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Study Title and Description

The moderating effect of anxiety sensitivity on caffeine-induced hypoalgesia in healthy women.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on behavior*?
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Primary Publication Information
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TitleData
Title The moderating effect of anxiety sensitivity on caffeine-induced hypoalgesia in healthy women.
Author E Keogh,N Chaloner,
Country
Year 2002
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Behavior - Design Details - INCLUDED Studies
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 12457274
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What outcome is being evaluated in this paper? Behavior
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What is the objective of the study (as reported by the authors)? The primary aim of this study was therefore to determine whether caffeine has a differential effect on the pain responses of those high, medium and low in anxiety sensitivity. Our secondary aim was to determine whether anxiety sensitivity groups differ in their physiological (blood pressure) and psychological (mood) responses to caffeine. We specifically predicted that (1) high anxiety sensitivity would be associated with greater pain responses, (2) caffeine would increase cardiovascular arousal and subjective mood, and (3) caffeine would reduce pain sensitivity in participants low in anxiety sensitivity, but increase pain sensitivity in those high in anxiety sensitivity.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Written consent was obtained from volunteers, and the study protocols granted ethical approval. Anxiety sensitivity group was based on pre-selected cut-off points on the Anxiety Sensitivity Index (ASI; Reiss et al. 1986), which is a 16-item scale that measures the fear of anxiety-related sensations. High anxiety sensitivity group was defined by scores above 22 (mean 33.75; SD 8.58), low anxiety sensitivity by scores below 14 (mean 7.00; SD 2.63), and medium by scores between the two (mean 17.67; SD 2.31). A total of 36 female participants were recruited (n=12 per group), with ages ranging between 18 and 55 years (mean 24.83; SD 8.71). No significant group differences were found in age or body mass. Participants were run in a placebo-controlled repeated measures experiment and followed previous protocols (Keogh and Witt 2001). In the caffeine condition, participants consumed a cup of decaffeinated coffee, which contained 250 mg caffeine. In the placebo condition, decaffeinated coffee was administered. Participants were initially tested in either the placebo or the caffeine condition (order was counterbalanced between participants), and then again around 1 week later, in the alternative condition. On each day of testing arousal (objective and subjective) was measured once prior to the ingestion of caffeine/placebo drink and again 40 min later, just prior to the pain induction task. At each testing phase, three readings of blood pressure and pulse were taken from the brachial artery on the inner side of the biceps and an average calculated. Mood was also measured using the bipolar version of the Profile of Mood States scale (POMS; McNair et al. 1982).
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) depression
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes depression-elation score (Profile Of Mood States)
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Clinical Clinical
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Physiological
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Other
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What is the study design? Controlled Trial
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Randomized or Non-Randomized? RCT
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What were the diagnostics or methods used to measure the outcome? Subjective
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Optional: Name of Method or short description Profile Of Mood States - depression elation score
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Caffeine (general) Caffeine (general)
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Coffee Coffee
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Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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Soda
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Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) placebo (0 mg caffeine) vs 250 mg caffeine
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) women were subdivided by their anxiety sensitivity
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Provide a general description of results (as reported by the authors). Mood became more positive at the second time of testing for all the POMS scales: clearheaded [pre=23.13, post=25.56; F(1,33)=11.25, P<0.005], energetic [pre=18.01, post=21.86; F(1,33)=14.13, P<0.001], confident [pre=20.24, post=22.94; F(1,33)=13.42, P<0.005], agreeable [pre=24.97, post=27.79; F(1,33)=21.50, P<0.001], composed [pre=22.57, post=24.99; F(1,33)= 8.87, P<0.01] and elated [pre=22.42, post=25.28; F(1,33)=12.76, P<0.005]. A near-significant interaction was found between caffeine and time of testing for confidence [F(1,33)=2.95, P<0.10]. When in the caffeine condition participants reported significantly higher confidence scores at the second phase of testing compared to the first [F(1,33)=19.60, P<0.001]. Finally, a significant interaction was found between anxiety sensitivity, caffeine and time of testing for elation [F(2,33)=3.45, P<0.05; see Fig. 1A]. Change scores revealed that amongst the low anxiety sensitivity group, higher elation was found in the caffeine condition when compared to the placebo condition [F(1,33)=4.24, P<0.05].
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? Those low in anxiety sensitivity benefited from a moderate dose of caffeine, in that they increased in positive mood and exhibited caffeine-induced hypoalgesia. These findings are consistent with studies that find caffeine has an arousing effect and anti-nociceptive properties (Keogh and Witt 2001). The fact that those high in anxiety sensitivity failed to show these beneficial caffeine effects is also consistent with findings that participants high in anxiety sensitivity report more negative reactions to caffeine-induced arousal (Telch et al. 1996). This study is the first, however, to demonstrate that alongside such mood effects, anxiety sensitivity moderates caffeine-related hypoalgesia.
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What were the sources of funding? None listed
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What conflicts of interest were reported? N/A
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Does the exposure (dose) need to be standardized to the SR? No
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest).
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  Depression - NOAEL = 250 mg/day
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. single dose Depression-elation scores actually improved in the low anxiety sensitivity group, though caffeine had no effect on the scores in the medium or high anxiety sensitivity groups
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What is the importance of the study with respect to the adverseness of the outcome? Important
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