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Smits JAJ, Zvolensky MJ, Rosenfield D, Brown RA, Otto MW, Dutcher CD, Papini S, Freeman SZ, DiVita A, Perrone A, Garey L. Community-based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial. Addiction 2021; 116:3188-3197. [PMID: 34033178 PMCID: PMC10091508 DOI: 10.1111/add.15586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interoceptive distress and thereby created tolerance to this distress in a safe environment. DESIGN, SETTING AND PARTICIPANTS Randomized clinical trial at four YMCA branches in Austin, Texas, USA. Participants [n = 150; 130 (86.7%) white; 101 (67.3%) female; meanage = 38.6, standard deviation (SD)age = 10.4] were adult, daily smokers with high anxiety sensitivity motivated to quit smoking, who reported no regular moderate-intensity exercise. INTERVENTIONS Participants were assigned a YMCA personal trainer who guided them through a 15-week intervention aerobic exercise program. Participants assigned to the personalized intervention trained at 60-85% of their heart rate reserve (HRR), whereas participants assigned to the control intervention trained at 20-40% of their HRR. Participants in both groups received standard behavioral support and nicotine replacement therapy. MEASUREMENTS The primary outcome was biologically verified 7-day point prevalence abstinence (PPA) at 6-month follow-up. FINDINGS Sixty-one per cent of participants were available at the 6-month follow-up. PPA at 6 months was higher in the personalized intervention than the control intervention [27.6 versus 14.8%; odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.28, 3.80, P = 0.005], assuming missing at random. Anxiety sensitivity declined in both groups with no evidence that this differed between groups. CONCLUSIONS An exercise program of high intensity increased abstinence from smoking in people with high anxiety sensitivity, but may not have done so by reducing anxiety sensitivity.
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Affiliation(s)
- Jasper A J Smits
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | | | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Richard A Brown
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Christina D Dutcher
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Santiago Papini
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Slaton Z Freeman
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Annabelle DiVita
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Alex Perrone
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
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Lanoye A, Rybarczyk B, Evans R, Leahey T, LaRose J. Pilot randomized clinical trial targeting anxiety sensitivity: effects on physical activity. Cogn Behav Ther 2021; 51:257-271. [PMID: 34374633 DOI: 10.1080/16506073.2021.1954082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Anxiety sensitivity (AS)-the tendency to interpret anxiety as an aversive state-is associated with low rates of physical activity. Previous interventions targeting AS via exercise-based interoceptive exposure have not assessed physical activity as an outcome and are limited by brief follow-up periods. This study replicated and extended previous work by including a 6-week follow-up and assessing physical activity. Participants were 44 sedentary young adults with elevated AS randomized to intervention (six 20-minute sessions of moderate-intensity walking) or assessment-only control. Assessments of AS and physical activity were conducted at baseline and weeks 2 (post-treatment), 4, and 8. Between-group change in AS and physical activity over time was assessed using hierarchical linear modeling. The intervention condition demonstrated a marginally significant reduction in AS compared to control at week 4, which eroded by week 8. There were no significant between-group differences for change in physical activity. Findings indicate that a brief intervention might not be sufficient to produce lasting changes in AS or related exercise avoidance without additional treatment. Intervention effects were weaker than previous reports, which may be due to the greater racial/ethnic diversity of the current sample. Future research should objectively measure physical activity and explore individual variability in response.ClinicalTrials.gov identifier: NCT03128437.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ronald Evans
- Department of Kinesiology & Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Tricia Leahey
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Jessica LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Smits JAJ, Zvolensky MJ, Otto MW, Piper ME, Baird SO, Kauffman BY, Lee-Furman E, Alavi N, Dutcher CD, Papini S, Rosenfield B, Rosenfield D. Enhancing panic and smoking reduction treatment with D-Cycloserine: A pilot randomized clinical trial. Drug Alcohol Depend 2020; 208:107877. [PMID: 32004998 PMCID: PMC7039743 DOI: 10.1016/j.drugalcdep.2020.107877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/18/2019] [Accepted: 01/20/2020] [Indexed: 11/18/2022]
Abstract
In this placebo-controlled randomized clinical trial, we examined the efficacy of 250 mg d-cycloserine (DCS) for enhancing the effects of cognitive behavior therapy targeting anxiety sensitivity reduction in the context of smoking cessation treatment among adults with a history of panic attacks. We hypothesized that DCS would enhance treatment of our mechanistic targets-anxiety sensitivity and panic and related symptoms-and result in greater smoking abstinence. A total of 53 smokers were randomized to a 7-week integrated treatment and received study medication (DCS or placebo) prior to sessions 3-5; these sessions emphasized interoceptive exposure practice. Nicotine replacement therapy was initiated at session 5 (quit date). We found that DCS augmentation led to greater reductions of one (anxiety sensitivity) of two of our mechanistic targets at early but not late assessments, and that engaging that target predicted better smoking outcomes. However, there was no evidence of group (DCS vs. placebo) differences in smoking cessation success at treatment endpoint or follow-up evaluations. Hence, although we found that DCS can enhance treatment targeting a smoking maintaining factor, additional strategies appear to be needed to significantly affect smoking outcomes.
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Affiliation(s)
- Jasper A J Smits
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Suite 104, Houston, TX, 77204, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Houston, TX 77030, United States
| | - Michael W Otto
- Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States
| | - Megan E Piper
- Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1930 Monroe St. #200, Madison, WI, 53711, United States
| | - Scarlett O Baird
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States
| | - Brooke Y Kauffman
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Suite 104, Houston, TX, 77204, United States
| | - Eunjung Lee-Furman
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States
| | - Noura Alavi
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States
| | - Christina D Dutcher
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States
| | - Santiago Papini
- Department of Psychology, Institute for Mental Health Research, The University of Texas at Austin, 305 E. 23rdStreet, Austin, TX, 78712, United States
| | | | - David Rosenfield
- Department of Psychology, Southern Methodist University, 6116 N. Central Expressway, Suite 1300, Dallas, TX, 75206, United States
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Jacquart J, Dutcher CD, Freeman SZ, Stein AT, Dinh M, Carl E, Smits JAJ. The effects of exercise on transdiagnostic treatment targets: A meta-analytic review. Behav Res Ther 2018; 115:19-37. [PMID: 30473437 DOI: 10.1016/j.brat.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study meta-analytically reviewed the effects of exercise on four transdiagnostic treatment targets: anxiety sensitivity (AS), distress tolerance (DT), stress reactivity (SR), and general self-efficacy (GSE). METHODS We conducted systematic searches of peer-reviewed studies in bibliographical databases (Cochrane Library, psychINFO, PubMed) before April 1, 2018. Only randomized controlled trials (RCT) evaluating the effect of exercise on AS, DT, SR, or GSE using at least one validated outcome instrument in a sample of adolescents (≥13 years old) or adults were selected. We employed a meta-analysis of effects using random-effects pooling modeling for each treatment target. RESULTS The systematic search yielded 28 RCTs meeting eligibility criteria. Exercise interventions had a large effect on reducing AS (six studies, Hedges's g = 0.72, p = .001), a medium effect on increasing GSE (eight studies, Hedges's g = 0.59, p < .001), and a small effect on reducing SR (ten studies, Hedges's g = 0.32, p < .001). Evidence from four studies suggested that exercise interventions had a small but non-significant effect on increasing DT (Hedges's g = 0.21, p = .26). CONCLUSIONS This meta-analysis provides preliminary evidence exercise can engage certain transdiagnostic targets. Further research is required to optimize exercise intervention parameters to achieve the strongest effects on these important mechanistic variables.
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Affiliation(s)
- Jolene Jacquart
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA.
| | - Christina D Dutcher
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Slaton Z Freeman
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Aliza T Stein
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Mike Dinh
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Emily Carl
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
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5
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Powers MB, Kauffman BY, Kleinsasser AL, Lee-Furman E, Smits JAJ, Zvolensky MJ, Rosenfield D. Efficacy of smoking cessation therapy alone or integrated with prolonged exposure therapy for smokers with PTSD: Study protocol for a randomized controlled trial. Contemp Clin Trials 2016; 50:213-21. [PMID: 27568069 PMCID: PMC5695545 DOI: 10.1016/j.cct.2016.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/16/2016] [Accepted: 08/22/2016] [Indexed: 01/05/2023]
Abstract
Posttraumatic stress disorder (PTSD) is related to an increased risk of smoking cessation failure. In fact, the quit rate in smokers with PTSD (23.2%) is one of the lowest of all mental disorders. Features of PTSD that contribute to smokers' progression to nicotine dependence and cessation relapse include negative affect, fear, increased arousal, irritability, anger, distress intolerance, and anxiety sensitivity. Anxiety sensitivity is higher in people with PTSD than in any other anxiety disorder except for panic disorder. High anxiety sensitivity is uniquely associated with greater odds of lapse and relapse during quit attempts. Distress intolerance, a perceived or behavioral tendency to not tolerate distress, is related to both the maintenance of PTSD and problems in quitting smoking. Prolonged exposure (PE) and interoceptive exposure (IE) reduce PTSD symptoms, distress intolerance, and anxiety sensitivity. Thus, they emerge as promising candidates to augment standard smoking cessation interventions for individuals with PTSD. The present study tests a 12-session specialized treatment for smokers with PTSD. This Integrated PTSD and Smoking Treatment (IPST) combines cognitive-behavioral therapy and nicotine replacement treatment for smoking cessation (standard care; SC) with PE to target PTSD symptoms and IE to reduce anxiety sensitivity and distress intolerance. Adult smokers (N=80) with PTSD will be randomly assigned to either: (1) IPST or (2) SC. Primary outcomes are assessed at weeks 0, 6, 8, 10, 14, 16, 22, and 30.
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Affiliation(s)
- Mark B Powers
- Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States.
| | - Brooke Y Kauffman
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Anne L Kleinsasser
- Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States; Department of Psychology, Baylor University, Waco, TX, United States
| | - Eunjung Lee-Furman
- Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States
| | - Jasper A J Smits
- Department of Psychology, Institute of Mental Health Research, University of Texas at Austin, Austin, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
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6
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Baird SO, Hopkins LB, Medina JL, Rosenfield D, Powers MB, Smits JAJ. Distress Tolerance as a Predictor of Adherence to a Yoga Intervention. Behav Modif 2015; 40:199-217. [DOI: 10.1177/0145445515612401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study tested whether distress tolerance, body image, and body mass index (BMI) predicted adherence to a yoga intervention. Participants were 27 women who participated in a yoga intervention as part of a randomized controlled trial. Attendance and distress tolerance were assessed weekly, and body image and BMI were measured at baseline. Multilevel modeling revealed a three-way interaction of distress tolerance, BMI, and body image ( p < .001). For participants with few body image concerns, distress tolerance was positively associated with adherence regardless of BMI ( p = .009). However, for those with poor body image, increases in distress tolerance were associated with increases in adherence among overweight participants ( p < .001) but lower adherence among obese participants ( p = .007). Distress tolerance may be implicated in adherence to a yoga intervention, although its effects may be dependent on body image concerns, BMI, and their interaction. Research and clinical implications are discussed.
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7
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Medina JL, DeBoer LB, Davis ML, Rosenfield D, Powers MB, Otto MW, Smits JA. Gender moderates the effect of exercise on anxiety sensitivity. Ment Health Phys Act 2014; 7:147-151. [PMID: 26617672 PMCID: PMC4659399 DOI: 10.1016/j.mhpa.2014.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A moderate to vigorous intensity exercise program is emerging as a promising strategy for reducing anxiety sensitivity (AS). Initial evidence suggests that the effects of exercise on mental health outcomes may vary as a function of gender, with men benefitting more than women. Building upon this evidence, the present study tested the hypothesis that the effect of exercise on AS would vary as a function of gender, such that the effect would be stronger for men than for women. We tested this hypothesis using the data from a published study (Smits, Berry, Rosenfield, et al., 2008). In this study, participants (N = 60) with elevated levels of AS were randomly assigned to a two-week exercise intervention [EX] or a waitlist control condition [WL]. Results revealed that males showed significantly greater initial AS reductions relative to females (following 1 week of exercise). However, these gender differences were no longer evident at the end of the intervention. Possible mechanisms for the observed findings and directions for future research are discussed.
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Affiliation(s)
- Johnna L. Medina
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, USA
| | | | - Michelle L. Davis
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, USA
| | | | - Mark B. Powers
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, USA
| | | | - Jasper A.J. Smits
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, USA
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8
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DeBoer LB, Powers MB, Utschig AC, Otto MW, Smits JAJ. Exploring exercise as an avenue for the treatment of anxiety disorders. Expert Rev Neurother 2012; 12:1011-22. [PMID: 23002943 PMCID: PMC3501262 DOI: 10.1586/ern.12.73] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anxiety disorders constitute a significant public health problem. Current gold standard treatments are limited in their effectiveness, prompting the consideration of alternative approaches. In this review, we examine the evidence for exercise as an intervention for anxiety disorders. This evidence comes from population studies, studies of nonclinical anxiety reduction, as well as a limited number of studies of clinically anxious individuals. All of these studies provide converging evidence for consistent beneficial effects of exercise on anxiety, and are consistent with a variety of accounts of the mechanism of anxiety reduction with exercise. Further study of clinical populations is encouraged, as are studies of the mechanism of change of exercise interventions, which have the potential to help refine exercise intervention strategies. Likewise, studies that identify moderators of treatment efficacy will assist clinicians in deciding how and for whom to prescribe exercise.
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Affiliation(s)
- Lindsey B DeBoer
- Southern Methodist University, 6116 N. Central Expressway, Ste. 1100, Dallas, TX 75206, USA
| | - Mark B Powers
- Southern Methodist University, 6116 N. Central Expressway, Ste. 1100, Dallas, TX 75206, USA
| | | | | | - Jasper AJ Smits
- Southern Methodist University, 6116 N. Central Expressway, Ste. 1100, Dallas, TX 75206, USA
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9
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DeBoer LB, Tart CD, Presnell KE, Powers MB, Baldwin AS, Smits JAJ. Physical activity as a moderator of the association between anxiety sensitivity and binge eating. Eat Behav 2012; 13:194-201. [PMID: 22664396 PMCID: PMC3614415 DOI: 10.1016/j.eatbeh.2012.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 12/16/2011] [Accepted: 01/17/2012] [Indexed: 10/14/2022]
Abstract
Individuals with elevated anxiety sensitivity (AS; i.e., fear of somatic arousal) may binge eat to reduce emotional distress. Because physical activity reduces stress reactivity, we predicted that: (1) the relation between AS and binge eating would be moderated by physical activity and (2) coping motives for eating would mediate the association between AS and binge eating such that the relation would be stronger for those low in physical activity. Participants (N=167) completed online self-report measures. Regression analyses revealed that moderate-intensity physical activity (MPA) moderated the relation between AS and binge eating such that AS was not related to binge eating among those who frequently engaged in MPA but was related to binge eating among those who did not report engaging in MPA. Vigorous-intensity physical activity (VPA) moderated in the opposite direction such that the relation between AS and binge eating was significant among persons reporting high levels of VPA but less strong among persons reporting low levels of VPA. The mediation model was also significant, but was not moderated by MPA or VPA. Theoretical and clinical implications are discussed.
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Affiliation(s)
| | | | | | | | | | - Jasper A. J. Smits
- Southern Methodist University, United States,Corresponding author at: Department of Psychology, Southern Methodist University, Dedman College, PO Box 750442, Dallas, TX 75275, United States. Tel.: +1 214 768 4125; fax: +1 214 768 4191.
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10
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Julian K, Beard C, Schmidt NB, Powers MB, Smits JAJ. Attention training to reduce attention bias and social stressor reactivity: an attempt to replicate and extend previous findings. Behav Res Ther 2012; 50:350-8. [PMID: 22466022 DOI: 10.1016/j.brat.2012.02.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 02/15/2012] [Accepted: 02/27/2012] [Indexed: 11/19/2022]
Abstract
Cognitive theories suggest that social anxiety is maintained, in part, by an attentional bias toward threat. Recent research shows that a single-session of attention modification training (AMP) reduces attention bias and vulnerability to a social stressor (Amir, Weber, Beard, Bomyea, & Taylor, 2008). In addition, exercise may augment the effects of attention training by its direct effects on attentional control and inhibition, thereby allowing participants receiving the AMP to more effectively disengage attention from the threatening cues and shift attention to the neutral cues. We attempted to replicate and extend previous findings by randomizing participants (N = 112) to a single-session of: a) Exercise + attention training (EX + AMP); b) Rest + attention training (REST + AMP); c) Exercise + attention control condition (EX + ACC); or d) Rest + attention control condition (REST + ACC) prior to completing a public speaking challenge. We used identical assessment and training procedures to those employed by Amir et al. (2008). Results showed there was no effect of attention training on attention bias or anxiety reactivity to the speech challenge and no interactive effects of attention training and exercise on attention bias or anxiety reactivity to the speech challenge. The failure to replicate previous findings is discussed.
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Affiliation(s)
- Kristin Julian
- Department of Psychology, Southern Methodist University, Dedman College, Dallas, TX 75275, USA
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Exercise and coping-oriented alcohol use among a trauma-exposed sample. Addict Behav 2011; 36:274-7. [PMID: 21111538 DOI: 10.1016/j.addbeh.2010.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 11/04/2010] [Indexed: 11/21/2022]
Abstract
The present investigation examined the relation between exercise intensity and alcohol use coping motives among trauma-exposed adults. Participants were 114 adults (58 women; M(age)=22.31 years, SD=8.89) who reported exposure to at least one traumatic event (American Psychiatric Association, 2000) and alcohol use in the past 30 days. Partially consistent with expectation, engagement in vigorous-intensity activities (≥6 resting metabolic rate [MET] score) demonstrated a significant, incremental (negative) association with alcohol use coping motives. This incremental association was observed after accounting for current alcohol consumption, non-criterion alcohol use motives, anxiety sensitivity, posttraumatic stress symptom severity, as well as engagement in light- and moderate-intensity activities (<6 resting MET score). Results are discussed in terms of better understanding the association between vigorous-intensity aerobic exercise and coping-oriented alcohol use among trauma-exposed individuals.
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Abstract
Anxiety disorders are the most common mental health condition and frequently co-occur with a variety of health risk factors, such as physical inactivity, cigarette smoking, and alcohol consumption. As such, untreated anxiety and increased risk for engagement in these health risk habits can further increase risk for later-onset chronic disease and complications in disease management. Contemporary studies have identified unique temporal relationships between the onset of specific anxiety disorders with smoking and alcohol use disorders. Incorporating exercise with evidence-based treatments for anxiety is emerging and promising in enhancing treatments for anxiety-related conditions. Likewise, substance use treatment programs may benefit from the detection and management of anxiety. Collaborative care models for anxiety may provide the needed systems-based approach for treating anxiety more effectively in primary and specialty care medical settings. Based on a qualitative review of the literature, this article summarizes the current research on the associations between anxiety, health risk factors, and the risk for chronic diseases. The authors also offer suggestions for future research that would help in better understanding the complex relationships between the role anxiety plays in the vulnerability for and management of physical inactivity and substance use.
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Affiliation(s)
- Craig N. Sawchuk
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington (CNS)
- Department of Psychology, Vanderbilt University, Nashville, Tennessee (BOO)
| | - Bunmi O. Olatunji
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington (CNS)
- Department of Psychology, Vanderbilt University, Nashville, Tennessee (BOO)
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Pappens M, Van den Bergh O, De Peuter S, Bresseleers J, Vansteenwegen D, Van Diest I. Defense reactions to interoceptive threats: A comparison between loaded breathing and aversive picture viewing. Biol Psychol 2010; 84:98-103. [DOI: 10.1016/j.biopsycho.2010.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 02/01/2010] [Accepted: 02/11/2010] [Indexed: 11/30/2022]
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Smits JAJ, Meuret AE, Zvolensky MJ, Rosenfield D, Seidel A. The effects of acute exercise on CO(2) challenge reactivity. J Psychiatr Res 2009; 43:446-54. [PMID: 18603261 DOI: 10.1016/j.jpsychires.2008.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 05/22/2008] [Accepted: 05/27/2008] [Indexed: 11/30/2022]
Abstract
The present study examined the effects of acute exercise on anxiogenic responding to 65% O(2)/35% CO(2) challenge. Participants (N=92) were 51 female and 41 male volunteers ranging in age from 17 to 24 (M=19.43, SD=1.31). Participants had no history of panic attacks and were randomized to moderate treadmill exercise (i.e., 70% of HR(max)) or quiet rest prior to taking a single vital capacity inhalation of 35% CO(2)/65% O(2). Gender and measures of negative affectivity and anxiety sensitivity were included in the design as control variables. Results indicated participants who exercised prior to challenge showed significantly reduced reactivity compared to their counterparts who rested prior to challenge. Importantly, the effect sizes for the advantage of exercise over rest remained in the medium to large range (i.e., partial eta(2)>.07) after controlling for the effects of gender, anxiety sensitivity, and negative affectivity. These findings are the first to demonstrate that the anti-panic effects of exercise are unique from, and cannot be better explained by, established risk factors of CO(2) challenge reactivity.
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Affiliation(s)
- Jasper A J Smits
- Department of Psychology, Southern Methodist University, Dallas, TX 75275, USA.
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15
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Starcevic V. Treatment of panic disorder: recent developments and current status. Expert Rev Neurother 2008; 8:1219-32. [PMID: 18671666 DOI: 10.1586/14737175.8.8.1219] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Panic disorder is a commonly encountered condition in general medical practice and in various medical settings. It is important for all medical practitioners to be able to recognize this disorder, provide patients with basic information and medical advice, and depending on the specific circumstances, to refer patients for appropriate treatment by primary care physicians, psychiatrists and/or clinical psychologists. This article reviews the developments in the treatment of panic disorder, focusing on the major treatment modalities of pharmacotherapy and cognitive-behavior therapy, as well as their combinations. In addition to providing information on current treatments for panic disorder and the main underlying treatment issues, the article identifies areas where improvements need to be made and areas where much research has been conducted in recent years. These include simplified modes of delivery of cognitive-behavior therapy, optimal ways of combining medications with cognitive-behavior therapy, and minimizing the risk of recurrence after the cessation of treatment.
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Affiliation(s)
- Vladan Starcevic
- University of Sydney, Discipline of Psychological Medicine Head, Academic Department of Psychological Medicine, Nepean Hospital, PO Box 63, Penrith NSW 2751, Australia.
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Smits JAJ, Berry AC, Tart CD, Powers MB. The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: a meta-analytic review. Behav Res Ther 2008; 46:1047-54. [PMID: 18687421 DOI: 10.1016/j.brat.2008.06.010] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 06/12/2008] [Accepted: 06/13/2008] [Indexed: 02/08/2023]
Abstract
The present study meta-analytically reviewed the efficacy of cognitive-behavioral therapy (CBT) vs. control conditions in the reduction of anxiety sensitivity. A computerized search was conducted to identify CBT outcome studies that included the Anxiety Sensitivity Index as a dependent variable. Of the 989 studies that were identified, 24 randomized-controlled trials with a total of 1851 participants met inclusion criteria and were included in the analysis. Data were extracted separately for treatment-seeking (16 studies) and at-risk (eight studies) samples. Results indicated large effect sizes for treatment-seeking samples, Hedges' g=1.40, SE=0.21, 95% CI: 1.00-1.81, p<0.001, and moderate to large effect sizes for at risk samples Hedges' g=0.74, SE=0.18, 95% CI: 0.39-1.08, p<0.001. Additionally, both the amount of therapist contact and control modality (waitlist vs. psychological control) moderated the effect sizes for treatment-seeking samples. Our review indicates that CBT is efficacious in reducing anxiety sensitivity. However, more research is needed to determine the mechanisms by which CBT exert its effects on anxiety sensitivity.
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Affiliation(s)
- Jasper A J Smits
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
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