Marijuana coping motives interact with marijuana use frequency to predict anxious arousal, panic related catastrophic thinking, and worry among current marijuana users

The present investigation evaluated whether coping motives for marijuana use interacted with past 30-day frequency of marijuana use in relation to anxiety-relevant variables among community-recruited young adult marijuana users (n=149). As expected, after covarying cigarettes per day, alcohol use, and total years of marijuana use, the interaction between frequency of past 30-day marijuana use and coping motives predicted anxious arousal symptoms, agoraphobic cognitions, and worry. Marijuana users who demonstrated high use frequency and high coping motives demonstrated the highest levels of anxiety across these anxiety-relevant criterion variables. No such effects were evident, as expected, for depressive symptoms, offering explanatory specificity for anxiety relative to depressive factors. These results are discussed in relation to better understanding the role of marijuana use and coping motives in regard to anxiety vulnerability.

Relations between anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations to coping and conformity marijuana use motives among young adult marijuana users

The present investigation examines anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations in relation to Coping and Conformity marijuana use motives among a sample of young adult marijuana users (n = 135; 46.7% women; Mage = 20.45, SD = 5.0). After controlling for current marijuana use frequency (past 30 days), daily cigarette smoking rate, average volume of alcohol used over the past year, negative affectivity, and other marijuana use motives, anxiety sensitivity was significantly and uniquely associated with Coping and Conformity motives for marijuana use. Distress tolerance evidenced significant and unique incremental relations to Coping motives, whereas fear reactivity to bodily sensations was unrelated to any marijuana use motive. These results provide novel information related to the role of emotional sensitivity and tolerance factors as they pertain to specific types of motives for marijuana use among young adults.

Prospective associations between cannabis use, abuse, and dependence and panic attacks and disorder

The present study prospectively evaluated cannabis use, abuse, and dependence in relation to the development of panic attacks and panic disorder. Participants at the start of the study were adolescents (n=1709) with a mean age of 16.6 years (SD=1.2; time 1) and were re-assessed 1 year later (time 2) and then again as young adults (time 3; mean age=24.2 years, SD=0.6). Results indicated that cannabis use and dependence were significantly prospectively associated with an increased odds for the development of panic attacks and panic disorder. However, cannabis was not incrementally associated with the development of panic after controlling for daily cigarette smoking. The theoretical and clinical implications of these findings are discussed.

Use of the Panic Attack Questionnaire-IV to assess non-clinical panic attacks and limited symptom panic attacks in student and community samples

Since its development in the mid-1980s, the Panic Attack Questionnaire (PAQ) has been one of the more, if not the most, commonly used self-report tools for assessing panic attacks. The usage of the instrument, however, has come amid potential concerns that instructions and descriptions may lead to an over-estimate of the prevalence of panic attacks. Furthermore, the instrument has not been revised since 1992, despite changes in DSM-IV criteria and more recent developments in the understanding of panic attacks. As a result, this paper describes a revision of the PAQ to improve the instruction and descriptive set, and to fully assess features of panic derived from recent conceptualizations. Students meeting DSM-IV panic attack criteria and those endorsing panic attacks, but not meeting criteria, showed few differences with the exception that those not meeting DSM-IV criteria typically reported a longer onset-to-peak intensity time than did Panickers. Results were cross-validated and extended using an independent Community Sample. A full descriptive phenomenology of panic attacks is described, and future directions for studying panic attacks using the PAQ are presented.

Panic-relevant predictability preferences: a laboratory test

In the present investigation the authors evaluated the role of verbally instructed safety periods as they relate to predictability preference within a single-session challenge paradigm involving recurrent administrations of 20% carbon dioxide (CO-sub-2) enriched air. Participants included 160 nonclinical young adults (91 women, 69 men) between the ages of 18 and 59 (M=21.6 years; SD=7.23). Results indicated that equivalent levels of anxiety were experienced during predictable and unpredictable administrations of 20% CO-sub-2, yet participants preferred predictable compared with unpredictable trials, with women showing a stronger predictability preference than men. Lower anxiety was reported during known safety periods (predictable room air trials) but not during predictable compared with unpredictable administrations of 20% CO-sub-2. Findings are discussed in relation to theoretical and applied implications for the role of predictability in the nature of anxiety and its disorders.

Negative reinforcement/negative affect reduction cigarette smoking outcome expectancies: incremental validity for anxiety focused on bodily sensations and panic attack symptoms among daily smokers

The present investigation evaluated the incremental validity of negative reinforcement/negative affect reduction smoking outcome expectancies in the prediction of anxious and fearful responding to bodily sensations. Participants included 171 daily smokers (82 women, 89 men; mean age = 25.67 years, SD = 10.54). Consistent with prediction, negative reinforcement/negative affect reduction smoking outcome expectancies were significantly predictive of anxiety focused on bodily sensations and postchallenge intensity of cognitive panic attack symptoms, but not of physical panic symptoms. The observed effects were evident above and beyond the statistically significant variance accounted for by the covariates of anxiety sensitivity, negative affectivity, cigarettes per day, and weekly alcohol use and independent of other smoking outcome expectancy factors. Findings are discussed in terms of the role of negative reinforcement/negative affect reduction smoking outcome expectancies and vulnerability for panic symptoms and psychopathology.

Anxiety sensitivity as a moderator of association between smoking status and panic-related processes in a representative sample of adults

The present investigation evaluated a moderational role of anxiety sensitivity (fear of anxiety and anxiety-related states; [McNally RJ. Anxiety sensitivity and panic disorder. Biological Psychiatry 2002; 52:938-946.]) in the relation between smoking status and anxiety/depressive symptoms in a Russian epidemiological sample (n = 390; 197 females, Mean age = 43.55). Consistent with prediction, anxiety sensitivity moderated the association of smoking status with indices of anxiety and depressive symptoms; the effects were evident after controlling for the variance accounted for by alcohol use problems, environmental stress (past month), and gender. These findings are discussed with regard to the role of anxiety sensitivity in etiologic connection between smoking and panic-related processes.

Emotional dysregulation: association with coping-oriented marijuana use motives among current marijuana users

The present investigation, conducted between 2005 and 2006, examined the relation between emotion dysregulation and motives for marijuana use among 136 (71 women; M(age) = 20.61 years) young adult marijuana smokers. As expected, after covarying for theoretically relevant variables, the DERS-total score was significantly related to marijuana use coping motives, but no other motives for marijuana use. Further analysis indicated that the Non-acceptance of Emotional Responses subscale of the DERS accounted for the DERS-total score effect. Results are discussed in relation to better understanding the role of coping-motivated marijuana use within the context of an emotional dysregulation explanatory framework. Limitations of the study are noted.

Outcomes in a community sex offender treatment program: a comparison between polygraphed and matched non-polygraphed offenders

This study compared a group of 104 adult male sex offenders who received community cognitive-behavioral treatment, correctional supervision, and periodic polygraph compliance exams with a matched group of 104 sex offenders who received the same type of treatment and supervision services but no polygraph exams. Polygraph exams focused on whether participants were following their conditions of community supervision and treatment and had avoided committing new sexual offenses. The two groups were exact pair-wise matched on three variables: (1) Static-99 risk score (Hanson & Thornton 2000, Law and Human Behavior, 24, 119-136), (2) status as a completer of prison sex offender treatment, and (3) date placed in the community. At fixed 5-year follow-up periods, the number of individuals in the polygraph group charged with committing a new non-sexual violent offense was significantly lower than in the no polygraph group (2.9% versus 11.5%). However, there were no significant between-group differences for the number of individuals charged for new sexual (5.8% versus 6.7%), any sexual or violent (8.7% versus 16.3%), or any criminal offense (39.4% versus 34.6%). The results are discussed in terms of their clinical and research implications.

Marijuana use motives: A confirmatory test and evaluation among young adult marijuana users

The present investigation evaluated the measurement model and construct validity of marijuana use motives as measured by the Marijuana Motives Measure (MMM; [Simons, J., Correia, C. J., Carey, K. B., and Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology, 45, 265-273]). Confirmatory factor analysis (CFA) and incremental tests of validity of marijuana use motives were conducted on a sample of young adult marijuana users (n=227, 127 women; M(age)=20.11, SD=4.30 years). As hypothesized, CFA analysis of marijuana use motives, as indexed by the MMM, demonstrated support for a multidimensional measurement model; specifically, a five-factor solution denoting Enhancement, Conformity, Expansion, Coping, and Social motives for marijuana use, each with satisfactory levels of internal consistency. Subsequent tests of incremental validity suggested that only certain motives were uniquely related to current substance use and cognitive-affective factors. Results are discussed in relation to refining the scientific understanding of marijuana use motives.

Marijuana use motives and social anxiety among marijuana-using young adults

Given the high rates of co-occurring marijuana use and social anxiety, the present investigation examined the relations among marijuana use motives, marijuana use and problems, and social anxiety in 159 (54.7% female) young adults (M(age)=18.74, SD=1.20). As expected, after covarying for a number of variables related to both marijuana use and social anxiety (e.g. gender, alcohol use problems, anxiety sensitivity), social anxiety predicted greater numbers of marijuana use problems. Interestingly, social anxiety was not related to marijuana use frequency. Also consistent with prediction, social anxiety was a significant predictor of coping and conformity motives for marijuana use above and beyond relevant variables. Finally, coping motives for marijuana use mediated the relation between social anxiety and marijuana use problems. These data provide novel evidence for the unique effects of coping-motivated marijuana use in the link between marijuana-related impairment and social anxiety.

Associations between psychedelic use, abuse, and dependence and lifetime panic attack history in a representative sample

The present investigation evaluated the associations between lifetime psychedelic use, abuse, and dependence and panic attacks. The study consisted of a representative epidemiological sample from a state wide survey of the Colorado general adult population (n=4745; 52% female). Consistent with prediction, after controlling for theoretically relevant variables, psychedelic abuse and dependence, but not use, were significantly related to an increased lifetime risk of panic attacks. The results are discussed in terms of better understanding the role of psychedelic use in relation to the occurrence of panic attacks.

Incremental validity of anxiety sensitivity in relation to marijuana withdrawal symptoms

The present investigation examined the relation between anxiety sensitivity (AS) and marijuana withdrawal severity among 84 (47 female) young adult marijuana smokers. As expected, after covarying for the theoretically-relevant variables of frequency of past 30-day marijuana use, number of cigarettes smoked per day, volume of alcohol consumed, and anxious arousal as well as anhedonic depressive symptoms, both the global AS factor and the AS-mental incapacitation concerns factor were significantly related to the severity of retrospectively reported marijuana withdrawal symptoms. Results are discussed in relation to better understanding cognitive-emotional variables related to the marijuana withdrawal.

Posttraumatic stress symptom severity predicts marijuana use coping motives among traumatic event-exposed marijuana users

The present study examines the relation between posttraumatic stress symptom severity and motives for marijuana use among 103 (55 women) young adult marijuana users (current) who reported experiencing at least one traumatic event in their lifetime. As expected, after covarying for the theoretically relevant variables of frequency of past 30-day marijuana use, number of cigarettes smoked per day, and volume of alcohol consumed, posttraumatic stress symptom severity was significantly related to marijuana use coping motives, but no other motives for marijuana use. Results are discussed in relation to better understanding the role of coping-motivated marijuana use among young adults experiencing posttraumatic stress.

Concurrent associations between anxiety sensitivity and perceived health and health disability among young adult daily smokers

The aim of this investigation was to evaluate the incremental validity of anxiety sensitivity (fear of arousal-related physical and psychological sensations) relative to health factors (smoking variables, alcohol use and exercise level), in predicting perceived health and disability among a sample of 225 young adult daily smokers (102 females; M(age) = 23.9 years, SD = 8.8). Consistent with prediction, anxiety sensitivity, relative to smoking-relevant variables, alcohol consumption (a single frequency by quantity composite) and exercise activity, predicted lower perceived general health and impairments in mental health and social functioning; no incremental effects were evident for anxiety sensitivity for predicting impairments in physical functioning, role functioning, or increased healthcare usage. These findings are discussed with respect to better understanding cognitive factors that affect perceptions of health status and functioning among daily smokers.

Perceived health moderates the association between smoking rate and panic vulnerability variables among daily smokers

Our aim in this investigation was to evaluate the moderating role of perceived health in the relation between smoking rate and panic variables in a community-based sample of 220 daily smokers (98 females; M(age)=23.76 years, SD=8.76). As hypothesized, the interaction between smoking and perceived health incrementally predicted anxiety sensitivity (fear of anxiety) and anxious arousal symptoms, but not depressive symptoms. Individuals who had higher smoking rates and lower perceived health reported higher levels of anxiety sensitivity and anxious arousal, but not depressive symptoms. The primary implication of these findings is that there may be segments of the cigarette smoking population who are at relatively greater risk for anxiety symptoms and fear of bodily sensations by virtue of individual differences in perceived health. The identification of such moderating effects is clinically important, because it helps to refine our understanding of complex associations between drug behavior and panic vulnerability.

Marijuana use motives: concurrent relations to frequency of past 30-day use and anxiety sensitivity among young adult marijuana smokers

The present investigation examined two theoretically relevant aspects of marijuana motives using the Marijuana Motives Measure (MMM) [Simons, J., Correia, C. J., Carey, K. B., & Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology 45, 265-273] among 141 (78 female) young adults (M(age)=20.17, S.D.=3.34). The first objective was to evaluate the incremental validity of marijuana motives in relation to frequency of past 30-day use after controlling for the theoretically relevant factors of the number of years using marijuana (lifetime), current levels of alcohol, as well as tobacco smoking use. As expected, coping, enhancement, social, and expansion motives each were uniquely and significantly associated with past 30-day marijuana use over and above the covariates; conformity motives were not a significant predictor. A second aim was to explore whether coping, but no other marijuana motive, was related to the emotional vulnerability individual difference factor of anxiety sensitivity (fear of anxiety). As hypothesized, after controlling for number of years using marijuana (lifetime), past 30-day marijuana use, current levels of alcohol consumption, and cigarettes smoked per day, anxiety sensitivity was incrementally and uniquely related to coping motives for marijuana use, but not other motives. These results are discussed in relation to the clinical implications of better understanding the role of motivation for marijuana use among emotionally vulnerable young adults.

Associations between age of onset and lifetime history of panic attacks and alcohol use, abuse, and dependence in a representative sample

OBJECTIVE

The present investigation evaluated associations between lifetime panic attacks and lifetime alcohol use, abuse, and dependence. Specifically, the relations between lifetime panic attacks and alcohol use, abuse, and dependence were examined after controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use.

DESIGN AND SETTING

Data for this study were obtained from a large statewide survey, the Colorado Social Health Survey. Participants were contacted using randomly sampled household addresses (response rate was 72%) and interviews took place in participants' homes.

PARTICIPANTS

The study consisted of a representative sample of the Colorado general adult population (n = 4,745; 52% women).

MAIN OUTCOME MEASURES

The Diagnostic Interview Schedule (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [3rd ed]. Washington [DC]: Author. 1980) was administered to obtain Axis I diagnoses.

RESULTS

After controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use, a lifetime history of panic attacks was significantly associated with alcohol dependence but not alcohol use or abuse. In addition, among participants reporting a lifetime history of both panic attacks and alcohol abuse or dependence, the number of participants for whom panic attacks developmentally preceded the onset of alcohol use problems was significantly greater (85.5%) than the number of participants for whom alcohol use problems preceded the onset of panic attacks (13.4%) or the number of participants for whom these problems developed at the same age (2.2%).

CONCLUSIONS

These data suggest panic attacks, particularly of early onset, may serve as a risk marker for alcohol dependence.

Anxiety sensitivity-physical concerns as a moderator of the emotional consequences of emotion suppression during biological challenge: an experimental test using individual growth curve analysis

Anxiety-related responding to, and recovery from, a 5-min 10% carbon dioxide-enriched air presentation among 80 participants with no history of psychopathology was examined. Half of participants were instructed to suppress challenge-induced emotional responses, whereas their matched counterparts were instructed to observe such responses. Responding from immediately post-challenge through a 10-min recovery period was analyzed as a function of Anxiety Sensitivity-Physical Concerns and experimental condition using individual growth curve modeling. Anxiety Sensitivity-Physical Concerns moderated the effect of suppression only on emotion valence during recovery. In terms of main effects, suppression resulted in increased heart rate during recovery and Anxiety Sensitivity-Physical Concerns was positively associated with post-challenge self-reported anxiety. Results are discussed in terms of the potential role of inhibition-oriented affect regulation processes in the etiology of panic disorder.

Anxiety sensitivity interacts with marijuana use in the prediction of anxiety symptoms and panic-related catastrophic thinking among daily tobacco users

The present investigation evaluated whether anxiety sensitivity interacted with marijuana use in relation to the prediction of panic-relevant variables among young adult tobacco smokers (n=265). Approximately 73% of the sample was composed of current marijuana smokers, with 78.5% of this sub-sample using marijuana more than once per week. As expected, after covarying cigarettes per day, alcohol use, and negative affectivity, the interaction between marijuana use and anxiety sensitivity predicted anxiety symptoms and agoraphobic cognitions. Partially consistent with prediction, the interaction between frequency of marijuana use and anxiety sensitivity predicted only anxiety symptoms. These results are discussed in relation to better understanding the potential role of regular marijuana use and anxiety sensitivity for panic-relevant emotional vulnerability among regular tobacco smokers.

Anxiety sensitivity: Concurrent associations with negative affect smoking motives and abstinence self-confidence among young adult smokers

The present study evaluated the association between the lower-order facets of Anxiety Sensitivity construct (Physical, Mental Incapacitation and Social Concerns) and theoretically relevant cognitive-based smoking processes. Participants were 151 young adult daily smokers (63 females); mean number of cigarettes/day = 12.3 [S.D. = 5.6]). Both AS Physical and Mental Incapacitation Concerns were significantly associated with greater negative affect reduction smoking motives and lower levels of self-confidence in remaining abstinent from smoking when emotionally distressed. The observed effects were over and above the variance accounted for by nicotine dependence, smoking rate, and gender. Results are discussed in relation to better understanding cognitive-based smoking processes among individuals at heightened risk for panic psychopathology.

Anxiety sensitivity: association with intensity of retrospectively‐rated smoking‐related withdrawal symptoms and motivation to quit

The present cross-sectional study evaluated the associations between anxiety sensitivity, intensity of retrospectively-rated nicotine withdrawal symptoms, and motivation to quit smoking. Participants were 127 young adult (mean age 20.4 years (SD 4.6)) regular smokers (mean cigarettes per day 10.2 (SD 5.1)). Anxiety sensitivity predicted intensity of retrospectively rated withdrawal symptoms during the first week of the most recent quit attempt as well as concurrent and lifetime indices of motivation to quit smoking even after controlling for theoretically-relevant smoking (e.g. nicotine dependence) and affect (e.g. panic attack history) factors. These results are discussed in relation to better understanding panic-related vulnerability factors in smoking cessation.

Emotional responding to biological challenge as a function of panic disorder and smoking

The present investigation evaluated anxious and fearful responding to bodily sensations as a function of panic disorder (PD) and smoking status. Participants completed a voluntary hyperventilation procedure that elicits panic-relevant bodily sensations. Psychophysiological data were collected throughout the study procedures. Assessments of anxiety and bodily distress were conducted pre-challenge baseline, post-hyperventilation, and during a recovery period following the challenge. Results indicated that smokers with PD reported greater levels of anxiety and bodily distress than smokers without PD and than nonsmokers with PD at the post-challenge assessment and recovery period. No differences in autonomic responding were evident during the challenge or in the recovery phase. In terms of rate of recovery, the linear decrease in anxiety, but not bodily distress, was significantly more steep for nonsmokers with PD than for smokers with PD. These findings are discussed in relation to better understanding the potential role that smoking may play in terms of anxious and fearful responding to bodily sensations.