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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] [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.
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Affiliation(s)
| | - Norman B Schmidt
- Department of Psychology, Florida State University, United States
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Martin RL, Smith NS, Caulfield NM, Capron DW. The Pathways of Aggression - Differential Indirect Associations Between Anxiety Sensitivity Cognitive Concerns and Suicidality. CRISIS 2020; 42:335-342. [PMID: 33151097 DOI: 10.1027/0227-5910/a000725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Suicide prevention efforts have focused on risk factors that help identify people with an increased risk for suicide. One risk factor related to suicide risk is anxiety sensitivity cognitive concerns (ASCC), which is the "fear of going crazy." The association between ASCC and suicidal ideation is hypothesized to result from the depression-distress amplification model, which postulates that ASCC exacerbates feelings of depression and concurrent distress. Furthermore, there is evidence for associations between ASCC/dysregulated anger and dysregulated anger/suicidal ideation. We hypothesized that aggression may provide pathways from ASCC to suicidality. The current study examined how facets of aggression (described as elevated agitation) meditated the association between ASCC and suicidality. Aims: The current study aimed to extend prior research by examining how different facets of aggression mediate the association between ASCC and suicidality. Method: Participants were 440 adults recruited online, 32.7% of whom endorsed experiencing lifetime suicidal ideation. Results: Our hypotheses were partially supported with two significant indirect effects. Results indicated that physical aggression and hostility provided significant indirect effects; however, verbal aggression and anger did not. Limitations: The study was cross-sectional in nature, limiting causal interpretations about the indirect effects. The sample included primarily White participants. Conclusion: Specific facets of aggression provide pathways through which ASCC is associated with suicidality. Aggression may be a catalyst for individuals to progress to suicidality. The current study provides foundational research for continued examination of physical aggression as a catalyst for suicide attempts.
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Affiliation(s)
- Rachel L Martin
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Nicole S Smith
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Nicole M Caulfield
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Daniel W Capron
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
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Watt MC, Gallagher CE, Couture ME, Wells R, MacLean K. Anxiety Sensitivity Mediates Relations Between Attachment and Aggression Differently by Gender. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:364-383. [PMID: 29294626 DOI: 10.1177/0886260516683173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study examined relations among attachment, aggression, and anxiety sensitivity (AS) in a sample of male and female undergraduates. Given that some individuals may use aggression to modulate negative emotional states, it was predicted that AS dimensions would mediate relations between attachment anxiety (vs. attachment avoidance) and certain forms of aggression, particularly impulsive aggression. Moreover, it was hypothesized that the relations among attachment, aggression, and AS would be moderated by gender. Participants (N = 1,042) completed measures of attachment (Experiences in Close Relationships-Revised [ECR-R]), aggression (Aggression Questionnaire [AQ]; Impulsive/Premeditated Aggression Scales [IPAS]), and AS (AS Index-3 [ASI-3]). Results indicated that AS mediated relations between attachment dimensions (both anxiety and avoidance) and most forms of aggression, with each of the AS dimensions playing a unique role differentially by gender. Cognitive concerns emerged as a significant mediator, particularly for men; physical and social concerns played more of a mediating role for women. Interestingly, none of the AS dimensions played a significant mediating role between attachment (either anxiety or avoidance) and physical aggression for men. Results are discussed in terms of their clinical implications and directions for future research.
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Affiliation(s)
- Margo C Watt
- St. Francis Xavier University, Antigonish, Nova Scotia, Canada
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Robyn Wells
- St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Kim MacLean
- St. Francis Xavier University, Antigonish, Nova Scotia, Canada
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Blanco E, Duque LM, Rachamallu V, Yuen E, Kane J, Gallego JA. Predictors of aggression in 3.322 patients with affective disorders and schizophrenia spectrum disorders evaluated in an emergency department setting. Schizophr Res 2018; 195:136-141. [PMID: 29102223 PMCID: PMC6510030 DOI: 10.1016/j.schres.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study is to determine odds of aggression and associated factors in patients with schizophrenia-spectrum disorders (SSD) and affective disorders who were evaluated in an emergency department setting. METHODS A retrospective study was conducted using de-identified data from electronic medical records from 3.322 patients who were evaluated at emergency psychiatric settings. Data extracted included demographic information, variables related to aggression towards people or property in the past 6months, and other factors that could potentially impact the risk of aggression, such as comorbid diagnoses, physical abuse and sexual abuse. Bivariate analyses and multivariate regression analyses were conducted to determine the variables significantly associated with aggression. RESULTS An initial multivariate regression analysis showed that SSD had 3.1 times the odds of aggression, while bipolar disorder had 2.2 times the odds of aggression compared to unipolar depression. A second regression analysis including bipolar subtypes showed, using unipolar depression as the reference group, that bipolar disorder with a recent mixed episode had an odds ratio (OR) of 4.3, schizophrenia had an OR of 2.6 and bipolar disorder with a recent manic episode had an OR of 2.2. Generalized anxiety disorder was associated with lower odds in both regression analyses. CONCLUSION As a whole, the SSD group had higher odds of aggression than the bipolar disorder group. However, after subdividing the groups, schizophrenia had higher odds of aggression than bipolar disorder with a recent manic episode and lower odds of aggression than bipolar disorder with a recent mixed episode.
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Affiliation(s)
- Emily Blanco
- Weill Cornell Medical College, New York, NY, USA
| | | | | | | | - John Kane
- Hofstra Northwell School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,The Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Juan A. Gallego
- Hofstra Northwell School of Medicine, Hempstead, NY, USA,The Feinstein Institute for Medical Research, Manhasset, NY, USA,The Zucker Hillside Hospital, Glen Oaks, NY, USA
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Bilgiç A, Tufan AE, Yılmaz S, Özcan Ö, Özmen S, Öztop D, Türkoğlu S, Akça ÖF, Yar A, Işık Ü, Çolak Sivri R, Polat H, Irmak A, Dönmez YE, Çon Bayhan P, Uçur Ö, Cansız MA, Savcı U. Association of Reactive-Proactive Aggression and Anxiety Sensitivity with Internalizing and Externalizing Symptoms in Children with Attention-Deficit/Hyperactivity Disorder. Child Psychiatry Hum Dev 2017; 48:283-297. [PMID: 27033363 DOI: 10.1007/s10578-016-0640-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.
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Affiliation(s)
- Ayhan Bilgiç
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey.
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, School of Medicine, Izzet Baysal University, Bolu, Turkey
| | - Savaş Yılmaz
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Özlem Özcan
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
| | - Sevgi Özmen
- Department of Child and Adolescent Psychiatry, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Didem Öztop
- Department of Child and Adolescent Psychiatry, Surp Pirgic Ermenian Hospital, Istanbul, Turkey
| | - Serhat Türkoğlu
- Department of Child and Adolescent Psychiatry, School of Medicine, Selcuk University, Konya, Turkey
| | - Ömer Faruk Akça
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Ahmet Yar
- Department of Child and Adolescent Psychiatry, Konya Education and Research Hospital, Konya, Turkey
| | - Ümit Işık
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Rukiye Çolak Sivri
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey
| | - Hatice Polat
- Department of Child and Adolescent Psychiatry, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Ayşe Irmak
- Department of Child and Adolescent Psychiatry, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Yunus Emre Dönmez
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
| | - Pelin Çon Bayhan
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
| | - Ömer Uçur
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
| | - Mehmet Akif Cansız
- Department of Child and Adolescent Psychiatry, School of Medicine, Izzet Baysal University, Bolu, Turkey
| | - Uğur Savcı
- Department of Child and Adolescent Psychiatry, School of Medicine, Izzet Baysal University, Bolu, Turkey
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Gerrior KG, Watt MC, Weaver AD, Gallagher CE. The role of anxiety sensitivity in the sexual functioning of young women. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1018885] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Broman-Fulks JJ, Urbaniak A, Bondy CL, Toomey KJ. Anxiety sensitivity and risk-taking behavior. ANXIETY STRESS AND COPING 2014; 27:619-32. [DOI: 10.1080/10615806.2014.896906] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kunimatsu MM, Marsee MA. Examining the Presence of Anxiety in Aggressive Individuals: The Illuminating Role of Fight-or-Flight Mechanisms. CHILD & YOUTH CARE FORUM 2012. [DOI: 10.1007/s10566-012-9178-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Halasz J, Zelena D, Toth M, Tulogdi A, Mikics E, Haller J. Substance P neurotransmission and violent aggression: The role of tachykinin NK1 receptors in the hypothalamic attack area. Eur J Pharmacol 2009; 611:35-43. [DOI: 10.1016/j.ejphar.2009.03.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 03/12/2009] [Accepted: 03/23/2009] [Indexed: 10/21/2022]
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