The Role of Personality Traits and Delivery Experience in Fear of Childbirth: A Prospective Study

This study aimed to examine fear of childbirth (FOC) before and after delivery in relation to personality (anxiety and anxiety sensitivity) and birth experience (type of delivery, pain, and staff support). One-hundred and five women completed questionnaires during pregnancy and one month after childbirth. Participants completed the Wijma Delivery Expectancy/Experience Questionnaire; the State and Trait Anxiety Inventory and Anxiety Sensitivity Index, and the McGill Pain Questionnaire and a Support from staff questionnaire. FOC levels decreased after childbirth, but only in the high-level fear group. Path analysis showed that physical concerns, one aspect of anxiety sensitivity, shape FOC during pregnancy. Together with interventions at delivery (instrumental vaginal delivery and emergency caesarean section), pain and low staff support, this in turn modifies FOC after delivery. In conclusion, FOC decreases after childbirth. However, combined with adverse birth experience and certain personality traits, FOC during pregnancy affects FOC after delivery.

Anxiety Sensitivity Domains are Differently Affected by Social and Non-social Autistic Traits

Anxiety sensitivity (AS) is implicated in the development and maintenance of several psychopathological conditions. Non-clinical individuals with high autistic traits may develop anxiety disorders and depressive symptoms. Here, we investigated the relationships of autistic traits with AS dimensions and depression, considering sex. We referred to the two-factor model of the autism spectrum quotient to distinguish social and non-social autistic traits and assessed 345 university students on AS and depression scales. Results showed that only social autistic traits predicted general AS and anxiety-related concerns regarding social and cognitive domains. The present results emphasize the need of assessing multiple domains of anxiety in individuals on the autistic spectrum, differentiating social and non-social traits.

Psychological contribution to understanding the nature of dry eye disease: a cross-sectional study of anxiety sensitivity and dry eyes

Dry eye disease (DED) represents a common health problem in the general population. Previous studies have demonstrated that the subjective symptoms of dry eye are associated with several psychological factors, including depression, anxiety and post-traumatic stress disorder. However, there is a lack of empirical information about the mechanisms underlying the relationships between DED and various psychological symptoms. In light of emerging evidence of its trans-diagnostic nature, anxiety sensitivity (i.e. AS) represents one promising factor for further understanding DED. The present study aimed to explore whether anxiety sensitivity plays a role in the perception of DED symptoms in a community-based sample of adults aged 20-89 years (N = 381; M = 39.72, SD = 12.6). A dry ocular surface was reported by 22.8% of the participants. As expected, women more often reported symptoms of dry eye that could be categorized as moderate to severe. The findings demonstrated that AS, and the AS-psychological concerns dimension in particular, predict the intensity of dry eye symptoms above and beyond depressive and anxiety symptoms. These findings add to a growing body of work underscoring the relevance of AS in increasing the risk of chronic medical conditions.

Are non-pregnant women afraid of childbirth? Prevalence and predictors of fear of childbirth in students

Introduction: Fear of childbirth (FOC) has been mostly studied in peripartum women; however, it can be present in non-pregnant young women, and the question is whether it occurs even before pregnancy planning. Objective: (1) to determine the prevalence of clinically significant FOC in non-pregnant female students, and (2) to investigate the role of anxiety sensitivity (AS), trait anxiety, childbirth pain expectancy, and sources of birth knowledge for FOC. Methods: Non-pregnant female students (N = 374) from different study programmes (health studies, social sciences and humanities, and biotechnical studies) participated in the study. They completed Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A), The State-Trait Anxiety Inventory (STAI-T), Anxiety Sensitivity Index (ASI), the average expected labor pain, and sources of information about childbirth. Results: The results showed that 25.9% of students reported clinically significant FOC. FOC could be predicted by postponing pregnancy planning, the high expectancy of labor pain, high trait anxiety, and high physical dimension of AS. Students from health sciences reported a lower level of FOC, as opposed to social science and humanities' students. Students reported receiving the most information about childbirth from family and the least from the professional books. Conclusions: Fear of childbirth is highly prevalent in the sample of young nulliparous women with one in four women reporting clinically significant fear. The higher levels of the FOC could be predicted, by AS, trait anxiety, expected labor pain, and sources of knowledge about the childbirth. Implications of the findings are discussed.

The experience of perimenopausal distress: examining the role of anxiety and anxiety sensitivity

OBJECTIVE

The hormonal changes that occur in perimenopause can result in distress for a significant proportion of women years before reaching menopause. Previous studies have suggested that various biopsychosocial characteristics and personality traits contribute to more intense reactions to these hormonal changes. In the present study, we examined the contribution of trait anxiety and anxiety sensitivity in predicting the experience of perimenopausal distress in pre- and early perimenopausal women while controlling for some menstrual experiences.

METHOD

A sample of 660 women aged 35-52 years was selected from a broader online survey of biopsychosocial changes in middle-aged women that considered age, menstrual cycle pattern, physical and mental health, and childbearing experience. Three hierarchical multiple regression analyses were conducted for different age subgroups: women aged 35-40, women aged 41-45 and women aged 46-52.

RESULTS

Results indicated that anxiety and anxiety sensitivity, along with a number of features of the menstrual experience, explained 56-66% of the perimenopausal distress variance. Different personality trait predictors were found to be important in different age subgroups. In the youngest and middle subgroups (45 years and younger), trait anxiety was found to be more significant, whereas anxiety sensitivity was found to be more important in explaining perimenopausal distress experienced by women older than 40.

CONCLUSION

Anxiety sensitivity (dimension of psychological concerns) might be an important vulnerability factor in the experience of perimenopausal distress among women closer to menopause, whereas the predisposition to an anxiety response might contribute to perimenopausal distress near the beginning of reproductive hormonal changes. Implications for better understanding the development of perimenopausal distress and psychological intervention are discussed.

Multimodal analysis of startle type responses

BACKGROUND AND OBJECTIVE

This article presents a multimodal analysis of startle type responses using a variety of physiological, facial, and speech features. These multimodal components of the startle type response reflect complex brain-body reactions to a sudden and intense stimulus. Additionally, the proposed multimodal evaluation of reflexive and emotional reactions associated with the startle eliciting stimuli and underlying neural networks and pathways could be applied in diagnostics of different psychiatric and neurological diseases. Different startle type stimuli can be compared in the strength of their elicitation of startle responses, i.e. their potential to activate stress-related neural pathways, underlying biomarkers and corresponding behavioral reactions.

METHODS

An innovative method for measuring startle type responses using multimodal stimuli and multimodal feature analysis has been introduced. Individual's multimodal reflexive and emotional expressions during startle type elicitation have been assessed by corresponding physiological, speech and facial features on ten female students of psychology. Different startle eliciting stimuli like noise and airblast probes, as well as a variety of visual and auditory stimuli of different valence and arousal levels, based on International Affective Picture System (IAPS) images and/or sounds from International Affective Digitized Sounds (IADS) database, have been designed and tested. Combined together into more complex startle type stimuli, such composite stimuli can potentiate the evoked response of underlying neural networks, and corresponding neurotransmitters and neuromodulators as well; this is referred to as increased power of response elicitation. The intensity and magnitude of multimodal responses to selected startle type stimuli have been analyzed using effect sizes and medians of dominant multimodal features, i.e. skin conductance, eye blink, head movement, speech fundamental frequency and energy. The significance of the observed effects and comparisons between paradigms were evaluated using one-tailed t-tests and ANOVA methods, respectively. Skin conductance response habituation was analyzed using ANOVA and post hoc multiple comparison tests with the Dunn-Šidák correction.

RESULTS

The results revealed specific physiological, facial and vocal reflexive and emotional responses on selected five stimuli paradigms which included: (1) acoustic startle probes, (2) airblasts, (3) IAPS images, (4) IADS sounds, and (5) image-sound-airblast composite stimuli. Overall, composite and airblast paradigms resulted in the largest responses across all analyzed features, followed by sound and acoustic startle paradigms, while paradigm using images consistently elicited the smallest responses. In this context, power of response elicitation of the selected stimuli paradigms can be described according to the aggregated magnitude of the participants' multimodal responses. We also observed a habituation effect only in skin conductance response to acoustic startle, airblast and sound paradigms.

CONCLUSIONS

This study developed a system for paradigm design and stimuli generation, as well as real-time multimodal signal processing and feature calculation. Experimental paradigms for monitoring individual responses to stressful startle type stimuli were designed in order to compare the response elicitation power across various stimuli. The developed system, applied paradigms and obtained results might be useful in further research for evaluation of individuals' multimodal responses when they are faced with a variety of aversive emotional distractors and stressful situations.

Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women

OBJECTIVE

The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensitivity in FOC among nulliparous and multiparous women in the last trimester of pregnancy.

METHOD

Two-hundred pregnant women completed a booklet with questionnaires including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Anxiety Sensitivity Index (ASI), The State - Trait Anxiety Inventory (STAI) and questions on expected labor pain and demographics.

RESULTS

Results showed that FOC was higher amongst nulliparous women, but FOC level was not associated with other demographic variables. Different predictors were established in nulliparous and multiparous women. While higher intensity of expected labor pain and anxiety sensitivity (dimension physical concern) were significant predictors in both groups, trait anxiety was significant for the first-time mothers only.

CONCLUSION

Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.