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Garey L, Senger AR, Smit T, Nizio P, Matoska CT, Kauffman B, Businelle MS, Gallagher MW, Zvolensky MJ. Anxiety sensitivity and reasons for smoking among Black smokers. Addict Behav 2023; 139:107593. [PMID: 36563479 PMCID: PMC9897199 DOI: 10.1016/j.addbeh.2022.107593] [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: 06/12/2022] [Revised: 11/15/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Black smokers demonstrate higher nicotine dependence and experience higher rates of smoking-related diseases and mortality relative to European American/White smokers. A potential factor relevant to race-specific smoking health disparities may be smoking motives (i.e., motivational basis of smoking). Yet, little research has been conducted to understand psychological factors that may be associated with specific smoking motives among Black smokers. To address this gap in the literature, the current study explored the association between anxiety sensitivity and smoking motives within a subset sample of Black smokers who were interested in participating in a smoking cessation trial (N = 105; 70.5 % male; Mage = 44.8 years, SD = 11.6 years). Hierarchical regression analyses indicated anxiety sensitivity was associated with smoking motives related to habit (β = 0.39, p <.001), negative affect reduction (β = 0.32, p <.001), stimulation (β = 0.31, p <.001), and sensorimotor manipulation (β = 0.26, p =.008). Limited support was found for the effect of motives on past quit attempt engagement. These results may broaden understanding of the psychological mechanisms related to smoking motivation among Black smokers and may inform future intervention efforts to reduce smoking motivation among this health disparities population.
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Amy R Senger
- Department of Psychology, University of Houston, Houston, TX, USA; Texas Institute for Measurement, Evaluation, and Statistics University of Houston, Houston, TX USA.
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA.
| | - Pamella Nizio
- Department of Psychology, University of Houston, Houston, TX, USA.
| | | | - Brooke Kauffman
- Department of Psychology, University of Houston, Houston, TX, USA.
| | - Michael S Businelle
- HEALTH Institute, University of Houston, Houston, TX, USA; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Matthew W Gallagher
- Department of Psychology, University of Houston, Houston, TX, USA; Texas Institute for Measurement, Evaluation, and Statistics University of Houston, Houston, TX USA; HEALTH Institute, 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, US.
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2
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Karnick AT, Buerke M, Caulfied N, Trussell D, Capron DW, Vujanovic A. Alcohol use in firefighters: A network model of behaviors and transdiagnostic risk. Drug Alcohol Depend 2022; 241:109677. [PMID: 36334469 DOI: 10.1016/j.drugalcdep.2022.109677] [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: 08/26/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Firefighters are at heightened risk for developing alcohol use disorder (AUD), possibly due to chronic stress and exposure to potentially traumatic events. Daily trauma experiences and transdiagnostic risk factors (i.e., anxiety sensitivity and distress intolerance) are related to posttraumatic stress and depressive symptoms, as well as alcohol use severity and alcohol as a coping strategy. Although alcohol use has been identified as a key target for addressing mental health in firefighters, prior research has not fully integrated transdiagnostic vulnerabilities, internalizing symptoms, posttraumatic stress symptoms, alcohol coping, and overall alcohol use into a dynamic network model. METHODS We assessed the symptom structure of overall alcohol use in firefighters with a likely AUD and transdiagnostic risk factors in all firefighters using network analysis. RESULTS Failing to meet expectations (Expected Influence [EI]: 1.32), morning dependence (EI: 1.07), and guilt about drinking (EI: 1.10) were most central to the network model developed for firefighters with a likely AUD. In a transdiagnostic model of use in firefighters overall, anxiety sensitivity cognitive concerns (EI: 1.48) and negative alterations to cognitions and mood related to trauma (EI: 1.87) had the highest influence on the network. Notable correlations were also identified between trauma arousal and overall alcohol use, between depression and alcohol coping motives, and between trauma avoidance and alcohol coping motives. CONCLUSIONS Alcohol use behaviors may follow a unique etiologic pathway in firefighters and intervention strategies should target factors found to be more central to symptom networks.
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Affiliation(s)
- Aleksandr T Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA.
| | - Morgan Buerke
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Nicole Caulfied
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Dylan Trussell
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Anka Vujanovic
- Department of Psychology, University of Houston, Houston, TX 77204, USA.
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3
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Garey L, Hébert ET, Mayorga NA, Chavez JF, Shepherd JM, Businelle MS, Zvolensky MJ. Evaluating the feasibility and acceptability of a mobile-based health technology for smoking cessation: Mobile Anxiety Sensitivity Program. Br J Clin Psychol 2022; 61 Suppl 1:111-129. [PMID: 33939190 PMCID: PMC8563508 DOI: 10.1111/bjc.12294] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 08/21/2020] [Revised: 11/21/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Cigarette smoking is the leading preventable cause of death and disability. Although most US smokers want to quit, more than 95% of cessation attempts end in relapse within 6 months. To improve cessation outcomes, research has turned to targetable mechanisms, such as anxiety sensitivity (AS), which maintain smoking behaviour, impede cessation success, and can be effectively targeted in the context of psychosocial interventions. Although integrated treatment programmes that address AS reduction in the context of smoking cessation have demonstrated promising results, presently, no mobile, technology-based integrated treatment exists to expressly address smoking and AS. The current study evaluated the initial feasibility and acceptability of a mobile smoking cessation intervention, Mobile Anxiety Sensitivity Program for smoking (MASP). METHODS Participants were 15 daily adult combustible cigarette smokers (females n = 6, Mage = 46.5 years, SD = 13.3) who completed a 6-week total intervention period (baseline visit, 2 weeks pre-quit, 4 weeks post-quit, follow-up visit). RESULTS Most participants (N = 12) completed the full 6-week intervention, and participant engagement with MASP was high. Participants reported that MASP was acceptable. Biochemical verification of smoking abstinence indicated 25% of smokers were abstinent for at least 24 hr prior to the in-person 4 weeks post-quit follow-up visit. CONCLUSIONS Findings indicated that MASP has the potential to provide effective assistance to those wanting to quit cigarettes. PRACTITIONER POINTS Mobile-based smoking cessation interventions may be a promising treatment option, particularly for those of lower socio-economic status. Targeting AS in the context of a mobile-based smoking cessation app may be a viable way to improve smoking cessation success and treatment outcome. Due to the pilot nature of this study, there was no control group. Thus, comparative conclusions and generalizability based on the current study must be made with caution.
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Texas, USA
| | - Emily T. Hébert
- University of Texas Health Science Center (UTHealth) School of Public Health,Austin, Texas, USA
| | | | | | | | - Michael S. Businelle
- Oklahoma Tobacco Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Texas, USA,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA,HEALTH Institute, University of Houston, Texas, USA,Corresponding author: Michael J. Zvolensky, Ph.D., Dept of Psychology, 3695 Cullen Blvd., Room 126. University of Houston, Houston, TX, 77204. (713) 743-8056,
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4
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Randazza MP, McKay D, Bakhshaie J, Storch EA, Zvolensky MJ. Unhealthy Alcohol Use Associated with Obsessive-Compulsive Symptoms: The Moderating Effects of Anxiety and Depression. J Obsessive Compuls Relat Disord 2022; 32:100713. [PMID: 35242506 PMCID: PMC8887883 DOI: 10.1016/j.jocrd.2022.100713] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol use occurs among individuals with obsessive-compulsive symptoms at a rate significantly greater than the general population. In clinical populations, obsessive-compulsive disorder (OCD) and substance use disorders (SUD) have been shown to share neurological substrates, but little is known about the mechanisms underlying substance use in individuals with OCD. Aspects of anxiety and depression frequently contribute to various SUD and are thought to play a role in the relationship between increased substance use and obsessive-compulsive symptomatology. The present research examines the moderating effects of depression and several anxiety-related constructs (anxious arousal, anxiety sensitivity, and social anxiety) on the relationship between health risk resulting from alcohol use and obsessive-compulsive symptoms in university students (n = 178). The physical concerns and social concerns subscales of the Anxiety Sensitivity Index increased the relationship between risky drinking and total OCD symptoms (as measured with the OCI-12). Additionally, general depression and social anxiety significantly increased the relationship between risky alcohol use and the obsessing dimension. All relationships were of a small to medium effect size. These findings help identify emotionally vulnerable subgroups of persons with OCD that may have greater liability for risky alcohol use.
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Affiliation(s)
- Michael P. Randazza
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA
| | - Dean McKay
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA
| | - Jafar Bakhshaie
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Eric A. Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St., Houston, TX 77030, USA
- HEALTH Institute, University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
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5
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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.
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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
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6
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Brooks JR, Lebeaut A, Zegel M, Walker RL, Vujanovic AA. Anxiety sensitivity and suicide risk: Mindfulness as a psychological buffer for Black adults. J Affect Disord 2021; 289:74-80. [PMID: 33945917 DOI: 10.1016/j.jad.2021.04.012] [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: 09/22/2020] [Revised: 03/18/2021] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS), defined as the fear of anxiety-related sensations, is associated with increased risk for suicide and related behavior. However, investigations of AS have centered on primarily non-Hispanic White men and women and with limited attention to clinically relevant underlying factors. METHODS The purpose of this preliminary study was to examine the indirect effect of AS on suicide ideation and elevated suicide risk through mindfulness in a sample of 307 Black adults (79.2% female; Mage = 22.4, SD = 5.6). Participants completed an online questionnaire battery that included measures of AS, mindfulness, suicide ideation, and elevated suicide risk. RESULTS After controlling for age and gender, results indicated that AS was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness. LIMITATIONS Limitations include using a cross-sectional methodological design and exclusive reliance on self-report measures. CONCLUSIONS These findings provide preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black Americans.
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Affiliation(s)
- Jasmin R Brooks
- Department of Psychology, University of Houston, Houston, TX
| | - Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, TX
| | - Rheeda L Walker
- Department of Psychology, University of Houston, Houston, TX
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7
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Avishai Cohen H, Zerach G. Associations Between Posttraumatic Stress Symptoms, Anxiety Sensitivity, Socially Prescribed Perfectionism, and Severity of Somatic Symptoms Among Individuals with Fibromyalgia. Pain Med 2021; 22:363-371. [PMID: 33164101 DOI: 10.1093/pm/pnaa327] [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] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The contribution of psychological risk factors to the intensification of pain experienced among individuals with fibromyalgia syndrome (FMS) is relatively under-studied. The present study aims to explore associations between FMS-related somatic symptom severity and two personality tendencies: anxiety sensitivity (AS) and socially prescribed perfectionism (SPP). Furthermore, the relative contributions of these personality tendencies are examined vis-à-vis the experience of potentially traumatic events (PTEs) and the psychopathology of posttraumatic stress symptoms (PTSS). METHODS A volunteer sample of 117 Israeli adults with FMS responded to online validated self-report questionnaires regarding their PTEs, PTSS, somatic symptom severity, FMS, AS, and SPP in a cross-sectional study. RESULTS Participants' self-reported PTSS rates (61.5%) were high. AS and SPP were positively related to somatic symptom severity. Interestingly, we found that PTSS positively predicted the severity of somatic symptoms above and beyond the contributions of AS and SPP. CONCLUSIONS The present study supports the assumption that psychological risk factors may affect the expression of somatic symptoms and the interpretation of pain stimulus arising in the body that might eventually be experienced as excessively painful. The study also suggests that above and beyond psychological risk factors, PTSS may express a high predominance and affect pain perception among participants with FMS.
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Affiliation(s)
- Hila Avishai Cohen
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
| | - Gadi Zerach
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
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8
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Shaw AM, Halliday ER, Tonarely NA, Ehrenreich-May J. Relationship of affect intolerance with anxiety, depressive, and obsessive-compulsive symptoms in youth. J Affect Disord 2021; 280:34-44. [PMID: 33202336 DOI: 10.1016/j.jad.2020.10.048] [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: 06/03/2019] [Revised: 09/11/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Structural research on the construct of affect intolerance (an overarching latent construct indicated by distress tolerance and anxiety sensitivity) has only been conducted in adults. Given that a self-report measure of distress tolerance was recently validated for youth and affect intolerance may be a core mechanism of transdiagnostic interventions for internalizing disorders, we examined how affect intolerance relates to internalizing symptoms in youth. We predicted that a latent affect intolerance factor (indicated by distress tolerance and anxiety sensitivity) would be associated with self and parent-reports of youth anxiety, depressive, and obsessive-compulsive symptoms, controlling for age and gender. METHODS At a pre-treatment evaluation, youth with a primary depressive, anxiety, or obsessive-compulsive spectrum disorder (N=277) aged 8-17, and their parent, completed questionnaires. RESULTS Greater levels of the affect intolerance factor predicted greater youth- and parent-reported youth anxiety, depression, and obsessive-compulsive symptoms, controlling for age. LIMITATIONS Future research should replicate findings in a sample with a greater proportion of depressed youth and utilize experimental or longitudinal methods. CONCLUSIONS Importantly, distress tolerance and anxiety sensitivity are core transdiagnostic processes that can be targeted in cognitive-behavioral interventions. Future research should examine how transdiagnostic interventions for youth with internalizing disorders can target these cross-cutting emotional vulnerabilities.
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Affiliation(s)
- Ashley M Shaw
- Florida International University, 11200 SW 8th St., AHC 1, Miami, Florida 33199.
| | | | - Niza A Tonarely
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL 33146, USA.
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9
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Overstreet C, Brown E, Berenz EC, Brown RC, Hawn S, McDonald S, Pickett T, Danielson CK, Thomas S, Amstadter A. Anxiety Sensitivity and Distress Tolerance Typologies and Relations to Posttraumatic Stress Disorder: A Cluster Analytic Approach. Mil Psychol 2018; 30:547-556. [PMID: 30886457 DOI: 10.1080/08995605.2018.1521682] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed veterans (N = 250). A cluster analytic approach was utilized to identify AS/DT profiles, and a series of MANOVAs with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a three-cluster solution including a high AS/low DT "at risk" profile, a low AS/high DT "resilient" profile, and an average AS/DT "intermediate" profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT "at risk" profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.
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Affiliation(s)
- Cassie Overstreet
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Emily Brown
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Erin C Berenz
- Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.,Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ruth C Brown
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Sage Hawn
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Suzanne Thomas
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Ananda Amstadter
- Department of Psychiatry, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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10
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Ebbert AM, Patock-Peckham JA, Luk JW, Voorhies K, Warner O, Leeman RF. The Mediating Role of Anxiety Sensitivity in Uncontrolled Drinking: A Look at Gender-Specific Parental Influences. Alcohol Clin Exp Res 2018; 42:914-925. [PMID: 29573434 DOI: 10.1111/acer.13631] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/12/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Anxiety sensitivity (AS) reflects an individual's belief that experiencing anxiety will cause illness or embarrassment, and may be a reason individuals self-medicate with alcohol. Harsh or indulgent parenting could contribute to the development of AS. We examined the direct and indirect associations between parenting styles and alcohol-related variables through AS and impaired control over drinking (IC; i.e., perceived failure to adhere to limits on alcohol consumption in the future). METHODS A multiple-group structural equation model with 614 university students (344 men; 270 women) was examined. Structural invariance tests were conducted to evaluate moderation by gender. We used a bias corrected bootstrap technique to obtain the mediated effects. RESULTS Father authoritarianism and mother permissiveness were directly linked to AS among women, whereas father permissiveness was directly linked to AS among men. This suggests unique parental influences based on gender regarding AS. While AS was directly linked to alcohol-related problems for both men and women, several gender-specific associations were found. AS was directly linked to IC for men but not for women. For men, father permissiveness was directly related to AS, and AS mediated the indirect link between father permissiveness and IC along both the heavy episodic drinking and alcohol-related problems pathways. Similar to other internalizing constructs (e.g., neuroticism and depression), higher AS was directly associated with less heavy episodic drinking but more alcohol-related problems. CONCLUSIONS Our findings highlight the dangers of AS for men as an important correlate of under-controlled drinking behaviors. Additionally, permissive parenting of the same-gender parent was associated with AS, which is consistent with the gender-matching hypothesis. Together, these results underscore the importance of measuring the independent influence of both parents.
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Affiliation(s)
- Ashley M Ebbert
- Department of Psychology, Arizona State University, Tempe, Arizona
| | | | - Jeremy W Luk
- Division of Intramural Population Health Research, Health Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Kirsten Voorhies
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Olivia Warner
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Robert F Leeman
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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11
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Brandt CP, Paulus DJ, Jardin C, Heggeness L, Lemaire C, Zvolensky MJ. Examining anxiety sensitivity as an explanatory construct underlying HIV-related stigma: Relations to anxious arousal, social anxiety, and HIV symptoms among persons living with HIV. J Anxiety Disord 2017; 48:95-101. [PMID: 27527687 PMCID: PMC5293677 DOI: 10.1016/j.janxdis.2016.08.001] [Citation(s) in RCA: 7] [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: 07/04/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 12/01/2022]
Abstract
Persons living with HIV (PLHIV) are a health disparity subgroup of the overall population for mental and physical health problems. HIV-related stigma has been shown to increase anxiety symptoms and HIV symptoms among PLHIV. However, little is known about factors that may impact the relations between HIV-related stigma and anxiety symptoms and HIV symptoms among PLHIV. To address this gap in the literature, the current study examined anxiety sensitivity (i.e., the extent to which individuals believe anxiety and anxiety-related sensations) in the relation between HIV-related stigma, social anxiety, anxious arousal, and HIV symptoms among a sample of 87 PLHIV (60.9% cis gender male, 52.9% Black, non-Hispanic). Results indicated that anxiety sensitivity mediated the relations between HIV-related stigma and the dependent variables, with effect sizes indicating moderate to large effects of anxiety sensitivity on these relations. Findings suggest that anxiety sensitivity be a mechanistic factor in the relations between HIV-related stigma and social anxiety, anxious arousal, and HIV symptoms, and therefore, be important element in efforts to reduce mental/physical health disparity among this population.
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Affiliation(s)
- Charles P. Brandt
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204,Baylor College of Medicine. 1 Baylor Plaza, Houston, Texas 77030,Corresponding author may be reached at
| | - Daniel J. Paulus
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204
| | - Charles Jardin
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204
| | - Luke Heggeness
- Kent State University, Department of Psychology. 144 Kent Hall, Kent, Ohio 44242
| | - Chad Lemaire
- Legacy Community Health. 1415 California St, Houston, Texas 77006
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204,The University of Texas MD Anderson Cancer Center, Department of Behavioral Science. 1515 Holcombe Blvd, Houston, Texas 77030
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12
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McCaul ME, Hutton HE, Stephens MAC, Xu X, Wand GS. Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers. Alcohol Clin Exp Res 2017; 41:836-845. [PMID: 28281290 PMCID: PMC5388456 DOI: 10.1111/acer.13350] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 02/06/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol-related problems have been equivocal. This study examined relationships between scores on self-report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD. METHODS Media-recruited, heavy drinkers with AUD (N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper-and-pencil measures, including the Beck Anxiety Inventory (BAI), the Anxiety Sensitivity Index-3 (ASI-3), and the Perceived Stress Scale (PSS). Eligible subjects (N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected. RESULTS In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI-3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI-3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI-3 scores but not PSS scores were related to greater self-reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress-induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity. CONCLUSIONS Overall, clinically oriented measures of anxiety compared with perceived stress were more strongly associated with a variety of alcohol-related measures in current heavy drinkers with AUD.
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Affiliation(s)
- Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Heidi E Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary Ann C Stephens
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xiaoqiang Xu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gary S Wand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Powers MB, Davis ML, Kauffman BY, Baird SO, Zvolensky M, Rosenfield D, Marcus BH, Church TS, Frierson G, Otto MW, Smits JAJ. Anxiety sensitivity and smoking variability among treatment seeking smokers. Addict Disord Their Treat 2016; 15:136-142. [PMID: 27672353 PMCID: PMC5034872 DOI: 10.1097/adt.0000000000000075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Anxiety sensitivity (AS) is associated with poor smoking cessation outcomes. One reason may be that smokers with high AS smoke differently (i.e., to manage negative affect and uncomfortable bodily sensations) than other smokers, leading to stronger addiction (due to an affect/sensation based and thereby highly variable rather than a regular smoking routine). Thus, we examined the relationship between AS and smoking variability in a group of treatment-seeking smokers. METHODS Participants (N = 136; 52.2% female; Mage = 44.19 years, SD = 11.29) were daily smokers with elevated AS (AS≥20 on the Anxiety Sensitivity Index 16-item at prescreen) recruited as part of a larger randomized controlled trial for smoking cessation. Most participants were Caucasian (73%), educated (with 76% attending some college), unmarried (73%), and employed full-time (56%). They smoked, on average, 17 cigarettes per day. RESULTS Consistent with prediction, a regression analysis of baseline assessments and a longitudinal analysis with multilevel modeling (MLM) both showed higher AS was associated with greater variability in cigarettes smoked per day while controlling for gender, age, ethnicity, and income. CONCLUSIONS This finding encourages investigation of how AS might interact with clinical strategies using a fixed smoking taper as part of quit attempts.
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Affiliation(s)
- Mark B. Powers
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michelle L. Davis
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Brooke Y. Kauffman
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Scarlett O. Baird
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Bess H. Marcus
- Department of Family Medicine and Public Health, University of California, San Diego, CA
| | | | | | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Jasper A. J. Smits
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
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14
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Mohammadkhani P, Pourshahbaz A, Kami M, Mazidi M, Abasi I. Anxiety Sensitivity Dimensions and Generalized Anxiety Severity: The Mediating Role of Experiential Avoidance and Repetitive Negative Thinking . Iran J Psychiatry 2016; 11:140-146. [PMID: 27928245 PMCID: PMC5139948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: Generalized anxiety disorder is one of the most common anxiety disorders in the general population. Several studies suggest that anxiety sensitivity is a vulnerability factor in generalized anxiety severity. However, some other studies suggest that negative repetitive thinking and experiential avoidance as response factors can explain this relationship. Therefore, this study aimed to investigate the mediating role of experiential avoidance and negative repetitive thinking in the relationship between anxiety sensitivity and generalized anxiety severity. Method: This was a cross-sectional and correlational study. A sample of 475 university students was selected through stratified sampling method. The participants completed Anxiety Sensitivity Inventory-3, Acceptance and Action Questionnaire-II, Perseverative Thinking Questionnaire, and Generalized Anxiety Disorder 7-item Scale. Data were analyzed by Pearson correlation, multiple regression analysis and path analysis. Results: The results revealed a positive relationship between anxiety sensitivity, particularly cognitive anxiety sensitivity, experiential avoidance, repetitive thinking and generalized anxiety severity. In addition, findings showed that repetitive thinking, but not experiential avoidance, fully mediated the relationship between cognitive anxiety sensitivity and generalized anxiety severity. α Level was p<0.005. Conclusion: Consistent with the trans-diagnostic hypothesis, anxiety sensitivity predicts generalized anxiety severity, but its effect is due to the generating repetitive negative thought..
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Kane EJ, Braunstein K, Ollendick TH, Muris P. Relations of Anxiety Sensitivity, Control Beliefs, and Maternal Over-Control to Fears in Clinic-Referred Children with Specific Phobia. J Child Fam Stud 2015; 24:2127-2134. [PMID: 26273182 PMCID: PMC4528981 DOI: 10.1007/s10826-014-0014-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The relations of fear to anxiety sensitivity, control beliefs, and maternal overprotection were examined in 126 7- to 13-year-old clinically referred children with specific phobias. Results indicated that anxiety sensitivity and control beliefs were significant predictors of children's fear levels, accounting for approximately 48% of the total variance. Unexpectedly, age, gender, and maternal overprotection did not emerge as significant predictors of fear in the overall sample. In subsequent analyses, anxiety sensitivity was found to be a consistent, significant predictor for both girls and boys, for both younger and older children, and for children with and without an additional anxiety disorder diagnosis. Control beliefs were only a significant predictor for girls, younger children, and children with an additional anxiety diagnosis. Maternal overprotection was not a significant predictor for any group. Children with an additional anxiety disorder diagnosis had higher levels of fear, anxiety sensitivity, and maternal overprotection, as well as lower levels of control beliefs than the non-additional anxiety disorder subgroup. Future directions and clinical implications are explored.
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Affiliation(s)
- Elisabeth J Kane
- Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24061
| | - Kara Braunstein
- Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24061
| | - Thomas H. Ollendick
- Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24061
| | - Peter Muris
- Maastricht University, Maastricht, The Netherlands
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16
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Wolitzky-Taylor K, Guillot CR, Pang RD, Kirkpatrick MG, Zvolensky MJ, Buckner JD, Leventhal AM. Examination of anxiety sensitivity and distress tolerance as transdiagnostic mechanisms linking multiple anxiety pathologies to alcohol use problems in adolescents. Alcohol Clin Exp Res 2015; 39:532-9. [PMID: 25706521 DOI: 10.1111/acer.12638] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [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: 08/31/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple forms of anxiety psychopathology are associated with alcohol use problems in adolescents. Yet, the mechanisms underlying this association are unclear. Anxiety sensitivity (AS) and distress tolerance (DT) represent 2 distinct, conceptually relevant transdiagnostic constructs implicated in multiple manifestations of anxiety that may also underlie alcohol use problems and thereby explain why people with anxiety are more likely to have alcohol problems. METHODS The current cross-sectional study examined whether AS and DT accounted for (i.e., statistically mediated) the relationship between manifest indicators of the 3 common anxiety phenotypes (generalized anxiety, social anxiety, and panic disorders) and alcohol problems in a sample of 534 high school students (14 to 15 years old). RESULTS Multiple manifestations of anxiety were associated with greater alcohol use problems. AS statistically mediated multiple anxiety-alcohol associations, but DT did not. CONCLUSIONS These findings provide preliminary evidence suggesting AS may be an important transdiagnostic target for alcohol prevention programs for those in early adolescence that experience elevated anxiety symptoms.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Psychiatry and Behavioral Sciences , University of Southern California, Los Angeles, California
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17
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McHugh RK, Daughters SB, Lejuez CW, Murray HW, Hearon BA, Gorka SM, Otto MW. Shared Variance among Self-Report and Behavioral Measures of Distress Intolerance. Cognit Ther Res 2011; 35:266-275. [PMID: 23894216 PMCID: PMC3721199 DOI: 10.1007/s10608-010-9295-1] [Citation(s) in RCA: 144] [Impact Index Per Article: 11.1] [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: 11/24/2022]
Abstract
Distress intolerance may be an important individual difference variable in understanding maladaptive coping responses across diagnostic categories. However, the measurement of distress intolerance remains inconsistent across studies and little evidence for convergent validity among existing measures is available. This study evaluated the overlap among self-report and behavioral measures of distress intolerance in four samples, including an unselected sample, a sample of patients with drug dependence, and two samples of cigarette smokers. Results suggested that the self-report measures were highly correlated, as were the behavioral measures; however, behavioral and self-report measures did not exhibit significant associations with each other. There was some evidence of domain specificity, with anxiety sensitivity demonstrating strong associations with somatic distress intolerance, and a lack of association between behavioral measures that elicit affective distress and those that elicit somatic distress. These findings highlight a potential divergence in the literature relative to the conceptualization of distress intolerance as either sensitivity to distress or as the inability to persist at a task when distressed. Further research is needed to elucidate the conceptualization and measurement of distress intolerance to facilitate future clinical and research applications of this construct.
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Affiliation(s)
- R. Kathryn McHugh
- Department of Psychology, Boston University, 648 Beacon Street, 6 Floor, Boston, MA 02215, USA
| | - Stacey B. Daughters
- Department of Public and Community Health, University of Maryland, College Park, MD 20742
| | - Carl W. Lejuez
- Center for Addiction, Personality, and Emotion Research, Department of Psychology, University of Maryland, College Park, MD 20742
| | - Heather W. Murray
- Department of Psychology, Boston University, 648 Beacon Street, 6 Floor, Boston, MA 02215, USA
| | - Bridget A. Hearon
- Department of Psychology, Boston University, 648 Beacon Street, 6 Floor, Boston, MA 02215, USA
| | - Stephanie M. Gorka
- Department of Public and Community Health, University of Maryland, College Park, MD 20742
- Center for Addiction, Personality, and Emotion Research, Department of Psychology, University of Maryland, College Park, MD 20742
| | - Michael W. Otto
- Department of Psychology, Boston University, 648 Beacon Street, 6 Floor, Boston, MA 02215, USA
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