Exploring the relationship between anxiety, patient characteristics and pain outcomes in oral surgery under local anesthesia: The measurement problem.

BACKGROUND: Anxiety during oral surgery can impact patient homeostasis, increase the difficulty of the procedure and create additional stress for the surgeon. Furthermore, it has been associated with more intense and prolonged pain during and after dental treatment. OBJECTIVES: The aim of the study is to evaluate the relationship between anxiety, patient characteristics and pain outcomes in oral surgery, as well as to verify the impact of anxiety on patient's perception of pain during and after oral surgery. MATERIAL AND METHODS: This is a prospective observational study. Several variables were evaluated during the course of the oral surgery. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), the Interval Scale of Anxiety Response (ISAR), and Patient SelfRated Anxiety (PAnx) during the procedure. RESULTS: General anxiety measures (STAI) were not associated with specific dental anxiety or external observations of anxiety. Anxiety levels varied according to gender and body mass index (BMI), and were correlated with increased heart rate (HR) (with variability among assessment tools). Odontectomy, ostectomy and an increased volume of anesthesia were associated with higher anxiety levels (with variability among the assessment tools). There was a correlation between pain and anxiety, with anxiety contributing to approx. 12% of the variability in postoperative pain. CONCLUSIONS: Dental anxiety is a complex, multidimensional mental phenomenon characterized by high variability due to the influence of several dynamic factors.

Procrastinación y ansiedad rasgo en estudiantes universitarios / Procrastination and trait anxiety in college students / Procrastinação e ansiedade-traço em estudantes universitários

Muchos universitarios no logran completar sus tareas escolares en el tiempo designado y optan por aplazar su realización. Esta conducta puede producir ansiedad e influir en su desempeño y responsabilidad académica. Objetivo: Determinar si existe relación entre la procrastinación y la ansiedad rasgo en estudiantes de primer año de la carrera de psicología de la Universidad Privada Inca Garcilaso de la Vega, en Perú. Materiales y Métodos: La investigación se desarrolló bajo un enfoque cuantitativo, de tipo no experimental, transeccional y correlacional. La muestra estuvo conformada por los 47 educandos inscritos en este año académico de esta carrera. Se recolectó la información mediante el cuestionario sobre la escala de procrastinación académica de Solomon y Rothblum; así como el de Inventario de la Ansiedad Rasgo-Estado propuesto por Spielberger y Díaz. Resultados: El 63.8 % y el 48.9 % de los alumnos tienen nivel medio de procrastinación y ansiedad rasgo respectivamente. Además, se determinó una correlación positiva débil (r=,111) donde (p>0,05), lo cual no es estadísticamente significativa. Conclusiones: No existe relación entre la procrastinación y ansiedad rasgo en este grupo de alumnos.

Many university students are unable to complete their schoolwork in the designated time and choose to postpone doing it. This behavior can cause anxiety and influence their academic performance and responsibility. Objective: Determine if there is a relationship between procrastination and trait anxiety in first-year psychology students at the Inca Garcilaso de la Vega Private University, in Peru. Materials and Methods: The research was developed under a quantitative, non-experimental, transectional and correlational approach. The sample was made up of the 47 students enrolled in this academic year of this career. The information was collected using the Solomon and Rothblum academic procrastination scale questionnaire; as well as the State-Trait Anxiety Inventory proposed by Spielberger and Díaz. Results: 63.8% and 48.9% of the students have a medium level of procrastination and trait anxiety respectively. Furthermore, a weak positive correlation was determined (r=.111) where (p>0.05), which is not statistically significant. Conclusions: There is no relationship between procrastination and trait anxiety in this group of students.

Muitos estudantes universitários não conseguem concluir os trabalhos escolares no prazo designado e optam por adiá-los. Esse comportamento pode causar ansiedade e influenciar seu desempenho e responsabilidade acadêmica. Objetivo: Determinar se existe relação entre procrastinação e ansiedade-traço em estudantes do primeiro ano de psicologia da Universidade Privada Inca Garcilaso de la Vega, no Peru. Materiais e Métodos: A pesquisa foi desenvolvida sob abordagem quantitativa, não experimental, transecional e correlacional. A amostra foi constituída pelos 47 alunos matriculados neste ano letivo desta carreira. As informações foram coletadas por meio do questionário da escala de procrastinação acadêmica de Solomon e Rothblum; bem como o Inventário de Ansiedade Traço-Estado proposto por Spielberger e Díaz. Resultados: 63,8% e 48,9% dos estudantes apresentam nível médio de procrastinação e ansiedade-traço respectivamente. Além disso, foi determinada uma correlação positiva fraca (r=0,111) onde (p>0,05), o que não é estatisticamente significativo. Conclusões: Não existe relação entre procrastinação e ansiedade-traço neste grupo de estudantes.

Post-Traumatic Stress Disorder in Brazilian Pregnant Women at the Beginning of the Coronavirus Disease Pandemic.

OBJECTIVE: Analyze the presence of PTSD symptoms and their risk among the pregnant women during the COVID-19 pandemic. METHODS: This is a cross-sectional study of pregnant women that received receiving prenatal care at two university hospitals in São Paulo, Brazil, during the COVID-19 pandemic, from April to June 2020. The sociodemographic and health data of the participants and their exposure to individuals suspected or confirmed to have COVID-19 were evaluated. The Impact of Event Scale-Revised and the State-Trait Anxiety Inventory were used to assess PTSD and anxiety symptoms, respectively. RESULTS: A total of 149 pregnant women were included in this study. The risk of PTSD among the participants was 55.1%. The independent risk factors for PTSD were state anxiety (ORadj = 2.6), trait anxiety (ORadj = 10.7), changes in routine due to the pandemic (ORadj = 4.7) and contact with a confirmed case of COVID-19 person (ORadj = 7.1). CONCLUSIONS: The COVID-19 pandemic had a significant negative impact on the mental health of pregnant women, more than half of the participants of the present study showed a risk of PTSD, exacerbated by anxiety symptoms and exposure to individuals with a confirmed case of COVID-19.

An animal model of trait anxiety: Carioca high freezing rats as a model of generalized anxiety disorder.

Despite being one of the main components of anxiety and playing a pivotal role in how an individual perceives and copes with anxiogenic situations or responds to a given treatment, trait anxiety is paradoxically omitted in most animal models of anxiety. This is problematic and particularly more concerning in models that are used to screen drugs and other treatments for specific anxiety disorders and to investigate their neurobiological mechanisms. Our group has been engaged in the search for specific anxiety-related traits in animal models of anxiety. We developed two new lines of rats with strong phenotypic divergence for high (Carioca High-conditioned Freezing [CHF]) and low (Carioca Low-conditioned Freezing [CLF]) trait anxiety as expressed in the contextual fear conditioning paradigm. Here, we summarize key behavioral, pharmacological, physiological, and neurobiological differences in one these lines, the CHF rat line, relative to randomized-cross controls and discuss how far they represent a valid and reliable animal model of generalized anxiety disorder and so high trait anxiety.

Increased hippocampal CREB phosphorylation after retrieval of remote contextual fear memories in Carioca high-conditioned freezing rats.

The participation of the hippocampal formation in consolidation and reconsolidation of contextual fear memories has been widely recognized and known to be dependent on the activation of the cAMP response element (CRE) binding protein (CREB) pathway. Recent findings have challenged the prevailing view that over time contextual fear memories migrate to neocortical circuits and no longer require the hippocampus for retrieval of remote fearful memories. It has also recently been found that this brain structure is important for the maintenance and recall of remote fear memories associated with aversive events, a common trait in stress-related disorders such as generalized anxiety disorder (GAD), major depression, and post-traumatic stress disorder. In view of these findings, here we examined the putative role of CREB in the hippocampus of an animal model of GAD during the retrieval of remote contextual fear memories. Specifically, we evaluated CREB phosphorylation in the hippocampus of male Carioca High- and Low-conditioned Freezing rats (CHF and CLF, respectively) upon re-exposure of animals to contextual cues associated to footshocks weeks after fear conditioning. Age-matched male rats from a randomized crossbreeding population served as controls (CTL). Adrenal catecholamine levels were also measured as a biological marker of stress response. Seven weeks after contextual fear conditioning, half of the sample of CHF (n = 9), CLF (n = 10) and CTL (n = 10) rats were randomly assigned to return to the same context chamber where footshocks were previously administrated (Context condition), while the remaining animals were individually placed in standard housing cages (Control condition). Western blot results indicated that pCREB levels were significantly increased in the hippocampus of CHF rats for both Context and Control conditions when compared to the other experimental groups. CHF rats in the Context condition also exhibited significant more freezing than that observed for both CLF and CTL rats. Lastly, CHF animals in the Context condition displayed significantly higher adrenal catecholamine levels than those in the Control condition, whereas no differences in catecholamine levels were observed between Context and Control conditions for CLF and CTL rats. These findings are discussed from a perspective in which the hippocampus plays a role in the maintenance and recall of remote contextual fear memories via the CREB pathway.

Decision-making styles during stressful scenarios: The role of anxiety in COVID-19 pandemic.

Introduction: Decision-making is not purely rational but highlighted by the influence of intuitive and emotional processes. Recently, researchers have focused more attention on understanding which environmental and personal features influence decision-making processes, and how. Objective and methods: On this study, we investigate whether Trait Anxiety moderates the impact of Post-Traumatic Stress (PTS) symptoms reported during COVID-19 pandemic on decision-making styles. Results: The study included 1,358 Brazilian participants (80% women) aged between 20 and 74 (M = 41.11; SD = 11.23) who responded to an online survey between May and August of the year 2021 of COVID-19 pandemic to The State-Trait Anxiety Inventory, The Decisions Styles Scale, The Impact of Event Scale - Revised and questions related to COVID-19. Through moderation analysis, we observed that experiencing PTS is associated with a higher tendency to biased/heuristic decision-making processes. Discussion: Trait Anxiety seems to influence how people respond to PTS symptoms on decision-making related processes. Subjects with higher Trait Anxiety reported lower tendency to appeal to rationality, especially under higher reported levels of PTS. Meanwhile, lower Trait Anxiety subjects exhibited more reason-based decision-making under higher rates of PTS. This work contributes to a deeper understanding of the interplay among environmental and individual differences on decision-making styles and helps to identify factors of vulnerability for poorer cognitive functioning on stressful scenarios.

High trait anxiety in mice is associated with impaired extinction in the contextual fear conditioning paradigm.

Trait anxiety is a form of chronic state anxiety that can be part of the individual's personality and one of the individual factors that increase the risk of developing PTSD. To be able to distinguish between trait and state anxiety in animal models might be challenging, since the tests themselves are often anxiogenic. One possible approach is the use of the free exploratory paradigm (FEP), a model that consists of providing the animal the choice to explore both a familiar and a novel environment. High trait anxiety animals choose to explore more the familiar environment. Thus, the objective of this study was to evaluate if differences in trait anxiety could lead to impairments in acquisition and extinction of fear memory in a contextual fear conditioning protocol. First, Swiss mice were divided into high trait anxiety (HTA) or low trait anxiety (LTA) based on their exploration of the novel environment (%TNS) in the FEP. We observed that the %TNS was stable across three testing sessions. Also, we observed that freezing behavior was not different between HTA and LTA mice in a retrieval session 1 day after the conditioning, which indicates that acquisition was not impaired. However, HTA presented higher freezing time during extinction training and test. Also, HTA presented higher freezing in reinstatement test, but this might be related to the poor extinction learning. Moreover, diazepam (0.25 or 1.0 mg/kg, i.p.) did not prevent the differences in extinction training and test when administer 30 min before conditioning training or 30 min before extinction training, even though diazepam (1.0 mg/kg) had anxiolytic effect in the elevated plus-maze. These results demonstrate that HTA mice presented increase in freezing during extinction training and test, as well as during reinstatement. These results indicate that increased freezing time in HTA mice is not explained by high state anxiety in a specific phase of the fear conditioning, but more likely, the overall high trait anxiety throughout the entire experiment.

The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study.

OBJECTIVE: The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. MATERIAL AND METHODS: A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah's Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. CONCLUSIONS: The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.

Evidencias psicométricas del inventario ansiedad estado-rasgo: IDARE en universitarios de Lima en tiempos de COVID-19 / Psychometric evidence of the state-Trait anxiety inventory: IDARE In University Students from Lima in times of Covid-19

Resumen 420 universitarios de Psicología y Derecho fueron evaluados con el objetivo de actualizar las evidencias psicométricas del Inventario ansiedad estado-rasgo: IDARE en tiempos de pandemia por COVID-19. La muestra estuvo compuesta por hombres y mujeres, siendo mayor el grupo de mujeres, con un rango de edad de entre 18 a 57 años. Las pruebas de validación con jueces expertos permiten obtener una "V" de Aiken mayor a 0.80, y los valores de la prueba binomial fueron significativos con una p <.05. Las pruebas de análisis discriminativo ítem-test obtuvieron puntajes para todo el Inventario que van entre 0.334 a 0.679, eliminando el ítem 34 por no cumplir los criterios esperados. Para la validez convergente, su correlación con el Cuestionario CASO A30 obtuvo para A-E una "r" de .320 y para A-R de .522; ambas con una p <.05. La validez de constructo fue evaluada mediante el análisis factorial exploratorio y confirmatorio, hallándose 4 escalas independientes: ansiedad estado, bienestar estado, ansiedad rasgo y bienestar rasgo. La confiabilidad se obtuvo calculando el coeficiente alfa de Cronbach = 0.86 y el coeficiente omega de McDonald = 0.89. Asimismo, en la confiabilidad por mitades de Guttman encontraron valores entre 0.76 a 0.89. Se establecieron baremos por sexo y por edad para la población total. La prevalencia de la ansiedad en universitarios de Lima fue de 29.4 %, se aproxima a los datos de China y Colombia, pero es más alta que en Inglaterra, todos en tiempos de COVID-19.

Abstract 420 university students of Psychology and Law were evaluated in order to update the psychometric evidence of the State Anxiety Inventory - trait: STAI in times of the COVID-19 pandemic. The sample consisted of men and women, the group of women being the largest, with an age range between 18 to 57 years old. The validation tests with expert judges allow obtaining an Aiken "V" greater than 0.80 and the values of the binomial test were significant with a p <.05. The item-test discriminative analysis tests obtained scores for the entire Inventory ranging from 0.334 to 0.679, with item 34 eliminated for not meeting the expected criteria. For convergent validity, its correlation with the CASE A30 questionnaire obtained for A-E an "r" of .320 and for A-R of .522, both with a p <.05. The construct validity was evaluated by means of the exploratory and confirmatory factor analysis, finding 4 independent scales: state anxiety, state well-being, trait anxiety and trait well-being. Reliability was obtained by calculating Cronbach's Alpha coefficient = 0.86 and McDonald's Omega coefficient = 0.89. Likewise, in the reliability by Guttman halves, values between 0.76 and 0.89 were found. Scales were established by sex and by age for the total population. The prevalence of anxiety in university students in Lima was 29.4 %, which is close to the data from China and Colombia, but it is higher than in England all in the time of COVID-19.

Resumo Foram avaliados 420 universitários de Psicologia e Direito para atualização das evidências psicométricas do Inventário de Ansiedade do Estado - traço: IDARE em tempos de pandemia do COVID-19. A amostra foi composta por homens e mulheres, sendo o maior grupo de mulheres, com faixa etária entre 18 e 57 anos. Os testes de validação com juízes especialistas permitiram obter um Aiken "V" maior que 0.80 e os valores do teste binomial foram significativos com p <0.05. Os testes de análise discriminativa do teste item-teste obtiveram escores para todo o Inventário variando de 0.334 a 0.679, sendo o item 34 eliminado por não atender aos critérios esperados. Para a validade convergente, sua correlação com o questionário CASE A30 obteve para A-E um "r" de .320 e para A-R de .522, ambos com p <0.05. A validade de construto foi avaliada por meio da análise fatorial exploratória e confirmatória, encontrando 4 escalas independentes: ansiedade-estado, bem-estar-estado, ansiedade-traço e bem-estar-traço. A confiabilidade foi obtida calculando o coeficiente alfa de Cronbach = 0.86 e o coeficiente ômega de McDonald = 0.89. Da mesma forma, na confiabilidade pelas metades de Guttman, foram encontrados valores entre 0.76 e 0.89. As escalas foram estabelecidas por sexo e por idade para a população total. A prevalência de ansiedade em estudantes universitários em Lima foi de 29.4 %, o que se aproxima dos dados da China e da Colômbia, mas é mais alta do que na Inglaterra durante toda a época de COVID-19.

Single-channel electroencephalography and its associations with anxiety and pain during oral surgery: a preliminary report.

BACKGROUND: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. METHODS: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. RESULTS: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. CONCLUSIONS: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.

Fear of COVID and trait anxiety: mediation of resilience in university students / Medo da COVID e ansiedade-traço: mediação da resiliência em estudantes universitários / Miedo al COVID y ansiedad: mediación de la resiliencia en estudiantes universitarios

The current research aimed to assess the effect of the trait anxiety on the fear of Covid-19 mediated by resilience. For that, we counted on a convenience sample of 261 university students from Brazil. Participants completed a survey composed of the Fear of Covid-19 Scale (FC-19S), the Brief Resilience Scale, the Trait Anxiety Inventory, and demographic questions. Results from a simple mediation with 5000 bootstrap simulations supported the hypothesis that resilience mediates the link between the trait anxiety and fear of Covid-19 (β = .14; 95% C.I. = .027, .254). It was observed that resilience mediated around 35% of the link between the trait anxiety and the fear of Covid-19. In sum, we concluded that resilience plays an important role in maintaining people's mental health, which is especially relevant in troubled times like the pandemic.

O objetivo principaldeste estudo foi verificar o poder explicativo da ansiedade-traço no medo da Covid-19 sendo mediado pela resiliência. Para tanto, contou-se com a participação de uma amostra por conveniência composta por 261 estudantes universitários brasileiros. Os participantes responderam a um questionário online (Google formulários) contendo a Escala de Medo da Covid-19 - (FC-19S), a Escala Breve de Resiliência, o Inventário de Ansiedade Traço e questões de caráter sociodemográficas. Por meio de uma análise de mediação simples e 5000 re-amostragens bootstrap, confirmou-se a hipótese do presente estudo, uma vez que houve efeito de mediação (efeito indireto) estatisticamente significativo (β=0,14; 95% C.I. = 0,027 - 0,254), onde a variável resiliência mediou aproximadamente 35% da relação entre ansiedade-traço e medo da Covid-19. Conclui-se que a resiliência tem um papel importante para manutenção da saúde mental das pessoas, sobretudo em períodos de crise como de uma pandemia.

El objetivo principal de este estudio fue verificar el poder explicativo del rasgo de ansiedad en el miedo Covid-19, mediado por la resiliencia. Para ello, participó una muestra de conveniencia de 261 estudiantes universitarios brasileños. Los participantes respondieron un cuestionario en línea (formularios de Google) que contiene Escala de miedo Covid-19 (FC-19S), Escala de resiliencia breve, Inventario de ansiedad de rasgos y preguntas sociodemográficas. Mediante un análisis de mediación simple y un remuestreo de 5000 bootstrap, se confirmó la hipótesis del presente estudio, ya que hubo un efecto de mediación estadísticamente significativo (efecto indirecto) (β = 0,14; IC 95% = 0,027 - 0.254), donde la variable resiliencia medió aproximadamente el 35% de la relación entre el rasgo de ansiedad y el miedo al Covid-19. Concluimos que la resiliencia juega un papel importante en el mantenimiento de la salud mental de las personas, especialmente durante períodos de crisis como una pandemia.

Anxiety and burnout symptomatology at the end of medicine career / [Sintomatología de ansiedad y burnout al término de la licenciatura de médico cirujano]

Introduction: Due to the high demands of the medicine career, coupled with students' work and personal obligations, they are a susceptible population to develop anxiety and Burnout syndrome (BS) which can influence their academic performance. The aim of the present study was to determine the prevalence and symptomatology of anxiety and Burnout, as well as to identify their impact on the academic performance of students at the end of their medical degree. Method: A cross-sectional, observational study was conducted on medical students at the end of their degree, using the Trait and State Anxiety inventory, the Maslach Burnout scale, and the grade point average through the Academic Secretary. Results: A prevalence of state anxiety (SA) of 40. 6% and trait anxiety (TA) of 31. 2% was observed, both with similar proportions between a medium and high level (75-25%), with an association between them. The prevalence of BS was 15. 6%, of which 17. 2% and 23. 4% respectively showed high levels of fatigue and depersonalization, moreover, 18. 8% showed low levels of personal fulfillment. Conclusion: At the end of the career, students show symptoms of SA and TA with a high association between them. Therefore, it is important to emphasize that transitory anxiety can become part of an anxious response as a personality trait. The prevalence of BS was low and not related to academic performance, age, or sex.

Introducción: Las altas exigencias que presenta la carrera de medicina, aunado a las obligaciones laborales y personales de los estudiantes, los predispone a desarrollar ansiedad y síndrome de Burnout (SB), lo cual puede influir en su rendimiento académico. El objetivo del presente estudio fue determinar la prevalencia y la sintomatología de ansiedad y Burnout, así como identificar su impacto en el rendimiento académico de los estudiantes al término de la licenciatura en médico cirujano. Método: Se realizó un estudio transversal, observacional en estudiantes de medicina al término de la carrera, se utilizó el inventario de Ansiedad Rasgo y Estado, la escala Maslach Burnout y el promedio de las calificaciones a través de la Secretaria Académica. Resultados: Se observó una prevalencia de ansiedad estado (AE) y rasgo (AR) de 40.6% y 31.2% respectivamente, ambas con proporciones similares entre nivel medio (75%) y alto (25%), y con asociación entre las mismas. La prevalencia del SB fue de 15.6%, de los cuales 17.2 y 23.4% presentaron niveles altos de cansancio y de despersonalización respectivamente, además 18.8% mostró niveles bajos de realización personal. Conclusión: Al término de la licenciatura los estudiantes muestran sintomatología de AR y AE con alta asociación entre ambas, por lo que es importante resaltar que la ansiedad transitoria puede llegar a integrar una respuesta ansiosa como rasgo de su personalidad. La prevalencia de SB fue baja y sin relación con el rendimiento académico, la edad o el sexo.

[The relation between preoperative anxiety and awareness during anesthesia: an observational study]. / Relação entre ansiedade pré­operatória e consciência durante a anestesia: estudo observacional.

BACKGROUND: Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA. METHODS: This study was planned to be prospective, observational, and cross-sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I-II, and aged 18-70 years were included in the study. The demographic characteristics of patients were recorded. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA. RESULTS: The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85±14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (p < 0.05). The mean STAI score was found as 40.3±13.8 in patients who dreamed during anesthesia. CONCLUSION: It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences.

The relation between preoperative anxiety and awareness during anesthesia: an observational study / Relação entre ansiedade pré-operatória e consciência durante a anestesia: estudo observacional

Abstract Background: Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA. Methods: This study was planned to be prospective, observational, and cross-sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I-II, and aged 18-70 years were included in the study. The demographic characteristics of patients were recorded. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA. Results: The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85 ± 14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (p < 0.05). The mean STAI score was found as 40.3 ± 13.8 in patients who dreamed during anesthesia. Conclusion: It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences.

Resumo Justificativa: A ansiedade é um estado de preocupação causado pela expectativa de perigo externo ou interno. Consciência durante a anestesia (CDA) é a evocação imprevista da memória de eventos intranestésicos. O objetivo deste estudo foi determinar os fatores que afetam a ansiedade pré-operatória, a incidência de CDA e os níveis de ansiedade nos pacientes com antecedente de CDA. Método: O estudo foi planificado como prospectivo, observacional e transversal. Foram incluídos no estudo pacientes programados para septoplastia eletiva, admitidos ao ambulatório de anestesiologia entre Março de 2018 e Setembro de 2018, com classe funcional ASA I-II e faixa etária entre 18 e 70 anos. As características demográficas dos pacientes foram registradas. O Inventário de Ansiedade Traço-Estado (IDATE) foi utilizado para determinar a ansiedade durante a avaliação pré-operatória. Simultaneamente, o escore de consciência de Brice modificado foi usado para determinar CDA anterior. Resultados: Os escores de ansiedade dos pacientes que apresentaram CDA foram mais elevados do que de outros pacientes. A pontuação média do IDATE foi 40,85±14,8 nos 799 pacientes que obedeceram aos critérios de inclusão do estudo. Quando os escores de ansiedade foram comparados, foram maiores no sexo feminino do que no masculino (p < 0,05). O escore médio do IDATE encontrado foi 40,3±13,8 nos pacientes que relataram sonhos durante a anestesia. Conclusão: É importante determinar no pré-operatório os níveis de ansiedade dos pacientes para evitar as complicações associadas. Ansiedade pré-operatória e a prevenção de CDA devem ser tratadas com abordagem multiprofissional. A CDA deve ser cuidadosamente investigada, avaliando-se as experiências vividas pelo paciente em anestesias pregressas.

Self-esteem and state-trait anxiety in Lima's university adults / Autoestima y ansiedad estado-rasgo en adultos universitarios de Lima

Background: This study sought to determine the relationship between self-esteem and anxiety in emerging adults from private universities in Lima. Method: Cross-sectional and correlational in design, it was aimed at determining the degree or strength of association between self-esteem, state/trait anxiety in emerging adulthood, for this purpose, the Coopersmith Self-Esteem Inventory (Form C) and the Anxiety Questionnaire State-Trait (IDARE) were applied to 221 university students of both sexes, aged between 18 to 25 years. Results: In the hypothesis test, a statistically significant negative correlation coefficient was obtained between self-esteem and state/trait anxiety, being the size of the median effect in both cases. Regarding comparisons in self-esteem and anxiety trait/state according to sex and age, no differences were found. Conclusion: From the analyzes, it is concluded that there are an inverse and significant relationship between self-esteem and state/trait anxiety in emerging adults from Lima.

Introducción: Este estudio buscó determinar la relación entre la autoestima y la ansiedad en adultos emergentes de universidades privadas de Lima. Método: De diseño transversal y correlacional, se orientó a determinar el grado o fuerza de asociación entre la autoestima la ansiedad estado/rasgo en la adultez emergente, para ello se aplicó el Inventario de Autoestima de Coopersmith (Forma C) y el Cuestionario de Ansiedad Estado-Rasgo (IDARE) a 221 universitarios de ambos sexos, con edades comprendidas entre 18 a 25 años. Resultados: En el contraste de las hipótesis, se obtuvo un coeficiente de correlación negativa moderada y estadísticamente significativa entre la autoestima y la ansiedad estado/rasgo, siendo el tamaño del efecto mediano en ambos casos. Con respecto a las comparaciones en autoestima, ansiedad rasgo y ansiedad estado según sexo y edad, no se hallaron diferencias. Conclusión: A partir de los análisis se concluye que existe una relación inversa y significativa entre la autoestima y la ansiedad estado/rasgo en adultos emergentes de Lima.

High- and Low-conditioned Behavioral effects of midazolam in Carioca high- and low-conditioned freezing rats in an ethologically based test.

The selective breeding of laboratory rodents with different anxiety-related traits is the subject of growing interest. The present study compared the effects of the benzodiazepine midazolam in the elevated plus maze (EPM) test of anxiety in two lines of Wistar rats that were selectively bred in our laboratory for either high or low anxiety-like traits based on a contextual freezing conditioning paradigm. After phenotyping anxiety-like traits (i.e., conditioned freezing behavior), Carioca High-Freezing [CHF], Carioca Low-Freezing [CLF]) and control rats were intraperitoneally injected (1.0 ml/kg) with .9 % saline or midazolam (.25, .5, .75, and 1.0 mg/kg) and subjected to the EPM 30 min later. After the saline injection, the CHF and CLF groups exhibited lower and higher open-arm exploration in the EPM, respectively, compared with control rats. These results indicate that anxiety-related traits previously selected from an associative learning paradigm can also be phenotypically expressed in an ethologically based animal model of anxiety. All midazolam doses significantly increased open-arm exploration in both CHF and control animals, but this anxiolytic-like effect in CLF rats was only observed at the lowest dose tested (.25 mg/kg). The present findings indicate that these two breeding lines of rats are a useful model for studying anxiety, and the anxiolytic effect of midazolam depends on genetic variability that is associated with basal reactions to threatening situations.

Effects of a rat model of gestational hypothyroidism on forebrain dopaminergic, GABAergic, and serotonergic systems and related behaviors.

We investigated the effects of maternal hypothyroidism on forebrain dopaminergic, GABAergic, and serotonergic systems and related behavior in adult rat offspring. Experimental gestational hypothyroidism (EGH) was induced by administering 0.02% methimazole (MMI) to pregnant rats from gestational day 9 to delivery. Neurotransmitter-related protein and gene expression were evaluated in offspring forebrain at postnatal day (P) 120. Exploratory behavior, contextual fear conditioning, locomotion, and 30-day reserpine Parkinson induction were assessed from P75-P120. Protein and gene expression assessments of medial prefrontal cortex showed group differences in dopaminergic, GABAergic, and serotonergic receptors, catabolic enzymes, and transporters. Striatum of MMI offspring showed an isolated decrease in the dopaminergic enzyme, tyrosine hydroxylase. MMI exposure increased GABA and dopamine receptor expression in amygdala. MMI offspring also had decreased state anxiety and poor contextual fear conditioning. We found that baseline locomotion was not changed, but reserpine treatment significantly reduced locomotion only in MMI offspring. Our results indicated that restriction of maternal thyroid hormones reduced dopaminergic, GABAergic, and serotoninergic forebrain components in offspring. Tyrosine hydroxylase deficiency in the striatum may underlie enhanced reserpine induction of Parkinson-like movement in these same offspring. Deficits across different neurotransmitter systems in medial prefrontal cortex and amygdala may underlie decreased state anxiety-like behavior and reduced fear conditioning in offspring, but no changes in trait anxiety-like behavior occurred with maternal MMI exposure. These findings strongly support the hypothesis that adequate delivery of maternal thyroid hormones to the fetus is crucial to the development of the central nervous system critical for emotion and motor regulation.

The Influence of Stress and Anxiety on the Expectation, Perception and Memory of Dental Pain in Schoolchildren.

The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in the city of Petropolis (RJ), Brazil. Demographic characteristics, stress (children's stress scale), and state and trait anxiety (state⁻trait anxiety inventory) were recorded before a dental procedure to restore the occlusal surface of a permanent first molar under local anaesthetic. Dental pain was assessed using the faces pain scale before (dental pain expectation), immediately after (dental pain perception) and six weeks after (memory of dental pain) the dental procedure. Dental pain expectation scores were significantly higher than dental pain perception, independent of the levels of stress, state anxiety and trait anxiety. Children with high scores of stress (OR 1.05 95%CI 1.02⁻1.09), state anxiety (OR 1.15 95%CI 1.05⁻1.27) and trait anxiety (OR 1.18 95%CI 1.07⁻1.30) were more likely to report greater scores of dental pain expectation. Children anticipated more dental pain than what was actually perceived after the dental restoration. Children with greater levels of stress and anxiety have a distorted evaluation of expected dental pain before the dental procedure.

Chronotype and anxiety are associated in patients with chronic primary insomnia

Objective: To assess the interaction of chronotype with anxiety in patients with chronic primary insomnia. Methods: Sixty-four patients (50 women) with mean age 43.9±8.1 years were investigated with the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) and State-Trait Anxiety Inventory (STAI). Results: Significant negative correlations of chronotype-MEQ score with STAI state-anxiety (r = -0.40, p < 0.05), STAI trait-anxiety (r = -0.40, p < 0.05), and STAI pre-sleep state anxiety (r = -0.30, p < 0.05) were observed. Eveningness preference was associated with higher trait, state, and pre-sleep state anxiety. Conclusions: These results suggest that chronotype may be an important parameter to identifying the origin and significance of a vicious anxiety-insomnia-depression cycle in patients with chronic primary insomnia.

Asociación entre la ansiedad materna y el parto pretérmino en Lima, Perú / Association between maternal anxiety and preterm delivery in Lima, Peru

Introducción: el parto pretérmino se define como el parto antes de las 37 semanas. Se han establecido diversos factores desencadenantes, entre los cuales se encuentra la ansiedad. En Perú se han realizado pocos estudios en relación con el tema. Objetivo: determinar la asociación entre la ansiedad materna durante el tercer trimestre de embarazo y el desarrollo de parto pretérmino. Métodos: estudio de tipo cohorte prospectiva realizado en un hospital público de Lima-Perú, que incluyó a 247 gestantes (enero de 2014 a enero de 2015). Se evaluó a gestantes entre las semanas 28 y 35 de embarazo, durante la visita prenatal. Los datos perinatales se obtuvieron del libro de partos y de la historia clínica materna. El instrumento utilizado para medir la ansiedad fue la encuesta State Trait Anxiety Inventori (STAI). El análisis de datos se realizó mediante STATA versión 11.1. Resultados: la mediana de edad de las participantes fue 27, 68,1 por ciento fueron convivientes y 58 por ciento tuvieron secundaria completa. Se encontró una incidencia de parto pretérmino de 11,6 por ciento. En el análisis multivariado ajustado, se encontró un riesgo relativo de 1,23 (IC 95 por ciento: 0,57-2,65) para ansiedad de estado y un riesgo relativo de 0,97 (IC 95 por ciento: 0,45-2,06) para ansiedad de rasgo. En el análisis bivariado se encontró una asociación significativa con preeclampsia. Conclusión: Se recomienda realizar más estudios longitudinales para establecer mejor la asociación ansiedad materna - parto pretérmino(AU)

Introduction: preterm delivery is defined as delivery before 37 weeks of gestational age. Several triggering factors have been established, anxiety being one of them. Few studies on the subject have been conducted in Peru. Objective: determine the association between maternal anxiety during the third trimester of pregnancy and preterm delivery. Methods: a prospective cohort study was conducted at a public hospital in Lima, Peru, from January 2014 to January 2015. The study sample consisted of 247 pregnant women of 28-35 weeks of pregnancy. Evaluation was performed during prenatal visits. Perinatal data were obtained from the labor and delivery registry and the patients' medical records. The tool used to measure anxiety was the survey State Trait Anxiety Inventory (STAI). Data were analyzed with STATA version 11,1. Results: mean age of participants was 27 years; 68,1 percent cohabitated with their partners, and 58 percent had completed high school. Preterm delivery had an incidence of 11,6 percent. Adjusted multivariate analysis revealed a relative risk of 1,23 (95 percent CI 0,57-2,65) for state anxiety and ,.97 (95 percent CI 0,45-2,06) for trait anxiety. Bivariate analysis found a significant association with preeclampsia. Conclusion: anxiety during the third trimester of pregnancy was found to be a risk factor for preterm delivery. It is recommended to perform other longitudinal studies to more clearly determine the association between maternal anxiety and preterm delivery(AU)