Search Results (432)

Anxiety is a common psychological challenge among athletes, particularly in response to intense training sessions. This randomized crossover study investigated the immediate effects of a single session of focused attention meditation on anxiety, autonomic responses, and performance during high-intensity intermittent training (HIIT) in twenty-six university-level speed skaters. Participants completed three pre-exercise interventions (focused attention meditation, controlled breathing, and random thinking) on separate occasions in a randomized order. Following each intervention, participants performed a leg cycling-based HIIT protocol consisting of 20 s of maximal effort work followed by 10 s of passive rest, repeated for 8 sets using a cycling ergometer. State anxiety was assessed using the State–Trait Anxiety Inventory, and mood disturbance was evaluated using the Profile of Mood States. Autonomic and physiological responses were assessed via heart rate variability (coefficient of variation), oxygen uptake, and power output, measured before and after the intervention and the HIIT bout. Focused attention meditation significantly reduced state anxiety compared with random thinking (ΔSTAI: −5.0 [6.0] vs. −1.0 [4.3]; p < 0.05, effect size = 0.527), whereas controlled breathing primarily influenced heart rate variability (CV: 0.10 [0.11] vs. 0.07 [0.03]; p = 0.041, effect size = 0.736). No significant differences were observed among conditions in mean power output or fatigue index during HIIT. These findings suggest that single-session focused attention meditation may serve as a practical pre-exercise strategy for an immediate reduction in state anxiety, without compromising subsequent high-intensity exercise performance. Full article

Background/Objectives: Despite the widespread recognition of preprocedural anxiety in awake invasive procedures, there is a paucity of data examining its prevalence and clinical impact in patients undergoing percutaneous kidney biopsy. This study aimed to determine the prevalence of preprocedural anxiety, assess its association with peri-procedural hemodynamic parameters, and identify factors associated with elevated anxiety. Methods: In this prospective observational study, 151 adults scheduled for percutaneous kidney biopsy between June 2023 and January 2025 were enrolled. Anxiety was assessed 24 h before the procedure using the Thai State–Trait Anxiety Inventory Y1 (STAI-Y1). Blood pressure and pulse rate were measured at baseline and 30 min before biopsy. Mixed-effects models evaluated associations between anxiety and hemodynamic changes, and logistic regression identified predictors of anxiety. Results: Clinically significant anxiety (STAI-Y1 ≥ 40) was present in 55% of patients, with 43.4% reporting very high anxiety. Anxiety status was not independently associated with changes in systolic or diastolic blood pressure or pulse rate. However, diastolic blood pressure increased significantly from baseline to preprocedural across all patients (mean increase 5.45 mmHg; p = 0.008), irrespective of anxiety. Higher serum creatinine (OR 1.29; p = 0.012) and a history of previous kidney biopsy (OR 4.28; p = 0.004) were independently associated with anxiety. Conclusions: Preprocedural anxiety is highly prevalent among patients undergoing kidney biopsy but does not independently influence peri-procedural hemodynamic parameters. Targeted screening and supportive interventions may benefit patients at increased risk of anxiety. Full article

Background: Psychological distress is increasingly recognized as an important determinant of health-related quality of life (HRQoL) in adults with diabetes mellitus (DM). However, data quantifying this burden in Eastern European populations remains limited. Objectives: This study aimed to assess psychological distress—defined as anxiety, depressive symptoms, or perceived stress—and HRQoL among Romanian adults with DM compared with healthy controls, and to explore potential differences between diabetes subtypes. Methods: A cross-sectional study was conducted, including 400 adults (201 with DM and 199 healthy controls). Psychological distress was evaluated using the State–Trait Anxiety Inventory (STAI-Y1, STAI-Y2), Beck Depression Inventory (BDI), and Holmes–Rahe Stress Scale, while HRQoL was assessed using the EQ-5D Visual Analogue Scale. Group comparisons were performed using appropriate parametric or non-parametric tests, with additional multivariable analyses adjusting for age, sex, and body mass index. Results: Adults with diabetes exhibited significantly higher levels of anxiety, depressive symptoms, and perceived stress, and lower HRQoL, compared with controls (all p < 0.001). These differences remained statistically significant after adjustment for age, sex, and body mass index. Exploratory analyses revealed no statistically significant differences between diabetes subtypes, although subgroup comparisons were limited by sample size. Conclusions: Psychological distress is highly prevalent among Romanian adults with DM and is associated with poorer self-perceived health-related quality of life. The results support the relevance of incorporating systematic psychosocial assessment into routine diabetes care. Full article

Background/Objectives: The Mediterranean diet (MD) constitutes one of the most broadly studied dietary patterns, which has been linked to the prevention of non-communicable diseases and mental health disorders. University students, a population exposed to significant psychosocial stressors and lifestyle changes, may particularly benefit from healthy eating patterns such as the MD. This study was designed to examine the potential associations of MD adherence with symptoms of depression and anxiety among Greek university students. Methods: A cross-sectional study was initially conducted among 7160 active university students from ten diverse geographic regions in Greece. After the enrollment procedure and the application of relevant exclusion criteria, 5191 university students (52.0% female; mean age: 21.3 ± 2.4 years) constituted the study population. MD adherence was assessed using the KIDMED index, while depressive and anxiety symptoms were evaluated using the Beck Depression Inventory-II (BDI-II) and State–Trait Anxiety Inventory (STAI-6), respectively. Sociodemographic and anthropometric data were collected for all the enrolled university students. All the questionnaires were completed by face-to-face interviews with expert personnel. Results: Students with low adherence to the MD were significantly more likely to report symptoms of depression (OR = 2.12; p ˂ 0.001) and anxiety (OR = 2.27; p ˂ 0.001) and to be overweight or obese (OR = 2.45; p ˂ 0.001) after adjustment for multiple confounding factors. Low MD adherence was also associated with male gender (OR = 0.73; p ˂ 0.01), living alone (OR = 0.78; p ˂ 0.01), smoking (OR = 0.75; p ˂ 0.01), low physical activity (OR = 1.84; p = 0.001), and poorer academic performance (OR = 0.83; p ˂ 0.01). Conclusions: Low adherence to the MD is significantly associated with increased likelihood of depression, anxiety, and excess body weight among university students in Greece. These findings underscore the importance of promoting healthy dietary habits and related lifestyle behaviors in young adult populations as a potential strategy for mental health prevention and intervention. Due to the presence of several limitations in the present study, future longitudinal and interventional studies should be performed to confirm the present findings. Full article

Background: Academic performance among university students is shaped by multiple factors, especially during examinations. This study aimed to explore the relationship between sleep quality, executive attention, and anxiety to identify potential predictors of academic performance across different academic fields. Method: Fifty-one students, between 19 and 25 years (M = 20.04, SD = 1.11), enrolled in the second year in Medicine (27.5%), Law (39.2%), and Economics (33.3%) programs at a university in Lisbon. The sample has mostly full-time students (98.04%), and female (68.6%). Data collection took place during examination periods and included: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESE), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), Stroop Test and Go/No-Go task. Results: Our findings revealed significant differences across academic fields: medical students reported poorer sleep quality, law students demonstrated reduced executive attention, and economics students exhibited better sleep but weaker inhibitory control. Sleep quality and state anxiety significantly predicted academic performance, whereas executive attention did not. Conclusions: These results underscore the importance of addressing sleep hygiene and anxiety management among university students, regardless of academic discipline. Institutional initiatives, including structured stress-reduction programs and educational support services, may equip students with the tools to manage academic pressures and enhance cognitive functioning and overall psychological well-being. Full article

Background/Objectives: Shift-working healthcare professionals are exposed to high psychophysiological demands associated with occupational stress, anxiety, and depressive symptoms. Salivary chromogranin A (sCgA) and secretory immunoglobulin A (sIgA) are non-invasive biomarkers reflecting sympathetic nervous system activation and mucosal immune function, respectively, and are increasingly used to assess biological stress responses. This study examined changes in these biomarkers and their associations with anxiety and depression. Methods: This cross-sectional comparative observational study was conducted among healthcare professionals working 12-h shifts (n = 95) and non-shift-working controls (n = 95) and included a within-shift pre-post assessment, with saliva samples collected before and after the work shift. Salivary biomarkers were determined using ELISA methods. Anxiety and depression were assessed using the State–Trait Anxiety Inventory and the Zung Self-Rating Depression Scale. Data were analyzed with t-tests, correlation, and multiple linear regression. Statistical analyses included between- and within-group comparisons, correlation analyses, and multiple linear regression models to examine independent associations between salivary biomarkers and psychological outcomes. Results: After a 12-h shift, healthcare professionals showed increased sCgA (3.82 ± 0.95 vs. 4.68 ± 1.02 ng/mL; p < 0.001) and decreased sIgA (165.3 ± 32.4 vs. 142.6 ± 29.8 mg/dL; p < 0.001). Psychological scores were higher in healthcare professionals than in controls (p < 0.001). Salivary sCgA correlated positively with anxiety and depression (r = 0.41 to 0.45), while sIgA correlated negatively (r = −0.29 to −0.36). Regression analysis confirmed occupational group (healthcare professionals vs. controls) as the strongest predictor, with independent contributions of sCgA and sIgA to psychological scores. Conclusions: A 12-h work shift in healthcare professionals leads to increased salivary chromogranin A, indicating sympathetic activation, and decreased secretory IgA, reflecting reduced mucosal immune activity. The combined assessment of sCgA and sIgA provides a sensitive and non-invasive approach for monitoring occupational stress and identifying early risks of anxiety and depressive symptoms among shift-working healthcare professionals. Full article

Test anxiety is considered to affect individuals’ cognitive control and task performance, particularly in error monitoring. While previous research has explored the relationship between anxiety and cognitive performance, this study aims to investigate the impact of test anxiety and cognitive stress on error processing, focusing on changes in error-related negativity (ERN). Participants were divided into high test anxiety (HTA) and low test anxiety (LTA) groups based on their scores on the Test Anxiety Scale (TAS). Cognitive stress was induced by administering the Raven’s Standard Progressive Matrices test, accompanied by instructions that emphasized score comparison with others. Participants completed the Subjective Test Anxiety Scale (STAS), the Short State Anxiety Inventory (SSAI), and a Flanker task before and after the stress manipulation. The effectiveness of the stress manipulation was confirmed by significant increases in STAS and SSAI scores and changes in behavioral performance. EEG data were recorded to analyze ERN, correct-response negativity (CRN), and ΔERN (ERN minus the CRN) amplitudes. HTA individuals exhibited a trend toward larger ERN amplitudes than LTA counterparts, indicating heightened sensitivity to errors. However, no significant changes in ERN amplitudes were observed between pre- and post-stress conditions. CRN and ΔERN amplitudes also showed no significant differences across anxiety groups or stress conditions. ERN changes appear to be more closely related to trait test anxiety than to transient stress. Full article

Objective: The purpose of this study was to explore the effects of an acute dose of cannabidiol (CBD) on physical and mental health, as well as running performance in a group of runners. Methods: This study used a randomized, cross-over design where individuals were given CBD (CBD-T) or placebo (PLA-T) capsules on two separate occasions. During their first visit, the subjects consumed 300 mg of either placebo or CBD capsules and were then instructed to sit quietly for 2 h. Then, participants filled out a State Trait Anxiety Inventory (STAI) and completed measures of resting systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), blood lactate (BL), and heart rate variability (HRV). Next, participants completed a 2-mile treadmill run as fast as possible. During each run, HR, rating of perceived exertion (RPE), and BL were measured during and after the run. Participants completed a gastrointestinal (GI) symptom questionnaire immediately after the 2-mile time trial. Results: Participants (N = 12; 4 males, 8 females) averaged 25.5 years ± 3.34 years of age. Mean CBD-T reported increased feelings of calm (21% p = 0.04) and relaxed (22%, p = 0.02) when compared to PLA-T. There were no differences in the severity of GI symptoms, SBP, DBP, or HRV between the treatments. The CBD-T experienced an 8% reduction in average RPE at mile 1 of the run compared with PLA-T (p = 0.05). There was no significant difference in run performance time. Conclusions: An acute dose of CBD (300 mg) taken 2 h before a 2-mile run may potentially benefit runners in shorter distance competitions by increasing calm and relaxed feelings and reducing perceived effort at the halfway point without impairing performance or increasing gastrointestinal upset. Full article

Background: Cancer and its treatments frequently lead to physical and psychological symptoms that negatively affect quality of life. Massage therapy has been proposed as a complementary intervention to reduce symptom burden through its effects on stress regulation and autonomic balance. This systematic review and meta-analysis evaluated the effectiveness of massage therapy in patients with cancer. Methods: A systematic search was conducted in MEDLINE, Web of Science, Scopus, Embase, Google Scholar, and CINAHL. Search terms included “massage therapy,” “reflexology,” “massage,” and “cancer.” Randomized controlled trials comparing massage therapy with placebo or standard care and reporting quantitative outcomes were eligible. Seven studies met inclusion criteria for the meta-analysis. Results: Compared with control conditions, massage therapy was associated with significant improvements in several outcomes: Behavioral Symptoms Frequency (BSF) (MD = −12.54; 95% CI: −18.70 to −6.38; p < 0.0001), Quality of Life Questionnaire (QLQ) scores (SMD = 10.10; 95% CI: 1.21 to 19.00; p = 0.03), Spielberger State–Trait Anxiety Inventory (STAI) scores (MD = −3.97; 95% CI: −4.63 to −3.31; p = 0.0001), and Visual Analog Scale (VAS) symptom intensity (MD = −1.09; 95% CI: −2.11 to −0.07; p = 0.04). Overall certainty of evidence was limited by methodological heterogeneity and risk of bias. Conclusions: Massage therapy may provide short-term improvements in selected physical and psychological symptoms in cancer patients and may serve as a supportive complementary intervention. However, the evidence remains limited, and well-designed trials with standardized protocols are needed to strengthen the reliability of these findings. Full article

Background: Body image, physical self-concept and anxiety are closely intertwined aspects of psychological well-being among youth. The growing influence of social media and appearance-focused culture has intensified self-evaluation pressures, making it essential to understand whether physical activity fosters protective effects or, conversely, contributes to anxiety. Methods: The study examined the relationship between body appreciation, physical self-concept, self-esteem, and anxiety among 246 young adults aged 18–35 years (47.6% athletes, 52.4% non-athletes). Participants completed the Rosenberg Self-Esteem Scale (RSES), Body Appreciation Scale-2 (BAS-2), State-Trait Anxiety Inventory (STAI), and the short form of Physical Self-Description Questionnaire (PSDQ-S). Group differences were analyzed using the Mann–Whitney U and Kruskal–Wallis H tests, and associations were explored with Spearman’s correlations. Moderation analyses (PROCESS Model 1) tested whether physical activity buffered BMI-related effects, and structural equation modeling (SEM) evaluated direct and indirect pathways. Results: Athletes reported higher self-esteem and body appreciation and scored higher on all PSDQ-S subscales, alongside lower trait anxiety but higher state anxiety than non-athletes. Higher BMI predicted lower self-esteem, body appreciation, and less favorable self-perceptions. Physical activity moderated the BMI—self-esteem and BMI—body appreciation relationships, buffering negative effects among athletes. SEM showed that physical activity positively influenced physical self-concept and body appreciation, which in turn reduced trait anxiety. Gender differences were minimal. Conclusions: Regular sport participation supports psychological resilience by enhancing self-esteem and body appreciation while reducing anxiety. However, the findings also highlight the complexity of body–mind dynamics where individuals with strong body appreciation may still experience transient anxiety in evaluative contexts. Promoting body functionality, self-compassion, and positive physical self-concept in educational and sport settings may help prevent maladaptive behaviors and foster lasting mental well-being among youth. Full article

Background/Objectives: Equine-assisted services are being increasingly utilized as complementary interventions for military veterans who have experienced trauma. However, rigorous research is lacking, and randomized controlled trials are needed. The H.O.O.V.E.S. Intensive intervention was developed for this population. This intensive program is an equine-assisted learning approach developed for veteran and active-duty military trauma survivors. The program integrates equine-assisted learning, peer mentorship and experiential learning in a residential retreat format. The primary aim of this pilot study was to determine if more rigorous studies of this intervention are warranted. Secondary aims were to assess preliminary outcomes and explore possible relationships between changes in outcome measures. Methods: This was a pilot prospective study. Inclusion criteria for the program included veteran or active-duty military status and a history of trauma exposure. Data were collected from April–October of 2024 in Ohio, USA. Six psychological instruments were administered to participants before, immediately after and 90 days and 120 days after the intervention. These were the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire II (AAQII), the Positive and Negative Affect Scale (PANAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI) and the Posttraumatic Growth Inventory (PTGI). Analyses were conducted to assess for significant changes across the study timeframe and for relationships among the changes in psychological instrument scores. Results: Study participants were 32 veterans with trauma histories ranging in age from 30 to 67 years old. There were statistically significant pre- to post-intervention improvements for all instruments except the PTGI, suggesting short-term increased psychological flexibility (AAQII) and positive affect (PANAS-positive) as well as decreased anxiety (STAI), negative affect (PANAS-negative), depression (BDI) and PTSD symptoms (PCL-5). Changes in BDI and PCL-5 scores persisted at 120 days post-intervention whereas changes in the AAQII, PANAS and STAI did not persist. Increased psychological flexibility was correlated with reductions in negative affect, PTSD symptoms and anxiety, as well as with increases in positive affect. Conclusions: Preliminary results reported herein suggest participation is associated with psychological benefits. Further, decreased experiential avoidance/increased psychological flexibility should be explored as an underlying mechanism potentially contributing to the benefits of participation in EAS. A randomized controlled trial of the H.O.O.V.E.S. Intensive program is warranted. Full article

Objectives: Arthroscopic meniscal surgery (AMS) is one of the most common orthopedic procedures worldwide, and its prevalence has been steadily increasing. In this study, we aimed to compare the short-term clinical outcomes (STCOs) and patient-reported outcome measures (PROMs) with anxiety and satisfaction in Mongolian patients. Methods: A prospective cohort study involved 103 patients who underwent arthroscopic knee surgery at The National Trauma Orthopedic Research Center and Grandmed Hospital in Mongolia between 2020 and 2023. STCO and PROM were calculated for the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, the visual analog scale was assessed for pain (VAS), and Knee Range of Motion (ROM), Measures of Anxiety State-Trait Anxiety Inventory (STAI), and The Surgical Satisfaction Questionnaire (SSQ-8) were also used. Results: Out of 103 patients (69 for partial meniscectomy and 34 for meniscal repair), KOOSs improved significantly from pre-operative to post-operative levels. The Koos subscores for pain were 57.93 ± 12.58 pre-operatively and 80.93 ± 5.70 post-operatively; Koos subscores for Symptoms (KOOS Sx) were 54.13 ± 12.73, 80.27 ± 6.22; Koos subscores for Activities of Daily Living (KOOS ADL) were 61.28 ± 13.19, 79.61 ± 4.91; Koos subscores for Sports/Recreation (KOOS SR) were 42.28 ± 13.21, 72.04 ± 6.88; and Koos subscores for Quality of Life (KOOS QOL) were 45.08 ± 12.46, 77.85 ± 7.96. On the other hand, the pre-operative and post-operative results of the STAI were not significant (46.03 ± 8.2 vs. 39.59 ± 7.13, p = 0.781). Conclusions: In the present study, we elucidated patient- and injury-specific factors that may guide personalized surgical decision-making in Mongolian patients. Our findings suggest that AMS is a viable option for alleviating pain and enhancing function in the short term for patients with meniscal tears. The high PROMs and satisfaction scores reflect good-to-excellent results, and meniscal repair was associated with better outcome scores. While pre-operative anxiety levels were high, they decreased after surgery, although they did not entirely disappear. Full article

Background/Objectives: Loneliness can be differentiated from social isolation. The first is the subjective perception of being isolated from others, while the other is the entire emotional and social experience. The feeling of loneliness defines the discrepancy between desired and actual social relations. Loneliness is an unpleasant phenomenon that involves quantitative and qualitative impoverishment of interpersonal relationships. The aim of this study was to analyze feelings of loneliness—including intimacy, social connections, and belonging—among adolescents and how these feelings relate to different aspects of family relationships, such as communication, cohesion, autonomy-control, and identity. Methods: The study was conducted among 136 adolescents (aged 15–17, 70% of girls and 30% of boys). The following self-report measures were used: the R-UCLA Loneliness Scale, the State–Trait Anxiety Inventory (STAI)—X2, and the Family Relations Questionnaire, version: My Family. Correlation analyses were performed, followed by stepwise regression for three loneliness sub-scales. Results: The results have shown that anxiety and adverse family relationship factors were identified as significant predictors of adolescent loneliness. Communication, cohesion, autonomy-control, and identity within the family context each contributed uniquely to the experience of loneliness. Conclusions: The conclusion is that trait anxiety and the evaluation of family functioning are very strong predictors of loneliness among young people. Moreover, distinct aspects of family relationships shape different forms of loneliness, highlighting the multifaceted nature of adolescent social experiences. Full article

Background: Depression and anxiety during pregnancy are global public health issues, as both are linked to adverse outcomes for mothers and their newborns. This study aimed to determine the prevalence of depression and anxiety during pregnancy and identify the factors associated with these conditions in Mexican women. Methods: This prospective cohort study included 288 participants. The Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory were applied during the second trimester of pregnancy. The factors associated with depression and anxiety were analyzed. Results: The prevalence of depression and anxiety was 20.5% (95% confidence interval (CI) 16.1–25.7) and 22.2% (95% CI 17.8–27.3), respectively. The factors independently associated with an increased risk of depression, expressed as adjusted odds ratios with (95% CI), were anxiety, 10.8 (5.4–21.6), p = 0.0001, and educational level, secondary school and high school, 2.6 (1.10–6.14). In contrast, a bachelor’s degree was associated with a lower risk of depression, 0.38 (0.16–0.90), p = 0.03. The factors independently associated with a higher risk of anxiety were depression, 11.2 (5.6–22.1), and having children, 3.1 (1.6–6.1), p = 0.03. Conclusions: Our results show that one in five pregnant women exhibit clinical symptoms of depression or anxiety, and one in eight women have both conditions simultaneously. These findings highlight the importance of routine mental health screening and assessment during pregnancy. The factors linked to depression include anxiety and having completed secondary or high school education, while depression and having children were associated with anxiety. Full article

Forest therapy, guided by clinical professionals (psychologists or psychotherapists), is increasingly recognized as a preventive and complementary health practice with evidence-based therapeutic potential; however, the specific contribution of therapist guidance compared to self-guided immersion remains unclear. This retrospective study evaluated the short-term mental health outcomes of therapist-guided (TG) compared to self-guided (SG) forest immersion, based on the validated State–Trait Anxiety Inventory and Profile of Mood States questionnaires. Data were collected from 282 adults participating in eight paired TG–SG sessions conducted at the same forest sites across Italy. The results showed that TG sessions were associated with greater improvements in state anxiety, self-esteem, and total mood disturbance, with statistically significant effects in most cases. Therapist-led guidance also occasionally reduced interindividual variability, suggesting enhanced emotional regulation. An illustrative economic assessment, based on standardized psychometric improvements translated into quality-adjusted life years (QALYs), indicated that the TG sessions yielded approximately 1.7 times the annual per-person economic value of the SG sessions, outweighing the associated therapist-related costs. These findings suggest that TG forest therapy interventions deliver significant and economically quantifiable added value compared to SG experiences, supporting their inclusion in preventive health and mental well-being programs and justifying further longitudinal and cost-effectiveness investigations. Full article