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

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.

Panic attacks, panic disorder, and agoraphobia: associations with substance use, abuse, and dependence

Anxiety and substance use disorders frequently co-occur. Despite the clinical importance of this co-occurrence, theory and research addressing the relations between anxiety-substance use disorder comorbidity remain limited. The present commentary is intended to briefly review and summarize key aspects of this literature, with a specific focus on panic-spectrum psychopathology (panic attacks, panic disorder, and agoraphobia) and its associations with tobacco, alcohol, and marijuana use, abuse, and dependence. A heuristic theoretical model for better understanding the panic-substance use relations also is offered. Extant data suggest clinically meaningful bidirectional associations are evident between panic problems and premorbid risk factors for such problems and various forms of tobacco, alcohol, and marijuana use. Key clinical implications and future directions are outlined based upon the review.

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.

Smoking and panic attacks, panic disorder, and agoraphobia: a review of the empirical literature

The empirical literature regarding panic-spectrum problems (i.e., panic attacks, panic disorder, and agoraphobia) and cigarette smoking is reviewed. In the first section of the paper, empirical studies that document the prevalence of smoking and panic-related problems are presented and discussed. In the second section of the paper, studies pertaining to the role cigarette smoking may play in the onset and maintenance of panic-related problems are critically reviewed. In the third section of the paper, studies related to the association between panic vulnerability factors and the nature of smoking behavior are presented. In the fourth section of the paper, specific areas not otherwise covered in the review are presented to stimulate further development in these areas (e.g., specialized treatment development).

Acute nicotine withdrawal symptoms and anxious responding to bodily sensations: A test of incremental predictive validity among young adult regular smokers

Although previous work has found associations between panic and smoking, little research has investigated potential mechanisms by which smoking may contribute to panic problems. The present investigation evaluated the incremental validity of acute nicotine withdrawal symptoms (elicited by an average of 2h of nicotine deprivation) relative to negative affectivity, anxiety sensitivity, and nicotine dependence in predicting anxiety responding to 3-min voluntary hyperventilation. The sample consisted of 90 regular smokers (46 females), as defined by smoking >or= 10 cigarettes per day for at least 1 year, recruited through the general community. Consistent with prediction, greater levels of pre-challenge nicotine withdrawal symptoms uniquely predicted post-challenge intensity of panic symptoms and anxiety relative to other established factors. Findings are discussed in the context of how regular smoking may promote panic symptomotology.

Evaluating the role of panic disorder in emotional sensitivity processes involved with smoking

The present study investigated the relationship between panic disorder and emotional sensitivity processes related to smoking. Participants were 170 young adult (mean age = 25.2 [8.4]) regular smokers (mean cigarettes per day = 15.6 [2.4]) with (n = 69) and without (n = 101) a primary diagnosis of panic disorder. Consistent with prediction, smokers with panic disorder showed greater motivation to smoke in order to reduce negative affect (but not other reasons for smoking), reported anxiety symptoms but not non-anxiety symptoms as problematic obstacles to quitting during past (lifetime) quit attempts, and reported lower levels of confidence in remaining abstinent when emotionally distressed. Results are discussed in relation to panic-relevant emotional sensitivity processes involved with smoking.

Health Perception Is a Unique Predictor of Anxiety Symptoms in Non‐Clinical Participants

This study evaluated the role of perceived health in predicting anxiety symptoms, bodily vigilance and agoraphobic cognitions among 71 individuals (30 females; mean age 19.9 years, SD=3.1) without a psychiatric history, including non-clinical panic attacks. Results indicated that, relative to anxiety sensitivity, perceived health was a distinct construct that incrementally predicted bodily-oriented catastrophic thinking (8% of unique variance) and heart-focused anxiety (13% of unique variance). Moreover, perceived health significantly incrementally predicted anxious arousal symptoms (9% of unique variance). Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for anxiety-related problems.