1
|
Zech JM, Patel TA, Zvolensky MJ, Schmidt NB, Cougle JR. Interpretation bias modification for hostility to facilitate smoking cessation in a sample with elevated trait anger: A randomized trial. Behav Res Ther 2024; 175:104499. [PMID: 38412574 PMCID: PMC11008596 DOI: 10.1016/j.brat.2024.104499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
Problematic anger is linked with multiple adverse smoking outcomes, including cigarette dependence, heavy smoking, and cessation failure. A smoking cessation intervention that directly targets anger and its maintenance factors may increase rates of smoking cessation. We examined the efficacy of an interpretation bias modification for hostility (IBM-H) to facilitate smoking cessation in smokers with elevated trait anger. Participants were 100 daily smokers (mean age = 38, 62% female, 55% white) with elevated anger were randomly assigned to eight computerized sessions of either IBM-H or a health and relaxation video control condition (HRVC). Participants in both conditions attempted to quit at mid-treatment. Measures of hostility, anger, and smoking were administered at pre-, mid-, post-treatment, as well as at up to three-month follow-up. Compared to HRVC, IBM-H led to greater reductions in hostile interpretation bias, both at posttreatment and follow-up. IBM-H also led to statistically significant reductions in hostility only at posttreatment, and trait anger only at three-month follow-up. Both conditions experienced reductions in smoking, although they did not differ in quit success. We discuss these findings in the context of literature on anger and smoking cessation and provide directions for future research.
Collapse
Affiliation(s)
- James M Zech
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, TX, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| |
Collapse
|
2
|
Preston TJ, Cougle JR, Schmidt NB, Macatee RJ. Decomposing the late positive potential to cannabis cues in regular cannabis users: A temporal-spatial principal component analysis. Psychophysiology 2024; 61:e14471. [PMID: 37937737 PMCID: PMC11008592 DOI: 10.1111/psyp.14471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/06/2023] [Accepted: 08/18/2023] [Indexed: 11/09/2023]
Abstract
Cannabis use disorder (CUD) is increasing in the United States, yet, specific neural mechanisms of CUD are not well understood. Disordered substance use is characterized by heightened drug cue incentive salience, which can be measured using the late positive potential (LPP), an event-related potential (ERP) evoked by motivationally significant stimuli. The drug cue LPP is typically quantified by averaging the slow wave's scalp-recorded amplitude across its entire time course, which may obscure distinct underlying factors with differential predictive validity; however, no study to date has examined this possibility. In a sample of 105 cannabis users, temporo-spatial Principal Component Analysis was used to decompose cannabis cue modulation of the LPP into its underlying factors. Acute stress was also inducted to allow for identification of specific cannabis LPP factors sensitive to stress. Factor associations with CUD severity were also explored. Eight factors showed significantly increased amplitudes to cannabis images relative to neutral images. These factors spanned early (~372 ms), middle (~824 ms), and late (>1000 ms) windows across frontal, central, and parietal-occipital sites. CUD phenotype individual differences were primarily associated with frontal, middle/late latency factor amplitudes. Acute stress effects were limited to one early central and one late frontal factor. Taken together, results suggest that the cannabis LPP can be decomposed into distinct, temporal-spatial factors with differential responsivity to acute stress and CUD phenotype variability. Future individual difference studies examining drug cue modulation of the LPP should consider (1) frontalcentral poolings in addition to conventional central-parietal sites, and (2) later LPP time windows.
Collapse
|
3
|
Albanese BJ, Sawyer H, Dreelin D, Fox H, Schmidt NB. Suicidal ideation is associated with safety behavior usage among trauma-exposed individuals. J Affect Disord 2024; 350:863-866. [PMID: 38272368 DOI: 10.1016/j.jad.2024.01.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Long-standing theoretical perspectives on suicidal ideation (SI) have posited that SI arises, in part, as a way to obtain relief from intense emotional pain. Yet, little research has examined whether SI is linked with other relief-driven behaviors. The present study sought to provide preliminary support for the link between SI and relief-driven safety behavior usage, a commonly used strategy for managing distress among trauma-exposed individuals. METHODS Trauma-exposed participants (n = 95) recruited for a larger study assessing mechanisms of posttraumatic stress disorder symptomology and completed a battery of self-report measures, including SI and their use of safety behaviors. Zero-inflated negative binomial regressions were utilized to examine the association of safety behavior usage with the presence/absence of SI (i.e., zero-inflation) and SI severity. RESULTS In bivariate models, safety behaviors were associated with a greater likelihood of experiencing any SI and reporting more severe SI. When covariates were added to the model, safety behavior usage remained significantly and positively associated with SI severity. LIMITATIONS The present study employed cross-sectional analyses of self-report data. Future research should use neurobehavioral tasks and intensive longitudinal data to test whether an underlying sensitivity to, or propensity to engage in, relief-driven behaviors contributes to SI. DISCUSSION Among trauma-exposed individuals, those who more frequently engage in negatively reinforced safety behaviors also report more severe SI. These findings dovetail with theoretical foundations of suicide linking SI with relief-driven motivations and provide further support that a propensity to engage in relief-driven behaviors is associated with SI.
Collapse
Affiliation(s)
- Brian J Albanese
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States of America.
| | - Hannah Sawyer
- Department of Psychological Sciences, Auburn University, Auburn, AL, United States of America
| | - Dorothy Dreelin
- Department of Psychological Sciences, Auburn University, Auburn, AL, United States of America
| | - Hailey Fox
- Department of Psychological Sciences, Auburn University, Auburn, AL, United States of America
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, United States of America
| |
Collapse
|
4
|
Morabito DM, Ebert KR, Bedford CE, Trotter A, Schmidt NB. Peritraumatic tonic immobility and posttraumatic symptoms among LGBTQ+ versus straight cisgender female sexual assault survivors. Psychol Trauma 2024:2024-60223-001. [PMID: 38451715 DOI: 10.1037/tra0001661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The current study examined group differences in peritraumatic tonic immobility (TI) and posttraumatic symptoms among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) females and their straight, cisgender counterparts. METHOD Adult female sexual assault (SA) survivors (N = 86; 41.9% LGBTQ+) completed a questionnaire battery assessing demographics, TI experience, posttraumatic stress disorder symptoms, dissociative symptoms, and posttraumatic cognitions. Chi-square analyses, analyses of variance, and hierarchical linear regressions were used to characterize the associations among these variables. RESULTS Individuals identifying as LGBTQ+ endorsed higher rates and severity of TI as well as greater posttraumatic stress symptoms compared to their straight, cisgender counterparts. Both LGBTQ+ status and TI experience predicted greater posttraumatic stress symptoms. CONCLUSIONS Findings suggest that LGBTQ+ individuals who endorse TI during SA experience greater posttraumatic symptoms than their non-LGBTQ+ and non-TI counterparts. These findings have important implications for future research and treatment of female SA survivors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
|
5
|
Patel TA, Raines AM, Morabito DM, Schmidt NB. Obsessive-compulsive symptoms, perceived burdensomeness, and thwarted belongingness: Associations and implications among US veterans. J Clin Psychol 2024; 80:323-338. [PMID: 37837647 DOI: 10.1002/jclp.23609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/16/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is among the most debilitating psychiatric disorders worldwide, but has gone relatively unnoticed within the US veteran population. Simultaneously, suicide rates continue to remain high within this population despite the high volume of veterans who receive psychiatric care. With recent research demonstrating OCD's unique relationship with suicidality, it is imperative to explore this association and factors that may explain this association within veterans. METHODS The present study investigated OCD symptoms and their relationship with two known risk factors of suicide, perceived burdensomeness (PB) and thwarted belongingness (TB), in two samples of veterans. RESULTS In the first study (N = 100), OCD symptoms were found to be uniquely related to both PB and TB even after covarying for demographics, trauma exposure, and probable depression. In the second study (N = 99), these relationships were replicated longitudinally. OCD symptoms at baseline were found to be indirectly related to suicidal ideation severity at a 1-month follow-up via PB and TB at post-treatment. CONCLUSION This study highlights the importance of assessing and addressing OCD symptoms within veterans due to the unique relationship these symptoms have with suicidal constructs. A deeper understanding of the impact of OCD within the veteran population will inform future prevention and intervention efforts.
Collapse
Affiliation(s)
- Tapan A Patel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, Los Angeles, USA
- Louisiana State University School of Medicine, New Orleans, Los Angeles, USA
| | - Danielle M Morabito
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
6
|
Zvolensky MJ, Bakhshaie J, Redmond BY, Garey L, de Dios M, Cano MÁ, Schmidt NB. Anxiety sensitivity reduction-smoking cessation intervention among individuals who engage in dual cigarette and cannabis use: A secondary analysis. J Subst Use Addict Treat 2024; 156:209211. [PMID: 37931686 DOI: 10.1016/j.josat.2023.209211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Cannabis use among individuals who smoke is prevalent in the general population and related to adverse health effects, including higher levels of interoceptive perturbation (i.e., a disturbance in internal experiences). An important aspect of smoking cessation among individuals who co-use cannabis is to address behavioral associations between physiological sensations and habitual behaviors via integrated treatments focused on reducing reactivity to internal perturbations such as anxiety sensitivity (i.e., the belief that such symptoms produce personal harm). METHODS The current study involved a secondary analysis of a randomized clinical trial (RCT) of an integrated anxiety sensitivity-smoking cessation intervention compared to standard smoking cessation. The current study sought to extend findings from the initial trial to examine if the integrated intervention produced better smoking cessation outcomes than standard care among individuals who engage in dual cigarette and cannabis use. Participants were 149 adults who engage in dual cigarette and cannabis use (41.6 % female; Mage = 30.89, SD = 13.1). RESULTS Results indicated that the anxiety sensitivity intervention produced statistically significant differences in distal (long-term) smoking abstinence at 3-, 6-, and 12-month follow-up assessments but not proximal (short-term; quit-week to 2-weeks) smoking abstinence. CONCLUSIONS Overall, the potential of an integrated anxiety sensitivity smoking cessation intervention to yield better long-term smoking abstinence rates than standard cessation treatment among individuals who engage in dual cigarette and cannabis use is clinically significant.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, 1 Bowdoin Square, Suite 100, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Brooke Y Redmond
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
7
|
Bedford CE, Trotter AM, Potter M, Schmidt NB. Minority stress and mental health in lesbian, gay, bisexual, transgender, and queer survivors of sexual assault. J Trauma Stress 2023; 36:1031-1043. [PMID: 37776211 PMCID: PMC10840671 DOI: 10.1002/jts.22970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 10/02/2023]
Abstract
Extant research has shown that sexual violence disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals, conferring risk for the development of posttraumatic stress symptoms (PTSS) and related mental health conditions. However, little research has focused on specific vulnerabilities among LGBTQ+-identified sexual assault (SA) survivors (e.g., minority stress) and their associations with post-SA psychopathology. To address this gap, we examined associations between experiences of minority stress and post-SA psychopathology in a sample of LGBTQ+ individuals who experienced SA (N = 92) and completed a battery of self-report measures. Results revealed significant differences in internalized stigma, community connectedness, alcohol use, and cannabis use across sexual orientation and gender modality groups, ηp 2 = .08-11. Additionally, regression analyses indicated that experiences of violence and victimization were significantly associated with higher PTSS, β = .31, p = .020; anxiety, β = .39, p = .003; and alcohol use severity, β = .31, p = .027, over and above other experiences of minority stress and psychopathology risk factors. Internalized stigma was significantly associated with cannabis use severity, β =.34, p = .011. Finally, community connectedness was significantly associated with lower anxiety symptom severity, β = -.42, p = .001. Although longitudinal work is needed, findings indicate that experiences of minority stress may serve as risk or maintenance factors for post-SA psychopathology. These results offer important considerations for future treatment approaches tailored to LGBTQ+ survivors of SA.
Collapse
Affiliation(s)
- Carter E Bedford
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Aoife M Trotter
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Miracle Potter
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
8
|
Afshar K, Cougle JR, Schmidt NB, Macatee RJ. Impact of a brief distress intolerance intervention on acute stress modulation of response inhibition neurophysiology in cannabis use disorder. Addict Behav 2023; 147:107811. [PMID: 37517377 PMCID: PMC10528376 DOI: 10.1016/j.addbeh.2023.107811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/30/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND The prevalence of cannabis use in the US has increased within the past two decades. Moreover, cannabis use disorder (CUD) is associated with significant disability, but the underlying neural mechanisms of CUD are unclear. Distress intolerance (DI), a psychological risk factor for CUD, may confer risk in part via impaired inhibitory control (IC) capacity during acute stress. DI and cannabis use problems have been associated with altered N2 amplitude, an IC-related event-related potential, in prior cross-sectional studies, but whether altered N2 is a state marker of CUD severity, a pathoplastic factor responsive to intervention and predictive of CUD symptom change over time, or an enduring trait-like vulnerability is unclear. In this secondary analysis, we tested the impact of a DI-targeted intervention on acute stress-related modulation of the N2 and whether pre-intervention N2 predicted CUD symptom change through follow-up. METHOD Sixty participants were randomly assigned to a DI-targeted or control intervention. Participants completed an IC task before and after a stress induction at pre- and post-intervention lab visits while EEG activity was recorded. RESULTS The DI intervention did not alter the N2 compared to a control intervention. Pre-intervention post-stress IC-related N2 was associated with worse CUD severity but did not predict changeover time. CONCLUSION Findings are consistent with blunted N2 after acute stress acting as a stable marker of CUD severity rather than a pathoplastic factor predictive of CUD trajectory. Future research should investigate whether stress-related blunting of N2 is a consequence of severe CUD or a pre-existing vulnerability.
Collapse
Affiliation(s)
- Kaveh Afshar
- Auburn University, Department of Psychological Sciences, United States.
| | - Jesse R Cougle
- Florida State University, Department of Psychology, United States
| | - Norman B Schmidt
- Florida State University, Department of Psychology, United States
| | - Richard J Macatee
- Auburn University, Department of Psychological Sciences, United States
| |
Collapse
|
9
|
Buitron V, Mayorga NA, Vujanovic AA, Schmidt NB, Zvolensky MJ. Potentially traumatic pandemic stressors and anxiety-related sleep disturbance among Latinx persons. J Trauma Stress 2023; 36:1090-1101. [PMID: 37845818 DOI: 10.1002/jts.22976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 10/18/2023]
Abstract
Latinx persons have endured elevated rates of traumatic stress related to the COVID-19 pandemic. The effect of potentially traumatic pandemic stressors on anxiety-related sleep disturbances, a factor implicated in trauma-related psychopathology, is largely unexamined in this population. The present study evaluated the additive effect of potentially traumatic pandemic stressors (e.g., hospitalization) on anxiety-related sleep disturbances. Further, given within-group disparities across Latinx communities with intersectional identities and COVID-19-related risk factors, comparisons of the likelihood of pandemic stressors, by subgroup (i.e., older persons, individuals with chronic illness, and Black Latinx persons), were evaluated. Participants were 292 (29.8% female, Mage = 35.03 years, SD = 8.72) Latinx adults who completed a questionnaire battery during a period of high contagion (June 2020-July 2021). There were statistically significant differences across groups such that participants who experienced any potentially traumatic pandemic stressors reported elevated scores on indices of anxiety, depressive symptoms, and anxiety-related sleep disturbances compared to those who had not experienced these stressors, ds = 0.54-93. Hierarchical regression analysis revealed that hospitalization was associated with anxiety-related sleep disturbances after controlling for age, sex, chronic illness history, other stressors, anxiety, depressive symptoms, and somatic symptom burden, ΔR2 = .01. Black Latinx identity and chronic illness were significantly associated with potentially traumatic pandemic-related stressors. This is the first empirical work to evaluate the role of potentially traumatic pandemic stressors on sleep disturbances among Latinx persons and indicates that hospitalization in a pandemic context has an incremental effect on sleep disturbances in this minoritized group.
Collapse
Affiliation(s)
- Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
10
|
Koscinski B, Accorso C, Albanese B, Schmidt NB, Allan NP. A replication and extension of bifactor modelling of perseverative thought in an at-risk community sample: Exploring sex differences in the structure of PT. Br J Clin Psychol 2023; 62:717-730. [PMID: 37493004 DOI: 10.1111/bjc.12434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexes. METHODS The study consisted of 280 individuals recruited for a larger study targeting risk factors for suicidal ideation and behaviours. Participants completed a diagnostic interview and self-report questionnaires. RESULTS A two-factor model of PT fit best in males, whereas a bifactor model fit best in females. In a structural equation model, worry was associated with generalized anxiety disorder diagnoses in females, but not males. Rumination was associated with depressive disorder diagnoses in females, but not males. CONCLUSIONS The present study contributes to a growing literature on PT; we found that dimensionality of PT varied by sex. We also found that relations between PT factors and generalized anxiety disorder differed by sex. Sex differences in the internalizing spectrum and related risk factors need to be considered when examining the structure and function of risk factors.
Collapse
Affiliation(s)
| | | | - Brian Albanese
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Nicholas P Allan
- Department of Psychology, Ohio University, Athens, Ohio, USA
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, Finger Lakes, New York, USA
| |
Collapse
|
11
|
Bedford CE, Schmidt NB. Efficacy of a novel safety behavior elimination intervention for posttraumatic stress symptoms: Results from a randomized controlled trial. J Affect Disord 2023; 339:640-647. [PMID: 37442451 PMCID: PMC10529664 DOI: 10.1016/j.jad.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/02/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Individuals with posttraumatic stress symptoms (PTSS) use a variety of safety behaviors: strategies intended to prevent, avoid, or manage distress in anxiety-provoking situations. However, when used in the absence of threat, safety behaviors maintain PTSS by preventing collection of disconfirming evidence about potential danger. Thus, individuals with PTSS may benefit from eliminating their maladaptive safety behavior use. METHODS The current study evaluated a brief, computer-based safety behavior reduction intervention, Safety Behavior Elimination for Traumatic Stress (SBETS). Seventy-five participants were recruited based on trauma exposure and elevated PTSS. Participants were randomly assigned to the SBETS condition or a physical health control. In the intervention, participants selected two behaviors to reduce or eliminate over the coming month. Participants were given reminders to reduce those behaviors twice a week, and treatment outcomes were assessed at two weeks and one month following the intervention. RESULTS Hierarchical regressions demonstrated that while participants in the two conditions did not differ in their reported safety behavior use at follow-up, individuals in the SBETS condition reported significantly lower month 1 PTSS (Cohen's d = 0.56). While week 2 safety behavior use and week 2 negative affect did not mediate the relationship between treatment condition and month 1 PTSS, this relationship was fully mediated by week 2 use of the two behaviors selected for elimination. LIMITATIONS The current study was limited by its homogenous sample and brief follow-up period. CONCLUSIONS Results suggest that SBETS has a significant effect on PTSS, and may represent an acceptable, accessible treatment option for trauma survivors.
Collapse
Affiliation(s)
- Carter E Bedford
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306, USA.
| | - Norman B Schmidt
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306, USA
| |
Collapse
|
12
|
Fox H, Preston TJ, Morabito D, Schmidt NB, Albanese BJ. The interactive effects of AS and trauma exposure on suicide capability and suicide risk. J Psychiatr Res 2023; 167:100-107. [PMID: 37862905 DOI: 10.1016/j.jpsychires.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 09/04/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Trauma exposure has been linked with heightened suicide risk purportedly through habituation to threatening stimuli, thereby reducing fear of suicide. However, no research has examined variables that may influence this process. Anxiety sensitivity (AS) is one cognitive-affective factor that may strengthen the relationship between trauma exposure and reduced fear of suicide by amplifying traumatic reactivity. The present study evaluated this by examining the interaction of AS and trauma exposure type (e.g., direct vs. witnessed) predicting fear of suicide and self-reported suicide risk. METHODS Participants (n = 124) were recruited for a long-term (∼3-4 years) follow-up after participation in a clinical trial targeting suicide risk factors and were asked to complete self-report measures of trauma history, AS, fear of suicide, and suicide risk. RESULTS Significant interactions emerged such that a greater number of direct traumasexperienced predicted lower fear of suicide and greater suicide risk among those with greater AS. The interactive effect of witnessed traumas and AS predicting suicidality was insignificant. Results remained even after including relevant covariates. DISCUSSION The current findings suggest that AS augments the effects of repeated trauma exposure on fear of suicide and suicide risk. It is plausible these painful and provocative events are more potent among those with high AS due to the amplification of traumatic affective responses, though future research examining the longitudinal relations is needed to confirm this process.
Collapse
Affiliation(s)
- Hailey Fox
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Thomas J Preston
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Danielle Morabito
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Brian J Albanese
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.
| |
Collapse
|
13
|
Morabito DM, Schmidt NB. Efficacy of a brief web-based tonic immobility psychoeducation intervention among trauma-exposed adults: A randomized clinical trial. J Trauma Stress 2023; 36:896-906. [PMID: 37467150 DOI: 10.1002/jts.22955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/21/2023] [Accepted: 05/06/2023] [Indexed: 07/21/2023]
Abstract
Tonic immobility (TI) is a defensive response that may occur during traumatic events. Although TI is adaptive in certain circumstances, it has been shown to contribute to increased trauma-related symptoms and poorer recovery. However, current frontline treatments for posttraumatic stress disorder (PTSD) have not focused significant attention on the experience of TI. Thus, the aim of this study was to develop and test the impact of a brief TI-focused psychoeducation (TIP) intervention on posttraumatic cognitions and PTSD symptoms relative to a health education control intervention. The sample included 46 adults with elevated PTSD symptoms who endorsed prior TI episodes. After providing informed consent, participants were randomly assigned to either the active or control intervention and completed self-report questionnaires including the tonic immobility questionnaire (TIQ-R), Life Events Checklist for DSM-5 (LEC-5), Posttraumatic Stress Checklist for DSM-5 (PCL-5), Posttraumatic Cognitions Inventory (PTCI), and Positive and Negative Affect Schedule (PANAS) at baseline, 1-week, and 1-month follow-up assessments. Results from linear mixed effects models indicated that participants in the TIP condition reported significantly larger reductions in posttraumatic cognitions and PTSD symptoms at 1-week, ds = 0.48 and 0.84, respectively, and 1-month, ds = 0.67 and 0.74. The findings suggest that TIP is a promising intervention that may be used to reduce posttraumatic cognitions and PTSD symptoms associated with TI. Given the ease of access, TIP could be used as a standalone intervention or as an add-on to existing evidence-based treatments for PTSD.
Collapse
Affiliation(s)
- Danielle M Morabito
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
14
|
Schmidt NB, Capron D, Raines AM, Albanese B, Short N, Mathes BM, Morabito DM, Saulnier K, Allan N. Evaluating the long-term (Three Year) durability of brief interventions targeting risk factors for psychopathology. J Anxiety Disord 2023; 96:102710. [PMID: 37058765 DOI: 10.1016/j.janxdis.2023.102710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/28/2023] [Accepted: 03/31/2023] [Indexed: 04/16/2023]
Abstract
Despite their brevity, prior work indicates that computer-based interventions can substantially impact risk factors for psychopathology including anxiety sensitivity (AS), thwarted belongingness (TB), and perceived burdensomeness (PB). However, very few studies have assessed the long-term (> 1 year) effects of these interventions. The primary aim of the current study was to evaluate post-hoc, the long-term (3 year) durability of brief interventions targeting risk factors for anxiety and mood psychopathology using data from a pre-registered randomized clinical trial. Moreover, we were interested in evaluating whether mitigation in these risk factors mediated long-term symptom change. A sample determined to be at-risk for anxiety and mood pathology based on elevations on several risk factors (N = 303) was randomly assigned to one of four experimental conditions focused on: (1) reducing TB and PB; (2) reducing AS, (3) reducing TB,PB, and AS; or (4) a repeated contact control condition. Participants were assessed at post-intervention, one, three, six, 12, and 36 month follow-ups. Participants in the active treatment conditions showed sustained reductions in AS and PB through long-term follow-up. Mediation analyses suggested that reductions in AS mediated long-term reductions in anxiety and depression symptoms. These findings suggest that brief and scalable risk reduction protocols have long-term durability and efficacy both in terms of reducing risk factors for psychopathology.
Collapse
Affiliation(s)
- Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA.
| | - Daniel Capron
- School of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA
| | - Amanda M Raines
- School of Medicine, Louisiana State University, New Orleans, LA 70112, USA; Southeast Louisiana Veterans Healthcare System, 2400 Canal Street, New Orleans, LA 70119, USA
| | - Brian Albanese
- Department of Psychological & Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX 77843, USA
| | - Nicole Short
- Department of Psychology, University of Nevada Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA
| | - Brittany M Mathes
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA
| | - Danielle M Morabito
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA
| | - Kevin Saulnier
- Department of Psychology, Ohio University, Porter 200, Athens, OH 45701, USA
| | - Nicholas Allan
- Department of Psychology, Ohio University, Porter 200, Athens, OH 45701, USA
| |
Collapse
|
15
|
Zvolensky MJ, Bakhshaie J, Garey L, Kauffman BY, Heggeness LF, Schmidt NB. Cumulative vulnerabilities and smoking abstinence: A test from a randomized clinical trial. Behav Res Ther 2023; 162:104272. [PMID: 36746057 DOI: 10.1016/j.brat.2023.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
Smoking cessation is often associated with socioeconomic and intrapersonal vulnerabilities such as psychopathology. Yet, most research that focuses on predicting smoking cessation outcomes tends focus on a small number of possible vulnerabilities. In a secondary data analysis, we developed and empirically evaluated a comprehensive, cumulative vulnerability risk composite reflecting psychologically based transdiagnostic processes, social determinants of health, and psychopathology. Participants were adult smokers who responded to study advertisements (e.g., flyers, newspaper ads, radio announcements) for an in-person delivered 4-session smoking cessation trial (N = 267; 47% female; Mage = 39.4, SD = 13.8). Results indicated that the decline in point prevalence abstinence (PPA) from quit week to 6-month post-quit was statistically significant (p < .001). There were statistically significant effects of cumulative risk score on the intercept (p < .001) and slope (p = .01). These findings were evident in unadjusted and adjusted (controlling for sex, treatment condition, and nicotine dependence) models. The present results indicate smokers with greater cumulative vulnerability demonstrated poorer smoking cessation outcomes. There may be clinical advantages to better understanding cumulative vulnerability among treatment-seeking smokers and other smoking populations to enhance the impact of public health efforts to reduce smoking.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Jafar Bakhshaie
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA
| | | | - Luke F Heggeness
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
16
|
Raines AM, Chambliss JL, Norr AM, Sanders N, Smith S, Walton JL, True G, Franklin CL, Schmidt NB. Acceptability, feasibility, and utility of a safety aid reduction treatment in underserved veterans: a pilot investigation. Cogn Behav Ther 2023; 52:1-17. [PMID: 36562141 PMCID: PMC10482000 DOI: 10.1080/16506073.2022.2130819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Access to mental health services, particularly for veterans residing in underserved communities, remain scarce. One approach to addressing availability barriers is through the use of group-based transdiagnostic or unified treatment protocols. One such protocol, Safety Aid Reduction Treatment (START), previously termed False Safety Behavior Elimination Treatment (FSET), has received increasing empirical support. However, prior research has only examined this treatment among civilians with a primary anxiety diagnosis. Thus, the purpose of the current study was to replicate and extend prior research by examining the acceptability, feasibility, and utility of START among veterans, particularly those living in underserved communities, and across a wider array of diagnoses. Veterans (n = 22) were assessed prior to, immediately after, and one month following the 8-week treatment. The majority of veterans found START useful and acceptable. Additionally, recruitment and retention rates suggest that the treatment was feasible. Notably, results revealed reductions in overall anxiety, depression, and safety aid usage, which were maintained throughout the brief follow-up period. These findings add to a growing body of literature highlighting the utility of transdiagnostic approaches in the amelioration of various anxiety and related disorders. Limitations include the small sample size and uncontrolled design.
Collapse
Affiliation(s)
- Amanda M. Raines
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119, USA
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
- School of Medicine, Louisiana State University, New Orleans, LA 70112, USA
| | - Jessica L. Chambliss
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
| | - Aaron M. Norr
- Northwest Network Mental Illness Research, Education and Clinical Center, Seattle, WA 98108, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98102, USA
| | - Natalie Sanders
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
| | - Shawn Smith
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
| | - Jessica L. Walton
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119, USA
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Gala True
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119, USA
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
- School of Medicine, Louisiana State University, New Orleans, LA 70112, USA
| | - C. Laurel Franklin
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119, USA
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL 32306, USA
| |
Collapse
|
17
|
Mathes Winnicki BM, Schmidt NB. Development and evaluation of an online intervention for reducing hostile interpretation bias: A randomized controlled trial. Behav Ther 2022; 54:496-509. [PMID: 37088506 DOI: 10.1016/j.beth.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/19/2022] [Accepted: 12/04/2022] [Indexed: 12/25/2022]
Abstract
Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility. Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.
Collapse
|
18
|
Preston TJ, Albanese BJ, Schmidt NB, Macatee RJ. Impact of acute stress on neural indices of positive and negative reinforcement processing in cannabis users. Psychol Addict Behav 2022; 36:1036-1047. [PMID: 35696184 PMCID: PMC9745563 DOI: 10.1037/adb0000846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Chronic cannabis use is maintained in part through dysregulated stress and reward response systems. Specifically, stress-related negative affect is thought to act as a salient motivator for chronic substance use. Models of addiction posit that the transition from positive to negative reinforcement motives for substance use is a key mechanism of disordered use. However, research in substance-using samples has not assessed stress-related neural processing of both positive and negative reinforcement. METHOD Therefore, the present study utilized laboratory stress induction to examine how stress affects the reward positivity, an event-related potential sensitive to both positive (RewP) and negative (relief-RewP) reinforcement, in 87 cannabis users (58.10% female, Mage = 19.40) varying in cannabis use disorder (CUD) severity and, as part of larger study aims, history of traumatic brain injury (TBI). We predicted greater CUD severity would be associated with a blunted RewP and enhanced relief-RewP, particularly after stress induction, independent of TBI status. RESULTS Findings indicated that CUD severity was not associated with RewP/relief-RewP amplitude regardless of acute stress. Exploratory analyses revealed, however, that among those with history of TBI +, CUD severity was associated with greater stress-elicited blunting of the RewP and enhancement of the relief-RewP. CONCLUSION Although initial findings contradict current allostatic models of addiction, exploratory findings suggest that history of TBI, and potentially other confounding variables related to increased risk of TBI experience, may influence the extent to which stressful experiences modulate the neurophysiology of both positive and negative reinforcement reward processing in CUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
|
19
|
Macatee RJ, Preston TJ, Afshar K, Schmidt NB, Cougle JR. Impact of a computerized distress intolerance intervention on electrocortical reactivity to cannabis and threat cues: A randomized controlled trial. Psychol Addict Behav 2022; 36:920-929. [PMID: 35129994 PMCID: PMC9357238 DOI: 10.1037/adb0000815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Given increasing rates of daily cannabis use and Cannabis Use Disorder (CUD) in the United States, it is imperative to understand CUD mechanisms in high-risk groups. Cannabis users with high distress intolerance (DI) are at elevated risk for severe and chronic CUD, but neural mechanisms linking CUD and DI are unknown. Cross-sectional data suggests that acute stress modulation of the cannabis and threat cue-elicited late positive potential (LPP), a neurophysiological marker of motivated attention, are possible mechanisms. However, longitudinal research is needed to clarify the roles of these elicited LPPs in CUD maintenance. METHOD Sixty cannabis users with high DI were randomized a brief computerized intervention targeting DI or a control intervention. Elicited LPPs were measured before and after a stressor at baseline and postintervention. Intervention effects on stress modulation of the cannabis and threat LPPs, as well as their prospective associations with CUD, were assessed. RESULTS Elicited LPPs did not significantly change in either intervention group. Acute stress enhancement of the cannabis LPP predicted more severe CUD and greater chronicity at 4-month follow-up. CONCLUSIONS Cannabis and threat LPPs were not altered by a brief DI intervention despite improvement in DI and cannabis use outcomes. Given that acute stress enhancement of the cannabis LPP predicted poorer CUD outcome, it may be a fruitful intervention target in distress intolerant cannabis users. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Richard J. Macatee
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Thomas J. Preston
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Kaveh Afshar
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R. Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
20
|
Bauer BW, Daruwala SE, Trapp NS, Karnick AT, Schubert FT, Elder D, Schmidt NB, Anestis M, Capron DW. Examining perceptions about the association between access to firearms and suicide risk. Psychiatry Res 2022; 317:114888. [PMID: 37732848 DOI: 10.1016/j.psychres.2022.114888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Brian W Bauer
- Department of Psychology, University of Georgia, United States.
| | | | - Nicole S Trapp
- Department of Psychiatry, Michael E. DeBakey VA Medical Center, United States
| | | | | | - Domynic Elder
- Department of Psychology, University of Southern Mississippi, United States
| | - Norman B Schmidt
- Department of Psychology, Florida State University, United States
| | - Michael Anestis
- New Jersey Gun Violence Research Center, United States; School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, United States
| |
Collapse
|
21
|
Schmidt NB, Schubert FT, Sheffler JL. Brief, interoceptive exposure focused treatment for anxiety in mild cognitive impairment. Age Ageing 2022; 51:6606051. [PMID: 35697353 DOI: 10.1093/ageing/afac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Indexed: 11/13/2022] Open
Abstract
Anxiety is common in older adults with mild cognitive impairment (MCI), and Alzheimer's disease and related dementias (ADRD). Anxiety has also been identified as a risk factor for cognitive decline. Brief interventions targeting risk mechanisms of anxiety, such as anxiety sensitivity (AS), have been effective in reducing overall anxiety in a variety of populations. This case series investigated the feasibility and efficacy of a brief AS intervention in anxious older adults with MCI (n = 9). Paired samples t-test results indicate that this intervention is capable of significantly reducing AS as measured by the Anxiety Sensitivity Index-3 (Δ = 5.11, Hedges g = 0.82, P < 0.05). Given these large AS reductions and high acceptability, further investigation of this intervention is warranted in older adults with MCI.
Collapse
Affiliation(s)
- Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | | | - Julia L Sheffler
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
22
|
Boffa JW, Tock JL, Morabito DM, Schmidt NB. Measuring Psychological Inflexibility of Suicidal Thoughts: The Acceptance and Action Questionnaire for Suicidal Ideation (AAQ-SI). Cogn Ther Res 2022. [DOI: 10.1007/s10608-022-10309-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
23
|
Arai H, Ishikawa SI, Okawa S, Kishida K, Korte KJ, Schmidt NB. Safety aid elimination as a brief, preventative intervention for social anxiety: A randomized controlled trial in university students. Curr Psychol 2022. [DOI: 10.1007/s12144-022-02981-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractAlthough there are a variety of treatment options for social anxiety, effective prevention strategies for those with subclinical social anxiety are limited. This study evaluated a single session group formatted prevention program focused on the reduction of safety behaviors in both a proof-of-concept study and a randomized controlled trial (RCT). Participants (N = 59) were nontreatment seeking Japanese university students with high levels of social anxiety. Participants were randomized to either an active treatment focused on identification and elimination of safety behavior or a control group involving the discussion of healthy coping strategies. Both conditions met for 120 min in small groups (4 to 6 participants per group). The preliminary proof-of-concept study as well as the RCT demonstrated high levels of acceptability. Findings from the RCT indicated significant improvement in social anxiety symptoms among those in the active treatment condition at post-treatment, which was maintained at follow-up. In addition, participants in the treatment condition showed significant improvement in levels of depression. The effect size difference in symptoms between conditions was in the large range. The present study provides preliminary support for the efficacy of a newly developed treatment program targeting safety behaviors in students with subclinical social anxiety. The current results also illustrate the promise of a brief, indicated prevention strategy focused on safety behavior among those with subclinical social anxiety.
Collapse
|
24
|
Short NA, Evans MK, Raudales AM, Shapiro M, Weiss NH, Schmidt NB. Anxiety sensitivity and cannabis use motives among trauma-exposed young adult cannabis users. Am J Addict 2022; 31:242-250. [PMID: 35365953 PMCID: PMC9117414 DOI: 10.1111/ajad.13285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Anxiety sensitivity, or fear of anxious arousal, may be an important risk factor for problematic cannabis use. Specifically, anxiety sensitivity may motivate cannabis use to cope with distress, particularly among trauma-exposed individuals. The current study tested associations among anxiety sensitivity, its subdomains, and cannabis use motives in a sample of trauma-exposed cannabis users. We hypothesized elevated anxiety sensitivity, particularly cognitive concerns, would be associated with increased maladaptive coping use motives, after covarying for the number of traumas and cannabis use quantity. METHOD Hypotheses were tested in a cross-sectional study of trauma-exposed young adult cannabis users (N = 56) (Mage = 20.7 years, 59% women, 73% white). Participants completed self-report measures, and a clinical interview assessing cannabis use quantity. RESULTS Multiple regression analyses indicated that elevated anxiety sensitivity was associated with increased cannabis use coping motives, after covarying for the number of traumas experienced and cannabis use quantity. Specifically, higher levels of anxiety sensitivity cognitive and social concerns were associated with coping motives for cannabis use. DISCUSSION AND CONCLUSIONS Anxiety sensitivity, particularly concerns about cognitive dyscontrol and negative social evaluations of anxious arousal, may motivate cannabis use to cope with stress among trauma-exposed cannabis users. Future research should include prospective studies with diverse samples to replicate results and determine whether intervening on anxiety sensitivity could reduce maladaptive coping motives for cannabis use. SCIENTIFIC SIGNIFICANCE The current study replicates prior research indicating anxiety sensitivity, particularly cognitive concerns, is associated with maladaptive cannabis use. Expanding on prior research, findings indicated anxiety sensitivity is associated with coping motives for cannabis use among trauma-exposed cannabis users.
Collapse
Affiliation(s)
- Nicole A. Short
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Mariah K. Evans
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Alexa M. Raudales
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Mary Shapiro
- Southeastern Louisiana VA Health Care System, New Orleans, LA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
25
|
Rogers AH, Garey L, Raines AM, Allan NP, Schmidt NB, Zvolensky MJ. Anxiety sensitivity and opioid use motives among adults with chronic low back pain. Exp Clin Psychopharmacol 2022; 30:23-30. [PMID: 32772532 DOI: 10.1037/pha0000381] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The opioid epidemic is a significant public health crisis in the United States, and chronic pain is a leading precipitating and maintaining factor for opioid misuse. To better understand substance misuse generally, research has examined motivational models of why people use substances, and pain management and affect-driven coping are cited as primary reasons for opioid misuse. Further, research examining psychosocial predictors of opioid misuse has identified anxiety sensitivity (AS; fear of anxiety-related physical sensations) as a unique predictor of opioid misuse severity, and it is possible that AS is uniquely related to opioid pain management and coping motives, which in turn, are related to opioid misuse. Therefore, the current study examined AS as a predictor of opioid pain management and coping motives, as well as the indirect effect of AS, through opioid motives, on opioid misuse status, among 292 adults (Mage = 45.76, SD = 11.20, 68.9% female) with chronic low back pain. Results for the current study support hypotheses that AS is significantly associated with pain management and coping motives (over and above variance of pain intensity) and indirectly associated with opioid misuse status through both motives. These results highlight the importance of better understanding opioid use motives in the context of chronic pain and provide potential treatment targets to add to a growing body of literature targeting psychosocial factors for opioid misuse. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Lorra Garey
- Department of Psychology, University of Houston
| | - Amanda M Raines
- Department of Psychiatry, Southeast Louisiana Veterans Health Care System
| | | | | | | |
Collapse
|
26
|
Shapiro MO, Thompson JS, Short NA, Schmidt NB. Uncertainty after sexual assault: Understanding associations between IU and PTSD within a treatment-seeking sample. Curr Psychol 2022. [DOI: 10.1007/s12144-021-02554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Kauffman BY, Gallagher MW, Viana AG, Schmidt NB, Zvolensky MJ. Computer-delivered intervention for individuals with obesity and elevated anxiety sensitivity: feasibility, acceptability, and initial test. Cogn Behav Ther 2022; 51:353-370. [PMID: 35037832 DOI: 10.1080/16506073.2021.2018487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Obesity is one the fastest growing public health problems related to numerous chronic diseases and frequently co-occurs with negative mood states. One promising approach to address the heterogeneity of affective vulnerabilities and obesity is to focus on processes (e.g. anxiety sensitivity [AS]) that underpin both conditions. Thus, this study aimed to evaluate the feasibility, acceptability, and initial efficacy of a brief, computer-delivered AS reduction program (AST) for adults with obesity and elevated AS. Participants were 131 individuals with obesity and elevated AS who received either AST or a health information control (HC). Latent growth curve modeling was utilized to examine the effect of treatment condition on change in AS, emotional eating, expectancies of eating to manage mood, and exercise self-efficacy from baseline to 1-week, 2-weeks, and 1-month follow-up. Results indicated it was feasible to recruit and retain individuals with obesity and elevated AS through the 1-month follow-up. Positive qualitative feedback was also provided for both AST and HC. AST was a statistically significant predictor of change in expectancies of eating to manage negative affect. No other statistically significant treatment effects were indicated. Current data provide initial empirical support for future work focused on persons with obesity and elevated AS.
Collapse
Affiliation(s)
- Brooke Y Kauffman
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Andres G Viana
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Behavioral Science, The University of Texas Md Anderson Cancer Center, Houston, Texas, USA.,Health Institute, University of Houston, Houston, Texas, USA
| |
Collapse
|
28
|
Saulnier KG, Allan NP, Judah MR, Koscinski B, Hager NM, Albanese B, Knapp AA, Schmidt NB. Attentional Control Moderates the Relations between Intolerance of Uncertainty and Generalized Anxiety Disorder and Symptoms. Cognit Ther Res 2021; 45:1193-1201. [PMID: 34720260 PMCID: PMC8553219 DOI: 10.1007/s10608-021-10223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Intolerance of uncertainty (IU), perceived attentional control (AC), and poor cognitive control abilities are risk factors for anxiety; however, few studies have examined their interactive effects in relation to anxiety. A more complete understanding of interplay between IU, perceived AC, and cognitive control could inform intervention efforts. METHODS The current study examined the direct and interactive effects of IU and AC on anxiety in a sample of 280 community outpatients (M age = 36.01 years, SD = 16.17). Perceived AC was measured using self-report and cognitive control abilities were measured using a Go/No-Go task. RESULTS Findings indicated a significant IU by perceived AC interaction predicting worry and GAD diagnoses. There was a positive relation between IU and worry/GAD diagnoses that was strongest among those with high perceived AC. Perceived AC was unrelated to cognitive control abilities, and cognitive control abilities did not interact significantly with IU. Cognitive control abilities were related to worry symptoms but not to GAD diagnoses. CONCLUSIONS These results indicate that at high levels of perceived AC, individuals with elevated IU report higher levels of worry, potentially due to the conscious use of worry as an emotion regulation strategy. Clinical implications and future directions are discussed.
Collapse
Affiliation(s)
| | | | - Matt R. Judah
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | | | - Nathan M. Hager
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Brian Albanese
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Ashley A. Knapp
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
29
|
Schiele MA, Vietz M, Gajewska A, Unterecker S, Gottschalk MG, Deckert J, Neufang S, Schmidt NB, Domschke K. The cognitive anxiety sensitivity treatment (CAST) in anxiety prevention - Focus on separation anxiety and interoception. Eur Neuropsychopharmacol 2021; 53:104-113. [PMID: 34536714 DOI: 10.1016/j.euroneuro.2021.08.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 01/04/2023]
Abstract
Given the high prevalence and considerable clinical and societal burden of anxiety disorders, preventive measures are urgently warranted to reduce their incidence and overall healthcare impact. Anxiety sensitivity (AS) - a key element in learning theories of anxiety disorders in the context of interoceptive conditioning - constitutes a malleable risk factor of particularly panic disorder and separation anxiety, which share developmental, nosological, epidemiological and pathomechanistic characteristics. The computer-assisted 'Cognitive Anxiety Sensitivity Treatment' (CAST) targeting interoceptive anxiety symptoms (cf. Schmidt et al., 2014) was translated, intensified and culturally adapted to German and evaluated in a sample of 105 healthy adult volunteers with elevated AS (mean ASI-3: 29.5) applying a randomized design. Success of the intervention was measured as a function of AS and separation anxiety (ASA-27) ∼6 weeks (T1) and ∼6 months (T2) after the intervention. As compared to waitlist, CAST resulted in a significant reduction of AS at both T1 and T2. Separation anxiety was not directly reduced by the intervention, but decreased mediated by a decline in AS. A composite interoceptive score capturing changes in sensitivity to respiratory symptoms during the baseline therapist-accompanied CAST session was shown to be predictive of overall response at T1. In sum, CAST-German Version was successfully established as an effective intervention reducing AS, while at the same time indirectly decreasing separation anxiety. A composite interoceptive score predicting treatment response might aid in further delineating risk markers informing targeted preventive interventions for anxiety disorders.
Collapse
Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Melanie Vietz
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Agnieszka Gajewska
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Michael G Gottschalk
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany,; Comparative Psychology, Institute of Experimental Psychology, Heinrich-Heine University, Düsseldorf, Germany
| | - Norman B Schmidt
- Florida State University, Department of Psychology, Tallahassee, FL, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| |
Collapse
|
30
|
Fitzgerald HE, Hoyt DL, Kredlow MA, Smits JAJ, Schmidt NB, Edmondson D, Otto MW. Anxiety Sensitivity as a Malleable Mechanistic Target for Prevention Interventions: A Meta-Analysis of the Efficacy of Brief Treatment Interventions. Clin Psychol (New York) 2021; 28:323-337. [PMID: 35300171 PMCID: PMC8923531 DOI: 10.1037/cps0000038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.
Collapse
Affiliation(s)
- Hayley E Fitzgerald
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - Danielle L Hoyt
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - M Alexandra Kredlow
- Department of Psychology, Harvard University, 52 Oxford Street, Cambridge, MA 02140
| | - Jasper A J Smits
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, 305 E. 23 St., Austin, TX 78712
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306
| | | | - Michael W Otto
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| |
Collapse
|
31
|
Thompson JS, Schmidt NB. The role of anxiety sensitivity in anger symptomatology: Results from a randomized controlled trial. J Anxiety Disord 2021; 83:102462. [PMID: 34384991 DOI: 10.1016/j.janxdis.2021.102462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Anger is often overlooked in the assessment and treatment of pathological anxiety, despite there being evidence that anger is elevated across all anxiety disorders. Anxiety sensitivity (AS), a major risk factor of anxiety disorders, has been shown to modulate anger in response to threat induced hyperarousal. The current study therefore examined if reductions in anxiety sensitivity (AS) mediate reductions in anger symptoms. Outcomes from a randomized control trial evaluating the efficacy of a brief AS mitigation intervention were analyzed. Patients with anxiety and comorbid conditions were randomly assigned to AS reduction (n = 58) or a repeated contact control condition (n = 60) and followed up with for three months. Analyses evaluated whether treatment related change in AS mediated later reductions in anger, hostility, verbal aggression, and physical aggression. Results revealed that reductions in AS temporally mediated the effects of treatment on later reductions in anger, hostility, verbal aggression, and physical aggression. Specificity analyses provided further support for the direction and specific variables examined in these models. Results suggest that AS may be a promising treatment target for anger symptoms among those with elevated anxiety symptoms.
Collapse
Affiliation(s)
| | - Norman B Schmidt
- Department of Psychology, Florida State University, United States
| |
Collapse
|
32
|
Albanese BJ, Capron DW, Macatee RJ, Bauer BW, Schmidt NB. Thwarted belongingness predicts greater neural reactivity to a novel social exclusion image set: Evidence from the late positive potential. Suicide Life Threat Behav 2021; 51:916-930. [PMID: 34080235 DOI: 10.1111/sltb.12775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Thwarted belongingness (TB) is among the most well-researched risk factors for suicidal ideation (SI). Yet, there is little research examining neural mechanisms underlying this construct. The present study used a novel social exclusion image set in concert with the late positive potential (LPP) to test the role of neural reactivity social exclusion in TB and SI. METHODS Participants (n = 243) were recruited based on elevated suicide risk and completed an emotional picture viewing task. The LPP was used to index neural reactivity to a novel set of social exclusion images and international affective picture system (IAPS) neutral, positive, and negative images. RESULTS Greater TB predicted a larger social exclusion ΔLPP (social exclusion LPP relative to neutral LPP) and social exclusion LPP even when accounting for SI, biological sex, age, negative affect, and perceived burdensomeness. Moreover, the social exclusion LPP was uniquely related to TB beyond the LPP to other images. Last, a larger social exclusion LPP predicted greater SI via elevations in TB. CONCLUSION Reactivity to social exclusion stimuli may play an important role in SI via elevated TB, but not perceived burdensomeness. Future research should further explore the neural mechanisms underlying other IPT constructs.
Collapse
Affiliation(s)
- Brian J Albanese
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Richard J Macatee
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Brian W Bauer
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
33
|
Schmidt NB, Allan NP, Koscinski B, Mathes BM, Eackles K, Accorso C, Saulnier KG, Allan DM, Potter K, Garey L, Suhr J, Austin M, Zvolensky MJ. COVID-19 Impact Battery: Development and Validation. J Psychopathol Behav Assess 2021; 44:326-343. [PMID: 34518734 PMCID: PMC8427558 DOI: 10.1007/s10862-021-09919-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 12/05/2022]
Abstract
In addition to impacting the physical health of millions of Americans, the novel-coronavirus (COVID-19) pandemic is a significant psychological stressor due to both the threat of the illness itself and the mitigation strategies used to contain the spread. To facilitate understanding of the impact of COVID-19, validated measures are needed. Using a stepwise procedure in line with best-practice measurement procedures, the current report summarizes the procedures employed to create the COVID-19 Impact Battery (CIB). Two independent samples recruited via Amazon Mechanical Turk (N = 175, N = 642) and a third community sample (N = 259) were used for reliability and validity testing. Validation procedures yielded a battery consisting of three scales assessing COVID-19 related behaviors, worry, and disability. The behaviors scale contains three subscales assessing stockpiling, cleaning, and avoidance. The worry subscale also contains three subscales assessing health, financial and catastrophic concerns. In addition, we created a short version of the battery (CIB-S) to allow for more flexibility in data collection. In summary, we have provided reliability and validity information for the CIB and CIB-S, demonstrating that these measures can facilitate evaluation of the broad impact of COVID-19 on mental health functioning.
Collapse
Affiliation(s)
- Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, USA
| | - Nicholas P Allan
- Department of Psychology, Ohio University, Athens, OH 45701 USA.,VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, Charleston, USA
| | | | - Brittany M Mathes
- Department of Psychology, Florida State University, Tallahassee, USA
| | - Kelsey Eackles
- Department of Psychology, Ohio University, Athens, OH 45701 USA
| | | | | | - Darcey M Allan
- Department of Psychology, Ohio University, Athens, OH 45701 USA
| | - Kaley Potter
- Department of Psychology, Ohio University, Athens, OH 45701 USA
| | - Lora Garey
- Department of Psychology, University of Houston, Houston, USA
| | - Julie Suhr
- Department of Psychology, Ohio University, Athens, OH 45701 USA
| | - Megan Austin
- Department of Psychology, Ohio University, Athens, OH 45701 USA
| | | |
Collapse
|
34
|
Schmidt NB, Morabito DM, Mathes BM, Martin A. Anxiety sensitivity prospectively predicts pandemic-related distress. J Affect Disord 2021; 292:660-666. [PMID: 34153837 PMCID: PMC8777063 DOI: 10.1016/j.jad.2021.05.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/29/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS) is a well-studied transdiagnostic risk construct that is believed to amplify responses to many forms of stress. The COVID-19 pandemic is a broad stressor with significant physical and social threats. In the current study, we were interested in ascertaining the degree to which AS would relate to distress and disability in the context of COVID-19. We hypothesized that AS would be associated with increased distress and disability. Moreover, we hypothesized that AS would be uniquely predictive while controlling for other relevant risk factors such as age, race, and perceived local COVID-19 infection rates. METHOD Participants (N = 249) were U.S. adults assessed using online data resourcing and re-assessed one month later. RESULTS At the first time point, during the beginning phases of the COVID-19 pandemic, AS was significantly related to COVID-19 distress and disability with a moderate effect size. AS was longitudinally associated with higher COVID-19 worry and depression. LIMITATIONS Our findings are limited by the use of a relatively small online sample. Additionally, assessment of pre-pandemic and post-pandemic symptoms and functioning would be beneficial for future research. CONCLUSIONS Taken together, the current study provided evidence consistent with AS as a causal risk factor for the development of distress and depression during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Norman B. Schmidt
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States,Corresponding author
| | - Danielle M. Morabito
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States
| | - Brittany M. Mathes
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States,VA Boston Healthcare System 150 South Huntington Ave, Boston, MA, 02130, United States
| | - Alex Martin
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States
| |
Collapse
|
35
|
Preston TJ, Gorday JY, Bedford CE, Mathes BM, Schmidt NB. A longitudinal investigation of trauma-specific rumination and PTSD symptoms: The moderating role of interpersonal trauma experience. J Affect Disord 2021; 292:142-148. [PMID: 34119870 DOI: 10.1016/j.jad.2021.05.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/12/2021] [Accepted: 05/23/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Interpersonal trauma (IPT) is one of the most commonly reported types of traumatic experiences and has the greatest likelihood of resulting in a diagnosis of posttraumatic stress disorder (PTSD). Relative to other types of trauma, victims of IPT report greater trauma-specific rumination, whereby they focus on negative consequences of the trauma on their life. Theoretical and empirical work suggest trauma-specific rumination leads to elevated posttraumatic stress symptoms (PTSS); however, there has been a dearth of research examining how trauma type may impact this association. Therefore, the current longitudinal study examined how the experience of IPT moderates the relationship between trauma-specific rumination and later PTSS. METHOD Participants (N = 204) enrolled in a clinical trial completed self-report measures of trauma experience, trauma-specific rumination, and PTSS at baseline and 1-month follow-up appointments. RESULTS Results revealed that IPT moderated the relationship between baseline rumination and 1-month trauma symptoms, even after covarying for participant age and sex, treatment condition, negative affect, and number of previously experienced traumas. Further, this moderation effect was specific to the PTSD numbing cluster. LIMITATIONS Major limitations include measurement of PTSS via PCL-C rather than the PCL-5, as well as a limited sample size, precluding moderation analyses of other trauma types. CONCLUSIONS The current study provides novel findings demonstrating specificity of index trauma type in the longitudinal relationship between rumination and PTSS. Future work is needed to examine how IPT impacts the development of pathways between rumination and PTSS.
Collapse
|
36
|
O'Bryan EM, McLeish AC, Norr AM, Ely S, Bass Z, Davies CD, Capron DW, Schmidt NB, Mano KEJ. A randomized controlled trial evaluating the efficacy of a brief computerized anxiety sensitivity reduction intervention for health anxiety. J Anxiety Disord 2021; 82:102425. [PMID: 34082279 DOI: 10.1016/j.janxdis.2021.102425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/20/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
It is estimated that individuals with severe health anxiety (HA) utilize 41 %-78 % more healthcare resources than individuals with identified medical diagnoses. Thus, identifying targets for intervention and prevention efforts for HA that are appropriate for primary care or specialty clinic settings is imperative. The aim of the present investigation was to evaluate the effect of a single-session, computerized anxiety sensitivity (AS) intervention on AS and HA. Participants were 68 university students (79.4 % female; Mage = 19.68) with elevated levels of AS and HA. Participants were randomized to either the AS intervention condition or an active control condition and completed self-report and behavioral follow-up assessments at post-intervention, 1-week follow-up, and 1-month follow-up. Results indicated a significant Time x Condition interaction for ASI-3 at each follow-up assessment (all ps < .001), such that individuals in the active condition exhibited greater reductions in AS compared to the control condition. There was no significant Time x Condition interaction for HA at any follow-up. Mediation analyses revealed a significant indirect effect of Condition on changes in HA through changes in AS. No significant effects were observed for behavioral outcomes. Findings suggest that this intervention successfully reduces AS among those who are high in HA and AS and may indirectly contribute to reductions in HA over time through reductions in AS.
Collapse
Affiliation(s)
- Emily M O'Bryan
- Department of Psychology, University of Cincinnati, USA; Anxiety Disorders Center, Hartford Hospital/Institute of Living, USA. Emily.O'
| | | | - Aaron M Norr
- VA VISN 20 Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC), USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, USA
| | - Sarah Ely
- Department of Psychology, University of Cincinnati, USA
| | - Zoey Bass
- Department of Psychology, University of Cincinnati, USA
| | - Carolyn D Davies
- Anxiety Disorders Center, Hartford Hospital/Institute of Living, USA; Department of Psychological and Brain Sciences, University of Massachusetts Amherst, USA
| | - Daniel W Capron
- School of Psychology, University of Southern Mississippi, USA
| | | | | |
Collapse
|
37
|
Morabito DM, Bedford CE, Woller S, Schmidt NB. Vulnerability to COVID-19-Related Disability: The Impact of Posttraumatic Stress Symptoms on Psychosocial Impairment During the Pandemic. J Trauma Stress 2021; 34:701-710. [PMID: 34245605 PMCID: PMC8426907 DOI: 10.1002/jts.22717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
As a result of the COVID-19 pandemic, many individuals have experienced disruptions in social, occupational, and daily life activities. Individuals with mental health difficulties, particularly those with elevated posttraumatic stress symptoms (PTSS), may be especially vulnerable to increased impairment as a result of COVID-19. Additionally, demographic factors, such as age, gender, and race/ethnicity, may impact individual difficulties related to the pandemic. The current study examined the concurrent and prospective associations between posttraumatic stress disorder (PTSD) symptoms, broader anxiety and depression symptoms, and COVID-19-related disability. Participants recruited through Amazon's Mechanical Turk (N = 136) completed questionnaire batteries approximately 1 month apart during the COVID-19 pandemic (i.e., Wave 1 and Wave 2). The results indicated that PTSD, anxiety, and depressive symptoms were all associated with increased COVID-19-related disability across assessment points, rs = .44-.68. PTSD symptoms, specifically negative alterations in cognition and mood, significantly predicted COVID-19-related disability after accounting for anxiety and depressive symptoms as well as demographic factors, βs = .31-.38. Overall, these findings suggest that individuals experiencing elevated PTSS are particularly vulnerable to increased functional impairment as a result of COVID-19 and suggest a need for additional outreach and clinical care among individuals with elevated PTSD symptoms during the pandemic.
Collapse
Affiliation(s)
| | - Carter E. Bedford
- Department of PsychologyFlorida State UniversityTallahasseeFloridaUSA
| | - Savannah Woller
- Department of PsychologyFlorida State UniversityTallahasseeFloridaUSA
| | - Norman B. Schmidt
- Department of PsychologyFlorida State UniversityTallahasseeFloridaUSA
| |
Collapse
|
38
|
Mayorga NA, Garey L, Viana A, Cardoso JB, Schmidt NB, Zvolensky MJ. Psychological Distress and Physical Health Symptoms in the Latinx Population During the COVID-19 Pandemic: Exploring the Role of Anxiety Sensitivity. Cognit Ther Res 2021; 46:20-30. [PMID: 34177003 PMCID: PMC8214047 DOI: 10.1007/s10608-021-10243-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2021] [Indexed: 12/24/2022]
Abstract
Objective The outbreak of the novel 2019 SARS2-Coronavirus disease (COVID-19) has led to substantial physical and mental health consequences. Rates of mortality and hospitalization are highest among those of racial and ethnic minority persons, including Latinx persons. Further, Latinx persons have been experiencing elevated mental health problems in response to the pandemic compared to non-Latinx Whites. The current study examined whether individual differences in anxiety sensitivity (AS) related to more severe emotional distress associated with social distancing, financial strain, fear of COVID-19, and physical health symptoms stemming from the COVID-19 pandemic among Latinx adults. Methods Participants included 188 Latinx persons (31.4% female, Mage = 34.1 years, SD = 8.16) recruited via an online survey panel program. Results Results indicated that AS significantly contributed to increased severity of the emotional stress response associated with social distancing (ΔR2 = 0.15, p < 0.001), financial strain (ΔR2 = 0.15, p < 0.001), physical health symptoms (ΔR2 = 0.03, p = 0.006), and fear of COVID-19 (ΔR2 = 0.15, p < 0.001). These effects were evident over and above the variance accounted for by gender, years living in the United States, education, and work and home life COVID-19-related stress. Conclusions These cross-sectional findings suggest AS may be an important individual difference factor for better understanding mental health among Latinx persons in the context of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX USA
| | - Andres Viana
- Department of Psychology, University of Houston, Houston, TX USA
- Texas Institute of Measurement, Evaluation, and Statistics, Houston, USA
| | - Jodi Berger Cardoso
- HEALTH Institute, University of Houston, Houston, TX USA
- Graduate College of Social Work, University of Houston, Houston, TX USA
| | | | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX USA
- HEALTH Institute, University of Houston, Houston, TX USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204 USA
| |
Collapse
|
39
|
Short NA, Zvolensky MJ, Schmidt NB. A pilot randomized clinical trial of Brief Behavioral Treatment for Insomnia to reduce problematic cannabis use among trauma-exposed young adults. J Subst Abuse Treat 2021; 131:108537. [PMID: 34148759 DOI: 10.1016/j.jsat.2021.108537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/17/2021] [Accepted: 06/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Insomnia symptoms may be an important etiological factor for substance use disorders; however, whether improving sleep leads to reductions in problematic substance use among at-risk populations remains unclear. METHOD As such, the current pilot study used a randomized controlled design to test the effects of Brief Behavioral Treatment for Insomnia (BBTI) against a waitlist control among a sample of trauma-exposed young adults with elevated insomnia symptoms who regularly use cannabis (N = 56). RESULTS Intent-to-treat multilevel modeling analyses indicated that BBTI may be more efficacious than waitlist control in reducing self-reported insomnia symptoms, with large effects three months post-treatment (d = 1.34). Further, our initial evidence suggested that BBTI resulted in reductions in cannabis-related problems with medium to large effects at three months post-treatment (d = 0.75). The current pilot analyses indicated BBTI also reduced cravings to use cannabis to reduce negative emotions in response to trauma cues with a large effect size. CONCLUSION This pilot study suggests BBTI may be efficacious not only in improving insomnia symptoms among cannabis users but also in reducing cannabis-related problems and cravings over three months. Future research should replicate these results in a larger, fully powered sample with improved follow-up rates designed to test temporal mediation using multimethod assessments of insomnia symptoms and problematic cannabis use. Overall, BBTI may be a promising intervention for trauma-exposed cannabis users to improve sleep and reduce cannabis-related problems.
Collapse
Affiliation(s)
- Nicole A Short
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; MD Anderson Cancer Center, Houston, TX, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| |
Collapse
|
40
|
Raines AM, Primeaux SJ, Ennis CR, Walton JL, Slaton KD, Vigil JO, Allan NP, Paulus DJ, Zvolensky MJ, Schmidt NB, Franklin CL. Posttraumatic Stress Disorder and Pain in Veterans: Indirect Association Through Anxiety Sensitivity. Cogn Ther Res 2021. [DOI: 10.1007/s10608-021-10230-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
41
|
Albanese BJ, Preston TJ, Bedford C, Macatee RJ, Schmidt NB. Distress Intolerance Prospectively Predicts Traumatic Intrusions Following an Experimental Trauma in a Non-clinical Sample. Cogn Ther Res 2021. [DOI: 10.1007/s10608-021-10228-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
42
|
Capron DW, Allan NP, Schmidt NB. The Depression Sensitivity Index: Initial Development and Tests of Convergent and Construct Validity. J Affect Disord 2021; 287:417-426. [PMID: 33839487 DOI: 10.1016/j.jad.2021.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression and suicide are prominent and increasing U.S. public health issues, which suggests novel assessment and treatment approaches are needed. Reiss' Expectancy Model of Fear, Anxiety, and Panic states that fear is based on two classes of variables, expectations and sensitivities, which has led to much research on anxiety sensitivity as a significant risk factor for later anxiety psychopathology. Major depressive disorder also includes biased expectations and sensitivities; however, a depression sensitivity rooted in Expectancy Theory has never been formalized. Uncovering depression-related sensitivities may lead to earlier risk detection and prevention before mood disorders develop. METHOD The goal of the paper was to create a Depression Sensitivity Index using exploratory factor analysis and item response theory and then conduct tests of convergent and construct validity using structural equation modeling using three independent samples. RESULTS indicated two lower order factors: 1) physical and cognitive concerns (DSPCC) and 2) social concerns (DSSC). Factors showed incremental associations with depression (DSPCC), social anxiety (both) and suicidal thoughts and behaviors (DSPCC), above and beyond anxiety sensitivity cognitive concerns. Both factors together predicted depressive disorder diagnoses LIMITATIONS: : Mostly self-report data, large percentage of non-Hispanic White participants in Study 1. CONCLUSIONS The results offer initial evidence that expectancy theory applies beyond "fear, anxiety, and panic" and that with further development depression sensitivity could be an important intervention target for prevention of major depressive disorder and suicidal thoughts and behaviors.
Collapse
Affiliation(s)
- Daniel W Capron
- Department of Psychology, University of Southern Mississippi.
| | - Nicholas P Allan
- Department of Psychology, Ohio University; VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System
| | | |
Collapse
|
43
|
Raines AM, Koscinski B, Mathes BM, Portero AK, Allan NP, Schmidt NB. Examination of a brief computerized Cognitive Anxiety Sensitivity intervention on obsessive-compulsive symptoms. Br J Clin Psychol 2021; 61 Suppl 1:93-110. [PMID: 33945163 DOI: 10.1111/bjc.12298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 04/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Despite the existence of several first-line treatments for obsessive-compulsive disorder (OCD), many patients fail to experience symptom reduction and/or do not complete treatment. As a result, the field has increasingly moved towards identifying and treating malleable underlying risk factors that may in turn improve treatment efficacy. One salient underlying risk factor, anxiety sensitivity (AS) cognitive concerns, has been found to be uniquely associated with obsessive-compulsive (OC) symptom dimensions. However, no studies have yet examined whether reductions in AS cognitive concerns will lead to subsequent reductions in OC symptoms. METHODS The current study attempted to fill this gap by recruiting individuals reporting elevations on both AS cognitive concerns and at least one OC symptom dimension. Participants were randomly assigned to receive either a one-session AS cognitive concerns intervention (n = 35) or a single health information control session (n = 37). AS cognitive concerns were assessed at post-intervention and one-month follow-up. RESULTS The active intervention produced significantly greater reductions in AS cognitive concerns post-intervention than the control intervention. However, this effect was no longer significant at one-month follow-up. Further, while there was not an effect of treatment condition on OC symptoms at one-month follow-up, changes in AS cognitive concerns from baseline to post-intervention mediated changes in OC symptoms at one-month follow-up. CONCLUSIONS Findings support previous research attesting to the malleable nature of AS. Extending this research, findings provide initial support for the efficacy of AS interventions among individuals with elevated OC symptoms. PRACTITIONER POINTS Clinicians should consider assessing anxiety sensitivity (AS) among patients with obsessive-compulsive disorder. If elevated, clinicians should consider targeting AS as an adjunct to treatment as usual.
Collapse
Affiliation(s)
- Amanda M Raines
- Department of Psychology, Florida State University, Tallahassee, Florida, USA.,Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana, USA.,South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, Louisiana, USA
| | | | - Brittany M Mathes
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Amberly K Portero
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
44
|
Raines AM, Ennis CR, Allan NP, McGrew SJ, Walton JL, Rogers AH, Zvolensky MJ, Schmidt NB, Laurel Franklin C. Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants. Addict Behav 2021; 116:106791. [PMID: 33497865 DOI: 10.1016/j.addbeh.2020.106791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. METHODS The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. RESULTS AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. CONCLUSIONS Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
Collapse
|
45
|
Betthauser LM, Albanese BJ, Cochran KL, McGarity S, Schneider AL, Schmidt NB, Brenner LA, Barnes SM. Acceptability of cognitive anxiety sensitivity treatment among veterans with mTBI. Rehabil Psychol 2021; 66:118-127. [PMID: 33382335 DOI: 10.1037/rep0000365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Anxiety sensitivity (AS) is a transdiagnostic risk factor for persistent physical and psychological symptoms relevant to veterans, such as postconcussive symptoms following mild traumatic brain injury (mTBI). The Cognitive Anxiety Sensitivity Treatment (CAST) computerized intervention has been shown to reduce AS but has not been widely used among veterans. The purpose of this study was to assess the acceptability and feasibility of CAST among veterans with elevated AS and mTBI eligible to receive Veterans Health Administration (VHA) care. DESIGN Twenty-two veterans with mTBI, elevated cognitive AS, and history of deployment to Iraq and/or Afghanistan completed a single assessment and intervention session. Acceptability was assessed with the Client Satisfaction Quesitonnaire-8 (CSQ-8) and a qualitative interview. Measures of feasibility included study enrollment, ease of participation, and intervention completion. AS was assessed pre- and post-CAST completion. RESULTS Consistent with interview responses, 77.3% of participants' CSQ-8 scores indicated that veterans found the intervention acceptable. Technological issues, such as internet connectivity, decreased feasibility of consistently delivering the intervention in the research setting readily available to the study team. Decreases on pre-to-post intervention AS outcomes were observed. CONCLUSIONS Acceptability of the CAST intervention in this sample was generally supported. Feasibility of implementing CAST in this study was limited by technological issues. Data did not indicate a critical need to revise content of the CAST intervention. Identified strategies for increasing the feasibility of future research and clinical implementation of CAST are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Lisa M Betthauser
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)
| | | | - Kathryn L Cochran
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)
| | - Suzanne McGarity
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)
| | | | | | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)
| | - Sean M Barnes
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC)
| |
Collapse
|
46
|
Abstract
The direct threat posed by the 2019 novel coronavirus (COVID-19), uncertainty surrounding best safety practices, and secondary consequences of the virus have led to widespread stress and declining mental health across communities and individuals. These stresses may impact parenting behaviors, potentially leading to negative consequences for children. Controlling parenting behaviors increase in the face of perceived environmental threat and are associated with adverse mental health outcomes for children; however, determinants of parenting behaviors have not been investigated during the COVID-19 pandemic. The current study prospectively evaluated parenting behaviors during the pandemic (N=87). Results indicated that all negative affect emotions investigated were positively associated with controlling parenting behaviors. However, only COVID-related fear predicted changes in controlling parenting behaviors across timepoints. Specifically, although controlling parenting behaviors decreased in the overall sample from time 1 to time 2, higher COVID-related fear scores at time 1 predicted maintenance of high levels of controlling parenting behaviors at time 2. Additionally, this effect was specific to controlling, as opposed to more adaptive, parenting behaviors. Future studies should investigate the association between parents' COVID-related fear, controlling parenting behaviors, and adverse mental health outcomes for children in the context of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Karl Wissemann
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Brittany Mathes
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Alexandria Meyer
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
47
|
Rogers AH, Bogiaizian D, Salazar PL, Solari A, Garey L, Fogle BM, Schmidt NB, Zvolensky MJ. COVID-19 and Anxiety Sensitivity Across Two Studies in Argentina: Associations with COVID-19 Worry, Symptom Severity, Anxiety, and Functional Impairment. Cognit Ther Res 2021; 45:697-707. [PMID: 33424059 PMCID: PMC7778696 DOI: 10.1007/s10608-020-10194-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 01/08/2023]
Abstract
Background The novel 2019 SARS2-Coronavirus (COVID-19) has had a devastating physical health, mental health, and economic impact, causing millions of infections and hundreds of thousands of deaths. While COVID-19 has impacted the entire world, COVID-19 has disproportionately impacted low-income countries, particularly in South America, causing not only increased mortality but also increased associated mental health complaints. Anxiety sensitivity (AS), reflecting fear of anxiety-related physical sensations, may be particularly important to understand COVID-19 mental health effects among Latinx individuals in South America (Argentina). Past work suggests that Latinx individuals report greater somatization of mental health symptoms, and AS has been specifically linked to greater mental health symptoms. Yet, to date, no work has examined AS as a vulnerability factor for the negative mental health effects of COVID-19. Method Therefore, the current manuscript examined the association of AS with COVID-19 worry, functional impairment, anxiety, and symptom severity across two samples of adults in Argentina: a community sample (n = 105, M age = 38.58, SD = 14.07, 69.5% female) and a clinical sample comprised of individuals with an anxiety disorder (n = 99, M age = 34.99, SD = 10.83, 66.7% female). Results Results from the current study provide support for AS as a potential vulnerability factor for COVID-19-related mental health problems across both samples, and these effects were evident over and above the variance accounted for by age, sex, pre-existing medical conditions, and COVID-19 exposure. Conclusions These data identify AS as a potential intervention target to reduce COVID-19 mental health burden among adults in Argentina.
Collapse
Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX USA
| | - Daniel Bogiaizian
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
| | | | - Adrian Solari
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX USA
| | - Brienna M Fogle
- Department of Psychology, University of Houston, Houston, TX USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA.,HEALTH Institute, University of Houston, Houston, TX USA
| |
Collapse
|
48
|
Macatee RJ, Albanese BJ, Okey SA, Afshar K, Carr M, Rosenthal MZ, Schmidt NB, Cougle JR. Impact of a computerized intervention for high distress intolerance on cannabis use outcomes: A randomized controlled trial. J Subst Abuse Treat 2020; 121:108194. [PMID: 33357604 DOI: 10.1016/j.jsat.2020.108194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/02/2020] [Accepted: 11/01/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Prevalence of regular cannabis use and cannabis use disorder (CUD) have increased in the past two decades, but treatment-seeking is low and extant brief interventions do not target causal risk factors implicated in etiological models of addiction. Elevated distress intolerance (DI) is one risk factor that has been empirically linked with greater CUD severity and maintenance in regular users, but, to our knowledge, research has never targeted it in a brief intervention among cannabis users with CUD or at high risk. The current RCT evaluated the impact of a DI intervention (i.e., Distress Tolerance Intervention [DTI]) compared to a healthy habits control intervention (i.e., Healthy Video Control [HVC]) on DI and cannabis use outcomes. METHOD We randomized cannabis users with high DI (N = 60) to the DTI or HVC condition and they received two computerized intervention sessions. We assessed relief cannabis craving at pre- and post-treatment; and we assessed DI, cannabis use coping motives, use-related problems, and use frequency at pre- and post-treatment as well as one- and four-month follow-ups. We assessed CUD symptoms via interviews at pre-treatment and four-month follow-up. RESULTS Significant, durable reductions in DI and all cannabis use outcomes occurred in both conditions. Compared to the HVC condition, the DTI led to greater reductions in use frequency during the treatment period. Reductions in self-reported DI were correlated with reductions in coping motives and CUD symptoms. CONCLUSION The DTI's impact on all outcomes was largely comparable to the control condition, though it may have utility as an adjunctive intervention.
Collapse
Affiliation(s)
| | | | - Sarah A Okey
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Kaveh Afshar
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - Meghan Carr
- Department of Psychology, Auburn University, Auburn, AL, USA
| | - M Zachary Rosenthal
- Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA; Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| |
Collapse
|
49
|
Mathes BM, Schmidt NB. An investigation of the impact of social exclusion on attachment to possessions and saving behaviors. J Behav Ther Exp Psychiatry 2020; 69:101588. [PMID: 32535407 DOI: 10.1016/j.jbtep.2020.101588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Hoarding disorder (HD) is a debilitating mental illness characterized by extreme difficulty parting with possessions and clutter that can result in dangerous living conditions. One hypothesis about why individuals with HD save possessions is that they possess a pathological attachment to their belongings, which may serve to compensate for unfulfilling interpersonal relationships. However, there is a dearth of empirical work examining this. The current study examined the impact of an experimental manipulation of social exclusion on attachment to possessions and saving behaviors in a sample of individuals with elevated hoarding symptoms. METHODS Participants (n = 117) were selected for scoring above the non-clinical mean on a measure of hoarding symptoms. Participants were randomized to either be included or excluded in a game of Cyberball. They completed a behavioral discarding task and object attachment measure before and after completion of the game. RESULTS Study condition was unrelated to in vivo attachment to possessions and saving behaviors during the discarding task. However, a post hoc mediation model showed that greater feelings of rejection, regardless of condition, were associated with greater in vivo attachment to possessions and subsequent number of items saved during the lab task. LIMITATIONS Limitations include the use of a non-clinical and homogeneous sample. CONCLUSIONS Taken together, individuals prone to feelings of rejection may be at risk for developing HD as they may use possessions to cope with interpersonal stress. Results will be discussed in light of implications for theoretical models and potential treatment targets in HD.
Collapse
|
50
|
Mathes BM, Kennedy GA, Morabito DM, Martin A, Bedford CE, Schmidt NB. A longitudinal investigation of the association between rumination, hostility, and PTSD symptoms among trauma-exposed individuals. J Affect Disord 2020; 277:322-328. [PMID: 32858313 DOI: 10.1016/j.jad.2020.08.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/08/2020] [Accepted: 08/13/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Rumination, defined as perseverative thinking regarding the causes and consequences of psychological symptoms, is a risk and maintaining factor for PTSD. Existing work has largely focused on the extent to which rumination functions as a coping strategy used to avoid traumatic memories and associated emotions. However, rumination may also maintain negative thinking patterns, such as hostility, which has been positively associated with both rumination and PTSD symptoms. The current study therefore investigated the extent to which hostility was a significant mediator of the prospective association between rumination and PTSD symptoms. METHODS The sample consisted of 119 trauma-exposed individuals (48.7% female), who completed self-report questionnaires at three time points during a clinical trial. RESULTS When controlling for treatment condition and baseline depressive disorder diagnosis, hostility temporally mediated the effects of rumination on PTSD symptoms. Specificity analyses provided further support for the direction and specific variables examined in this model, such that rumination was positively and uniquely associated with later hostility. LIMITATIONS Our findings are limited by the use of a sample in which only 30% of participants met diagnostic criteria for a trauma-related disorder, as well as the administration of the rumination measure at only one time point. CONCLUSIONS Results suggest that rumination and hostility may be promising treatment and prevention targets for PTSD symptoms.
Collapse
Affiliation(s)
- Brittany M Mathes
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301 USA
| | - Grace A Kennedy
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301 USA
| | - Danielle M Morabito
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301 USA
| | - Alex Martin
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301 USA
| | - Carter E Bedford
- 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.
| |
Collapse
|