Associations between (sub) clinical stress- and anxiety symptoms in mentally healthy individuals and in major depression: a cross-sectional clinical study

Abstract

Background: Responses to stressful circumstances have psychological and physiological dimensions, and are related to anxiety symptoms and mental disorders such as depression. Nonetheless, the relationship between subclinical stress and anxiety symptoms is still elusive. Methods: To explore possible associations between stress and anxiety symptoms, patients with major depression (N = 77) and mentally healthy individuals of different age clusters and occupations (N = 412) were enrolled into the study. Stress was assessed with the new subclinical stress symptom questionnaire (SSQ-25). Anxiety was studied with the Beck Anxiety Inventory (BAI), mainly focusing on clinical anxiety, whilst anxiety as a personality trait was assessed with the trait aspect of the State Τrait Αnxiety Ιnventory Y (STAI Y). Statistical analyses included ANOVA, Scheffe test, linear regression models and a two-step cluster analysis using Log-Likelihood Distance measure and fixed number of two clusters. Results: Age, stress symptoms and BAI scores differed significantly between among groups (P < 0.001), whilst STAI Y scores did not. Stress levels were found to be related to clinical anxiety (P < 0.001), while neither group identity nor age exerted any influence on anxiety levels (P > 0.05). The two Step Cluster analysis classified 76 out of 77 participants with milder stress (subclinical) symptoms into the cluster with moderate anxiety, as indicated by BAI scores, and all individuals with more severe stress into the severe anxiety cluster. Conclusions: The observed associations between stress and anxiety shed light on the interrelations between even very mild (subclinical) stress and anxiety symptoms and may point to the potential of mild stress to serve as a target for early interventions aiming to prevent anxiety morbidity.

Poor sleep quality is associated with greater negative consequences for cognitive control function and psychological health after mild traumatic brain injury than after orthopedic injury.

“…Recent findings have suggested that the BSI-18 is better at capturing psychiatric morbidity with a substantially lower cut-off score for clinical significance than the originally defined BSI-18 cut-off, when compared to a psychiatric interview (Grassi et al, 2018). Still, excessive, but subclinical levels of psychological distress may have negative consequences and interfere with daily life (Konstantopoulou et al, 2020) and our results indicate that such subclinical symptoms are also important to consider after mTBI. Our findings extend findings from prior studies (Kalmbach et al, 2018; Theadom et al, 2015) by showing that poor sleep quality seems to be particularly disruptive to psychological health after mTBI.…”

Anxiety mediates the relationship between childhood adversity and perceived current life stress in a diverse sample of emerging adults

“…We justified the inclusion of both anxiety measures in the current study due to the overlap between anxiety and depression symptoms (Janiri et al, 2020) and the weaker discriminant validity of the STAI (Julian, 2011). In addition, a recent study comparing non-clinical and depressive groups were found to exhibit similar levels of stress not attributable to trait anxiety alone, as both groups did not differ on this measure (Konstantopoulou et al, 2020). Moreover, our results are consistent with past research that has demonstrated high convergent validity between the measures administered in our study (Julian, 2011).…”

Hospital workforce mental reaction to the pandemic in a low COVID-19 burden setting: a cross-sectional clinical study

“…Despite the considerable symptom overlap between anxiety and depression and their common pathogenetic underpinnings [ 40 ], there was a decoupling between the pattern of anxiety and depression symptom variation across the groups. In accordance with the pattern of anxiety symptom variation, more severe depression symptoms were detected in backstage hospital workforces compared to online survey participants, while quite unexpectedly, frontline health professionals reported less severe depression symptoms than backstage hospital employees.…”