Thesis (doctoral)--University of Tartu, 2006. / Thesis based on three papers.

Summary When children are exposed to traumatic events, they might develop many physical and psychological symptoms that need immediate intervention in order to alleviate further adverse consequences. The overall aim of this study is to assess the impact of political violence on behavioral problems, anxiety and depression among the Palestinian children in Gaza Strip. This has also been carried out through taking into consideration some other factors; i.e. gender, age, educational level of the mother, family income, place of residence and periods of exposure. Analytical study was carried out a sample of 130 Palestinian children aged from 9 - 16 years (elementary and preparatory school stages) living in Gaza Strip. These children were assessed during the second school semester using structured self-report questionnaire for possible types of behavioral problems, anxiety and depression as a result of the traumatic events they were exposed to. Rutter's behavioral problem scale for children, Beck's depression scale and Reynolds anxiety scale were used in the study. Main findings 1.It was found that 23.8 % of the children in the case group suffer from a high level of anxiety which needs therapy. 2.By looking at the results, we can see that 18.8% of the children suffer from depression and they need intervention. 3.It was found that 88% of the children whose ages ranged from (9-12) suffered from various kinds of behavioral problems and neurotic symptoms and they need psychological help. 4.Comparing the case group and control group whose ages ranged between 13 and 16 years, we can see that the case group (high trauma) got high scores on anxiety than the control group (low trauma) (t value=4.2 P-value < 0.001). 5.Comparing the case group and control group whose ages ranged between 13 and 16 we can see that the case group (high trauma) got high scores on depression scale than the control group (low trauma) (t value=4.5 P-value < 0.001). 6.It was found that the educational level of the mother was one of the factors that was related to behavioral problems and neurotic symptoms among children. The differences were significant between preparatory and secondary children. 7.By looking to the results, we can find that gender as one of the variables which was examined with its relationship with anxiety and depression was not significant. 8.Periods of exposure were not significant with their relationship with anxiety, depression and behavioral problems in all groups.

This thesis studied three plants traditionally used for treating a variety of anxiety related conditions. The three species were Roseroot, Rhodiola rosea from Nunavik, Cordonsillo, Piper amalago from Belize and “Sin Susto”, Souroubea sympetala from Costa Rica. The main objective of this research project was to investigate effects on behavior of these traditionally used native plants. It was found that the crude ethanol extracts derived from these plants administered intragastrically had measurable anxiolytic effects in male Sprague Dawley rats. Rats treated with extracts of these plants were then tested in several behavioral paradigms: elevated plus maze (EPM), social interaction (SI), conditioned emotional response (CER) and fear potentiated startle FPS. “Sin susto” produced significant anti-anxiety effects in several paradigms. Its active principle, betulinic acid, was significantly active in the EPM and FPS at a dose of 0.5mg/kg. Cordonsillo had strong activity in the SI paradigm and Roseroot in the CER paradigm. The results suggest that traditional use is based on pharmacological activity of the plants.

This research aimed to help caregivers easily recognize physiological indicators of pediatric anxiety. To this purpose, we first elucidated the physiological indicators of anxiety in children by presenting an anxiety-inducing task while recording biosignals. We discovered patterns suggestive of cardiac reciprocal inhibition, increased respiration rate, and increased electrodermal activity. These patterns informed the optimization of an existing auditory prototype for presenting biosignals to caregivers (biosongs), which maps physiological features to musical elements. The effectiveness of the optimized biosongs for conveying anxiety was evaluated by quantifying the accuracy with which adults could distinguish anxious and calm states by listening to music translated from children's physiological signals. High overall sensitivity (90%), specificity (78%), and accuracy (84%) were achieved, suggesting the promise of biosongs as an effective anxiety screening tool. This technology could lead to profound improvements in caregiving contexts, including anxiety management during medical procedures, and home-based monitoring for chronic conditions.

Dental anxiety is not typically associated with orthodontic treatment because of the lack of evoking stimuli (i.e., drills, needles). Its prevalence in orthodontic patients is unknown but reported anecdotally. This study aimed to assess the prevalence of and factors contributing to dental anxiety in future and current orthodontic patients. University dental clinics and private orthodontic office patients completed a questionnaire including the Modified Dental Anxiety Scale (MDAS), MDAS-Ortho (both scored 1-not anxious to 5-extremely anxious; sum score >15=dentally anxious), and list of concerns about orthodontic treatment. 675 patients participated (60.4% private practice; 64.3% female; 24.9% new patients; 85.5% aged 12-20 years). University clinic patients reported significantly higher MDAS and MDASO scores (p<0.05). 22.8% were dentally anxious and 18.7% anxious about orthodontic treatment, with concerns related to their relationship with the orthodontist, perceptions of orthodontic treatment and treatment factors. Results confirm dental anxiety in orthodontic patients and factors contributing to that anxiety.

This research aimed to help caregivers easily recognize physiological indicators of pediatric anxiety. To this purpose, we first elucidated the physiological indicators of anxiety in children by presenting an anxiety-inducing task while recording biosignals. We discovered patterns suggestive of cardiac reciprocal inhibition, increased respiration rate, and increased electrodermal activity. These patterns informed the optimization of an existing auditory prototype for presenting biosignals to caregivers (biosongs), which maps physiological features to musical elements. The effectiveness of the optimized biosongs for conveying anxiety was evaluated by quantifying the accuracy with which adults could distinguish anxious and calm states by listening to music translated from children's physiological signals. High overall sensitivity (90%), specificity (78%), and accuracy (84%) were achieved, suggesting the promise of biosongs as an effective anxiety screening tool. This technology could lead to profound improvements in caregiving contexts, including anxiety management during medical procedures, and home-based monitoring for chronic conditions.

Dental anxiety is not typically associated with orthodontic treatment because of the lack of evoking stimuli (i.e., drills, needles). Its prevalence in orthodontic patients is unknown but reported anecdotally. This study aimed to assess the prevalence of and factors contributing to dental anxiety in future and current orthodontic patients. University dental clinics and private orthodontic office patients completed a questionnaire including the Modified Dental Anxiety Scale (MDAS), MDAS-Ortho (both scored 1-not anxious to 5-extremely anxious; sum score >15=dentally anxious), and list of concerns about orthodontic treatment. 675 patients participated (60.4% private practice; 64.3% female; 24.9% new patients; 85.5% aged 12-20 years). University clinic patients reported significantly higher MDAS and MDASO scores (p<0.05). 22.8% were dentally anxious and 18.7% anxious about orthodontic treatment, with concerns related to their relationship with the orthodontist, perceptions of orthodontic treatment and treatment factors. Results confirm dental anxiety in orthodontic patients and factors contributing to that anxiety.

Dental anxiety is a common problem found in approximately 80% of the adult population in the United States. This study examined the role of dental anxiety within the dentist/patient relationship. Negative experiences were found to be the most significant contributor of dental anxiety. The negative experiences result largely from the relationship between the dentist and the patient. Both dentist and patient are affected from the effects of dental anxiety. Therefore it is important for the dentist to establish a trusting relationship with the patient to ensure that proper dental care can be provided.

This thesis studied three plants traditionally used for treating a variety of anxiety related conditions. The three species were Roseroot, Rhodiola rosea from Nunavik, Cordonsillo, Piper amalago from Belize and “Sin Susto”, Souroubea sympetala from Costa Rica. The main objective of this research project was to investigate effects on behavior of these traditionally used native plants. It was found that the crude ethanol extracts derived from these plants administered intragastrically had measurable anxiolytic effects in male Sprague Dawley rats. Rats treated with extracts of these plants were then tested in several behavioral paradigms: elevated plus maze (EPM), social interaction (SI), conditioned emotional response (CER) and fear potentiated startle FPS. “Sin susto” produced significant anti-anxiety effects in several paradigms. Its active principle, betulinic acid, was significantly active in the EPM and FPS at a dose of 0.5mg/kg. Cordonsillo had strong activity in the SI paradigm and Roseroot in the CER paradigm. The results suggest that traditional use is based on pharmacological activity of the plants.

The purpose of this study was to examine the effect of high and low anxiety on motivation for treatment, length of stay in treatment, and intrapsychic focus of attention in Veterans Administration drug-abuse patients. The dependent variables were measured by the Minnesota Multiphasic Personality Inventory (MMPI), Reasons For Seeking Treatment Inventory (RFST), State Trait Anxiety Inventory (STAI), Psychopathic State Inventory (PSI), and the total number of days each subject participated in the treatment program. The major hypothesis was stated in the null form.The PSI and the STAI were used to measure motivation for seeking treatment. The MMPI and the RFST were used to measure intrapsychic focus of attention.On admission and on day 60, the subjects in the High Stress Treatment Group and the subjects in the Low Stress Treatment Group were not found to he significantly different, as measured by the STAI and the PSI, and intrapsychic focus of attention, as measured by the MMPI and the RFST.This study revealed that the subjects in the High Stress Treatment Group developed a higher level of motivation than the subjects in the Low Stress Treatment Group. The Subjects in the High Stress Treatment Group stayed in treatment longer than the subjects in the Low Stress Treatment Group. Subjects in the High Stress Treatment Group focused more on intrapsychic issues than subjects in the Low Stress Treatment Group.