BACKGROUND: High levels of attention-deficit/hyperactivity disorder (ADHD) traits are associated with various outcomes, including depressive symptoms, functional impairment, and low self-esteem. Additionally, individuals with high levels of ADHD traits are reported to be more adversely affected by fear of coronavirus disease 2019 (COVID-19). The current study aimed to examine whether the association between ADHD traits and outcomes was partially mediated by fear of COVID-19 using mediation analysis. METHODS: A cross-sectional study was conducted in a sample of university students in medical-related faculties (n = 1,166). ADHD traits, fear of COVID-19, depressive symptoms, functional impairment, and self-esteem were assessed using the adult ADHD Self-Report Scale, Fear of COVID-19 Scale, K6 Scale, Sheehan Disability Scale, and Rosenberg Self-Esteem Scale, respectively. We used linear regression analysis and the Paramed command in Stata to analyze whether fear of COVID-19 mediated the association between ADHD traits and outcomes. RESULTS: ADHD traits were significantly associated with outcomes. Regarding the impact of fear of COVID-19, the results revealed a significant association between ADHD traits and fear of COVID-19, and between fear of COVID-19 and outcomes. The results of the mediation analyses showed that the association between ADHD traits and outcomes was partially mediated by the fear of COVID-19 (depressive symptoms: direct effect B = 1.029, 95% confidence interval [CI] 0.878, 1.181, indirect effect B = 0.021, 95% CI 0.002, 0.040; functional impairment: direct effect B = 0.786, 95% CI 0.593, 0.979, indirect effect B = 0.033, 95% CI 0.005, 0.060; self-esteem: direct effect B = -1.052, 95% CI -1.226, -0.878, indirect effect B = -0.024, 95% CI -0.046, -0.002). CONCLUSIONS Developing preventive measures against the adverse impacts of pandemics like COVID-19 will be particularly important for individuals with high levels of ADHD traits in future.
Humans ; COVID-19/psychology* ; Attention Deficit Disorder with Hyperactivity/epidemiology* ; Cross-Sectional Studies ; Self Concept ; Male ; Female ; Depression/epidemiology* ; Fear/psychology* ; Young Adult ; Universities ; Students/psychology* ; Adult ; SARS-CoV-2 ; Mediation Analysis ; Adolescent

OBJECTIVE: To investigate the current status of kinesiophobia after lumbar fusion surgery in patients with lumbar disc herniation (LDH) and to analyze its influencing factors. METHODS: A total of 489 LDH patients who underwent lumbar fusion surgery in our hospital from January 2021 to December 2022 and effectively filled out the tampa scale for kinesiophobia (TSK) and other questionnaires on the first day after surgery were collected as the study subjects, the current status of kinesiophobia in LDH patients after lumbar fusion surgery were investigated using the TSK. The LDH patients were grouped into a kinesiophobia group (n=221) and a non kinesiophobia group (n=268) based on whether there was kinesiophobia after lumbar fusion surgery. The self-designed general data questionnaires were used to collect data, and Logistic regression was applied to analyze independent risk factors for kinesiophobia after lumbar fusion surgery in the LDH patients. RESULTS: In the study, 221 out of the 489 LDH patients (45.19%) had kinesiophobia after lumbar fusion surgery. Univariate analysis showed that there were statistically significant differences between the phobic group and the non phobic group in terms of gender, education level, course of disease, whether there was hypoproteinemia, pain level, self-efficacy, social support, whether there was anxiety, and whether there was depression (P < 0.05). There were no statistically significant differences in terms of age, body mass index, monthly family income, marital status, residence, medical expense payment form, whether there was hypertension, whether there was diabetes, whether there was cardiovascular and cerebrovascular disease, whether there was respiratory disease, whether there was surgery experience, whether there was anemia, work conditions, and responsibility segments (P>0.05). Male (95%CI: 3.289-10.586, P < 0.001), education level below undergraduate level (95%CI: 6.533-45.162, P < 0.001), severe pain (95%CI: 10.348-72.025, P < 0.001), moderate pain (95%CI: 6.247-37.787, P < 0.001), low self-efficacy (95%CI: 4.238-15.095, P < 0.001), and medium self-efficacy (95%CI: 2.804-8.643, P < 0.001) were influencing factors for kinesiophobia after lumbar fusion surgery in the patients with LDH (P < 0.05). CONCLUSION The incidence of kinesiophobia after lumbar fusion surgery in patients with LDH is high, and its influencing factors include gender, education level, pain level, and self-efficacy.
Humans ; Spinal Fusion/psychology* ; Intervertebral Disc Displacement/psychology* ; Lumbar Vertebrae/surgery* ; Male ; Female ; Middle Aged ; Phobic Disorders/etiology* ; Surveys and Questionnaires ; Adult ; Risk Factors ; Aged ; Fear ; Kinesiophobia

Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by traumatic past experiences, rooted in the neurocircuits of fear memory formation. Memory processes include encoding, storing, and recalling to forgetting, suggesting the potential to erase fear memories through timely interventions. Conventional strategies such as medications or electroconvulsive therapy often fail to provide permanent relief and come with significant side-effects. This review explores how fear memory may be erased, particularly focusing on the mnemonic phases of reconsolidation and extinction. Reconsolidation strengthens memory, while extinction weakens it. Interfering with memory reconsolidation could diminish the fear response. Alternatively, the extinction of acquired memory could reduce the fear memory response. This review summarizes experimental animal models of PTSD, examines the nature and epidemiology of reconsolidation to extinction, and discusses current behavioral therapy aimed at transforming fear memories to treat PTSD. In sum, understanding how fear memory updates holds significant promise for PTSD treatment.
Fear/psychology* ; Extinction, Psychological/physiology* ; Animals ; Stress Disorders, Post-Traumatic/psychology* ; Humans ; Memory Consolidation/physiology* ; Memory/physiology*

Objective To explore the relationship between bedtime procrastination and fear of missing out and the intervention effect of aerobic exercise on bedtime procrastination,so as to provide a theoretical basis and practical reference for remedying bedtime procrastination.Methods Totally 988 students were selected through random sampling and then surveyed with the bedtime procrastination scale and the fear of missing out scale.Correlation and regression analyses were performed to explore the relationship between bedtime procrastination and fear of missing out.A total of 36 students were recruited from the 988 students to participate in the exercise intervention and they were assigned into an exercise group and a control group by the random number table method,with 18 students in each group.The exercise group performed aerobic exercise for 12 weeks,while the control group maintained daily activities.The participants' scores on the bedtime procrastination scale and the fear of missing out scale were recorded before and after the intervention and compared.Results The fear of missing out was positively correlated with bedtime procrastination among college students(r=0.214,P<0.001),and it was an important predictive factor for bedtime procrastination(β=0.241,P<0.001).After the intervention,the scores of bedtime procrastination scale decreased in the exercise group(t=2.277,P=0.036),while there was no significant difference in the scores of the control group before and after intervention(t=-0.787,P=0.442).Conclusions A high level of fear of missing out indicates severe bedtime procrastination.And 12-week exercise intervention could remedy bedtime procrastination.
Humans ; Fear ; Exercise ; Male ; Female ; Procrastination ; Young Adult ; Cross-Sectional Studies ; Students/psychology* ; Adult ; Surveys and Questionnaires ; Adolescent

OBJECTIVES: To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression. METHODS: A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression. RESULTS: The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05). CONCLUSIONS In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.
Humans ; Adolescent ; Female ; Male ; Depression/psychology* ; Psychotherapy/methods* ; Fear/psychology* ; Prospective Studies ; Surveys and Questionnaires

OBJECTIVE: Patients with gynecological cancer commonly use complementary and alternative medicine (CAM) methods to cope with the disease. However, despite the existence of treatment strategies, the effect of fear and anxiety caused by coronavirus disease 2019 (COVID-19) pandemic on attitudes about CAM use is unclear. This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM. METHODS: This is a cross-sectional and descriptive study that included 177 women with gynecological cancer; participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021. Data were collected using an online survey that included the Personal Information Form, the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Attitude Towards Holistic Complementary and Alternative Medicine Scale. Descriptive statistics, t-test, Pearson's correlation test, and simple linear and multiple regression analyses were performed to analyze the data. RESULTS: During the pandemic, 55.4% of the participants reported using CAM methods, but only 22.6% were using CAM before the pandemic. The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales (20.69 ± 5.37 and 13.09 ± 6.29, respectively) compared to the participants who did not use CAM (9.29 ± 2.72 and 6.35 ± 2.06, respectively). Fear of COVID-19 accounted for 52% of the CAM attitude score, while coronavirus anxiety accounted for 15% of the CAM attitude score. Fear of COVID-19 and coronavirus anxiety together accounted for 53% of CAM attitude. CONCLUSION Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more. Given that the psychological effects of the pandemic will continue in the coming years, CAM use should be evaluated as a coping strategy, especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer. While the rational and effective CAM methods should be supported, strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments. Please cite this article as: Uslu-Sahan F, Yesilcınar I, Kurt G, Hancer E, Guvenc G. Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic. J Integr Med. 2023; 21(4): 377-384.
Humans ; Female ; COVID-19 ; Pandemics ; Cross-Sectional Studies ; Anxiety/psychology* ; Attitude ; Neoplasms ; Fear ; Complementary Therapies/psychology*

Pathological anxiety is among the most difficult neuropsychiatric diseases to treat pharmacologically, and it represents a major societal problem. Studies have implicated structural changes within the prefrontal cortex (PFC) and functional changes in the communication of the PFC with distal brain structures in anxiety disorders. Treatments that affect the activity of the PFC, including cognitive therapies and transcranial magnetic stimulation, reverse anxiety- and fear-associated circuit abnormalities through mechanisms that remain largely unclear. While the subjective experience of a rodent cannot be precisely determined, rodent models hold great promise in dissecting well-conserved circuits. Newly developed genetic and viral tools and optogenetic and chemogenetic techniques have revealed the intricacies of neural circuits underlying anxiety and fear by allowing direct examination of hypotheses drawn from existing psychological concepts. This review focuses on studies that have used these circuit-based approaches to gain a more detailed, more comprehensive, and more integrated view on how the PFC governs anxiety and fear and orchestrates adaptive defensive behaviors to hopefully provide a roadmap for the future development of therapies for pathological anxiety.
Anxiety ; Anxiety Disorders/therapy* ; Fear/psychology* ; Humans ; Neural Pathways ; Prefrontal Cortex

OBJECTIVES: To explore the psychological status of medical staff in the epidemic period of coronavirus disease 2019 (COVID-19), and to analyze its influential factors. METHODS: A total of 373 medical staff from Xiangya Hospital and the Second Xiangya Hospital of Central South University were enrolled for this study. The General Sociological Data Questionnaire, Symptom Check-List 90 (SCL-90), and self-designed public opinion response questionnaire were used to assess general sociological data, mental health scores, and ability to respond to COVID-19 related public opinion information of medical staff. The mental health scores of medical staff with different general sociological data and public opinion information coping abilities were compared. Influential factors of mental health were analyzed. RESULTS: The average score of 10 factors in SCL-90 of 373 medical staff was less than 2 points. 14.21% medical staff had one or more factor scores more than two points, including 11.26% with terror symptoms, 7.77% with compulsive symptoms, and 5.63% with anxiety. The main sources of COVID-19 information for medical staff included WeChat, microblog, Jinri toutiao, TV and radio. 66.22% medical staff regularly verified information about COVID-19 through official websites or formal channels. A great deal of COVID-19 information in WeChat could make medical staff nervous (34.05%), anxious (30.29%), and insecure (29.22%). 68.63% medical staff sometimes were worried about getting infected because they knew information about COVID-19. Different departments of medical staff, getting cough or having a fever recently, and the degree of fear of infection had an impact on the SCL-90 score of medical staff, the differences were all statistically significant (all <0.05). Stepwise regression analysis showed that the impact of COVID-19 information on their life in WeChat, getting cough or having a fever recently, insomnia-early caused by COVID-19 information in WeChat, different departments, and the degree of fear of infection COVID-19 were the influential factors for the mental health of medical staff (all <0.05). CONCLUSIONS During the epidemic of COVID-19, medical staff suffered from psychological problems to various degrees. It is necessary to establish a psychological assistance platform and guide the direction of public opinion correctly to promote the mental health of medical staff.
Anxiety ; Betacoronavirus ; China ; Compulsive Behavior ; Coronavirus Infections ; epidemiology ; psychology ; Fear ; Health Status ; Humans ; Medical Staff ; psychology ; Mental Health ; Pandemics ; Pneumonia, Viral ; epidemiology ; psychology ; Surveys and Questionnaires

The world is now plagued by a pandemic of unprecedented nature caused by a novel, emerging, and still poorly understood infectious disease, coronavirus disease 2019 (COVID-19) (Wu and McGoogan, 2020). In addition to the rapidly growing body of scientific and medical literature that is being published, extensive public reports and stories in both the traditional media and social media have served to generate fear, panic, stigmatization, and instances of xenophobia (Zarocostas, 2020).
Betacoronavirus ; COVID-19 ; Coronavirus Infections/psychology* ; Fear ; Health Education ; Humans ; Pandemics ; Panic ; Pneumonia, Viral/psychology* ; SARS-CoV-2 ; Social Media ; Trust

Although extensively studied, the exact role of sleep in learning and memory is still not very clear. Sleep deprivation has been most frequently used to explore the effects of sleep on learning and memory, but the results from such studies are inevitably complicated by concurrent stress and distress. Furthermore, it is not clear whether there is a strict time-window between sleep and memory consolidation. In the present study we were able to induce time-locked slow-wave sleep (SWS) in mice by optogenetically stimulating GABAergic neurons in the parafacial zone (PZ), providing a direct approach to analyze the influences of SWS on learning and memory with precise time-windows. We found that SWS induced by light for 30 min immediately or 15 min after the training phase of the object-in-place task significantly prolonged the memory from 30 min to 6 h. However, induction of SWS 30 min after the training phase did not improve memory, suggesting a critical time-window between the induction of a brief episode of SWS and learning for memory consolidation. Application of a gentle touch to the mice during light stimulation to prevent SWS induction also failed to improve memory, indicating the specific role of SWS, but not the activation of PZ GABAergic neurons itself, in memory consolidation. Similar influences of light-induced SWS on memory consolidation also occurred for Y-maze spatial memory and contextual fear memory, but not for cued fear memory. SWS induction immediately before the test phase had no effect on memory performance, indicating that SWS does not affect memory retrieval. Thus, by induction of a brief-episode SWS we have revealed a critical time window for the consolidation of hippocampus-dependent memory.
Animals ; Cues ; Electroencephalography ; Electromyography ; Evoked Potentials, Motor ; physiology ; Fear ; psychology ; Glutamate Decarboxylase ; metabolism ; Hippocampus ; physiology ; Light ; Luminescent Proteins ; genetics ; metabolism ; Maze Learning ; physiology ; Memory Consolidation ; physiology ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Sleep Deprivation ; Sleep, Slow-Wave ; physiology ; Time Factors ; Vesicular Inhibitory Amino Acid Transport Proteins ; genetics ; metabolism