Biological Formative Evaluation, Part 2

This week, I continue with my instruction in how to evaluate your anti-anxiety plan. As I said in my last podcast, such evaluation not only offers you an objective view of how well you’re doing, but also helps you to do better. Bio-Counting One of the best things you can do is to design charts to track more objective data. Measurements such as pulse rate, blood pressure, oxygen-in-the-blood calculations, and galvanic skin response are also relevant, although the last three require equipment. For charting your relative pulse rate, press the largest two fingers of your left hand on your carotid artery at the side of your neck, and as the second hand hits 12, begin counting beats. As the second hand passes 4, stop counting and record the total number of beats you counted in 20 second, times 3. This will give you a good approximation of your actual heart rate. You can make these entries at various times of the day and/or before, during and after an anti-anxiety activity. One word of caution: as with anything else in life, it is possible to overdo chart making: The Obsessive Pulse-Taker I have advocated a number of evaluation methods that involve self-evaluation. I should warn you about a possible backlash, however. I once was asked to counsel a 21-year-old woman, Cassie, who was diligent in her efforts to monitor her anti-anxiety plan. She unfailingly took her carotid pulse before, during, and after each effort to confront her panic. She meticulously entered these readings on a chart that she had carefully designed. Unfortunately, instead of getting lower and lower readings, her rates gradually ascended. She was very frustrated by this, finally to the point of tears. When her parents called  me, she had been experiencing the problem for about three weeks. When she and I discussed the situation, her plan made sense to me, and even more important, Cassie really liked it. Further discussion uncovered the core of her difficulty. She wanted too desperately to succeed. Many anxious folks are perfectionistic. Whether that causes the anxiety, or the anxiety causes striving to be perfect, we do not know. At any rate, in Cassie’s case, she was so worried that her pulse readings would not drop, of course they rose. When anxiety is mixed with perfectionist leanings, it is probably best to de-emphasize evaluation and concentrate on keeping your nerves calm. Now for a quick look at the other three techniques. Blood pressure, which is associated with anxiety in both its upper number (systolic) and lower number (diastolic), can be checked by a blood pressure meter available at your local drugstore for around $30. As with heart rate, you must be careful that your drive to reduce your anxiety doesn’t drive your blood pressure up. Two other bio-indicators of anxiety levels are blood oxygenation, measured by an oximeter and galvanic skin response, measured by a GSR meter. These can be obtained from any number of medical supply sources such as Amazon. It probably won’t be necessary for you to use either of these, but if you think you’d like to come read more about them online. The next item on the agenda is a questionnaire about biological factors that affect your level of anxiety. When you have scored the test, I will give you data as to how you compare to the hundreds of others who have taken this test. The Dacey Biological Factors Questionnaire Think about how much each statement is true of you. Then  choose the statement after the phrase that indicates how much you think that statement is true or untrue of you. Be as objective and forthcoming as you can. Symptom Scoring 1. I am worried at least a quarter of every day. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 2. I wake up soaked in sweat at least once a month. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 3.I would say I am almost never fearful of catching other people's diseases. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 4.A number of things scare me, even though they are not really dangerous. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 5. I sometimes find myself sweating with panic, and yet I don’t know why. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 6. I expect that even friendly dogs are likely to bite me, although I must admit that none ever has. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 7. Nothing awful has ever happened to me. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 8. I almost never worry about whether dirt and germs will make me sick. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 9. I have never gone anywhere on a weekend. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 10. Most nights, I am awakened by a scary dream. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 11. I enjoy myself more when I am home than when I am away. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 12. When I leave home, I usually feel like going back to make sure things are okay. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 13. Few things give me a bigger kick than riding a roller coaster. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 14. It doesn’t bother me when my heart beats faster than usual. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 15. I must admit I am usually on the lookout for danger more than is necessary. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 16. I hate speeding of any kind, no matter what the vehicle. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 17. I really enjoy trying out new places, even if they are somewhat dangerous. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 18. I love to walk in the woods, because I feel that fresh air is good for my lungs. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 19. I am not aware of obsessing over my health, airborne sicknesses or disease. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ 20. I worry a lot that if my anxiety makes me so scared, I might have a heart attack. Strongly agree ___       Agree ___ Disagree ___             Strongly disagree___ This survey measures a broad spectrum of feelings you may have about yourself. The best way to use it is to fill it out before you design your anxiety plan, and then when you have finished it. You can also use it when you are carrying out your plan, to see how you are progressing. See whether the posttest yields a significantly lower score on anxiety than the pretest. If so, your plan is successful. Scoring: For items 1, 2, 4, 5, 6, 10, 11, 15, 16, and 20, the scoring is as follows: Strongly agree = 4; Agree = 3; Disagree = 2; Strongly disagree = 1.   For the rest of the items (numbers 3,  8, 13, 14, 17, 18, and 19), this scoring is reversed, that is; Strongly agree =1; etc.  Numbers 7 and 9 is not scored lying. as they measure, . Add up all scores to measure your biological anxiety. Save your data – later you will combine it with other results to get one overall level. This self-report measure is used to analyze the biological part of your anxiety. In accordance with the biopsychosocial model, the next two tests will involve psychological and social areas of your life. Remember, these tests are designed for formative evaluation (measuring progress as you plan is carried out). The final questionnaire I will ask you to take, one with 60 questions on it, will be for summative purposes. See you next week!