Anxiety, depression, and the content of worries

Depressive and anxiety symptoms during the COVID-19 pandemic in the oldest-old population and the role of psychosocial factors: a multivariate and multi-wave analysis

Background

Since the oldest-old population was identified as a high-risk group for a severe course of the coronavirus disease and higher mortality, it was assumed that they might be particularly psychologically burdened. The aim of the study is to analyze the development of anxiety and depressive symptoms over the course of the pandemic from 2020 to 2022, as well as psychosocial factors associated with these outcomes.

Method

We analyzed data of n = 135 participants aged 78 to 97 years old (2020: M = 86.77, SD = 4.54) with three points of measurement from May to June 2020 (t1), March to May 2021 (t2) and November to January 2022 (t3). Besides sociodemographic variables, worries about the Sars-Cov-2 virus, living situation, perceived social support (ESSI), resilience (BRS), anxiety and depressive symptoms (BSI-18) were assessed. We calculated multilevel mixed-effects generalized linear models with a negative binominal distribution to model anxiety and depressive symptoms over time.

Results

While there is an increase in depressive and anxiety symptoms in the investigated oldest-old individuals in Germany from 2020 to 2021, there is no further increase in symptomatology from 2021 to 2022. Participants of older age reported higher levels of anxiety symptoms. Higher perceived social support was associated with both less depressive and less anxiety symptoms, while resilience was associated with less depressive symptoms only. More worries about the Sars-Cov-2 virus were associated with higher anxiety levels.

Conclusion

Overall, the oldest-old population appeared to show rather stable mental health after a slight increase in symptomatology within the first year of the pandemic. Social support is an important factor to target in mental health prevention programs for oldest-old individuals in times of future crises such as a pandemic.

What Are You Worried About? Content and Extent of Worry in Autistic Adults

Autistic adults commonly experience anxiety and worry, although knowledge on how worry presents and the content, extent, and experiences among autistic adults is limited. A convergent parallel mixed-methods approach was used to explore the presentation and experiences of worry in autistic and non-autistic adults. Quantitative surveys were used to compare the content and extent of worry in autistic adults to non-autistic adults, with semi-structured interviews also conducted with autistic adults to gain a deeper understanding of the experiences, impacts and content of worry in autistic adults. Findings indicated that autistic adults demonstrated clinically significant levels of worry which were substantially higher than non-autistic adults. Autistic adults described worry as a cycle of negative thoughts impacting their daily life. Findings indicate that autistic adults may worry more than non-autistic adults, impacting on participation in activities of daily living, sleep, and mental health.

Depression and Anxiety in Old Age during the COVID-19 Pandemic: A Comparative Study of Individuals at Cardiovascular Risk and the General Population

Our study aims to examine the associations of sociodemographic factors, social support, resilience, and perceptions of the COVID-19 pandemic with late-life depression and anxiety symptoms in a cardiovascular risk group and a matched sample from the German general population during the beginning of the pandemic and draw a comparison regarding psychosocial characteristics. Data of n = 1236 participants (aged 64-81 years) were analyzed, with n = 618 participants showing a cardiovascular risk profile, and n = 618 participants from the general population. The cardiovascular risk sample had slightly higher levels of depressive symptoms and felt more threatened by the virus due to pre-existing conditions. In the cardiovascular risk group, social support was associated with less depressive and anxiety symptoms. In the general population, high social support was associated with less depressive symptoms. Experiencing high levels of worries due to COVID-19 was associated with more anxiety in the general population. Resilience was associated with less depressive and anxiety symptoms in both groups. Compared to the general population, the cardiovascular risk group showed slightly higher levels of depressive symptomatology even at the beginning of the pandemic and may be supported by addressing perceived social support and resilience in prevention programs targeting mental health.

Coping with stress during the COVID-19 pandemic in the oldest-old population

The aim of the study is to investigate psychosocial factors that are associated with positive and negative coping with stress, as well as with worries about and perceived threat by COVID-19 to enable us to provide adequate support for oldest-old individuals. A paper-pencil-based survey assessed COVID-19 worries and perceived threat, depression, anxiety, somatization, social support, loneliness, resilience, positive and negative coping in a sample of n = 197 oldest-old individuals (78-100 years). Linear multivariate and binary logistic regression analyses were conducted. Individuals with high levels of resilience were more likely to feel self-efficient when coping with stress. High levels of depression, anxiety and loneliness were associated with feeling more helpless when coping with stress. However, oldest-old individuals who felt lonely also experienced situations where they felt competent in stress coping. Being male and experiencing high levels of social support was more likely associated with high levels of worries due to COVID-19. Increased age and higher levels of depression were associated with lower levels of perceived personal threat, whereas higher somatization scores were more likely associated with higher perceived personal threat. Findings suggest that mental health factors may shape the way oldest-old individuals cope with pandemic-related stress. Resilience might be an important factor to take into account when targeting an improvement in positive coping with stress. Oldest-old individuals who have higher levels of depression, anxiety and feel lonely may be supported by adapting their coping skill repertoire to reduce the feeling of helplessness when coping with stress.

Examining the mental health adversity among healthcare providers during the two waves of the COVID-19 pandemic: results from a cross-sectional, survey-based study

OBJECTIVES

The current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors.

DESIGN

Cross-sectional surveys.

SETTING AND PARTICIPANTS

Self-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020.

PRIMARY AND SECONDARY OUTCOME MEASURES

COVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed.

RESULTS

The results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald's χ²=4.36, p=0.04) and distress (Wald's χ²=25.18, p<0.001), as well as compromised well-being (Wald's χ²=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic.

CONCLUSIONS

Our results render the need for regular psychological surveillance in healthcare workers.

REGISTRATION

Hungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).

Neuroplastin in Neuropsychiatric Diseases

Molecular mechanisms underlying neuropsychiatric and neurodegenerative diseases are insufficiently elucidated. A detailed understanding of these mechanisms may help to further improve medical intervention. Recently, intellectual abilities, creativity, and amnesia have been associated with neuroplastin, a cell recognition glycoprotein of the immunoglobulin superfamily that participates in synapse formation and function and calcium signaling. Data from animal models suggest a role for neuroplastin in pathways affected in neuropsychiatric and neurodegenerative diseases. Neuroplastin loss or disruption of molecular pathways related to neuronal processes has been linked to various neurological diseases, including dementia, schizophrenia, and Alzheimer's disease. Here, we review the molecular features of the cell recognition molecule neuroplastin, and its binding partners, which are related to neurological processes and involved in learning and memory. The emerging functions of neuroplastin may have implications for the treatment of diseases, particularly those of the nervous system.

Correlation between private education costs and parental depression in South Korea

Background

In Korea, higher education has rapidly grown influenced by sociocultural tradition. Parents invest a significant portion of their household income in their children’s education. Private education has been considered to greatly affect students’ psychology and behavior. However, past research has largely neglected to study parents who pay these costs. Since household income and education level are important determinants of socioeconomic status (SES), education expenditures are likely to cause depressive symptoms. Therefore, the study aimed to investigate the correlation between private education costs and parental depression in South Korea.

Methods

Data were collected from the Korean Welfare Panel Study (KoWePS, 2015, 2018). The sample analyzed consisted of 397 and 337 fathers and 403 and 370 mothers in 2015 and 2018, respectively. The independent variable in this study was the proportion of private education cost. This proportion was calculated by dividing each household’s private education costs by its equivalized household disposable income (EHDI) and multiplying this number by 100. The main dependent variable was parental responses to the Center for Epidemiologic Studies Depression Scale-11 (CESD-11). Using a generalized linear model, we investigated the effects of the proportion of private education cost on parental depression.

Results

The results showed that fathers with higher proportions of private education cost exhibited higher CESD-11 scores compared to fathers with lower proportions cost (moderate: β = 0.419, S. E = 0.164, p = 0.0105; high: β = 0.476, S. E = 0.178, p = 0.0076), indicating that a higher ratio of private education cost may negatively affect depression in fathers. However, there was no discernable correlation between mothers’ CESD-11 scores and the proportion of private education cost (moderate: β = − 0.078, S. E = 0.250, p = 0.7555; high: β = 0.003, S. E = 0.215, p = 0.9882).

Conclusions

These results may be explained by the tendency for fathers to experience greater economic burdens than mothers in patriarchal Korean society.

Comorbid anxiety in late-life depression: Relationship with remission and suicidal ideation on venlafaxine treatment

OBJECTIVE

The purpose of this study was to examine the influence of comorbid anxiety symptoms on antidepressant treatment remission in older adults with major depressive disorder (MDD).

METHOD

In this multisite clinical trial, 468 older adults aged 60 years or older with MDD received open-label protocolized treatment with venlafaxine extended release (ER) titrated to a maximum of 300 mg daily. At baseline, anxiety was assessed with the Anxiety Sensitivity Index, the Brief Symptom Inventory (BSI) anxiety subscale, and the Penn State Worry Questionnaire. To measure treatment response, depressive symptoms and suicidality were assessed every 1-2 weeks with the Montgomery-Asberg Depression Rating Scale and the 19-item Scale for Suicide Ideation; anxiety was assessed with the BSI. Logistic regression and survival analysis were used to evaluate whether anxiety symptoms predicted depression remission. We also examined the relationships between anxiety scores and suicidality at baseline.

RESULTS

Baseline anxiety symptoms did not predict remission or time to remission of depressive symptoms. Depressive, worry, and panic symptoms decreased in parallel in patients with high anxiety. Anxiety symptoms were associated with the severity of depression and with suicidality.

CONCLUSION

In older adults with MDD, comorbid anxiety symptoms are associated with symptom severity but do not affect antidepressant remission or time to remission.

Heavy Study Investment in Italian College Students. An Analysis of Loscalzo and Giannini's (2017) Studyholism Comprehensive Model

Loscalzo and Giannini (2017) recently proposed the construct of studyholism (or obsession toward study) and a theoretical model highlighting its potential antecedents and outcomes. This study aims to analyze some of these antecedents and outcomes by means of a path analysis including both studyholism and study engagement. The participants are 1,958 Italian college students aged between 18 and 60 years (M age = 23.53 ± 4.43) and heterogeneous as far as their year and major of study are concerned, as well as concerning the city in which they attended their courses. They filled some instruments that allow evaluating studyholism and study engagement, along with individual and situational antecedents (e.g., worry and overstudy climate) and outcomes (e.g., sleep quality, study-relationships conflict, dropout intention). In addition to the path model we performed aiming to test the direct effects we hypothesized, we performed two MANOVAs for analyzing if there were differences on the antecedents and outcomes among the four kinds of student suggested by Loscalzo and Giannini (2017; i.e., engaged studyholics, disengaged studyholics, engaged students, and detached students). The results of this study support Loscalzo and Giannini's (2017) conceptualization of studyholism as an internalizing disorder, since worry is the strongest predictor of studyholism (β = .67, p < .001). In addition, in line with Loscalzo and Giannini's (2017) theorization, we found some differences among the four kinds of student on both the antecedents and outcomes we analyzed. This study has critical theoretical, preventive, and clinical implications. It supports the definition of studyholism as an OCD-related disorder. Also, about preventive implications, it shows that interventions aiming to favor students' wellbeing should target also engaged students, since study engagement predicts social impairment as well as studyholism. Finally, it suggests that in a clinical setting, it is important to distinguish between disengaged studyholics and engaged studyholics as they have different relationships with some antecedents and outcomes; also, they both have functional impairment, even if in different areas.

Heterogeneity Matters: Predicting Self-Esteem in Online Interventions Based on Ecological Momentary Assessment Data

Self-esteem is a crucial factor for an individual's well-being and mental health. Low self-esteem is associated with depression and anxiety. Data about self-esteem is oftentimes collected in Internet-based interventions through Ecological Momentary Assessments and is usually provided on an ordinal scale. We applied models for ordinal outcomes in order to predict the self-esteem of 130 patients based on diary data of an online depression treatment and thereby illustrated a path of how to analyze EMA data in Internet-based interventions. Specifically, we analyzed the relationship between mood, worries, sleep, enjoyed activities, social contact, and the self-esteem of patients. We explored several ordinal models with varying degrees of heterogeneity and estimated them using Bayesian statistics. Thereby, we demonstrated how accounting for patient-heterogeneity influences the prediction performance of self-esteem. Our results show that models that allow for more heterogeneity performed better regarding various performance measures. We also found that higher mood levels and enjoyed activities are associated with higher self-esteem. Sleep, social contact, and worries were significant predictors for only some individuals. Patient-individual parameters enable us to better understand the relationships between the variables on a patient-individual level. The analysis of relationships between self-esteem and other psychological factors on an individual level can therefore lead to valuable information for therapists and practitioners.

Examining characteristics of worry in relation to depression, anxiety, and suicidal ideation and attempts

BACKGROUND

Pathological worry is defined as worry that is excessive, pervasive, and uncontrollable. Although pathological worry is related to depression, anxiety, and suicidal ideation, less is understood about what specific features of worry confer risk for these mental health conditions. The current study examined associations between four characteristics of worry-frequency, duration, controllability, and content-and self-reported symptoms of depression, anxiety, suicidal ideation, and lifetime suicide attempts.

METHODS

A sample of 548 community participants (53.6% female, 45.4% male, 0.5% transgender male, 0.2% transgender female, and 0.2% gender non-binary), aged 19-98 years (M = 36.54, SD = 12.33), was recruited via Amazon's MTurk and completed a battery of self-report questionnaires online.

RESULTS

Results indicated that controllability of worry was uniquely associated with depression, anxiety, and suicidal ideation above and beyond other characteristics of worry, demographic variables, negative affect, and future-oriented repetitive thinking. Lifetime suicide attempts were found non-significant to these mental health outcomes. Frequency of worry was also positively related to depression.

LIMITATIONS

This study utilized a cross-sectional design with exclusive self-report measures.

CONCLUSIONS

Overall, these findings suggest that controllability of one's thoughts may be a key transdiagnostic factor that confers risk for a variety of psychopathology-related concerns. Clinical relevance includes identifying potential risk factors for varying psychopathology. Future research should examine relationships between worry controllability and anxiety, depression, suicidal ideation, and attempts, within clinical samples and utilizing a variety of methodologies.

Salivary Cortisol Levels and Depressive Symptomatology in Consumers and Nonconsumers of Self-Help Books: A Pilot Study

The self-help industry generates billions of dollars yearly in North America. Despite the popularity of this movement, there has been surprisingly little research assessing the characteristics of self-help books consumers, and whether this consumption is associated with physiological and/or psychological markers of stress. The goal of this pilot study was to perform the first psychoneuroendocrine analysis of consumers of self-help books in comparison to nonconsumers. We tested diurnal and reactive salivary cortisol levels, personality, and depressive symptoms in 32 consumers and nonconsumers of self-help books. In an explorative secondary analysis, we also split consumers of self-help books as a function of their preference for problem-focused versus growth-oriented self-help books. The results showed that while consumers of growth-oriented self-help books presented increased cortisol reactivity to a psychosocial stressor compared to other groups, consumers of problem-focused self-help books presented higher depressive symptomatology. The results of this pilot study show that consumers with preference for either problem-focused or growth-oriented self-help books present different physiological and psychological markers of stress when compared to nonconsumers of self-help books. This preliminary study underlines the need for additional research on this issue in order to determine the impact the self-help book industry may have on consumers' stress.

A Biobehavioral Framework of Worry for Nursing Application

Worry, characterized by repetitive and involuntary aversive thoughts about perceived concerns, is a central mental health complaint known to negatively impact quality of life of individuals facing perceived threats to health or well-being. Although empirical focus on worry has escalated over the past three decades, there has been less attention to current research trends and knowledge development related to this important phenomenon in nursing. This article presents a biobehavioral conceptual framework of worry for nursing application that is derived from a concept synthesis of biological, behavioral, clinical, and cognitive psychology sources.

Databases including CINAHL, EBM Review, Health & Wellness Resource Center, PsycINFO, and PubMed were systematically reviewed for the years 2000–2012. The adapted conceptual framework describes relationships among perceived threat; process, structure, and content worry attributes; and outcomes of worry. The framework may be applied in clinical environments as a resource to better understand and care for patients facing perceived threats to health and well-being. The framework contributes a foundation to build empirical knowledge for nursing practice, theory, and research that has potential to improve patient well-being and health-related quality of life outcomes.

Watching the paint dry at work: psychometric examination of the Dutch Boredom Scale

Boredom at work is a state of employee unwell-being that is characterized by relatively low arousal and high dissatisfaction. At present little is known about boredom at work. In order to facilitate future research, the current study introduces a brief self-report questionnaire that assesses boredom at work, the Dutch Boredom Scale (DUBS). We argue that (1) boredom at work can be distinguished empirically from related concepts such as work engagement and job burnout; (2) boredom at work results from having an unchallenging, "passive" job; and (3) the subsequent lack of challenge in the form of boredom may result in dissatisfaction with the job and with the organization. Using data from 6315 employees, factor analysis supported the factorial and discriminant validity of the DUBS vis-à-vis engagement and burnout. As expected, structural equation modeling revealed that demands and resources were negatively associated with boredom. Moreover, boredom at work was negatively related with job satisfaction and organizational commitment, and positively with turnover intention. These findings support the validity of the DUBS. Future research may focus on underemployment as an antecedent of boredom at work, and on the effects of boredom on job performance.

The spectrum of worry in the community-dwelling elderly

OBJECTIVES

In this study, we examine the prevalence and distribution of worry, its content, and its associations with quality of life and depression, based on a large sample of community-dwelling elderly. We will attempt to distinguish between pathological and non-pathological worry based on these associations.

DESIGN

Community survey.

SETTING

Inner-city population.

PARTICIPANTS

A total of 2136 people aged between 65 and 96, of whom 66% were women, were recruited through general practitioners and interviewed in their own homes.

MEASUREMENTS

The GMS-AGECAT structured psychiatric interview was used to rate symptoms which were classified into five levels of severity of worry ranging from simple, non-excessive to generalised anxiety disorder (GAD).

RESULTS

In this study, 79% of the participants reported worrying, 37% worrying excessively, while 20% reported excessive, uncontrollable worry and 6.3% met criteria for GAD. Prevalence of all types of worry declined with age and was lower in men. The prevalence of depressed mood was similar in those without worry and those with non-severe worry (Wald post hoc test, p = 0.06) but rose significantly with each level of severe worry (Wald post hoc tests, all p < 0.05). Major depressive disorder was absent in those who did not worry, and had a prevalence of only 0.2% in those with non-severe worry (p = 0.552, Fisher's exact test). It has a significantly elevated prevalence at all levels of excessive worry, and a significantly higher prevalence in those with GAD. All levels of excessive worry were associated with reduced quality of life.

CONCLUSION

Severe worry is highly prevalent in the elderly; most severe worriers do not meet criteria for GAD, but have a reduced quality of life and an increased prevalence of depression.

Worry in Older Community-Residing Adults

With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly ( n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0–3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4–8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills.

What drives retirement income worries in Europe? A multilevel analysis

Nations in Europe have been developing rapidly since the formation of the European Union (EU), not only socially and demographically, but economically as well. One question a number of countries will face during this period of structural transition will be how (and how well) they are able to support their citizens in old age. A related question involves whether individuals worry about their financial future in retirement, and the extent to which they take active steps to save in order to ensure an adequate standard of living. In this study, we analyze data from the third wave of the European Social Survey, which represents 21,416 working adults from 23 countries in Europe. We used multilevel modeling to focus on the explanatory factors that underlie individual and country-level effects in worry about future retirement income and saving behavior. Findings suggest that once individual-level dimensions are taken into account, country-level predictors explain appreciable variance in worry, but not saving practices. Moreover, we found that retirement income worries are more severe in countries with a strong projected increase in future population aging and a high level of income inequality. Finally, pension age reforms were not found to appreciably affect retirement income worries. Results of the study are discussed in terms of not only the individual difference dimensions that precipitate future income worry and saving, but also ways in which macro-level policy initiatives could potentially alleviate some of the worries of European citizens.

Interacting effects of worry and anxiety on attentional disengagement from threat

Recent work suggests that the ability to disengage attention from threatening information is impaired in people who suffer from anxiety and dysphoria. It has been suggested that this impaired ability to disengage from threat might specifically be associated with the tendency to perseverate about threat (i.e., worry), which is a main characteristic of anxiety disorders and a wide range of other psychopathologies. However, no studies have yet addressed this issue. The present study examined whether trait worry as well as worry intensity after experimental worry induction are associated with impaired ability to disengage attention from threatening cues (angry faces), independently from or in conjunction with anxiety. Sixty-one participants performed a visual cueing experiment that required detection of a target stimulus at one of two possible locations. Prior to the target neutral, happy or angry facial cues appeared at one of these two locations; when there is a relatively long period between the cue and the target (> 300 ms), an overall faster responding to invalidly cued trials relative to validly cued trials is believed to indicate inhibition of return (IOR) to a recently attended location. A reduced IOR for angry faces was only found when both trait worry and anxiety were high. When anxiety was kept constant, both trait worry and state worry were associated with enhanced IOR for neutral faces instead. The results seem to suggest that specific threat-related deficiencies in IOR may be a function of the co-occurrence of worry and anxiety.

Capturing worry in daily life: Are trait questionnaires sufficient?

Worry is crucial in the development and maintenance of anxiety disorders and has been associated with several other adverse health outcomes. Yet, little is known about the frequency and perseveration of worry in daily life, and its predictability by widely used trait questionnaires. In this study 432 students completed the Penn State Worry Questionnaire (PSWQ), the Worry Domains Questionnaire (WDQ) and the State-Trait Anxiety Inventory-Trait version (STAI-T) and kept a log of worry frequency and duration during six consecutive days and nights. The results showed that worry is a very common phenomenon that is predicted by the two trait worry questionnaires, independent of trait anxiety. The often clinically utilized PSWQ predicted worry duration better than the WDQ, and exclusively predicted night-time worry and several other indices of perseverative and potentially pathogenic worry. Although this study provides some support for the predictive validity of the PSWQ and the WDQ, these questionnaires did not account for the larger part of variance in daily worry. Future studies of worry and its associated perseverative processes should consider using momentary assessments.

Cognitive specificity of anxiety disorders: a review of selected key constructs

Cognitive models of anxiety disorders propose that certain cognitive constructs, that is, underlying beliefs and cognitive processes, may be specific for particular disorders. In this article, we review the specificity of four representative cognitive constructs-anxiety sensitivity, pathological worry, intolerance of uncertainty, and thought-action fusion-for particular disorders. Conceptual overlap, inconsistent definitions, and insufficient consideration of the components of these constructs are limitations of the existing literature. We suggest that the constructs are unlikely to be pathognomonic for any given disorder or to occur in isolation. Rather, the association of each cognitive construct is evident, to varying degrees, with different disorders. Relative to other disorders, anxiety sensitivity is to a certain extent specific for panic disorder, as are pathological worry for generalized anxiety disorder, intolerance of uncertainty for generalized anxiety disorder and obsessive-compulsive disorder, and thought-action fusion for obsessive-compulsive disorder. We discuss the implications of these findings for diagnostic systems and treatment, and suggest areas for further research.

A Brief Measure of Worry Severity (BMWS): personality and clinical correlates of severe worriers

This report describes the development of a brief and valid self-report measure to assess severe and dysfunctional worry (the Brief Measure of Worry Severity or BMWS). Using three independent subject groups (clinical and non-clinical), the measure was used to examine the differential severity of worry in depression and anxiety and to examine the clinical and personality correlates of severe worriers. Preliminary psychometric evaluation revealed that the BMWS possesses good construct and clinical discriminant validity. Subjects reporting greater worry severity tended to be more "introverted" and "obsessional," but less "agreeable" and "conscientious." Subjects with depression only, reported less problems with worrying compared to those with co-morbid anxiety disorders. However, among the anxiety disorders, severe and dysfunctional worry was not exclusively experienced by subjects with generalized anxiety disorder (GAD). This study suggests that pathological worry is not only relevant for patients with GAD, but may be an equally detrimental cognitive activity for patients with panic disorder and obsessive-compulsive disorder.

Stress, burnout, anxiety and depression among dentists

BACKGROUND

Dentists encounter numerous sources of professional stress, beginning in dental school. This stress can have a negative impact on their personal and professional lives.

CONCLUSIONS

Dentists are prone to professional burnout, anxiety disorders and clinical depression, owing to the nature of clinical practice and the personality traits common among those who decide to pursue careers in dentistry. Fortunately, treatment modalities and prevention strategies can help dentists conquer and avoid these disorders.

PRACTICE IMPLICATIONS

To enjoy satisfying professional and personal lives, dentists must be aware of the importance of maintaining good physical and mental health. A large part of effective practice management is understanding the implications of stress.

Development of a Worry Questionnaire for Nursing Home Residents

This paper describes a new measure, the Worry Questionnaire for Nursing Home Residents (WQNHR), designed to assess the frequency of specific worries. It was administered to 67 residents. Psychometric evaluation showed an average item-to-total correlation of 0.20 (range = 0.15 to 0.58), an internal consistency estimate of 0.79, and a test-re-test reliability coefficient of 0.80. The WQNHR showed good convergent validity with other measures of worry obtained from residents, good discriminant validity with measures of health, but poor discriminant validity with self-ratings of depression. Psychometric results also indicated that the WQNHR performed better for residents with higher cognitive functioning. In addition, a collateral form (WQNHR-C) was administered to family or friends; however, it was not significantly correlated with the WQNHR. Overall, the WQNHR is a promising screening instrument for assessing worry in nursing home residents.

What's the use of worrying? Its function and its dysfunction

OBJECTIVE

To provide an overview of theory and research regarding the phenomenology and function of worry.

METHOD

A systematic literature search focusing on conceptualizations of worry as a cognitive activity and worry research over the last 20 years was conducted.

RESULTS

Worry can be both functional and dysfunctional. Disruption to daily functioning, perceived uncontrollability, pervasiveness and extensive coverage of worry themes (including "remote" events and the presence of meta-worry), all have specificity to more severe and dysfunctional worry.

CONCLUSIONS

Research investigating both the relationship between worry and anxiety and the attributes of severe worriers, has brought attention to its role in fostering emotional disturbance and has clarified factors relevant to treatment.