Perspectives of anxiety in stressful environments : Prospective studies in real-life settings

Sammanfattning: The present thesis deals with perspectives of anxiety experienced in stressful environments. As such two major issues are addressed. The first issue is whether increased trait anxiety during work in a high-stress environment is related to impaired performance on executive control tasks. The second issue is whether the characteristic of a stressor and pre-stress individual differences in executive control capacity, personality traits and subjective mental health are related to high levels of experienced anxiety during or after stressor exposure. In all studies prospective designs were used. All studies were also performed in real-life settings involving real threats to the participants. Study I showed that increased trait anxiety during work in a high-stress environment predicted poor performance on a mental set-shifting task measuring the rerouting domain of executive control. In the analysis both baseline trait anxiety, level of education and error during performance were controlled for implicating a possible effect of increased trait anxiety. Study II indicated that baseline performance on an executive control task predicted subjective experience of state anxiety during exposure to a potentially life-threatening acute stressor. This result suggests that executive control capacity mediates the emotional experience of anxiety during stressful situations. Study III suggested that frequency of exposure to chronic stressors during work in a high-stress environment predicted an increase in trait anxiety. Further, it was found that neither baseline trait anxiety nor difficulty identifying or describing feelings predicted an increase in trait anxiety. Additionally, an interaction between the baseline alexithymia dimension difficulty describing feelings and frequency of exposure to chronic stressors was related to decreased trait anxiety. In contrast to the prediction no evidence was found for any interaction between chronic stressor exposure and baseline trait anxiety on increased trait anxiety. Study IV showed that objective uncontrollability of a situation, baseline trait anxiety and the alexithymia dimensions difficulty describing feelings and externally oriented thinking predicted retrospective assessments of state anxiety experienced during acute stressor exposure. Study V suggested that the interaction between baseline trait anxiety and trauma exposure predicted post-trauma symptoms of anxiety and insomnia. Beyond that, baseline trait anxiety and baseline symptoms of anxiety and insomnia individually predicted post-trauma symptoms of anxiety and insomnia.