Involvement of the lateral habenula in the regulation of generalized anxiety- and panic-related defensive responses in rats

Recently obtained evidence points to the involvement of the lateral habenular nuclei (LHb) in the mediation of coping defensive responses to threatening/stressful stimuli. Nevertheless, the role of this brain area in the regulation of defensive responses that have been associated with specific subtypes of anxiety disorders recognized in clinical settings is presently unknown. To address this question, we investigated the effects of either electrolytic lesions or chemical stimulation of the LHb on the defensive behaviors generated in rats by the elevated T-maze. This experimental model allows the measurement, in a same rat, of two defensive behaviors, inhibitory avoidance and escape, that have been related in terms of psychopathology to generalized anxiety and panic disorders, respectively. Bilateral electrolytic lesions of the LHb (1 mA, 10 s) impaired inhibitory avoidance acquisition and facilitated escape performance. On the other hand, chemical stimulation of the LHb by bilateral microinjection of kainic acid (30-60 pmol/0.2 mu L) had the opposite effect, i.e., facilitated inhibitory avoidance and impaired escape. The present results indicate that the LHb exerts an opposed regulatory control on generalized anxiety- and panic-related defensive responses in rats. (c) 2008 Elsevier Inc. All rights reserved.

Facilitation of 5-HT(2A/2C)-mediated neurotransmission in the ventromedial hypothalamic nucleus decreases anxiety in the elevated T-maze

Previous evidence has shown that facilitation of GABA/benzodiazepine-mediated neurotransmission in the ventromedial hypothalamus (VMH) inhibits both escape and inhibitory avoidance responses generated in the elevated T-maze test of anxiety (ETM). These defensive behaviors have been associated with panic and generalized anxiety, respectively. Aside from GABA/benzodiazepine receptors, the VMH also contains a significant number of serotonin (5-HT) receptors, including 1A, 2A and 2C subtypes. The purpose of the present study was to investigate the effect of the activation of 5-HT(1A) and 5-HT(2A/2C) receptors in the VMH on defensive behavioral responses in rats submitted to the ETM. For that, male Wistar rats were treated intra-VMH with the 5-HT(1A) agonist 8-OH-DPAT, with the 5-HT(2A/2C) agonist DOI, with the 5-HT(2C) selective agonist MK-212, or with the 5-HT(2A/2C) antagonist ketanserin and 10 min after were submitted to the ETM. Results showed that both DOI and MK-212 significantly decreased avoidance measurements, an anxiolytic-like effect, without altering escape. 8-OH-DPAT and ketanserin were without effect, although the last drug attenuated the effects of DOI. None of the drugs altered locomotor activity in an open field. These results suggest that 5-HT(2A/2C) receptors of the VMH are involved in the regulation of inhibitory avoidance and might be of relevance to the physiopathology of generalized anxiety. (C) 2010 Elsevier B.V. All rights reserved.

ANXIETY, DYSPHORIA, AND DEPRESSION SYMPTOMS IN MOTHERS OF PRETERM INFANTS

To compare presence and severity of clinical symptoms of anxiety, dysphoria, and depression in mothers of preterm and of full-term infants and to observe changes in symptoms of mothers of preterm infants during hospitalization of the infants and after discharge, 50 mothers of preterm infants and 25 mothers of full-term infants completed the State-Trait Anxiety Inventory and the Beck Depression Inventory. The mothers with preterm infants had significantly higher clinical symptoms of State Anxiety during hospitalization than the group with full-term infants, but the clinical symptoms of anxiety in mothers of preterm infants decreased significantly after discharge. The health staff in a neonatal intensive care unit should not only be aware of infants` clinical status but also of the mothers` emotional state.

Further psychometric study of the Beck Anxiety Inventory including factorial analysis and social anxiety disorder screening

Objective. To analyze the psychometric properties of the Brazilian Portuguese version of the Beck Anxiety Inventory (BAI) in terms of its internal consistency, scores distribution, concurrent and discriminant validity, and factorial analysis in a sample of university students and social anxiety disorder (SAD) cases and non-cases. Methods. A sample of Brazilian university students from the general population (N = 2314) and a sample of university students identified as cases (N = 88) and non-cases (N = 90) of SAD were assessed, using as a parameter the Structured Clinical Interview for the DSM-IV. The different instruments were completed individually in the presence of an experienced rater. Results. The BAI showed adequate internal consistency (0.88-0.92) and discriminant validity, with 0.74 sensitivity and 0.71 specificity for a cut-off score of 10. The factorial analysis suggested a three-factor solution to be the most adequate. Conclusions. The version of the BAI studied is quite adequate to be used in the context of Brazilian university students, identifying the presence of anxiety indicators. However, its usefulness to screen for SAD seems limited.

Social anxiety disorder: studies of instrument validation for the Brazilian context

Social anxiety disorder (SAD) is a highly prevalent condition even though its recognition and diagnosis are underestimated by both patients and clinicians. In view of the importance of assessment scales for systematic diagnosis in psychiatry, the objective of this investigation was to present studies of validation for the Brazilian population of three instruments for the assessment of different aspects of SAD. The following psychometric studies were carried out: a) discriminative validity of the Mini Social Phobia Inventory (Mini-SPIN-MS), a reduced instrument for the screening of SAD; b) reliability and discriminative validity of the Brief Social Phobia Scale (BSPS), a hetero-applied instrument for the assessment of different aspects of SAD, and c) discriminative validity of the items and subscales of the Self-Statements during Public Speaking Scale (SSPS), an instrument for the assessment of cognitive aspects related to public speaking. All instruments showed excellent psychometric qualities, especially indicators of discrimination between persons with and without SAD, with diagnostic confirmation by the Structured Clinical Interview for DSM-IV (SCID-IV). It was concluded that this set of instruments, with specificity regarding their objectives, could be of great clinical usefulness, especially for the Brazilian population that, until recently, had no such resources for the measurement and assessment of the different aspects of SAD. New multicenter and intercultural studies may provide further information about cultural influences on SAD.

Maternal Anxiety and Depression and Development of Prematurely Born Infants in the First Year of Life

The Purpose of this study was: (a) to assess and to compare anxiety and depression symptoms in mothers of preterm neonates during hospitalization in the Neonatal Intenive Care Unit, after discharge, and at the end of the infants` first year of life and (b) to assess the child`s development at 12 months of chronological corrected age (CCA). Thirty-six mothers, with no psychiatric antecedents assessed with the SCID-NP were evaluated by STAI and BDI The infants were assessed with Bayley-II Scales. There was a significant decrease in clinical symptoms of state-anxiety in mothers (p =.008). comparing the period during hospitalization and after discharge of the infants. Clinical symptoms of anxiety and depression were observed in 20% of the mothers at the end of the infants` first year of age. The majority of the infants exhibited normal development on Bayley-II at 12 months CCA: however. 25% of the infants displayed cognitive problems and 40% motor problems. The mothers` anxiety and depression symptoms decreased it the end of the first year of life of the pre-term infants and the children showed predominately normal development Lit this phase.

CHRONIC LITHIUM TREATMENT PREVENT ANXIETY-LIKE BEHAVIOR RELATED TO DIETARY RESTRICTION

Caloric intake reduction has been considered as the major experimental manipulation able to increase longevity in experimental models. Therefore, its effects upon cognition and mood like behavior are poorly explored. On the other hand, Li(+) is a re-emergent therapeutic drug used to treat mood disorders, mainly bipolar disorder, with antipanic and antidepressant actions. On the hypothesis that lithium treatment could attenuate the negatives effects of stress on Central Nervous Systems (CNS), we evaluated the role of chronic lithium treatment on anxiety-like behaviors in animals submitted to stress by chronic moderated feed restriction (FR). Male wistar rats were divided into four groups (n = 7-8/group) according to dietary and drug manipulation: ad libitum (AL) with unlimited access to standard rat diet, lithium treatment ( AL + Li) which received approximately 50 mg/Kg animal/day of LiCl solved in water and ad libitum diet, FR that were fed with equivalent to 70% of total rat diet consumed by AL group, and FR + Li which received diet corresponding to FR and Li administration. After 12 weeks of drug and FR manipulation, anxiety like behavior was evaluated in elevated plus mazes (EPM). Chronic lithium treatment prevent the anxiogenic like effect of FR ( open time, F(3,30) = 3.588; P = 0.0265; percentage of open entries, F(3,30) = 6.004; P= 0.00029; and open time at the first min, 2.35; F(3,30) = 4.937; P = 0.0073, Duncan test P < 0.05) compared to AL diet. Ours results adding to evidences that moderate feed restriction my increase anxiety-like behavior; also suggest that chronic lithium treatment may be attenuated this effects.

GABAA receptor β3 subunit gene and psychiatric morbidity in a post-traumatic stress disorder population

GABAergic systems have been implicated in the pathogenesis of anxiety, depression and insomnia. These symptoms are part of the core and comorbid psychiatric disturbances in post-traumatic stress disorder (PTSD) In a sample of Caucasian male PTSD patients, dinucleotide repeat polymorphisms of the GABAA receptor beta3 subunit gene were compared to scores on the General Health Questionnaire-28 (GHQ). As the major allele at this gene locus (GABRB3) was GI, the alleles were divided into GI and non-GI groups. On the total score of the GHQ, which comprises the somatic symptoms, anxiety/insomnia, social dysfunction and depression subscales, patients with the GI non-GI genotype had a significantly higher score when compared to either the G1G1 genotype (alpha = 0.01) or the non-GI non-GI genotype (alpha = 0.05). No significant difference was found between the G1G1 and non-Gl non-G1 genotypes. When the GI non-G1 heterozygotes were compared to the combined G1G1 and non-GI non-GI homozygotes, a significantly higher total GHQ score was found in the heterozygotes (P = 0.002). These observations suggest a heterosis effect. Further analysis of GHQ subscale scores showed that heterozygotes compared to the combined homozygotes had higher scores on the somatic symptoms (P = 0.006), anxiety/insomnia (P = 0.003), social dysfunction (P = 0.054) and depression (P = 0.004) subscales. In conclusion, the present study indicates that in a population of PTSD patients, heterozygosity of the GABRB3 major (GI) allele confers higher levels of somatic symptoms, anxiety/insomnia, social dysfunction and depression than found in homozygosity. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

Adjustment of homeless adolescents to a crisis shelter: Application of a stress and coping model

The present study examined the utility of a stress and coping model of adaptation to a homeless shelter among homeless adolescents. Seventy-eight homeless adolescents were interviewed and completed self-administered scales at Time 1 (day of shelter entry) and Time 2 (day of discharge). The mean duration of stay at the shelter was 7.23 days (SD = 7.01). Predictors included appraisal (threat and self-efficacy), coping resources, and coping strategies (productive, nonproductive, and reference to others coping). Adjustment outcomes were Time I measures of global distress, physical health, clinician-and youthworker- rated social adjustment, and externalizing behavior and Time 2 youthworker-rated social adjustment and goal achievement. Results of hierarchical regression analyses indicated that after controlling for the effects of relevant background variables (number of other shelters visited, sexual, emotional, and physical abuse), measures of coping resources, appraisal, and coping strategies evidenced distinct relations with measures of adjustment in ways consistent with the model's predictions with few exceptions. In cross-sectional analyses better Time I adjustment was related to reports of higher levels of coping resources, self-efficacy beliefs, and productive coping strategies, and reports of lower levels of threat appraisal and nonproductive coping strategies. Prospective analyses showed a link between reports of higher levels of reference to others coping strategies and greater goal achievement and, unexpectedly, an association between lower self-efficacy beliefs and better Time 2 youthworker-rated social adjustment. Hence, whereas prospective analyses provide only limited support for the use of a stress and coping model in explaining the adjustment of homeless adolescents to a crisis shelter, cross-sectional findings provide stronger support.

Mapping Gray's model of personality onto the Eysenck Personality Profiler (EPP)

The aim of this study was to determine how well Gray's model of personality [Gray, J.A. (1982). The neuropsychology of anxiety: an enquiry into the functions of the septo-hippocampal system. Oxfords: Oxford University Press, Gray, J.A. (1987). The psychology of fear and stress. Cambridge: Cambridge University Press], as measured by the Gray Wilson Personality Questionnaire (GWPQ), can provide a full description of personality as measured by the primary scales of the Eysenck Personality Profiler (EPP) and the type scales of the short version or the EPQ-R. Factor analysis of the GWPQ the Anxiety and linpulsivity scales of the EPP and the Learning Styles Questionnaire (LSQ) showed that the GWPQ seemed to measure general activation and inhibition factors, but not the finer features of Gray's theory. When the GWPQ scales were regressed against each scale of the EPP., it was round that they generally provide only a reasonable explanation of the EPP primary scales. It is concluded that the GWPQ measures general propel-ties of Gray's model, that the linpulsivity and Anxiety scales of the EPP also scent related to the GWPQ scales, and that Gray's model of personality provides only a partial explanation of personality in general. (C) 2002 Published by Elsevier Science Ltd. All rights reserved.

Stress affects theta activity in limbic networks and impairs novelty-induced exploration and familiarization

Exposure to a novel environment triggers the response of several brain areas that regulate emotional behaviors. Here, we studied theta oscillations within the hippocampus (HPC)-amygdala (AMY)-medial prefrontal cortex (mPFC) network in exploration of a novel environment and subsequent familiarization through repeated exposures to that same environment; in addition, we assessed how concomitant stress exposure could disrupt this activity and impair both behavioral processes. Local field potentials were simultaneously recorded from dorsal and ventral hippocampus (dHPC and vHPC respectively), basolateral amygdala (BLA) and mPFC in freely behaving rats while they were exposed to a novel environment, then repeatedly re-exposed over the course of 3 weeks to that same environment and, finally, on re-exposure to a novel unfamiliar environment. A longitudinal analysis of theta activity within this circuit revealed a reduction of vHPC and BLA theta power and vHPC-BLA theta coherence through familiarization which was correlated with a return to normal exploratory behavior in control rats. In contrast, a persistent over-activation of the same brain regions was observed in stressed rats that displayed impairments in novel exploration and familiarization processes. Importantly, we show that stress also affected intra-hippocampal synchrony and heightened the coherence between vHPC and BLA. In summary, we demonstrate that modulatory theta activity in the aforementioned circuit, namely in the vHPC and BLA, is correlated with the expression of anxiety in novelty-induced exploration and familiarization in both normal and pathological conditions.

Impacto de um programa de relaxamento na percepção de stress nos cuidadores formais de um lar do concelho de Águeda

O papel de cuidador formal é, habitualmente, exercido por profissionais devidamente qualificados, designadamente, médicos, enfermeiros psicólogos, assistentes sociais, terapeutas ocupacionais, fisioterapeutas e auxiliares. A sua formação académica, profissional é específica para o desempenho deste papel, integrada no contexto de uma actividade profissional onde são exercidas competências, no âmbito da saúde. Nos lares, hospitais, instituições comunitárias, entre outros, existem indivíduos que se enquadram no perfil traçado, a actividade é desgastante, quer física, quer psicologicamente, o que muitas vezes facilita o aparecimento da ansiedade e a percepção do stress. O relaxamento enquanto técnica terapêutica poderá atenuar o seu surgimento. Este trabalho teve como objectivo avaliar o impacto de um programa de relaxamento, na percepção de stress, nos cuidadores formais do lar da Liga de Amigos de Aguada de Cima. Para este fim, consideramos adequado um estudo do tipo experimental. Assim aplicámos á nossa amostra, dezasseis funcionárias, antes e depois da aplicação do programa de relaxamento progressivo de Jacobson, questionários de auto-preenchimento, adaptados à população portuguesa. Para além disso, nas dezasseis sessões que efectuámos, medimos a tensão arterial e a frequência cardíaca com um esfigmomanómetro digital de pulso, no período antes e depois da implementação do programa. Pela análise dos resultados que obtivemos, constatámos que não houve diferenças significativas do ponto de vista estatístico, entre a ansiedade e a percepção do stress, após o programa de relaxamento Jacobson. Confirmámos porém, que existiram diferenças em alguns itens dos questionários após a implementação do programa de relaxamento, assim como uma diminuição da pressão arterial diastólica e da correlação positiva entre a ansiedade e a percepção de stress. Desta forma, parece existir uma indicação de que o programa de relaxamento progressivo de Jacobson talvez tenha contribuído para minimizar o nível de stress das funcionárias do lar da Liga de Amigos de Aguada de Cima

Occupational stress and coping resources in physiotherapists: a survey of physiotherapists in three general hospitals

Objectives - To identify occupational stressors and coping resources in a group of physiotherapists, and to analyse interactions between subjective levels of stress, efficacy in stress resolution and coping resources used by these professionals. Design - A sample of 55 physiotherapists working in three general hospitals in Portugal completed the Coping Resources Inventory for Stress, the Occupational Stressors Inventory and two subjective scales for stress and stress resolution. Main results - Most physiotherapists perceived that they were moderately stressed (19/55, 35%) or stressed (20/55, 36%) due to work, and reported that their efficacy in stress resolution was moderate (25/54, 46%) or efficient (23/54, 42%). Issues related to lack of professional autonomy, lack of organisation in the hierarchical command chain, lack of professional and social recognition, disorganisation in task distribution and interpersonal conflicts with superiors were identified as the main sources of stress. The most frequently used coping resources were social support, stress monitoring, physical health and structuring. Perceived efficacy in stress resolution was inversely related to perceived level of occupational stress (r = −0.61, P < 0.01). Significant correlations were found between several coping resources and the perceived level of stress and efficacy in stress resolution. Associations between problem solving, cognitive restructuring and stress monitoring and both low levels of perceived stress and high levels of perceived efficacy were particularly strong. Implications for practice - The importance of identifying stressors and coping resources related to physiotherapists’ occupational stress, and the need for the development of specific training programmes to cope with stress are supported.

Performing PET/CT studies: do they create anxiety?

Introduction: Anxiety is a common problem in primary care and specialty medical settings. Treating an anxious patient takes more time and adds stress to staff. Unrecognised anxiety may lead to exam repetition, image artifacts and hinder the scan performance. Reducing patient anxiety at the onset is probably the most useful means of minimizing artifactual FDG uptake, both fat brown and skeletal muscle uptake, as well patient movement and claustrophobia. The aim of the study was to examine the effects of information giving on the anxiety levels of patients who are to undergo a PET/CT and whether the patient experience is enhanced with the creation of a guideline. Methodology: Two hundred and thirty two patients were given two questionnaires before and after the procedure to determine their prior knowledge, concerns, expectations and experiences about the study. Verbal information was given by one of the technologists after the completion of the first questionnaire. Results: Our results show that the main causes of anxiety in patients who are having a PET/CT is the fear of the procedure itself, and fear of the results. The patients who suffered from greater anxiety were those who were scanned during the initial stage of a disease. No significant differences were found between the anxiety levels pre procedural and post procedural. Findings with regard to satisfaction show us that the amount of information given before the procedure does not change the anxiety levels and therefore, does not influence patient satisfaction. Conclusions: The performance of a PET/CT scan is an important and statistically generator of anxiety. PET/CT patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. The creation of a guideline may reduce the stress of not knowing what will happen, the anxiety created and may increase their satisfaction in the experience of having a PET/CT scan.

Use of Distress and Depression Thermometers to Measure Psychosocial Morbidity Among Southern European Cancer Patients

GOALS OF WORK: Recent literature has indicated the need for rapid evaluation of psychosocial issues secondary to cancer. Because of the problems of routine use of psychometric instruments, short instruments such as visual analogue scales or one-item 0-10 scales have been developed as valid assessment alternatives. PATIENTS AND METHODS: A study was conducted to examine the role of two 0-10 scales in measuring emotional stress (distress thermometer, DT) and depressed mood (mood thermometer, MT), respectively, in a multicenter study carried out in southern European countries (Italy, Portugal, Spain, and Switzerland). A convenience sample of 312 cancer outpatients completed the DT and MT and the Hospital Anxiety Depression Scale (HADS). MAIN RESULTS: DT was more significantly associated HADS anxiety than HADS depression while MT was related both to HADS anxiety and depression. The correlation of MT with HADS was higher than DT. A cutoff point >4 on the DT maximized sensitivity (65%) and specificity (79%) for general psychosocial morbidity while a cutoff >5 identified more severe "caseness" (sensitivity=70%; specificity=73%). On the MT, sensitivity and specificity for general psychosocial morbidity were 85% and 72% by using the cutoff score >3. A score >4 on the MT was associated with a sensitivity of 78% and a specificity of 77% in detecting more severe caseness. CONCLUSIONS: Two simple instruments, the DT and the MT, were found to have acceptable levels of sensitivity and specificity in detecting psychosocial morbidity. Compared to the HADS, however, the mood MT performed better than the DT.