Relationship between gagging severity and its management in dentistry

The purpose of this study was to investigate how grading according to our new gagging reflex index correlated with patient background and subsequent management. After obtaining institutional approval and informed consent, 110 patients with a gagging problem were enrolled. The patients completed the State–Trait Anxiety Inventory (STAI), the Dental Anxiety Scale (DAS), and a health questionnaire at initial consultation. On the second visit, an intra‐oral examination was carried out and the severity of gag reflex determined according to our new, 5‐level Classification of Gagging Problem (CGP) index: normal gagging but not desensitised (G1 = score 1); mild gagging (G2 = score 2); moderate gagging (G3 = score 3); severe gagging (G4 = score 4); and very severe gagging (G5 = score 5). No difference was found in grade based on age or STAI or DAS scores. The CGP score in male patients was significantly higher than that in female. The management classification method and degree of desensitisation were investigated retrospectively in each patient at 3 months and 1 year after initial consultation. The higher the CGP grade, the more often intravenous sedation or general anaesthesia was required due to difficultly in desensitisation. The present results suggest that determining whether it is possible to examine the molar area without inducing the gag reflex offers the key to deciding the treatment strategy.     

Trait emotional intelligence,the Big Five personality traits and isometric maximal voluntary contraction level under stress in athletes

ObjectivesThe purpose of the study was to investigate the effects of trait emotional intelligence (EI) and the Big Five personality traits on athletes’ ability to tolerate stress during isometric maximal voluntary contraction (MVC).MethodsFifty-two elite athletes with a mean age of 21.5 year (17 female) volunteered to participate. The Short Form Big Five Inventory and the Schutte Self-Report Emotional Intelligence Test measured personality and trait EI, respectively. Electromyography (EMG) determined the MVC level of the triceps surae muscle group in the absence and presence of a stressor. The mental stressor was to count downwards, repeatedly subtracting 13 from a starting value of 1000.ResultsAthletes’ MVC values were positively associated with conscientiousness and trait EI regardless of the presence or absence of a mental stressor. Two hierarchical regressions were conducted to determine whether personality traits and trait EI could predict MVC values measured during the absence and presence of mental stressor. Results show that personality traits explain variability in MVC values measured in both the absence and the presence of a mental stressor. Further, trait EI increased the model's ability to predict MVC. Personality traits combined with trait EI had stronger predictive ability for MVC values during exposure to a mental stressor.ConclusionAthletes with higher levels of conscientiousness and trait EI may be able to tolerate more stress without a decrease in performance.     

门诊焦虑障碍患者的自我分化水平研究

目的 探讨精神科门诊焦虑障碍患者的自我分化水平及其与焦虑特质的关系.方法 对符合简明国际神经精神访谈(MINI)中文版诊断的123名焦虑障碍患者和120名健康对照予以自我分化量表修订版的中文版(DSI-R)、状态-特质焦虑量表(STAI)问卷调查.结果 (1)焦虑障碍组DSI-R总分、情绪反应性(ER)维度和自我位置(IP)维度分值低于健康对照组,差异有显著性(P＜0.01),而情感断绝(EC)维度和与他人融合(FO)维度分值两组差异无显著性;(2)焦虑障碍组年龄与DSI-R总分、ER、IP、EC维度呈正相关(P＜0.05或P＜0.01),与FO维度无相关关系.男性焦虑障碍患者的ER维度分值高于女性焦虑障碍患者(P＜0.05),健康对照组年龄与IP维度正相关(P＜0.01),未婚者的DSI-R总分及ER维度分值高于已婚者(P＜0.01);(3)逐步回归分析表明,情绪反应性(ER)和自我位置(IP)是特质焦虑的重要预测因素,能联合预测特质焦虑的27.2％(焦虑障碍组)、39.9％(健康对照组)的变异量.结论 焦虑障碍患者自我分化水平较健康对照组低,自我分化能预测个体的焦虑特质.     

Induced Stress, Situationally-Specific Trait Anxiety, and Dark Focus

In the absence of direct stimulation for accommodation, the eye assumes an intermediate state of accommodation known as dark focus (DF). While there has been some indirect evidence that DF may be influenced by stress, such an effect has not been demonstrated using direct experimental manipulation. Thirty-three undergraduate subjects had their DF levels measured under two stress conditions–an experimental condition, where they were told that their responses were being evaluated by the experimenter, and a control condition, where no such evaluation was implied. Subjects also completed the S-R Inventory of General Trait Anxiousness, a measure of situationally-specific trait anxiety. One of the five subscales on this instrument assesses evaluation anxiety, the degree to which the individual feels anxious in situations where he/she is being evaluated. It was found that DF increased (i.e., shifted closer to the observer) in the experimental condition. However, the effect was limited to subjects who scored high in evaluation anxiety. It was concluded that such induced stress does have an impact on DF, and that experiments involving stress manipulations must consider the relative sensitivities of subjects to the specific stress situations being used.     

Differences in Trait Anger Among Children with Varying Levels of Anger Expression Patterns

PROBLEM: Little research has been done with children to determine effects of using various patterns of anger expression on trait anger. The purpose was to examine differences in trait anger of children who indicated high, moderate, or low use of three patterns of anger expression. METHODS: A convenience sample of 1,060 third through sixth graders completed trait anger and patterns of expressing anger instruments. FINDINGS: High users of anger-out (anger expressed outwardly) had the highest trait anger for every grade while high users of anger-reflection/control had the lowest. CONCLUSIONS: Anger-reflection/control may be more effective than anger-out in reducing trait anger in school-age children.     

Factors associated with anxiety in critically ill patients: A prospective observational cohort study

BackgroundAnxiety is an unpleasant emotion that most intensive care patients experience. This emotion is an important issue in intensive care settings because of its prevalence, adverse effects and severity. Little is known about the factors associated with state and trait anxiety during critical illness.ObjectivesTo describe the patterns of state anxiety reported by intensive care patients, and identify factors associated with state and trait anxiety.DesignProspective observational cohort study.SettingsOne mixed intensive care unit in Brisbane, Australia.ParticipantsAdults (n = 141, ≥18 years) admitted to the intensive care unit for ≥24 h; able to communicate verbally or non-verbally; understand English; and, open their eyes spontaneously or in response to voice.MethodsOutcomes were state anxiety as measured by the Faces Anxiety Scale and trait anxiety as measured by the State-Trait Anxiety Inventory. Pre-intensive care factors tested for possible associations with both state and trait anxiety were: age, gender, marital status, employment status, level of education, smoking status, personality trait of optimism and evidence of mental health care/treatment. Intra-intensive care factors tested were: reason for admission to the intensive care unit, delirium, pain, airway status, hours of mechanical ventilation, severity of illness, days of stay in intensive care, exposure to corticosteroids, opioids, benzodiazepines, anxiolytics, antidepressants, beta-blockers, anaesthetic agents and analgesics; length of sedation and analgesia and total doses of sedatives and analgesics.ResultsOf 141 participants, 98 (70%) were male with an average age of 54 (standard deviation: ±15) years and stayed in intensive care for about 4 (Interquartile Range: 3–7) days. The majority (n = 115; 82%) of participants experienced state anxiety at least once during their stay in intensive care, with 57% reporting moderate to severe levels. Factors related to state anxiety in intensive care were pain and trait anxiety. Factors associated with trait anxiety were trait optimism, state anxiety, evidence of mental health care/treatment and age.ConclusionsThis study provides a better understanding of contributing factors for anxiety in the critically ill. Trait anxiety and state anxiety were significantly associated with each other, namely, patients who were anxious by nature experienced higher levels of state anxiety, which persisted throughout their stay in the intensive care unit. Recognising the importance of state and trait anxiety assessments using validated tools and determining ways to manage anxiety in the critically ill are critical aspects of the intensive care nurses role.     

In ICU state anxiety is not associated with posttraumatic stress symptoms over six months after ICU discharge: A prospective study

BackgroundPosttraumatic stress symptoms are common after intensive care treatment. The influence of anxiety during critical illness on the development of posttraumatic stress symptoms needs to be investigated.ObjectiveTo determine the association between anxiety during critical illness (state and trait components) and posttraumatic stress symptoms over six months after ICU discharge.MethodsProspective study including 141 patients admitted ≥24 h to a closed mixed adult ICU in a tertiary hospital. State anxiety was assessed with the Faces Anxiety Scale during ICU stay. Trait anxiety was measured with the State-Trait Anxiety Inventory Form Y-2. Posttraumatic stress symptoms were measured at three and six months after ICU discharge using the Post-Traumatic Stress Symptoms 10-Question Inventory. Clinical and demographical data were also collected. Mixed effect regression models were used to determine if state and trait anxiety were factors significantly associated with posttraumatic stress symptoms over time.ResultsModerate to severe levels of state anxiety in ICU were reported by 81 (57%) participants. Levels of trait anxiety (median 36 IQR: 29–47) were similar to the Australian population. High levels of posttraumatic stress symptoms occurred at three (n = 19, 19%) and six months (n = 15, 17%). Factors independently associated with posttraumatic stress symptoms were trait anxiety (2.2; 95% CI, 0.3–4.1; p = 0.02), symptoms of anxiety after ICU discharge (0.6; 95% CI, 0.2–1.1; p = 0.005), younger age (−1.4; 95% CI, −2.6 to −0.2; p = 0.02) and evidence of mental health treatment prior to the ICU admission (5.2; 95% CI, 1.5–8.9; p = 0.006).ConclusionsPosttraumatic stress symptoms occurred in a significant proportion of ICU survivors and were significantly associated with higher levels of trait anxiety, younger age, mental health treatment prior to the ICU admission and more symptoms of anxiety after ICU discharge. Early assessment and interventions directed to reduce state and trait anxiety in ICU survivors may be of benefit.     

Unique effects of different components of trait emotional intelligence in traditional bullying and cyberbullying

This study investigated whether different components of trait emotional intelligence (or trait emotional self-efficacy) were uniquely related to traditional bullying and cyberbullying in a sample of 529 preadolescents (mean age of 12 years and 7 months), while controlling for the other forms of bullying/victimization. Binary logistic regressions showed that the dimension of emotional intelligence concerning the regulation and use of emotions was negatively related both to traditional bullying and cyberbullying; however, this association did not emerge when traditional bullying was controlled for cyberbullying, whilst it still emerged when cyberbullying was controlled for traditional bullying and both forms of victimization. Differently, the dimensions concerning appraisal of own and others' emotions were not deficient in children performing bullying and/or cyberbullying behaviors. Despite high co-occurrence between traditional and electronic bullying, our results suggested that these two forms are distinct phenomena, involving different personality traits. Implications for interventions are discussed.     

Mapping genetic influences on human brain structure

Recent advances in brain imaging and genetics have empowered the mapping of genetic and environmental influences on the human brain. These techniques shed light on the 'nature/nurture' debate, revealing how genes determine individual differences in intelligence quotient (IQ) or risk for disease. They visualize which aspects of brain structure and function are heritable, and to what degree, linking these features with behavioral or cognitive traits or disease phenotypes. In genetically transmitted disorders such as schizophrenia, patterns of brain structure can be associated with increased disease liability, and sites can be mapped where non-genetic triggers may initiate disease. We recently developed a large-scale computational brain atlas, including data components from the Finnish Twin registry, to store information on individual variations in brain structure and their heritability. Algorithms from random field theory, anatomical modeling, and population genetics were combined to detect a genetic continuum in which brain structure is heavily genetically determined in some areas but not others. These algorithmic advances motivate studies of disease in which the normative atlas acts as a quantitative reference for the heritability of structural differences and deficits in patient populations. The resulting genetic brain maps isolate biological markers for inherited traits and disease susceptibility, which may serve as targets for genetic linkage and association studies. Computational methods from brain imaging and genetics can be fruitfully merged, to shed light on the inheritance of personality differences and behavioral traits, and the genetic transmission of diseases that affect the human brain.