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Yan K, Feng Y, Liu Z, Shi W, Jiang Y, Liu J. Impulsivity Drives Adolescents to Smoke and Drink: Gender Differences in the Mediating Effects of Resilience and Depression. Psychol Rep 2023:332941231216894. [PMID: 37982432 DOI: 10.1177/00332941231216894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
High and rising rates of smoking and drinking among Chinese adolescents are contributing to increasingly serious physical and mental health issues. While impulsivity has been demonstrated to be significantly related to adolescent cigarette and alcohol use, little is known about the mechanisms behind this association. The current study focused on resilience and depressive symptoms as potential mediators of this link, exploring the indirect pathways connecting impulsivity to teenage tobacco and alcohol use. Possible gender differences in this indirect pathway were also explored. Participants were secondary school students from southern China (N = 3466; 49.2% were female; Mage = 14.18; SDage = 1.57). Results revealed that adolescents who were more impulsive used cigarettes and alcohol more frequently, and that this effect was partially mediated by lower resilience and more depressive symptoms. It is noteworthy that there were gender differences in this mediating effect, with the effect of impulsivity on cigarette use for girls being mediated by resilience and depressive symptoms, whereas this statistically significant association was not identified for boys. These findings show how adolescents' impulsivity drives them to smoke and drink, and also emphasize gender as a crucial consideration for intervening with adolescents' drinking and smoking behaviors.
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Affiliation(s)
- Kai Yan
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yonghui Feng
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Ziyao Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Wei Shi
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yubin Jiang
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Juan Liu
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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Chorot P, Valiente RM, Sandín B. The Spanish Version of the Childhood Anxiety Sensitivity Index: Factorial Dimensions and Invariance across Gender in a Sample of Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3045. [PMID: 36833740 PMCID: PMC9958708 DOI: 10.3390/ijerph20043045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
Anxiety sensitivity is a transdiagnostic construct that has been associated with the etiology of emotional disorders, especially panic and other anxiety disorders. Although it is well known that, for the adult population, the factor structure of anxiety sensitivity includes three separate facets (physical, cognitive, and social concerns), the facets of anxiety sensitivity for adolescents have not yet been established. The main goal of the present study was to examine the factor structure of the Spanish version of the Childhood Anxiety Sensitivity Index (CASI). A large sample of nonclinical adolescents completed the Spanish version of the CASI in school settings (N = 1655; aged 11-17 years; 800 boys and 855 girls). Exploratory and confirmatory factor analyses of the full scale (CASI-18) indicate that a three first-order factor solution represents appropriately the three anxiety sensitivity facets previously defined for the adult population. The 3-factor structure had a better fit and was more parsimonious than a 4-factor solution. Results also indicate that the 3-factor structure remains invariant across genders. Girls scored significantly higher than boys on the total scale and on all three dimensions of anxiety sensitivity. In addition, the present study provides information concerning normative data for the scale. The CASI holds promise as a useful tool for assessing general and specific facets of anxiety sensitivity. It could be helpful for the assessment of this construct in clinical and preventive settings. The limitations of the study and suggestions for further research are outlined.
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Affiliation(s)
| | | | - Bonifacio Sandín
- Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
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3
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Paulus DJ, Gallagher MW, Zvolensky MJ, Leventhal AM. Reciprocal longitudinal associations between anxiety sensitivity and alcohol consumption/problems across adolescence: Examining anxiety as a mediator and race/ethnicity as a moderator. Behav Res Ther 2021; 142:103861. [PMID: 34049078 PMCID: PMC8542277 DOI: 10.1016/j.brat.2021.103861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 03/16/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
The conditions and populations for which anxiety sensitivity (AS; i.e., the tendency to interpret unpleasant physiological sensations as dangerous) relates to adolescent alcohol use is unclear. This study tested latent-variable cross-lagged panel modeling of AS-alcohol relations in a racially/ethnically heterogenous longitudinal youth cohort (N = 3396; 53.4% female, 45.8% Latinx) assessed annually across high school. Anxiety and race/ethnicity were tested as mediators and moderators, respectively, of AS-alcohol associations. AS prospectively predicted alcohol problems (β's = 0.05-0.07) but not alcohol consumption (β's = 0.02-0.04) across high school. Alcohol problems predicted AS at the end (β = 0.09) but not beginning (β's = 0.01-0.03) of high school and alcohol consumption predicted lower AS at the beginning (β = -0.06) but not end (β's = -0.02-0.01) of high school. Anxiety mediated AS's predictive effects on alcohol problems (βindirect's = 0.01, 95% CI [0.003, 0.03]) across high school. Race/ethnicity did not moderate interrelations of AS, anxiety, and alcohol outcomes. These findings lend support to the risk factor model of AS on alcohol problems (but not consumption) through anxiety and the scar/complication model whereby alcohol problems may exacerbate AS later in adolescence. Addressing reciprocal risk processes between AS, anxiety, and alcohol problems warrant consideration in adolescent behavioral health promotion for various racial/ethnic populations.
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Affiliation(s)
- Daniel J Paulus
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, United States.
| | - Matthew W Gallagher
- University of Houston, Department of Psychology, Houston, TX, United States; University of Houston, Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX, United States
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States; Health Institute, University of Houston, Houston, TX, United States
| | - Adam M Leventhal
- University of Southern California Keck School of Medicine, Department of Preventative Medicine, Los Angeles, CA, United States; University of Southern California, Department of Psychology, Los Angeles, CA, United States
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Bilsky SA, Friedman HP, Karlovich A, Smith M, Leen-Feldner EW. The interaction between sleep disturbances and anxiety sensitivity in relation to adolescent anger responses to parent adolescent conflict. J Adolesc 2020; 84:69-77. [PMID: 32871495 DOI: 10.1016/j.adolescence.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sleep disturbances are common among adolescents and are associated with elevated anxiety, and difficulties managing affect. Familial conflict is associated with both anxiety sensitivity and adolescent sleep disturbances. No work to date has examined how adolescent sleep disturbances may interact with anxiety sensitivity in relation to adolescent affective responding to parent-adolescent conflict. The current study was designed to address this gap in the literature by examining how adolescent sleep disturbances, anxiety sensitivity, conflict elicited anger, and conflict avoidance are associated. METHOD Seventy-two American adolescents (n = 39 males) between the ages of 12 and 16 years (Mage = 13.84, SD = 1.38) completed a baseline assessment as well as a well-validated mother-adolescent laboratory-based conflict task. RESULTS For youth low in anxiety sensitivity, greater sleep disturbance related positively to conflict-elicited anger, which in turn predicted higher conflict avoidance. In contrast, this indirect effect was not significant for adolescents relatively higher in anxiety sensitivity. Instead, for these adolescents, increased sleep disturbances were associated with lower levels of conflict elicited anger. CONCLUSIONS Results suggest that the effects of sleep disturbances on conflict elicited anger may vary as a function of adolescent anxiety vulnerability. These findings highlight the importance of considering the unique effects of sleep disturbances on adolescent affect as a function of adolescent anxiety vulnerability.
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Affiliation(s)
- Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, MS, USA.
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, MS, USA
| | - Ashley Karlovich
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Madeleine Smith
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Ellen W Leen-Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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Guillot CR, Blackledge SM, Douglas ME, Cloutier RM, Liautaud MM, Pang RD, Kirkpatrick MG, Leventhal AM. Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents. Behav Med 2020; 46:161-169. [PMID: 31039083 PMCID: PMC6821558 DOI: 10.1080/08964289.2019.1573797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, University of North Texas, Denton, TX,Corresponding author: Casey Guillot, PhD, University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX 76203-5017; Tel: 1-940-369-8426; Fax: 1-940-565-4682;
| | - Sabrina M. Blackledge
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | | | - Madalyn M. Liautaud
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | | | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Department of Psychology, University of California, Los Angeles, CA
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Francis SE, Noël VA, Ryan SL. A Systematic Review of the Factor Structure of Anxiety Sensitivity Among Children: Current Status and Recommendations for Future Directions. CHILD & YOUTH CARE FORUM 2019. [DOI: 10.1007/s10566-019-09502-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Do Youth with Separation Anxiety Disorder Differ in Anxiety Sensitivity From Youth with Other Anxiety Disorders? Child Psychiatry Hum Dev 2018; 49:888-896. [PMID: 29666976 DOI: 10.1007/s10578-018-0805-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Studies on the relationship between separation anxiety disorder (SAD) in childhood and panic disorder (PD) in adolescence and adulthood have yielded results which suggest a common underlying vulnerability for both disorders. In this study, we examined whether one such possible vulnerability-anxiety sensitivity-differed for youth diagnosed with SAD versus other anxiety disorders. Anxiety sensitivity was assessed using the Childhood Anxiety Sensitivity Index (CASI) in 315 clinic-referred youth (ages 6-17, 113 girls). 145 children (46%) were diagnosed with one or more primary anxiety disorder, including SAD (n = 22), generalized anxiety (GAD) (n = 79), social anxiety (SocA) (n = 55), and specific phobia (SP) (n = 45). Children with SAD reported higher levels of anxiety sensitivity and fears of physical symptoms than children with SP and SocA, but not children with GAD. We speculate that children who have SAD and GAD and high anxiety sensitivity may be more vulnerable to develop PD.
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Associations of anxiety sensitivity and emotional symptoms with the subjective effects of alcohol, cigarettes, and cannabis in adolescents. Addict Behav 2017; 73:192-198. [PMID: 28544955 DOI: 10.1016/j.addbeh.2017.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 12/26/2022]
Abstract
Maladaptive emotional traits (anxiety sensitivity [AS], fear of anxiety-related sensations and consequences) and symptoms (major depressive disorder [MDD] and generalized anxiety disorder [GAD] symptoms) could play a role in altering sensitivity to the subjective effects of drugs of abuse in adolescents. Data were drawn from a longitudinal study of high school students in Los Angeles, CA, USA who completed surveys and reported past six-month use of alcohol (n=1054), cigarettes (n=297), or cannabis (n=706). At each of the four semi-annual waves during mid-adolescence (14-16years old), students reported positive and negative subjective drug effects experienced in the prior six-months. Controlling for covariates and the simultaneous covariance across the three domains of emotional dysfunction, AS was associated with more positive and negative cannabis effects (βs=0.09-0.16, ps<0.05), and MDD symptoms were associated with fewer negative cigarette effects (β=-0.13, p=0.04) and more negative cannabis effects (β=0.10, p=0.004). The acceleration of positive alcohol and cannabis effects over time was slower among adolescents with higher baseline MDD (MDD×time: β=-0.04, p=0.044) and GAD (GAD×time: β=-0.05, p=0.03) symptoms, respectively. These findings suggest that emotional dysfunction factors show differential and overlapping effects on subjective drug effects, which may vary across time. Future research should investigate emotional dysfunctions and subjective drug effects in relation to substance use across adolescence and emerging adulthood.
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9
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Bilsky SA, Feldner MT, Knapp AA, Babson KA, Leen-Feldner EW. The interaction between anxiety sensitivity and cigarette smoking level in relation to sleep onset latency among adolescent cigarette smokers. J Adolesc 2016; 51:123-32. [PMID: 27351343 DOI: 10.1016/j.adolescence.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/09/2016] [Accepted: 06/11/2016] [Indexed: 12/23/2022]
Abstract
Cigarette smoking during adolescence is linked to a number of sleep disturbances and has been consistently linked to sleep onset latency among adults. However, little research has examined factors that may influence the relation between cigarette smoking level and sleep onset latency among adolescents. One factor that may be particularly important in this regard is anxiety sensitivity (AS). The current study examined whether cigarette smoking level interacted with AS in its association with sleep onset latency among 94 adolescent (Mage = 15.72) cigarette smokers. As hypothesized, AS interacted with smoking level to relate to sleep onset latency, even after controlling for age and gender. This relation was specific to sleep onset latency as opposed to other types of sleep disturbances, and that adolescents who smoked at higher levels tended to go to sleep later and wake up later than adolescents who smoked at relatively lower levels.
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Affiliation(s)
- Sarah A Bilsky
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
| | - Matthew T Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA; Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Ashley A Knapp
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Kimberly A Babson
- National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ellen W Leen-Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
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10
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Wright KD, Lebell MANA, Carleton RN. Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth. J Anxiety Disord 2016; 41:35-42. [PMID: 27302203 DOI: 10.1016/j.janxdis.2016.04.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 04/19/2016] [Accepted: 04/22/2016] [Indexed: 12/30/2022]
Abstract
Intolerance of uncertainty (IU) - difficulty coping with uncertainty and its implications - is traditionally studied in adult populations, but more recently has been explored in children and adolescents. To date, the association between IU and health anxiety has not been explored in a child or adolescent sample. Further, it is unknown whether the relationship between IU and health anxiety may be mediated by anxiety sensitivity (i.e., fear of anxiety-related sensations) in this population. We sought to extend the existing research and expand our understanding of IU as a transdiagnostic construct by exploring the association between IU and health anxiety, anxiety sensitivity, and DSM-IV anxiety disorder symptom categories in 128 youth (M age=12.7years, SD=0.82, range 11-17 years). Participants completed measures of IU, health anxiety, anxiety sensitivity, and anxiety disorder symptom categories. Results demonstrated significant positive associations between IU and all measures. Mediation analyses supported the direct and indirect importance of each IU subscale on health anxiety. Future directions and implications are discussed.
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Affiliation(s)
- Kristi D Wright
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada.
| | - Megan A N Adams Lebell
- Department of Educational Psychology and Special Education, University of Saskatchewan, Saskatoon, SK, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada
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11
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Bilsky SA, Feldner MT, Knapp AA, Rojas SM, Leen-Feldner EW. The roles of sex, anxious reactivity to bodily arousal, and anxiety sensitivity in coping motives for cigarette smoking among adolescents. Exp Clin Psychopharmacol 2016; 24:147-155. [PMID: 27054780 PMCID: PMC4891293 DOI: 10.1037/pha0000071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Evidence suggests that smoking to cope among adolescents is associated with a number of problematic outcomes (e.g., greater smoking frequency, higher rates of dependence). It is thus imperative to better understand factors that may increase the likelihood of smoking to cope among adolescents. Research suggests anxiety sensitivity (AS) is associated with smoking to cope among adults, although the link between AS and coping motives for cigarette use among youth is less clear. Gender differences have also been noted in AS. The current study investigates this association using a biological challenge paradigm. Specifically, the indirect effects of anxious reactivity to bodily arousal on the relation between the physical and mental AS factors and coping motives for cigarette smoking were examined within a sample of 108 adolescent cigarette smokers. Gender was examined as a moderator. Results suggested significant indirect effects of self-reported anxiety in response to bodily arousal on the relation between physical AS and coping motives for cigarette smoking. This indirect effect was moderated by gender, such that it was significant for females but not males. Models examining AS mental concerns and psychophysiological responding to the challenge were not significant. These results suggest that, relative to their low AS counterparts, female adolescents high in physical concerns respond with elevated anxiety in response to interoceptive arousal and, in turn, endorse elevated coping-related smoking motives. Findings are discussed in terms of implications for understanding the nature and origins of coping-related smoking motives and how such information can be used to inform intervention efforts. (PsycINFO Database Record
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Affiliation(s)
- Sarah A. Bilsky
- Department of Psychological Science, University of Arkansas, Fayetteville, AR,Correspondence concerning this article should be addressed to Sarah A. Bilsky, University of Arkansas, Department of Psychological Science, Arkansas Interdisciplinary Sciences Laboratory, 216 Memorial Hall, Fayetteville, AR, 72701; ; phone: (479) 575-3523; Ellen Leen-Feldner,
| | - Matthew T. Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR,Laureate Institute for Brain Research, Tulsa, OK
| | - Ashley A. Knapp
- Department of Psychological Science, University of Arkansas, Fayetteville, AR
| | - Sasha M. Rojas
- Department of Psychological Science, University of Arkansas, Fayetteville, AR
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12
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Martin L, Kidd M, Seedat S. Anxiety Sensitivity in School Attending Youth: Exploratory and Confirmatory Factor Analysis of the 18-Item CASI in a Multicultural South African Sample. Front Psychol 2016; 6:1996. [PMID: 26779098 PMCID: PMC4703811 DOI: 10.3389/fpsyg.2015.01996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022] Open
Abstract
Anxiety sensitivity (AS) is a risk factor for the development of anxiety disorders in youth. To date, the applicability of the Childhood Anxiety Sensitivity Index (CASI) in youth from a low or middle income country (LMIC) setting on the African continent has not been assessed. A representative sample of 1149 secondary school learners from 29 schools in Cape Town, South Africa, participated in the study. Participants completed the CASI on a single occasion. One-, two-, and four-factor models of the CASI were assessed. A one-factor solution that comprised items predominantly represented by physical concerns appeared to provide the best fit to our data, however, relatively low variance (26%) was explained. Subsequent item deletion resulted in a 9-item ‘physical concerns’ factor that showed good construct reliability (0.83) but also explained a low amount of variance (35%). In terms of gender, a one-factor model provided the best fit, however, low variance was explained (i.e., 25%). Configural, metric and scalar invariance of the CASI by gender was determined. Our results suggest that the 18-item CASI is not applicable to our target population and may require adaptation in this population; however, replication of this study in other multicultural adolescent samples in South Africa is first needed to further assess the validity of the AS construct as measured by the CASI.
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Affiliation(s)
- Lindi Martin
- Department of Psychiatry, Stellenbosch University Cape Town, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences, Stellenbosch University Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University Cape Town, South Africa
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13
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Knapp AA, Blumenthal H, Mischel ER, Badour CL, Leen-Feldner EW. Anxiety Sensitivity and Its Factors in Relation to Generalized Anxiety Disorder among Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 44:233-44. [DOI: 10.1007/s10802-015-9991-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Norr AM, Albanese BJ, Allan NP, Schmidt NB. Anxiety sensitivity as a mechanism for gender discrepancies in anxiety and mood symptoms. J Psychiatr Res 2015; 62:101-7. [PMID: 25687739 DOI: 10.1016/j.jpsychires.2015.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 01/04/2023]
Abstract
Despite the well-established gender differences in the prevalence of anxiety and depressive disorders, there is a dearth of research looking at sex-linked, variable risk factors that could serve as appropriate intervention targets to ameliorate these discrepancies. One such potential variable risk factor is anxiety sensitivity (AS), or a fear of anxiety related sensations. Studies have established elevated AS in women compared to men, and that AS prospectively predicts the development of anxiety and depressive symptoms. Additionally, research has demonstrated some specificity with regard to the lower-order AS dimensions (physical, cognitive, and social concerns) in relation to symptoms of anxiety and depression. The purpose of the current study was to examine whether overall AS, as well as lower-order AS dimensions, statistically mediate the relations between gender and anxiety and depressive symptoms in a sample of individuals with elevated AS presenting for an AS intervention. Data for the current study were collected from participants (N = 106) at baseline prior to randomization to treatment condition. Results revealed that overall AS statistically mediated the relations between gender and symptoms of anxiety and depression. Significant statistical mediation was also found for AS physical and social concerns for anxiety symptoms, and AS cognitive concerns for depressive symptoms. These results suggest the possible importance of AS in the gender discrepancies in anxiety and depression. Future research should examine whether an AS intervention can help ameliorate this prevalence gap.
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Affiliation(s)
- Aaron M Norr
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Brian J Albanese
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Nicholas P Allan
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
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15
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Brown HM, Waszczuk MA, Zavos HMS, Trzaskowski M, Gregory AM, Eley TC. Cognitive content specificity in anxiety and depressive disorder symptoms: a twin study of cross-sectional associations with anxiety sensitivity dimensions across development. Psychol Med 2014; 44:3469-3480. [PMID: 25066519 DOI: 10.1017/s0033291714000828] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The classification of anxiety and depressive disorders has long been debated and has important clinical implications. The present study combined a genetically sensitive design and multiple time points to investigate cognitive content specificity in anxiety and depressive disorder symptoms across anxiety sensitivity dimensions, a cognitive distortion implicated in both disorders. METHOD Phenotypic and genetic correlations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were examined at five waves of data collection within childhood, adolescence and early adulthood in two representative twin studies (n pairs = 300 and 1372). RESULTS The physical concerns dimension of anxiety sensitivity (fear of bodily symptoms) was significantly associated with anxiety but not depression at all waves. Genetic influences on physical concerns overlapped substantially more with anxiety than depression. Conversely, mental concerns (worry regarding cognitive control) were phenotypically more strongly associated with depression than anxiety. Social concerns (fear of publicly observable symptoms of anxiety) were associated with both anxiety and depression in adolescence. Genetic influences on mental and social concerns were shared to a similar extent with both anxiety and depression. CONCLUSIONS Phenotypic patterns of cognitive specificity and broader genetic associations between anxiety sensitivity dimensions, anxiety and depressive disorder symptoms were similar at all waves. Both disorder-specific and shared cognitive concerns were identified, suggesting it is appropriate to classify anxiety and depression as distinct but related disorders and confirming the clinical perspective that cognitive therapy is most likely to benefit by targeting cognitive concerns relating specifically to the individual's presenting symptoms across development.
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Affiliation(s)
- H M Brown
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry,King's College London,UK
| | - M A Waszczuk
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry,King's College London,UK
| | - H M S Zavos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry,King's College London,UK
| | - M Trzaskowski
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry,King's College London,UK
| | - A M Gregory
- Department of Psychology, Goldsmiths,University of London,UK
| | - T C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry,King's College London,UK
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Cognitive Vulnerabilities for Depression and Anxiety in Childhood: Specificity of Anxiety Sensitivity and Rumination. Behav Cogn Psychother 2014; 44:30-42. [DOI: 10.1017/s1352465814000472] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Childhood anxiety and depression frequently co-occur. Exploring specificity in cognitive processes for anxiety and depression in childhood can provide insight into cognitive vulnerabilities contributing to the development of anxiety and depressive disorders and inform targeted psychological interventions. Anxiety sensitivity and rumination are robust cognitive vulnerabilities for anxiety and depression, respectively. However, despite conceptual similarities, they are rarely considered together within a single study. Aims: The current study explored specific and shared associations between anxiety sensitivity subscales and rumination and anxiety and depressive symptoms in unselected children. Method: Multiple regression analyses explored to what extent specific self-reported anxiety sensitivity subscales (physical, social and mental concerns) and rumination predicted anxiety and depressive symptoms in 147 unselected children, aged 7–11 years. Results: Physical and social concern subscales of anxiety sensitivity were specifically associated with anxiety, whilst rumination was specifically associated with depressive symptoms. The mental concerns subscale of anxiety sensitivity was independently associated with both anxiety and depressive symptoms. These associations were only partially mediated by rumination. Conclusions: Anxiety and depression in young people are characterized by specific and shared cognitions. Evidence for shared and specific associations between the cognitive vulnerabilities of anxiety sensitivity and rumination, and anxiety and depression highlight the utility of transdiagnostic research and confirm that cognitive therapies may benefit from targeting cognitive concerns relating specifically to the patient's presenting symptoms.
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Allan NP, MacPherson L, Young KC, Lejuez CW, Schmidt NB. Examining the latent structure of anxiety sensitivity in adolescents using factor mixture modeling. Psychol Assess 2014; 26:741-51. [PMID: 24749756 DOI: 10.1037/a0036744] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anxiety sensitivity has been implicated as an important risk factor, generalizable to most anxiety disorders. In adults, factor mixture modeling has been used to demonstrate that anxiety sensitivity is best conceptualized as categorical between individuals. That is, whereas most adults appear to possess normative levels of anxiety sensitivity, a small subset of the population appears to possess abnormally high levels of anxiety sensitivity. Further, those in the high anxiety sensitivity group are at increased risk of having high levels of anxiety and of having an anxiety disorder. This study was designed to determine whether these findings extend to adolescents. Factor mixture modeling was used to examine the best fitting model of anxiety sensitivity in a sample of 277 adolescents (M age = 11.0 years, SD = 0.81). Consistent with research in adults, the best fitting model consisted of 2 classes, 1 containing adolescents with high levels of anxiety sensitivity (n = 25) and another containing adolescents with normative levels of anxiety sensitivity (n = 252). Examination of anxiety sensitivity subscales revealed that the social concerns subscale was not important for classification of individuals. Convergent and discriminant validity of anxiety sensitivity classes were found in that membership in the high anxiety sensitivity class was associated with higher mean levels of anxiety symptoms, controlling for depression and externalizing problems, and was not associated with higher mean levels of depression or externalizing symptoms controlling for anxiety problems.
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Affiliation(s)
| | - Laura MacPherson
- Center for Addictions, Personality, and Emotion Research, University of Maryland
| | - Kevin C Young
- Center for Addictions, Personality, and Emotion Research, University of Maryland
| | - Carl W Lejuez
- Center for Addictions, Personality, and Emotion Research, University of Maryland
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A French Translation of the Childhood Anxiety Sensitivity Index (CASI): Factor Structure, Reliability and Validity of This Scale in a Nonclinical Sample of Children. Psychol Belg 2014. [DOI: 10.5334/pb.an] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Capron DW, Allan NP, Norr AM, Zvolensky MJ, Schmidt NB. The effect of successful and unsuccessful smoking cessation on short-term anxiety, depression, and suicidality. Addict Behav 2014; 39:782-8. [PMID: 24457901 DOI: 10.1016/j.addbeh.2013.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 12/14/2013] [Accepted: 12/18/2013] [Indexed: 11/26/2022]
Abstract
Research on the mental health effects of quitting smoking is limited. Smokers with mental illness appear to be at a higher risk of unsuccessful smoking cessation. Recent work suggests they are at elevated risk for post-cessation increases in anxiety, depression and suicidal ideation. The current study tested the effects of successful and unsuccessful smoking cessation on short-term psychopathology in 192 community participants. Smoking cessation outcomes were classified using expired carbon monoxide levels that were taken at quit week, 1 and 2 week follow-up and 1 month follow-up. We found no psychopathology increases in participants who successfully quit smoking. For individuals struggling to quit our results partially supported a recently proposed struggling quitters hypothesis. However, the vast majority of individuals posited to be vulnerable by the struggling quitters hypothesis did not experience clinically significant increases in psychopathology. These findings have implications for clinicians whose clients are interested in smoking cessation.
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Stevanovic DS, Silverman WK, Nichols-Lopez KA, Popovic-Deusic SD, Pejovic-Milovancevic MM. Facets of the childhood anxiety sensitivity index among Serbian youth. Cogn Behav Ther 2013; 42:342-6. [PMID: 23952679 DOI: 10.1080/16506073.2013.773060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Data from factor analytic studies using the Child Anxiety Sensitivity Index (CASI) suggest that global anxiety sensitivity (AS) is best represented by three or four underlying factors or facets. The aim of this study was to identify facets best representing the CASI structure in its Serbian version. Confirmatory factor analysis was used on data collected from 456 non-referred children in Serbia. A 13-item version of the CASI provided a better fit to the data than the original 18-item version. The four-factor model of the CASI-13 with disease, unsteady, mental incapacitation, and social concerns facets provided the best fits for the data and it was found to be fully invariant (configural, metric, and scalar invariance) across gender and age. Among Serbian children, hierarchical structure was found for a 13-item CASI version with a single higher-order factor of global AS represented by four underlying facets. Future research will consider these AS facets and their role in the development, maintenance, and exacerbation of anxiety symptoms in children.
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21
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Knapp AA, Frala J, Blumenthal H, Badour CL, Leen-Feldner EW. Anxiety Sensitivity and Childhood Learning Experiences: Impacts on Panic Symptoms Among Adolescents. COGNITIVE THERAPY AND RESEARCH 2013. [DOI: 10.1007/s10608-013-9558-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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22
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Abstract
BACKGROUND Mood disorders are expressed in many heterogeneous forms, varying from anxiety to severe major clinical depression. The disorders are expressed in individual variety through manifestations governed by co-morbidities, symptom frequency, severity, and duration, and the effects of genes on phenotypes. The underlying etiologies of mood disorders consist of complex interactive operations of genetic and environmental factors. The notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of disease state. AIMS This review evaluates the role of genetic biomarkers in assisting clinical diagnosis, identification of risk factors, and treatment of mood disorders. METHODS Through a systematic assessment of studies investigating the epigenetic basis for mood disorders, the present review examines the interaction of genes and environment underlying the pathophysiology of these disorders. RESULTS The majority of research findings suggest that the notion of endophenotypes, which encompasses the markers of several underlying liabilities to the disorders, may facilitate efforts to detect and define, through staging, the genetic risks inherent to the extreme complexity of the disease states. Several strategies under development and refinement show the propensity for derivation of essential elements in the etiopathogenesis of the disorders affecting drug-efficacy, drug metabolism, and drug adverse effects, e.g., with regard to selective serotonin reuptake inhibitors. These include: transporter gene expression and genes encoding receptor systems, hypothalamic-pituitary-adrenal axis factors, neurotrophic factors, and inflammatory factors affecting neuroimmune function. Nevertheless, procedural considerations of pharmacogenetics presume the parallel investment of policies and regulations to withstand eventual attempts at misuse, thereby ensuring patient integrity. CONCLUSIONS Identification of genetic biomarkers facilitates choice of treatment, prediction of response, and prognosis of outcome over a wide spectrum of symptoms associated with affective states, thereby optimizing clinical practice procedures. Epigenetic regulation of primary brain signaling, e.g., serotonin and hypothalamic-pituitary-adrenal function, and factors governing their metabolism are necessary considerations. The participation of neurotrophic factors remains indispensable for neurogenesis, survival, and functional maintenance of brain systems.
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Affiliation(s)
- T Archer
- Department of Psychology, University of Gothenburg, Box 500, SE-40530 Gothenburg, Sweden
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23
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Phenotypic and genetic structure of anxiety sensitivity in adolescence and early adulthood. J Anxiety Disord 2012; 26:680-8. [PMID: 22721752 DOI: 10.1016/j.janxdis.2012.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 04/16/2012] [Accepted: 05/03/2012] [Indexed: 11/22/2022]
Abstract
Anxiety sensitivity is a risk factor for emotional disorders. The structure of anxiety sensitivity was examined using phenotypic and genetic analyses. Self-reported anxiety sensitivity was measured at three time points from adolescence into young adulthood by 2651 individuals from the G1219 twin study. Confirmatory factor analyses revealed comparable statistical support for anxiety sensitivity models consisting of three or four dimensions across all time points. The three-factor model depicting Physical, Social and Mental anxiety-related concerns was favoured due to greater interpretability and parsimony. Multivariate quantitative genetic analyses supported a hierarchical structure with general genetic (.09-.61) and non-shared environmental (.39-.72) influences acting via a higher-order factor as well as dimension-specific genetic (.09-.21) and non-shared environmental (.23-.68) influences. The findings provide further evidence for a hierarchical structure underlying different dimensions of anxiety sensitivity.
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Jokić-Begić N, Jurin T, Lauri Korajlija A. Factor Structure and Psychometric Properties of the Modified Childhood Anxiety Sensitivity Index in a Sample of Croatian Children and Adolescents. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2011. [DOI: 10.1007/s10862-011-9244-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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