Caffeine Consumption and Anxiety Levels: A Convenience Sample. Operation Righteous Cowboy Lightning: Ian Sande, Johnny Rider,

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1 Caffeine Consumption and Anxiety Levels: A Convenience Sample Operation Righteous Cowboy Lightning: Ian Sande, Johnny Rider, Dani Goddard, Natalie Noss, Josh Hensley and Gary Pearson Touro University Nevada

2 Methods Information on Participants and Data Collection Participants were graduate students recruited from the first year occupational therapy program at Touro University Nevada in Henderson, Nevada. The students (26 females, 5 males) were recruited during their Introduction to Research and Quantitative Research Methods course during the summer 2013 semester. The age of participants ranged from 22 years to 55 years old. Students received a donut as compensation for participation in the study in hopes to motivate accurate and complete documentation. Of the 31 total participants who initially accepted the packet to participate in our study, 29 participants completed and turned the packet in on Monday October 7 th, The mortality rate was 6% with 2 of the 31 participants dropping out of the study. Materials Zung Self-Rating Anxiety Scale. The Zung scale is a brief, 20-question anxiety assessment which was taken online and then scores were reported on the provided survey. An example of a question is I feel more nervous and anxious than usual and was answered according to Likert scale spanning from a little of the time to most of the time. Scores were generated by the online system and then displayed to the participant after choosing Score my Answers. Scores between indicate normal anxiety, mild to moderate anxiety, marked to severe anxiety and indicate extreme anxiety according to the Zung Scale. Caffeine Survey Self Report. Frequency and serving size of caffeinated sources including beverages, soft drinks, energy drinks and shots, over the counter (OTC), weightloss drugs and foods were self-reported. Beverages included but were not limited to coffee, tea and hot

3 chocolate. Soft drinks included Coke, Dr. Pepper, Pepsi and Mountain Dew, to name a few. Energy drinks and shots included Monster, Red Bull and 5-Hour Energy for example. OTC and weightloss drugs included Midol, Excedrin, Trimspa and Xenadrine. Some caffeinated foods were also included such as chocolate candy, chocolate cookies and many other chocolate foods. Procedure Surveys were preassembled in packets and handed out to participants on Monday September 30, 2013 at 12:00pm. The surveys contained a cover letter with detailed instructions as well as the experimenter s contact information. Participants were instructed to complete the Zung Self-Rating Anxiety Scale each day for a period of one week between the hours of 5:00-6:00pm. Participants were to report any caffeine consumed for a 24 hour period from 12:00am- 11:59pm. The team of experimenters collected the packets on Monday October 7, 2013 between the hours of 8:30-11:30am. There was no control group assigned. Results, Method of Data Analysis, Discussion and Implications for Practice The topic of caffeine use in relation to anxiety is relevant because many people use caffeine in order to get through their day. It is important to understand the potential implications of caffeine use and how it affects stress. Many college and graduate level students utilize caffeine to help them retain focus and stay on task when studying for exams. It is believed that anxiety levels tend to increase with school. Research suggests that there are mixed findings regarding caffeine and stress level. Some research found that caffeine intake impacted physiological responses to stress, such as increased cortisone levels in saliva, but other research that used self-reported surveys of stress indicated the opposite to be true in which participants were found to have decreased levels of stress.

4 For this study, we compared caffeine use in relation to self-reported stress level. After gathering the results, we were able to compare the average caffeine consumption over a week long period to the average Zung anxiety score over that same period for each participant. In comparing these two surveys, we used excel to attain the mean anxiety score, variance, find the p-value, and to calculate the standard deviations. Initially it was hypothesized that above 300mg of caffeine consumption would correlate to higher anxiety scores. However, after collecting the data, there were no subjects that reported taking over 300mg of caffeine per day and therefore we had to alter our level of caffeine consumption to 150mg per day to obtain statistical data. This will be mentioned further in our limitations. The results of the study failed to support our hypothesis in that the results found there to be an insignificant correlation between caffeine intake and Zung anxiety scores. Additionally, results indicated that caffeine intake correlated to a decreased anxiety score which some previous studies also found to be true. The results included 22 subjects that reported consuming less than 150mg and 7 who reported consuming greater than 150mg per day. The subjects who consumed less than 150 mg a day reported an average anxiety score of 42.3 (normal anxiety level range) with a SD of 8.5. The subjects who consumed more than 150 mg a day reported an average anxiety score of 36.3 (normal anxiety level range) with a SD of 4.2. See Table 1. The p-value which was calculated was.08, finding the results to be insignificant. (p>.05). See Table 1. Due to the p-value being greater than.05, the correlation between the amount of caffeine consumed and the anxiety score was found to be obsolete. There was no direct link between the caffeine consumption, and the subjects reported anxiety scores. The p-value indicated that the results were too likely due to chance.

5 Although it was hypothesized that greater consumption of caffeine would result in a higher anxiety score, it was found that the opposite occurred. Subjects which reported consuming greater than 150 mg a day actually had a lower mean anxiety score as opposed to subjects which drank less than 150 mg a day. Based on these results, further research may be conducted in order to see if caffeine consumption correlates to lower anxiety scores. Some possible limitations include the survey being too daunting, and over too long of a time period for the subjects to complete accurately. The results may have also been skewed due to the compensation of donuts given to participants who completed the study. Subjects may have quickly completed the surveys at the last minute in order to receive a donut. The anxiety survey may have not been completed at the required time resulting in inaccurate data. The amount of caffeine consumed may be different than that which was actually reported. Our p-value may have been more significant if we had a larger number of subjects. It may be possible that although physiological stress levels may have been elevated as seen in previous research, the effects of the caffeine may cause participants to self-report lower levels of stress. We also adjusted our daily intake mg correlating with high doses of caffeine from 300 mg to 150 mg due to zero participants reporting more than 300 mg of caffeine intake per day. Previous research had shown that a high percentage of graduate students did consume more than 300 mg of caffeine per day which led us to our hypothesis and also leads us to believe the self-reported data was neither complete nor accurate. Additionally, we are not considering the cumulative effects of caffeine over the entire day versus acute symptoms just after caffeine intake. Also, anxiety rating scores may be altered if the caffeine is already out of the participant s system (i.e. caffeine effects depend on time of consumption as well as time of test administration), and temporal aspects of caffeine

6 consumption are not factored into this study. This study is also administered over a short-period of time (five days) and does not take into account other possible external sources of anxiety. This study is not completely blind, and participants may fail to properly report all daily caffeine intake. The survey is a self-report, so there could be potential discrepancies with the recording of caffeine consumption such as forgetting about a cup of coffee or not drinking the entire cup but reporting it anyway. Our surveyed population is a convenience sample only and is a small sample of Touro University Nevada OT graduate students, so the generalizability is limited. Also, it is impossible to list every conceivable caffeine product since there are literally thousands on the market. Additionally, the researchers are not aware of the preexisting health or mental health conditions of participants. We are not aware of individual stress factors not correlated with caffeine consumption such as having a baby, death in the family, test anxiety, etc. There is also no baseline taken by participants with zero caffeine consumption measuring stress levels without any caffeine.

7 References Salkind, N. J. (2012). Exploring research (8th ed.). Upper Saddle River, NJ: Pearson.