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We examined possible correlations between type of surgery major or minor and trauma subscores and total CTQ scores. Finally, we compared STAI scores of patients with or without 270 doi: 10.
Discussion In this study we found significant correlation between higher CTQ scores and preoperative STAI scores —both Trait and State- which indicates close relationship between having a history of childhood trauma and increased prepoperative anxiety.
STAI is a very commonly used, validated with high reliability inventory that measures levels of anxiety. It has two categories -trait and state anxiety which trait anxiety is closely related with feature of personality an anxious personality where state anxiety indicates the level of the anxiety at the time of assessment.
We used this inventory because of advantage of two way measurement regarding trait and state anxiety levels which are good indicators of showing anxious personality and preoperative anxiety.
There are many environmental and personal factors that influence and trigger preoperative anxiety. Fear of death, being in an unfamiliar condition, feeling vulnerable, feeling of loss of control, extent of surgery major surgeries like coronary artery bypass surgery etc, fear of awareness during operation, postoperative pain, female gender, low educational level are prominent factors that influence prepoperative anxiety.
Also without a previous history of surgery, younger or middle ages, non-smokers, being divorced are other factors might have effects on preoperative anxiety.
There are large number of studies investigating preoperative anxiety provoking factors however —to the best of our knowledge- there is no study investigating possible correlation between childhood traumas and preoperative anxiety.
Childhood trauma is closely associated with inception, severity and course of anxiety disorders.
Physical, emotional neglect, abuse, sexual abuse are important types of childhood trauma which can result in adulthood anxiety, depression, personality disorders and other psychopathologic diseases. Although exact pathways that provoke anxiety are not clear, cognitive-behavioral approach suggests threat and danger in childhood as triggering factor for anxiety.
Impaired hypothalamo pituitary axis HPA and corticotropin releasing factor CRF stress systems following biological effect of trauma have been shown.
As a consequence increased stress sensitivity leads to decreased threshold which provoke anxiety. In this context our findings those indicating positive correlation between an anxious personality with higher STAI scores and having childhood trauma history indicated by higher CTQ scores become more important.
Preoperative STAI-state scores were higher in only emotionally abused patients where preoperative STAI-trait scores were higher in all childhood trauma types except physical neglect Table 3. As mentioned above, STAI-trait inventory investigates anxious personality and the correlation between high preoperative STAItrait scores and childhood trauma types is evidence of prolonged effect of childhood trauma in adulthood.
Generally childhood physical and sexual abuse are accepted as primary causative Med Science;8 2:268-73 factors for various psychological disorders include depression, substance dependency, dissociation, anxiety disorders however there is accumulating data indicating important role of emotional abuse on psychological disorders.
Similarly Huh et al. They concluded that co-occurence of emotional and physical trauma —not only physical trauma- lead more to severe trait anxiety and state anxiety.
In line with previous studies we showed that emotional abuse is the only trauma type that correlates with increased preoperative STAI-state scores.
Many previous studies showed that females had higher preoperative STAI-trait and state scores than males.
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