitivity of the questionnaire. Statistical analyses were conducted for each stage of this study. Data were entered in Excel® spreadsheet and analyzed using SPSS 17.0 and AMOS 22.0 for Windows®. Results Study participants were 38 individuals with PFP aged 19-78 years with predominance of idiopathic paralysis (44.7%). Results of the Cronbach's Alpha coefficient showed strong internal consistency between the thematic groups and the questions; however, Confirmatory Factor Analysis indicated some questions with week causal relationship between thematic groups, namely, questions 5 and 6 of the group Functional Aspects of Face, question 17 of the group Social Aspects, and question 23 of the group Emotional Aspects. Conclusion This study provided the first steps for the subsidy and support of an instrument designed to investigate the psychosocial aspects associated with PFP, enabling the preparation of questions and their organization into thematic groups. However, further studies are needed to conclude the validation processes.

Quality of life, depression, anxiety and coping strategies after heart transplantation

Abstract Introduction: Heart transplantation is the therapeutic procedure indicated to increase the survival of patients with refractory heart failure. Improvement in overall functioning and quality of life are expected factors in the postoperative period. Objective: To identify and evaluate mental disorders and symptoms, such as depression and anxiety, quality of life and coping strategies in the post-surgical situation of heart transplantation. Methods: A cross-sectional, quantitative study with patients who have undergone heart transplantation. Participants answered to the Sociodemographic Questionnaire, Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), MINI International Neuropsychiatric Interview, Escala Modos de Enfrentamento de Problemas (Ways of Coping Scale) (EMEP) and World Health Organization Quality of Life-BREF (WHOQOL-BREF). For data analysis, the significance level was considered P≤0.05. Results: A total of 33 patients participated in the study. The BDI-II results indicated that 91% (n=30) of the patients presented a minimal level. In BAI, 94% (n=31) of the patients demonstrated minimal level of anxiety symptoms. WHOQOL-BREF showed a perception of quality of life considered good in all domains. The EMEP data have registered a problem-focused coping strategy. According to MINI, a single case of major depressive episode, current and recurrent was recorded. Conclusion: Although most participants in the sample had symptoms of depression and anxiety, only one patient was identified with moderate symptoms in both domains. The most used strategy was coping focused on the problem. Patients have classified the perceptions of quality of life as 'good', pointing out satisfaction with their health.

Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders

Abstract The etiology of temporomandibular disorders (TMD), which are considered as a heterogeneous group of psychophysiological disturbances, remains a controversial issue in clinical dentistry. This study aimed to evaluate whether the salivary alpha-amylase (sAA), cortisol levels, and anxiety symptoms differ between children with and without TMD. Initially, 316 young subjects were screened in public schools (nonreferred sample); 76 subjects aged 7-14 years were selected and comprised the TMD and control groups with 38 subjects each matched by sex, age, and the presence/absence of sleep bruxism. Four saliva samples were collected: upon waking, 30 min and 1 h after awakening (fasting), and at night (at 8 PM) on 2 alternate days to examine the diurnal profiles of cortisol and sAA. Anxiety symptoms were screened using the Multidimensional Anxiety Scale for Children (MASC-Brazilian version). Shapiro-Wilk test, Student's t-test/Mann-Whitney U test, and correlation tests were used for data analysis. No significant differences were observed in the salivary cortisol area under the curve (AUCG mean ± SD = 90.22 ± 63.36 × 94.21 ± 63.13 µg/dL/min) and sAA AUCG (mean ± SD = 2544.52 ± 2142.00 × 2054.03 ± 1046.89 U/mL/min) between the TMD and control groups, respectively (p > 0.05); however, the clinical groups differed in social anxiety domain (t = 3.759; CI = 2.609, 8.496), separation/panic (t = 2.243; CI = 0.309, 5.217), physical symptoms (U = 433.500), and MASC total score (t = −3.527; CI = −23.062, −6.412), with a power of the test >80% and large effect size (d = 0.80), with no significant correlation between the MASC total score, cortisol, and sAA levels. Although children with TMD scored higher in anxiety symptoms, no difference was observed in the salivary stress biomarkers between children with and without TMD.

Anxiety before dental surgery under local anesthesia: reducing the items on state anxiety in the State-Trait Anxiety Inventory-form X

BACKGROUND: It is important to evaluate preoperative anxiety and prepare sedation when performing dental surgery under local anesthesia. Spielberger's State-Trait Anxiety Inventory (STAI) is useful for predicting preoperative anxiety. State anxiety is defined as a subjective feeling of nervousness. Reduction in the number of the state anxiety items (questions) will be clinically important in allowing us to predict anxiety more easily. METHODS: We analyzed the STAI responses from 1,252 patients who visited our institution to undergo dental surgery under local anesthesia. Multiple linear regression analysis was conducted for 9 groups comprising anxiety level determinations using the STAI; we then developed a coefficient of determination and a regression formula. We searched for a group satisfying the largest number of requirements for regression expression while setting any necessary conditions for accurately predicting anxiety before dental surgery under local anesthesia. RESULTS: The regression expression from the group determined as normal for preoperative state anxiety was deemed the most suitable for predicting preoperative anxiety. CONCLUSIONS: It was possible to reduce the number of items in the STAI by focusing on “Preoperative anxiety before dental surgery.”

Analysis of the Construct Validity and Internal Consistency of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) Scale for Pregnant Women during Labor / Análise da validade de constructo e consistência interna da escala de estado de ansiedade (E-Ansiedade) do inventário de ansiedade traço-estado (Idate) para gestantes em trabalho de parto

Abstract Purpose To analyze the internal consistency and the construct validity of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) scale for pregnant women during labor. Method A study of measurement property including 150 pregnant women aged between 15 and 45 years old, during the first period of labor and with term pregnancies. The questionnaire used was the STAI S-Anxiety scale. In order to assess the internal consistency, Cronbach’s α was calculated through an exploratory factor analysis. The correlation between the factors was calculated using the Pearson coefficient. The state of significance used for this analysis was 0.05. Results The STAI S-Anxiety scale used in the context of labor showed two factors represented as the absence (factor 1) and the presence of anxiety (factor 2); item 4 (“I regret it”) did not show a representative value. Both factors showed high indications of Cronbach’s α, varying from 0.830 for factor 1, and 0.723 for factor 2. In the results of the Pearson coefficient between the two factors, a significant but weak correlation was observed (r = -0.188; p = 0.021). Conclusion The STAI S-Anxiety scale used in pregnant women during labor presented appropriate values of internal consistency; however, item 3 did not show a significant factorial value. Therefore, this questionnaire must be applied cautiously and carefully without the use of the item 4 in the clinical practice and in researches about labor.

Resumo Objetivo Analisar a consistência interna e validade de constructo da escala de estado de ansiedade do Inventário de ansiedade traço-estado (Idate) para gestantes em trabalho de parto. Métodos Trata-se de um estudo de propriedades de medida incluindo 150 gestantes comidade entre 15 e 45 anos, no primeiro período de trabalho de parto e comgestação a termo. O questionário utilizado foi a escala estado de ansiedade do Idate. Para a avaliação da consistência interna, o alfa de Cronbach foi calculado por meio da análise fatorial exploratória. A correlação dos fatores foi realizada por correlação de Pearson. O nível de significância adotado para esta análise foi de 0,05. Resultados Verificou-se que a escala estado do Idate no contexto de parto apresenta dois fatores, representados como ausência (fator 1) e presença de ansiedade (fator 2); o item 4 (“Estou arrependida”) não apresentou valor representativo. Ambos os fatores apresentaram índices altos de alfa de Cronbach, variando entre 0,830 para o fator 1 e 0,723 para o fator 2. Nos resultados da correlação de Pearson entre os dois fatores, foi observada uma correlação significativa, porém fraca (r = -0,188; p = 0,021). Conclusões A escala de estado de ansiedade do Idate utilizada em gestantes durante o trabalho de parto apresentou valores de consistência interna adequados, porém o item 4 não apresentou valor fatorial representativo. Portanto, a utilização desse questionário na prática clínica e em pesquisas sobre o parto deve ser realizado sem a utilização do item 4 de maneira cautelosa e criteriosa.

A family-based association study of the HTR1B gene in eating disorders

Objective: To explore the association of three polymorphisms of the serotonin receptor 1Dβ gene (HTR1B) in the etiology of eating disorders and their relationship with clinical characteristics. Methods: We analyzed the G861C, A-161T, and A1180G polymorphisms of the HTR1B gene through a family-based association test (FBAT) in 245 nuclear families. The sample was stratified into anorexia nervosa (AN) spectrum and bulimia nervosa (BN) spectrum. In addition, we performed a quantitative FBAT analysis of anxiety severity, depression severity, and Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) in the AN and BN-spectrum groups. Results: FBAT analysis of the A-161T polymorphism found preferential transmission of allele A-161 in the overall sample. This association was stronger when the sample was stratified by spectrums, showing transmission disequilibrium between the A-161 allele and BN spectrum (z = 2.871, p = 0.004). Quantitative trait analysis showed an association between severity of anxiety symptoms and the C861 allele in AN-spectrum participants (z = 2.871, p = 0.004). We found no associations on analysis of depression severity or preoccupation and ritual scores in AN or BN-spectrum participants. Conclusions: Our preliminary findings suggest a role of the HTR1B gene in susceptibility to development of BN subtypes. Furthermore, this gene might have an impact on the severity of anxiety in AN-spectrum patients.

Manifestaciones somáticas en un grupo de adolescentes con ansiedad / Somatic manifestations in a group of adolescents with anxiety disorders

INTRODUCCIÓN: la ansiedad es el síntoma psiquiátrico más prevalente en la sociedad moderna, también en la infancia y adolescencia. OBJETIVO: caracterizar un grupo de adolescentes ansiosos, la intensidad de la ansiedad, las manifestaciones clínicas y las áreas de conflictos. MÉTODOS: se realizó un estudio descriptivo con técnicas cuanti-cualitativas en 30 adolescentes entre 11 y 16 años de edad, con ansiedad de más de 6 meses de evolución, seleccionado aleatoriamente, que dieron el consentimiento para ser incluidos en el estudio. Fueron atendidos por Psiquiatría Infantil del Hospital Pediátrico Universitario Centro Habana, entre enero y junio del año 2014. Las variables estudiadas fueron: edad, sexo, intensidad de la ansiedad, manifestaciones clínicas y áreas de conflictos. Se realizó historia social psiquiátrica, examen psiquiátrico, entrevista psicológica, test IDAREN y de Frases Incompletas de Rotter. RESULTADOS: 77 % tienen entre 11 y 14 años, 73 % es del sexo femenino, con nivel medio y alto para la ansiedad-estado (97 %) y ansiedad-rasgo del 83 %; predominaron las manifestaciones somáticas, como trastornos del sueño (83 %), hiperactividad-excitación (80 %), síntomas cardíacos (77 %), salto epigástrico (70 %), dolor abdominal (63 %) y sudoración (53 %); y las psicológicas, como inseguridad (70 %), sensación de amenaza (67 %), dificultad en la concentración y la memoria (63 %), sentimientos negativos (60 %) e irritabilidad (53 %). El 83 % tenía conflictos en área familiar, 70 % en las relaciones sociales, y 50 % en área escolar. CONCLUSIONES: predominan el sexo femenino, las edades entre 11 y 14 años, con niveles medio y alto para ansiedad-estado y ansiedad-rasgo, así como los síntomas somáticos de ansiedad y conflictos en el área familiar.

INTRODUCTION: anxiety is the most prevailing psychiatric symptom in the modern society and also in childhood and adolescence. Objective: to characterize a group of anxious adolescence, the intensity of anxiety, the clinical manifestations and the areas of conflict. METHODS: a descriptive study based on quantitative and qualitative techniques was performed in 30 adolescents aged 11 to 16 years, who presented anxiety disorders for over 6 months and randomly selected after giving their consent to be included in the study. These patients had been seen at the infantile psychiatry service of the university pediatric hospital Centro Habana from January to June 2014. The studied variables were: age, sex, intensity of anxiety, clinical manifestations and areas of conflicts. A psychiatric social history, psychiatric exam, psychological interview, IDAREN test and Rotter's incomplete phrase test were all applied. RESULTS: in the study group, 77 % were 11 to 14 years, 73 % were females, with middle and high level for anxiety-state (97 %) and anxiety-trait (83 %); somatic manifestations such as sleep disorders (83 %), hyperactivity-excitement (80 %), heart symptoms (77 %), epigastric_beat (70 %), stomachache (63 %), sweating (53 %), and psychological manifestations as insecurity (70 %), feeling of being threatened (67 %), difficult concentration and memorization (63 %), negative feelings (60 %) and irritability (53 %) predominated. Eighty three percent of them faced conflicts in their family setting, 70 % with their social relationships and 50 % at the school area. CONCLUSIONS: females, 11-14 years of age, middle and high levels for anxiety-state and anxiety-trait, somatic symptoms of anxiety and conflicts in the family setting are predominant.

Virtual reality exposure using three-dimensional images for the treatment of social phobia

Objective: To test a potential treatment for social phobia, which provides exposure to phobia-inducing situations via computer-generated, three-dimensional images, using an open clinical trial design. Methods: Twenty-one patients with a DSM-IV diagnosis of social phobia took part in the trial. Treatment consisted of up to 12 sessions of exposure to relevant images, each session lasting 50 minutes. Results: Improvements in social anxiety were seen in all scales and instruments used, including at follow-up 6 months after the end of treatment. The average number of sessions was seven, as the participants habituated rapidly to the process. Only one participant dropped out. Conclusion: This study provides evidence that exposure to computer-generated three-dimensional images is relatively inexpensive, leads to greater treatment adherence, and can reduce social anxiety. Further studies are needed to corroborate these findings.

Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic

Abstract This study evaluated the dental anxiety levels of preschool children at a kindergarten and at a dental clinic. The anxiety levels of ninety 4-6-year-old (4.99 ± 0.81) preschool children were evaluated according to pulse rates, the facial image scale (FIS), the Venham picture test (VPT), and the Frankl behavior rating scale. The children's mothers were asked to complete the state-trait anxiety inventory (STAI) forms 1 and 2 (STAI 2 and STAI 2). The sample t-test, Mann-Whitney U test, and Pearson's correlation test were used. A statistically significant difference was observed between the children's pulse rates when measured at the dental clinic and those when measured at the kindergarten (p < 0.001). Although the results were not statistically significant, more negative facial expressions were observed in the children at the dental clinic than in those at the kindergarten when assessed using FIS and VPT (p = 0.090 and p = 0.108, respectively). There was a statistically significant correlation between the transient anxiety levels (STAI 1) of mothers and the VPT scores of their children evaluated at the dental clinic (r = 0.506, p < 0.001). The continuous anxiety level of the mothers of males was found to be significantly higher (p = 0.033) than that of the mothers of females (STAI 2). Although the children had been informed about dentistry and were introduced to a dentist at the kindergarten, their anxiety levels seemingly increased as they arrived at the dental clinic. The significant increase observed in the children's pulse rates was a physical indicator that their anxiety levels had increased. It can be concluded that the children felt more anxious at the dental clinic that at the kindergarten.

Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women

Objective:To explore the relationship between individual and co-occurring childhood sexual, physical, and verbal abuse, prenatal depressive (PDS) and anxiety symptoms (PAS), and history of suicidal behavior (HSB) among Mexican pregnant women at risk of depression.Methods:A sample of 357 women screened for PDS was interviewed using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q), the Beck Depression Inventory (BDI-II), the anxiety subscale of the Hopkins Symptoms Checklist (SCL-90), and specific questions on verbal abuse and HSB.Results:Logistic regression analyses showed that women who had experienced childhood sexual abuse (CSA) were 2.60 times more likely to develop PDS, 2.58 times more likely to develop PAS, and 3.71 times more likely to have HSB. Childhood physical abuse (CPA) increased the risk of PAS (odds ratio [OR] = 2.51) and HSB (OR = 2.62), while childhood verbal abuse (CVA) increased PDS (OR = 1.92). Experiencing multiple abuses increased the risk of PDS (OR = 3.01), PAS (OR = 3.73), and HSB (OR = 13.73).Conclusions:Childhood sexual, physical, and verbal abuse, especially when they co-occur, have an impact on PDS and PAS and lifetime HSB. These findings suggest that pregnant women at risk for depression should also be screened for trauma as a risk factor for perinatal psychopathology.