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Gessner J, Schulz JO, Melzig CA, Benke C. Role of interoceptive fear and maladaptive attention and behaviors in the escalation of psychopathology-a network analysis. Cogn Behav Ther 2024; 53:524-543. [PMID: 38593025 DOI: 10.1080/16506073.2024.2336036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
The complex interplay of fear, attention, and behavior toward bodily sensations with psychopathological symptoms and how they mutually influence and potentially reinforce one another remains to be fully elucidated. In this study, we used a network analytical approach to unravel these complex interactions. Specifically, we aimed to identify central symptoms and etiologically relevant factors that might be associated with anxiety and depressive core symptoms. To this end, the following clusters were assessed in 791 adults: interoceptive fear, interoceptive attention, maladaptive behaviors related to bodily sensations, and core symptoms of anxiety and depression. This network was modeled using a Gaussian Graphical Model. Central variables (nodes) were identified using centrality indices and bridge analysis. Self-examination and attention to bodily sensations emerged as central nodes. Moreover, time spent paying attention to bodily sensations, fear of anxiety-related sensations, and self-examination were identified as central bridge nodes, that is, central nodes connecting psychopathologically relevant symptom clusters. The present study indicates that fear of bodily sensations, the amount of attention and time spent focusing on somatic sensations, and self-examination are central factors. The findings suggest potential targets for future longitudinal studies on the impact of these factors for the escalation of anxiety and depressive symptoms.
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Affiliation(s)
- Jana Gessner
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Jan-Ole Schulz
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Christiane A Melzig
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, CMBB, Philipps University Marburg and Justus Liebig University Giessen, Gießen, Germany
| | - Christoph Benke
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
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2
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Raymond C, Cernik R, Beaudin M, Arcand M, Pichette F, Marin MF. Maternal attachment security modulates the relationship between vulnerability to anxiety and attentional bias to threat in healthy children. Sci Rep 2024; 14:6025. [PMID: 38472274 DOI: 10.1038/s41598-024-55542-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/24/2024] [Indexed: 03/14/2024] Open
Abstract
This study aimed to investigate whether attentional bias to threat, commonly observed in clinically anxious children, also manifests in healthy children, potentially aiding the early detection of at-risk individuals. Additionally, it sought to explore the moderating role of parent-child attachment security on the association between vulnerability factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) as indicators of vulnerability to anxiety, and attentional bias towards threat in healthy children. A total of 95 children aged 8 to 12 years completed the Visual Search Task to assess attentional bias. Vulnerability to anxiety was measured using a composite score derived from the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. Parent-child attachment security was assessed using the Security Scale-Child Self-Report. Analyses revealed that higher vulnerability to anxiety was associated with faster detection of anger-related stimuli compared to neutral ones, and this association was further influenced by high maternal security. These findings in healthy children suggest an interaction between specific factors related to anxiety vulnerability and the security of the mother-child relationship, leading to cognitive patterns resembling those seen in clinically anxious individuals. These results hold promise for early identification of children at risk of developing anxiety disorders.
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada.
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada.
| | - Rebecca Cernik
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Myriam Beaudin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Maryse Arcand
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Florence Pichette
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec À Montréal, Montreal, Canada
- Stress, Trauma, Emotion, Anxiety, and Memory (STEAM) Lab, Research Centre of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada
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3
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Kim AJ, Stewart SH, Sherry SB, McGrath DS, Mushquash CJ, Olthuis JV, Mushquash AR. Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates. Eat Behav 2024; 52:101843. [PMID: 38217932 DOI: 10.1016/j.eatbeh.2024.101843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.
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Affiliation(s)
- Andy J Kim
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada.
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, T2N1N4, Canada.
| | | | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, E3B5A3, Canada.
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4
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Hamrick HC, Hager NM, Middlebrooks MS, Mach RJ, Abid A, Allan NP, Judah MR. Social concerns about anxious arousal explain the association between neural responses to anxious arousal pictures and social anxiety. Biol Psychol 2024; 185:108718. [PMID: 37951347 DOI: 10.1016/j.biopsycho.2023.108718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/13/2023]
Abstract
Cognitive theories propose that social anxiety disorder involves heightened attention to anxious arousal symptoms due to worries that they may evoke rejection from others. Supporting this, studies have shown that social anxiety is related to greater attention to representations of anxious arousal and to anxiety sensitivity social concerns, which refers to sensitivity to feelings of anxious arousal during social situations. However, this has not yet been tested using neural indices of attention to images depicting anxious arousal. To examine these associations, the current study examined early and sustained attentional bias to anxious arousal images using the P2 and the late positive potential (LPP), respectively. Electroencephalogram data were collected while a non-clinical sample of undergraduate students (N = 106) viewed images of people exhibiting anxious arousal in addition to blocks of negative and neutral images from the IAPS. The neural response to anxious arousal images was isolated using residual scores (e.g., using linear regression to predict the P2 elicited by anxious arousal images from the P2 elicited by neutral images (P2neutral→AA) or negative images (P2negative→AA), then saving the unstandardized residuals). There was an indirect effect of the P2neutral→AA and P2negative→AA waveforms that was explained by anxiety sensitivity social concerns. Additionally, there was an indirect effect of both LPP waveforms on social anxiety symptoms during the early time window of the LPP (400-700 ms). At the later time window of the LPP (700-1000 ms), there was an indirect effect of the LPPneutral→AA residual waveform, but not the LPPnegative→AA, on social anxiety symptoms.
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Affiliation(s)
- Hannah C Hamrick
- University of Arkansas, Department of Psychological Science, Fayetteville, AR, United States.
| | - Nathan M Hager
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, United States; Old Dominion University, Department of Psychology, Norfolk, VA, United States
| | - Morgan S Middlebrooks
- University of Arkansas, Department of Psychological Science, Fayetteville, AR, United States
| | - Russell J Mach
- University of Arkansas, Department of Psychological Science, Fayetteville, AR, United States
| | - Arooj Abid
- University of Arkansas, Department of Psychological Science, Fayetteville, AR, United States
| | | | - Matt R Judah
- University of Arkansas, Department of Psychological Science, Fayetteville, AR, United States
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Belanger AN, Timpano KR, Eng GK, Bragdon LB, Stern ER. Associations Between Suicidality and Interoception in Obsessive-Compulsive Disorder. J Obsessive Compuls Relat Disord 2023; 39:100844. [PMID: 37901053 PMCID: PMC10610034 DOI: 10.1016/j.jocrd.2023.100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Background Individuals with obsessive-compulsive disorder (OCD) are at increased risk for suicide. One potential risk factor is interoceptive sensibility (IS), which is one's subjective experience of bodily sensations. The current study examined the relationship between IS and current suicidal ideation and lifetime history of suicide attempt, controlling for relevant covariates. Methods Participants (N = 145) were a clinical sample of individuals with OCD from the New York City area. A clinical rater administered a diagnostic interview and an OCD severity assessment, and participants completed questionnaires about demographics, IS, and suicidality. Results Current suicidal ideation was associated with reduced trusting of the body, and lifetime history of suicide attempt was related to greater general awareness of sensation. These associations remained significant after controlling for covariates. Conclusions These results suggest that specific facets of IS may be associated with specific domains of suicidality. Decreased body trusting may represent a feeling of disconnection from the body that facilitates desire for death. Increased noticing of bodily sensations may lead to greater mental pain, which could interact with deficits in emotion regulation to increase risk for suicide attempt. Further research on the relationships between IS and suicidality in OCD is warranted.
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Affiliation(s)
- Amanda N. Belanger
- University of Miami, Department of Psychology; 5665 Ponce de Leon Boulevard, Coral Gables, FL, USA 33146
| | - Kiara R. Timpano
- University of Miami, Department of Psychology; 5665 Ponce de Leon Boulevard, Coral Gables, FL, USA 33146
| | - Goi Khia Eng
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
| | - Laura B. Bragdon
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
| | - Emily R. Stern
- New York University Grossman School of Medicine, Department of Psychiatry; One Park Avenue, 8th Floor, New York, NY, USA 10016
- Nathan S. Kline Institute for Psychiatric Research; 140 Old Orangeburg Road, Orangeburg, NY, USA 10962
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6
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Pavlacic JM, Witcraft SM, Allan NP, Gros DF. Anxiety sensitivity and social support in veterans with emotional disorders. J Clin Psychol 2023; 79:2337-2350. [PMID: 37310172 PMCID: PMC10527913 DOI: 10.1002/jclp.23554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE An understanding of the incremental value of social support in predicting psychopathology above transdiagnostic risk factors could speak to the benefit of leveraging social factors into existing, evidence-based interventions in veterans with emotional disorders. This cross-sectional study aimed to expand our understanding of associations between domains of anxiety sensitivity and facets of psychopathology in veterans with emotional disorders. We also determined whether social support predicted psychopathology above anxiety sensitivity domains and combat exposure and explored these relationships with a path model. METHODS One hundred and fifty-six treatment-seeking veterans with emotional disorders completed diagnostic interviews and assessments of demographics, social support, symptom measures (e.g., PTSD, depression, anxiety, and stress), and transdiagnostic risk factors (i.e., anxiety sensitivity). After data screening, 150 were included in regressions. RESULTS Using regression analyses with cross-sectional data, cognitive anxiety sensitivity concerns predicted PTSD and depression above combat exposure. Cognitive and physical concerns predicted anxiety, and cognitive and social concerns predicted stress. Above combat exposure and anxiety sensitivity, social support predicted PTSD and depression. CONCLUSION Focusing on social support in tandem with transdiagnostic mechanisms in clinical samples is critical. These findings inform transdiagnostic interventions and recommendations related to incorporation of assessment of transdiagnostic factors in clinical contexts.
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Affiliation(s)
- Jeffrey M. Pavlacic
- Mental Health Service, Ralph H. Johnson, VA Healthcare System, Charleston, South Carolina, USA
- Department of Psychology & Behavioral, Sciences, Medical University of South, Carolina, Charleston, South Carolina, USA
| | - Sara M. Witcraft
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nicholas P. Allan
- Department of Psychiatry and Behavioral, Health, Ohio State University, Columbus, Ohio, USA
- VA Center of Excellence for Suicide, Prevention, VA Finger Lakes Healthcare, System, Canandaigua, New York, USA
| | - Daniel F. Gros
- Mental Health Service, Ralph H. Johnson, VA Healthcare System, Charleston, South Carolina, USA
- Department of Psychology & Behavioral, Sciences, Medical University of South, Carolina, Charleston, South Carolina, USA
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7
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Jemcov A, Olthuis JV, Watt MC, Stewart SH. Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample? J Anxiety Disord 2023; 97:102731. [PMID: 37236069 DOI: 10.1016/j.janxdis.2023.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/08/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.
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Affiliation(s)
- Anastasija Jemcov
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada
| | - Janine V Olthuis
- Department of Psychology, Faculty of Arts, University of New Brunswick, 38 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
| | - Margo C Watt
- Department of Psychology, Faculty of Science, St. Francis Xavier University, 2323 Notre Dame Ave., Antigonish, Nova Scotia B2G 2W5, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, 1355 Oxford St., Halifax, Nova Scotia B3H 4R2, Canada; Department of Psychiatry, Faculty of Medicine, Dalhousie University, 5909 Veteran's Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada.
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8
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Raymond C, Pichette F, Beaudin M, Cernik R, Marin MF. Vulnerability to anxiety differently predicts cortisol reactivity and state anxiety during a laboratory stressor in healthy girls and boys. J Affect Disord 2023; 331:425-433. [PMID: 36972852 DOI: 10.1016/j.jad.2023.02.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Children diagnosed with anxiety disorders show altered cortisol and state anxiety reactivity to stressful situations. To date, it remains unclear whether these dysregulations emerge after the pathology or whether they are also detectable in healthy children. If the latter is true, this may provide insight into children's vulnerability to develop clinical anxiety. Various personality factors (anxiety sensitivity, intolerance of uncertainty, perseverative cognitions) increase youth's vulnerability to develop anxiety disorders. This study aimed to examine whether vulnerability to anxiety was associated with cortisol reactivity and state anxiety in healthy youth. METHODS 114 children (8-12 y/o) were exposed to the Trier Social Stress Test for Children (TSST-C), where saliva samples were collected for cortisol quantification. State anxiety was assessed 20 min before and 10 min after the TSST-C using the state form of the State-Trait Anxiety Inventory for Children. Vulnerability to anxiety was assessed using a composite score of the Childhood Anxiety Sensitivity Index, Intolerance of Uncertainty Scale for Children, and Perseverative Thinking Questionnaire. RESULTS Higher vulnerability to anxiety was associated with enhanced cortisol reactivity in boys. Irrespective of vulnerability level, girls reported greater changes in state anxiety in response to the TSST. LIMITATIONS Given the correlational nature of this study, the directionality of the results remains to be elucidated. CONCLUSIONS These results indicate that endocrine patterns characterizing anxiety disorders are detectable in healthy boys who exhibit a high level of self-reported vulnerability to anxiety. These results could aid in the early identification of children at risk of developing anxiety disorders.
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Florence Pichette
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Myriam Beaudin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Rebecca Cernik
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada; Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
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9
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Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample. J Affect Disord 2023; 324:455-462. [PMID: 36566937 DOI: 10.1016/j.jad.2022.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 11/14/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous research suggests that high anxiety sensitivity (AS) - a fear of arousal-related body sensations - may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model. METHOD Participants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis. RESULTS Results revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators. LIMITATIONS Results are limited by the cross-sectional nature of the data. CONCLUSIONS The present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.
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10
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Kreminski MA, Courtney JA, Drummond SPA, Norton PJ. The Influence of Transdiagnostic Vulnerability Factors on PTSD Symptom Clusters in a Veteran Sample. Aust N Z J Psychiatry 2023; 57:442-455. [PMID: 35674388 DOI: 10.1177/00048674221103488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is continuing debate as to the latent structure underpinning posttraumatic stress disorder symptomatology. The transdiagnostic vulnerability factors of negative affect, anxiety sensitivity (and subcomponents) and intolerance of uncertainty have previously demonstrated the ability to explain symptom clusters in a range of anxiety and depressive disorders, and may give further understanding of PTSD symptomatology. METHOD Within an Australian Defence Force veteran population, structural equation modeling is utilized to assess whether a hierarchical Original Model containing negative affect as the general cognitive factor, anxiety sensitivity and intolerance of uncertainty as mid-level factors, can explain variability among posttraumatic stress disorder symptom clusters as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A further hierarchical Anxiety Sensitivity Extended model consisting of the general cognitive factor of negative affect and the three sub-factors of anxiety sensitivity as mid-level factors was also tested upon PTSD symptom clusters. RESULTS Both the hierarchical Original and Anxiety Sensitivity Extended models fit the data well. Within both models, negative affect consistently showed significant direct effects upon the posttraumatic stress disorder symptom clusters. In the Original Model, anxiety sensitivity served as a significant mediator of negative affect for several symptom clusters, while intolerance of uncertainty was non-significant both as a direct effect and as a mediator of negative affect. In the Anxiety Sensitivity Extended Model, the cognitive concerns sub-factor of anxiety sensitivity served as a significant mediator of negative affect for several symptom clusters, while the social and physical concerns sub-factors did not have significant direct or mediating effects. CONCLUSIONS This study demonstrates a transdiagnostic hierarchical model significantly explains the severity of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition posttraumatic stress disorder symptom constructs within a subclinical population. Negative affect and anxiety sensitivity can each be targeted with specific interventions, suggesting new avenues to augment current gold standard psychotherapeutic interventions.
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Affiliation(s)
- Michael A Kreminski
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - James A Courtney
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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11
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Journault AA, Plante I, Charbonneau S, Sauvageau C, Longpré C, Giguère CÉ, Labonté C, Roger K, Cernik R, Chaffee KE, Dumont L, Labelle R, Lupien SJ. Using latent profile analysis to uncover the combined role of anxiety sensitivity and test anxiety in students' state anxiety. Front Psychol 2022; 13:1035494. [PMID: 36619097 PMCID: PMC9811949 DOI: 10.3389/fpsyg.2022.1035494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies report a growing tendency for students to experience state anxiety in schools. However, the combination of individual susceptibilities likely to trigger students' anxious states remains unclear. Aims This study examined whether distinct profiles of students emerge regarding their susceptibility to anxiety sensitivity and/or test anxiety and evaluated whether students' profile predicted anxious states. We also verified whether susceptibility profiles varied across gender, school level, and school type. Sample and methods In total, 1,404 Canadian students in Grades 5 and 10 (589 boys; M age = 15.2, SD = 2.1) from 13 public and private schools completed self-reported measures of state/trait anxiety, anxiety sensitivity, and test anxiety. Results Latent profile analyses identified four susceptibility profiles: (1) Double-susceptibility: highest anxiety sensitivity and test anxiety scores; (2) Unique-susceptibility to test anxiety: high test anxiety score and low anxiety sensitivity score; (3) Unique-susceptibility to anxiety sensitivity: high anxiety sensitivity score and low test anxiety score; and (4) No-susceptibility: lowest anxiety sensitivity and test anxiety scores. The profiles comprised 12, 9, 6, and 73% of the sample, respectively, and their membership varied across gender and school type, but not across school levels. A linear mixed-effect model showed that state anxiety varied significantly between profiles, where the Double-susceptibility profile predicted the highest state anxiety scores, followed by the two Unique-susceptibility profiles (indifferently), and the No-susceptibility profile. Conclusion Beyond their theoretical contribution to the state-trait anxiety literature, these findings suggest that selective interventions designed more specifically for students with the Double-susceptibility profile may be worthwhile. Results also highlight the high proportion of students with the No-susceptibility profile and shed light on the reassuring portrait regarding students' anxiety.
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Affiliation(s)
- Audrey-Ann Journault
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada,*Correspondence: Audrey-Ann Journault,
| | - Isabelle Plante
- Department of Didactics, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sandrine Charbonneau
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Claudia Sauvageau
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Charlotte Longpré
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | | | | | | | - Rebecca Cernik
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Laurence Dumont
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Réal Labelle
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sonia J. Lupien
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada,Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
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12
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Anxiety Sensitivity Social Concerns Predicts Electrodermal Activity during the Niacin Biological Challenge Paradigm. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3040028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Anxiety sensitivity social concerns (ASSC), or the fear of observable anxiety symptoms, is a risk factor for social anxiety. ASSC predicts anxiety following the niacin biological challenge, a paradigm in which niacin is used to manipulate facial flushing during a speech task. However, it remains unclear if ASSC predicts physiological arousal during this task. The current study was designed to examine the effects of ASSC on self-reported distress and electrodermal activity (EDA) during the niacin biological challenge in a sample of undergraduates (N = 36; M age = 18.9, SD = 0.84; 69.4% female). Participants were randomly assigned to one of four conditions in a 2 (100 mg niacin vs. 100 mg sugar) × 2 (instructional set) design. Participants completed a speech task in a virtual reality environment. Participants rated their distress halfway through the speech and EDA was averaged over four intervals. There was a main effect for ASSC on subjective distress. There was a significant ASSC by condition interaction predicting EDA, in that ASSC was related to EDA only in the niacin condition. ASSC also was more strongly related to EDA anticipating the speech. These findings highlight the role of ASSC in predicting anxiety and physiological arousal.
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13
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Geyer RB, Magee JC, Clerkin EM. Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance. ANXIETY, STRESS, & COPING 2022:1-18. [DOI: 10.1080/10615806.2022.2146102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Elise M. Clerkin
- Student Health and Wellness, University of Virginia, Charlottesville, VA, USA
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14
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Brown CS, Amir N. The moderating effect of anxiety diagnosis on the relationship between error-related negativity and anxiety sensitivity cognitive concerns. Biol Psychol 2022; 175:108443. [DOI: 10.1016/j.biopsycho.2022.108443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/14/2022] [Accepted: 10/09/2022] [Indexed: 11/02/2022]
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15
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The Relationship Among Anxiety Sensitivity, Psychache, and Suicidality in Patients With Generalized Anxiety Disorder. J Nerv Ment Dis 2022; 210:760-766. [PMID: 35605224 DOI: 10.1097/nmd.0000000000001534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although generalized anxiety disorder (GAD) is associated with suicide, not all dimensions of this relationship have been addressed. This study aimed to investigate the relationship between psychache and anxiety sensitivity with suicidality in patients with GAD. We included 80 patients with GAD (17 of whom had previous suicide attempts). The Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Scale (HAM-D), Beck Scale for Suicidal Ideation (BSIS), Psychache Scale (PS), and Anxiety Sensitivity Index-3 (ASI) were applied to the participants. The patients with previous suicide attempts had significantly higher scores on ASI total, ASI-physical and cognitive subdimensions, HAM-A total and psychic subscale, PS, and BSIS than those without ( p < 0.05 for each). Mediation analyses revealed that psychache was a full mediator in the relationship between ASI-cognitive subdimension and suicidal ideation. Therapeutic interventions for anxiety sensitivity and psychache in patients with GAD will help reduce the risk of suicide.
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16
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Toward an integrative model of transdiagnostic risk factors and suicide: A network comparison of psychiatric outpatients. J Psychiatr Res 2022; 154:252-260. [PMID: 35961181 DOI: 10.1016/j.jpsychires.2022.07.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/20/2022] [Accepted: 07/21/2022] [Indexed: 11/21/2022]
Abstract
Predictive models using traditional statistical methods have largely failed to describe suicide etiology. Network theory, which conceptualizes factors as mutually interacting, reinforcing elements of a complex outcome, can model relationships between transdiagnostic and neurocognitive vulnerability factors. The present study used a network approach to produce an atheoretical model of psychological factors and their interrelationships within a population of ideators and non-ideators. We developed two network models (i.e., suicidal ideators and psychiatric controls) describing the relationships between a diverse set of risk factors and symptom measures for a population of psychiatric outpatients. We compared networks using three measures of network structure (i.e., network structure invariance, global strength invariance, edge invariance) and described the differences. Network structures for ideators (N = 229) and non-ideators (N = 454) were stable and accurate. In non-ideators, cognitive-affective depression symptoms (Expected Influence [EI]: 2.06), trauma avoidance (EI: 1.08), and negative affect (EI: 0.81) were most influential to the psychological network. In ideators, cognitive-affective depression symptoms (EI: 1.77), intolerance of uncertainty-negative self-referent implications (EI: 1.29), and negative affect (EI: 1.19) were most influential. Invariance testing did not indicate significant differences in overall network structure between ideators and non-ideators (p = .111), but did indicate significant differences in node strength (p = .013). Significant differences in node EI were detected for intolerance of uncertainty-negative self-referent implications, anxiety sensitivity physical concerns, thwarted belongingness, worry, and negative affect. These findings indicated differences in network structures for suicidal psychiatric outpatients and provide crucial directions for future research on therapeutic targets for suicidal thoughts and behaviors.
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17
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Saulnier KG, Saulnier SJ, Allan NP. Cognitive risk factors and the experience of acute anxiety following social stressors: An ecological momentary assessment study. J Anxiety Disord 2022; 88:102571. [PMID: 35487044 DOI: 10.1016/j.janxdis.2022.102571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/30/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022]
Abstract
To better understand how social anxiety develops, it is crucial to identify mechanisms that influence anxiety following social stressors. Anxiety sensitivity social concerns (ASSC; fear of publicly observable anxiety symptoms) and fear of negative evaluation (FNE; distress arising from concerns about negative judgment) are constructs that amplify anxiety following social stressors. However, it is unclear how ASSC and FNE influence acute anxiety following stressors in naturalistic settings. In the current study, the impact of ASSC and FNE on anxious arousal and anxious apprehension following stressors was examined in community adults (N = 83; M age = 29.66 years, SD = 12.49, 59.0% female) who completed questionnaires five times per day for two-weeks. Dynamic structural equation modeling was used to examine predictors of overall levels of anxiety as well as anxiety following social and nonsocial stressors. ASSC interacted with the presence of social stressors, such that ASSC positively predicted anxious arousal following social stressors. FNE interacted with the presence of nonsocial stressors to predict both forms of anxiety, such that FNE positively predicted anxiety following nonsocial stressors. These findings suggest ASSC may specifically amplify anxious arousal following social stressors, whereas FNE may broadly amplify anxiety following nonsocial stressors.
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Affiliation(s)
| | - Shelby J Saulnier
- Department of Adolescent Medicine, Akron Children's Hospital, Akron, OH, USA
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18
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He D, Liu QQ, Jiang F. How is cybervictimization associated with Chinese adolescent suicidal ideation? A moderated mediation analysis. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03044-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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19
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Caulfield NM, Martin RL, Smith NS, Karnick AT, Norr AM, Capron DW. A preliminary assessment of the link between anxiety sensitivity cognitive concerns and suicidal thoughts through dissociative symptoms. J Trauma Dissociation 2022; 23:97-109. [PMID: 34633910 DOI: 10.1080/15299732.2021.1989112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Anxiety sensitivity (AS) and AS subfactors (physical, cognitive, and social) have been found to have robust associations with suicide risk. While the direct association between AS subfactors and suicide risk have been explored, little is known about how specific mechanisms, such as dissociation, might explain this relationship. This study aimed to run three analyses to examine the direct and indirect effects of suicidal thoughts and AS via dissociative symptoms. We predicted that dissociation would be a pathway through which AS physical concerns (ASPC) and AS cognitive concerns (ASCC) predicts suicidal ideation. Participants included 84 undergraduate students from a Southeastern University who were elevated on ASCC. Participants completed measures examining dissociative experiences, anxiety sensitivity, and current suicidal ideation. Results revealed that dissociation had a significant indirect effect with ASPC but not ASCC. The current preliminary study showed that ASCC had direct associations with suicide risk; however, those with lower levels of ASPC and dissociation may also be more likely to develop suicide risk. Future research should explore the possibility that the dissociation/ASPC and ASCC pathways are separate, but related, paths to suicidality.
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Affiliation(s)
- Nicole M Caulfield
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Rachel L Martin
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Nicole S Smith
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Aleksandr T Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Aaron M Norr
- Mental Health Research Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
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20
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Raymond C, Provencher J, Bilodeau-Houle A, Leclerc J, Marin MF. A longitudinal investigation of psychological distress in children during COVID-19: the role of socio-emotional vulnerability. Eur J Psychotraumatol 2022; 13:2021048. [PMID: 35087645 PMCID: PMC8788367 DOI: 10.1080/20008198.2021.2021048] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has increased the incidence of distress in youth, some children show increased resilience, emphasizing the need to better understand the predictors of distress in youth. OBJECTIVE This longitudinal study aimed to assess the combined impact of known socio-emotional predictors of stress-related psychopathology, namely anxiety sensitivity, anxiety trait, intolerance to uncertainty, and rumination, on COVID-related distress in healthy youth. METHOD A total of 92 parent-child dyads that previously participated in a laboratory-based experiment assessing observational fear learning in families between 2017 and 2019 (T0) were recontacted. Of them, 84 children aged between 9 and 14 agreed to participate. They completed online questionnaires in June 2020 (T1), September 2020 (T2), December 2020 (T3), and March 2021 (T4). Participants were free of mental illness at T0 and T1. To create a socio-emotional composite score (SECS), we measured anxiety sensitivity (Childhood Anxiety Sensitivity Index) at T0, trait anxiety (Trait subscale of the State-Trait Anxiety Inventory for Children (STAI-C)), intolerance to uncertainty (Intolerance of Uncertainty Scale for Children), and trait rumination (Children's Response Style Scale) at T1 and created a weighted z-score. To assess symptoms of anxiety, post-traumatic stress (PTS), and depression in reaction to COVID-19, participants completed the State subscale of the STAI-C, the Children's Revised Impact of Event Scale, and the Children's Depression Inventory at T1-T4. Three general linear models were run with sex, age group (9-11 and 12+ years old), and SECS as predictors. RESULTS Analyses revealed a SECS*Time interaction, with higher SECS predicting elevated anxiety symptoms at T1 and T4, and elevated PTS symptoms at T1 and T2. CONCLUSION These results suggest that healthy youth endorsing high levels of socio-emotional vulnerability to psychopathology have a higher risk of suffering from anxiety and PTS, but not depressive symptoms, in the year following a major stressor.
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Affiliation(s)
- Catherine Raymond
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Jessie Provencher
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Alexe Bilodeau-Houle
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Julie Leclerc
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
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21
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Allan NP, Volarov M, Koscinski B, Pizzonia KL, Potter K, Accorso C, Saulnier KG, Ashrafioun L, Stecker T, Suhr J, Allan DM. Lonely, anxious, and uncertain: Critical risk factors for suicidal desire during the COVID-19 pandemic. Psychiatry Res 2021; 304:114144. [PMID: 34364010 PMCID: PMC8442981 DOI: 10.1016/j.psychres.2021.114144] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/17/2021] [Accepted: 07/25/2021] [Indexed: 11/24/2022]
Abstract
Public health measures enacted early in response to the COVID-19 pandemic resulted in unprecedented physical isolation. Social isolation, or the objective experience of being alone, and loneliness, the subjective feeling of being lonely, are both implicated in suicidal ideation. Anxiety sensitivity (i.e., fear of somatic anxiety) and intolerance of uncertainty (distress due to uncertainty), may also be heightened in response to the pandemic increasing risk for suicidal ideation in response to social isolation and loneliness. The direct and interactive relations loneliness, anxiety sensitivity, and intolerance of uncertainty shared with suicidal ideation were examined using structural equation modeling across two samples. Sample 1 comprised 635 people (M age = 38.52, SD = 10.00; 49.0% female) recruited using Mechanical Turk in May 2020. Sample 2 comprised 435 people (M age = 34.92, SD = 14.98; 76.2% female) recruited from faculty, staff, and students at a midwestern university in June 2020. Loneliness and anxiety sensitivity were positively, uniquely associated with suicidal ideation across samples. Results of this study were cross-sectional and included only self-report measures. These findings highlight loneliness and anxiety sensitivity as important correlates of suicidal ideation. Modular treatments should be employed to target these mechanisms to reduce COVID-19-related suicidal ideation.
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Affiliation(s)
- Nicholas P Allan
- Department of Psychology, Ohio University, Athens, OH, United States; VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, United States.
| | - Marija Volarov
- Department of Psychology, University of Novi Sad, Novi Sad, Serbia
| | - Brandon Koscinski
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Kendra L Pizzonia
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Kaley Potter
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Catherine Accorso
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Kevin G Saulnier
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Lisham Ashrafioun
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, United States; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Tracy Stecker
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, United States; College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Julie Suhr
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Darcey M Allan
- Department of Psychology, Ohio University, Athens, OH, United States
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22
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Kraemer KM, Carroll AJ, Clair M, Richards L, Serber ER. The role of anxiety sensitivity in exercise tolerance and anxiety and depressive symptoms among individuals seeking treatment in cardiopulmonary rehabilitation. PSYCHOL HEALTH MED 2021; 26:1100-1107. [PMID: 32496848 PMCID: PMC7714701 DOI: 10.1080/13548506.2020.1776889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
The aim of the current cross-sectional study was to examine the effects of specific anxiety sensitivity (AS) dimensions (AS -Physical, -Cognitive, and -Social concerns) on exercise tolerance (i.e. 6-minute walk test) and factors that interfere with cardiopulmonary rehabilitation (CPR) and exercise adherence (i.e. depression and anxiety symptoms) among individuals seeking treatment in cardiopulmonary rehabilitation (CPR). Participants were 69 individuals (65.2% male, Mage = 63.60, SD = 12.55, Range = 27-85 years) with various cardiovascular or pulmonary conditions meeting criteria for CPR entry, who presented for an intake appointment at an outpatient phase 2 CPR clinic. Higher levels of AS-Physical and-Social concerns were significantly associated with poorer exercise tolerance and greater generalized anxiety symptoms, respectively. Though none of the AS dimensions were significant individual predictors, they were collectively associated with greater depressive symptoms. Future work should assess whether it may be useful to target AS in some patients prior to or throughout CPR.
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Affiliation(s)
- Kristen M. Kraemer
- Department of Psychiatry and Behavioral Sciences, Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, Charleston, SC 29452
- Department of General Medicine and Primary Care, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Avenue, CO-1309, 2 Floor, Boston, MA 02215
| | - Allison J. Carroll
- Department of Psychiatry and Behavioral Sciences, Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, Charleston, SC 29452
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Chicago, IL 60611
| | - Mark Clair
- Cardiopulmonary Rehabilitation Program, Medical University of South Carolina, 122 Bee Street, Suite 201, Charleston, SC 29452
| | - Lisa Richards
- Cardiopulmonary Rehabilitation Program, Medical University of South Carolina, 122 Bee Street, Suite 201, Charleston, SC 29452
| | - Eva R. Serber
- Department of Psychiatry and Behavioral Sciences, Division of Bio-Behavioral Medicine, Medical University of South Carolina, 67 President Street, Charleston, SC 29452
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23
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Schmidt NB, Morabito DM, Mathes BM, Martin A. Anxiety sensitivity prospectively predicts pandemic-related distress. J Affect Disord 2021; 292:660-666. [PMID: 34153837 PMCID: PMC8777063 DOI: 10.1016/j.jad.2021.05.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/29/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS) is a well-studied transdiagnostic risk construct that is believed to amplify responses to many forms of stress. The COVID-19 pandemic is a broad stressor with significant physical and social threats. In the current study, we were interested in ascertaining the degree to which AS would relate to distress and disability in the context of COVID-19. We hypothesized that AS would be associated with increased distress and disability. Moreover, we hypothesized that AS would be uniquely predictive while controlling for other relevant risk factors such as age, race, and perceived local COVID-19 infection rates. METHOD Participants (N = 249) were U.S. adults assessed using online data resourcing and re-assessed one month later. RESULTS At the first time point, during the beginning phases of the COVID-19 pandemic, AS was significantly related to COVID-19 distress and disability with a moderate effect size. AS was longitudinally associated with higher COVID-19 worry and depression. LIMITATIONS Our findings are limited by the use of a relatively small online sample. Additionally, assessment of pre-pandemic and post-pandemic symptoms and functioning would be beneficial for future research. CONCLUSIONS Taken together, the current study provided evidence consistent with AS as a causal risk factor for the development of distress and depression during the COVID-19 pandemic.
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Affiliation(s)
- Norman B Schmidt
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States.
| | - Danielle M Morabito
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States.
| | - Brittany M Mathes
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States; VA Boston Healthcare System 150 South Huntington Ave, Boston, MA, 02130, United States
| | - Alex Martin
- Florida State University 1107 West Call Street, Tallahassee, FL, 32304, United States
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24
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Brooke CM, Intrieri RC. The influence of anxiety sensitivity, & personality on social anxiety symptoms. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02238-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Rogers AH, Garey L, Bakhshaie J, Viana AG, Ditre JW, Zvolensky MJ. Anxiety, Depression, and Opioid Misuse Among Adults With Chronic Pain: The Role of Anxiety Sensitivity. Clin J Pain 2021; 36:862-867. [PMID: 32769415 DOI: 10.1097/ajp.0000000000000870] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The opioid epidemic is a significant public health problem largely driven by opioid prescriptions for chronic pain. Among those with chronic pain, anxiety and depressive symptoms have been linked to opioid misuse, and individual differences in anxiety and depressive symptoms among adults with chronic pain may be important for better understanding pain. Yet, little work has examined mechanisms that may link anxiety and depressive symptoms to opioid misuse among adults with chronic pain. Anxiety sensitivity (AS), or the fear of anxiety-related physical sensations, may be one candidate construct that has been linked independently to anxiety and depressive symptoms as well as opioid misuse. METHODS The current survey-based study examined the indirect association of AS in the relation between anxiety and depressive symptoms and opioid misuse among 429 adults with chronic pain currently using prescription opioid medication (73.9% female, Mage=38.32 y, SD=11.07). RESULTS Using structural equation modeling, it appears that AS is a potential construct in the interrelation between anxiety and depressive symptoms and opioid misuse. However, an alternative model found equally strong empirical support, as mental health symptoms may serve as an explanatory factor between AS and opioid misuse. DISCUSSION Bi-directional effects are apt to be involved among the studied variables. Prospective research is needed to replicate the study results and isolate the temporal patterning between the studied constructs. Nonetheless, the data overall highlight the importance of both AS and anxiety and depressive symptoms in terms of understanding opioid misuse among adults with chronic pain.
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Affiliation(s)
| | | | | | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY
| | - Michael J Zvolensky
- Department of Psychology.,HEALTH Institute, University of Houston.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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26
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Yang H, Zhao X, Fang J, Elhai JD. Relations between anxiety sensitivity's cognitive concerns and anxiety severity: brooding and reflection as serial multiple mediators. CURRENT PSYCHOLOGY 2021; 42:9218-9224. [PMID: 34426723 PMCID: PMC8372224 DOI: 10.1007/s12144-021-02195-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
The outbreak of COVID-19 has caused a major impact on productivity and life functioning, and also led to adverse emotional reactions. In the face of this public health event, increased anxiety is one of the most common emotional reactions. Previous studies have shown that anxiety sensitivity, rumination and anxiety are closely related. Various dimensions of anxiety sensitivity have different effects on anxiety. Also, rumination can be divided into brooding and reflection. To explore the relationships among anxiety sensitivity’s cognitive concerns, anxiety and different types of rumination, we conducted an online survey during the outbreak of coronavirus (February 17–25, 2020), using the Anxiety Sensitivity Scale-3 (ASI-3), Ruminative Responses Scale (RSS), and Depression Anxiety Stress Scale-21 (DASS-21). The results showed significant positive correlations among anxiety sensitivity’s cognitive concerns, anxiety, brooding and reflection. Furthermore, brooding and reflection had a chain mediation effect between cognitive concerns and anxiety, and the mediation effect of reflection was even stronger. Results suggest that anxiety sensitivity’s cognitive concerns may not only affect anxiety directly, but also affect anxiety through rumination, especially reflection.
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Affiliation(s)
- Haibo Yang
- Academy of Psychology and Behavior of Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China.,Tianjin Social Science Laboratory of Students' Mental Development and Learning, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Xiaoyu Zhao
- Faculty of Psychology, Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Jianwen Fang
- Faculty of Psychology, Tianjin Normal University, No. 393 Binshuixi Road, Tianjin, 300387 Xiqing District China
| | - Jon D Elhai
- Department of Psychology, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606 USA.,Department of Psychiatry, University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614 USA
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27
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Looming Cognitive Style More Consistently Predicts Anxiety than Depressive Symptoms: Evidence from a 3-Wave Yearlong Study. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-020-10189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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28
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Raines AM, Ennis CR, Allan NP, McGrew SJ, Walton JL, Rogers AH, Zvolensky MJ, Schmidt NB, Laurel Franklin C. Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants. Addict Behav 2021; 116:106791. [PMID: 33497865 DOI: 10.1016/j.addbeh.2020.106791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. METHODS The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. RESULTS AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. CONCLUSIONS Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
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Knapp AA, Allan NP, Cloutier R, Blumenthal H, Moradi S, Budney AJ, Lord SE. Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives. J Behav Med 2021; 44:187-201. [PMID: 32980966 PMCID: PMC7965231 DOI: 10.1007/s10865-020-00182-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 09/05/2020] [Indexed: 12/14/2022]
Abstract
Anxiety sensitivity (AS) is a promising intervention target due to its relevance to negative health behaviors broadly, and substance use specifically. The aim of the current study was to evaluate the direct and indirect pathways through which elevated AS could relate to recent substance use among a national adolescent sample recruited via social-media. As predicted, AS was indirectly associated with greater likelihood of using alcohol, cigarettes, and electronic nicotine delivery systems in the past-month through anxiety symptoms. Regarding cannabis, AS was directly related to increased likelihood of past-month cannabis use; however, the indirect relation between AS and likelihood of past-month use via anxiety symptoms was not significant. Through chained indirect effects, AS was related positively to past-month alcohol and cannabis use via anxiety symptoms and coping-related motives, and through withdrawal symptoms and coping-related motives. Study findings can be used to generate hypotheses on potential pathways through which AS could prospectively relate to substance use among youth.
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Affiliation(s)
- Ashley A Knapp
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr. 10th Floor, Chicago, IL, 60611, USA.
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA.
| | - Nicholas P Allan
- Department of Psychology, Ohio University, Porter Hall 209, Athens, OH, 45701, USA
| | - Renee Cloutier
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Heidemarie Blumenthal
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Shahrzad Moradi
- Department of Psychology, Ohio University, Porter Hall 209, Athens, OH, 45701, USA
| | - Alan J Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA
| | - Sarah E Lord
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA
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Manning K, Eades ND, Kauffman BY, Long LJ, Richardson AL, Garey L, Zvolensky MJ, Gallagher MW. Anxiety Sensitivity Moderates the Impact of COVID-19 Perceived Stress on Anxiety and Functional Impairment. COGNITIVE THERAPY AND RESEARCH 2021; 45:689-696. [PMID: 33500595 PMCID: PMC7819144 DOI: 10.1007/s10608-021-10207-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 02/04/2023]
Abstract
Background The COVID-19 pandemic has had a profound negative impact on mental health symptoms and daily life functioning across the United States and worldwide. Past work has revealed that perceived stress relates to poorer outcomes, however, little work to date has examined factors that may exacerbate these outcomes, and no work to date has examined this relation in terms of COVID-19. Anxiety sensitivity is a promising individual difference factor that has shown to be related to mental health and functional impairment. Anxiety Sensitivity is also a vulnerability factor related to heightened stress perception. Method Therefore, the current study sought to examine the potential moderating role of anxiety sensitivity in the relation between COVID-19 specific perceived stress and global anxiety symptom severity, anxious arousal symptom severity, and functional impairment among 563 adults (58.1% male; M age = 38.3 years; SD = 12.15). Results Results indicated a statistically significant interaction between COVID-19 perceived stress and anxiety sensitivity with global anxiety symptom severity, anxious arousal symptom severity, and functional impairment. Post-hoc analysis indicated that COVID-19 perceived stress was associated with an increased likelihood of clinically significant global anxiety symptom severity and anxious arousal symptom severity at higher levels of anxiety sensitivity. Conclusions The current study provides support for the role of anxiety sensitivity in identifying individuals at risk for clinically significant global anxiety symptom severity and anxious arousal symptom severity.
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Affiliation(s)
- Kara Manning
- Department of Psychology, University of Houston, Houston, TX 77204 USA
| | - Natasha D. Eades
- Department of Psychology, University of Houston, Houston, TX 77204 USA
| | | | - Laura J. Long
- Department of Psychology, University of Houston, Houston, TX 77204 USA
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX 77204 USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX 77204 USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- HEALTH Institute, University of Houston, Houston, TX USA
| | - Matthew W. Gallagher
- Department of Psychology, University of Houston, Houston, TX 77204 USA
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX USA
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Paulus DJ, Capron DW, Zvolensky MJ. Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor. Cogn Behav Ther 2020; 50:378-394. [DOI: 10.1080/16506073.2020.1840622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Daniel J. Paulus
- Department of Neuroscience, Medical University of South Carolina, Charlestion, SC, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Daniel W. Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Health Institute, University of Houston, Houston, TX, USA
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The Co-occurrence of Pediatric Chronic Pain and Anxiety: A Theoretical Review of a Developmentally Informed Shared Vulnerability Model. Clin J Pain 2020; 35:989-1002. [PMID: 31513056 DOI: 10.1097/ajp.0000000000000763] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The development and maintenance of pediatric chronic pain and anxiety are complex, underscoring the need to better understand the interactive forces contributing to their co-occurrence. The shared vulnerability model (SVM) was developed to explain the co-occurrence of chronic pain and posttraumatic stress disorder in adults. Although many core tenets have been well supported by pediatric research, the SVM has yet to be extended to pediatric pain populations. We propose a developmentally informed pediatric SVM for advancing our understanding of the co-occurrence of pediatric chronic pain and anxiety disorders. The proposed SVM postulates that youth at increased risk for the development of chronic pain and/or anxiety share predisposing vulnerabilities, including anxiety sensitivity, and that these shared vulnerabilities give rise to negative emotional responses (child and parent) in the context of stressful events. Consequences of fear and anxiety, including avoidance behavior, further contribute to the development of chronic pain, anxiety, and their co-occurrence. The parental, school, and peer contexts in which these problems develop and are maintained in youth are pertinent to integrate into a SVM, as pediatric chronic pain and anxiety disorders share several social-contextual risk and maintenance factors. We also highlight new areas of inquiry.
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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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Thiruchselvam T, Patel A, Daros AR, Jain E, Asadi S, Laposa JM, Kloiber S, Quilty LC. A multidimensional investigation of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Res 2020; 293:113446. [PMID: 32980716 DOI: 10.1016/j.psychres.2020.113446] [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: 04/27/2020] [Accepted: 09/05/2020] [Indexed: 12/13/2022]
Abstract
We examined how anxiety sensitivity - the fear of symptoms of anxiety due to their perceived harmful effects - and gender are associated with treatment trajectory and outcomes in a large outpatient sample (N = 278) who received 14-weeks of cognitive-behavioral group therapy (CBGT) for depression. Three dimensions of anxiety sensitivity (cognitive, physical, and social concerns) and depression were assessed at pre-treatment, and the latter was assessed weekly during treatment. Latent growth curve models supported a link between cognitive concerns (fears of losing control over thoughts) and greater improvement in depression near the end of treatment (i.e., weeks 10-14); gender did not moderate trajectory. Gender (i.e., identifying as a woman) and greater physical concerns (fears of physical consequences of arousal symptoms) were associated with completion of < 8 sessions. Results suggest that those with more cognitive concerns might require greater time in treatment and/or benefit most from the focus on maladaptive assumptions and core beliefs in later CBGT sessions. Future research, including investigation of intervening variables, may elucidate the mechanisms through which greater physical concerns and gender are associated with treatment non-completion. Results supported differential associations of anxiety sensitivity dimensions with depression treatment outcomes, though further research attention is needed.
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Affiliation(s)
- Thulasi Thiruchselvam
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alina Patel
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Alexander R Daros
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Esha Jain
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Shayan Asadi
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada
| | - Judith M Laposa
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Stefan Kloiber
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, CAMH, 33 Ursula Franklin Street, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
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Duyser FA, van Eijndhoven PFP, Bergman MA, Collard RM, Schene AH, Tendolkar I, Vrijsen JN. Negative memory bias as a transdiagnostic cognitive marker for depression symptom severity. J Affect Disord 2020; 274:1165-1172. [PMID: 32663947 DOI: 10.1016/j.jad.2020.05.156] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/04/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Negative memory bias is a strong risk factor for the development and maintenance of depression. Recent evidence also found negative memory bias in other mental disorders. Here, we aim to: 1) assess the presence and strength of negative memory bias in a range of (comorbid) mental disorders, 2) investigate which disorder-specific symptoms are associated with negative memory bias, and 3) test whether negative memory bias might be a transdiagnostic mechanism. METHODS Negative memory bias was measured in patients with at least one diagnosis of a stress-related disorder (n = 86), a neurodevelopmental disorder (n = 53), or both (n = 68), and 51 controls. Depression, anxiety, attention-deficit/hyperactivity disorder, and autism spectrum disorder symptom severity was assessed using questionnaires. Groups were compared on negative memory bias and the associations between negative memory bias and symptom severity were made using linear regression models. RESULTS All patient groups showed stronger negative memory bias than the controls. Negative memory bias was individually associated with all symptom severity indices, but when added into a single model, only the association with depressive symptom severity remained. This persisted after controlling for diagnostic group. LIMITATIONS Due to the cross-sectional sectional study design, we could only look at the associations between negative memory bias and disorder-specific symptoms and not at the direction of the effects. CONCLUSIONS Negative memory bias is characteristic of a depressotypic processing style and present in different mental disorders. It might play a mechanistic role in the development of (subclinical) co-occurrence between mental disorders.
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Affiliation(s)
- F A Duyser
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands.
| | - P F P van Eijndhoven
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - M A Bergman
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - R M Collard
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A H Schene
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands
| | - I Tendolkar
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands; Department of Psychiatry and Psychotherapy, University Hospital Essen, Germany
| | - J N Vrijsen
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, The Netherlands; Pro Persona Mental Health Care, Depression Expertise Centre, Nijmegen, The Netherlands
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Caulfield NM, Martin RL, Norr AM, Capron DW. The Association Between Posttraumatic Stress Symptoms and Anxiety Sensitivity in a College Sample. Psychol Rep 2020; 124:1539-1558. [PMID: 32781893 DOI: 10.1177/0033294120948227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES One-half of all U.S. adults will experience at least one traumatic event, and of those, approximately 11% develop posttraumatic stress disorder (PTSD) symptoms. Despite efficacious treatments for PTSD, one-third of people diagnosed still express symptoms after treatment.Thus, it is important to identify underlying factors that may be associated with PTSD symptom clusters to improve treatment efficacy. One potential factor is anxiety sensitivity (AS), or "the fear of fear," and includes three different subfactors: physical, cognitive, and social concerns, yet few studies have examined this association using the Anxiety Sensitivity Index-3. METHOD Participants included 65 undergraduate students from a Southeastern University who were elevated on anxiety sensitivity cognitive concerns and experienced at least one traumatic event. Participants completed measures of trauma exposure, anxiety sensitivity, posttraumatic stress symptoms, and suicidal ideation. RESULTS Results revealed that AS physical symptoms had the most robust association with potential PTSD symptoms and individual PTSD symptom clusters with the exception of the avoidance and numbing cluster. CONCLUSIONS These findings may help clarify the nature of the relationship between PTSD symptoms and AS using the most updated measure of AS (ASI-3).
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Affiliation(s)
| | - Rachel L Martin
- 5104University of Southern Mississippi, Hattiesburg, MS, USA
| | - Aaron M Norr
- 20128VA Puget Sound Health Care System, Seattle, WA, USA
| | - Daniel W Capron
- 5104University of Southern Mississippi, Hattiesburg, MS, USA
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Núñez D, Ulloa JL, Guillaume S, Olié E, Alacreu-Crespo A, Courtet P. Suicidal ideation and affect lability in single and multiple suicidal attempters with Major Depressive Disorder: An exploratory network analysis. J Affect Disord 2020; 272:371-379. [PMID: 32553380 DOI: 10.1016/j.jad.2020.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/28/2020] [Accepted: 04/01/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION A better understanding of the specific contribution of risk factors to suicidal behavior could arise from analyzing suicidal ideation (SI) in clinical samples, and comparing single versus multiple suicide attempters through contemporary methods allowing complex and dynamical analyses of multiple and simultaneously interacting suicide risk factors. METHOD We explored associations among suicidal ideation (SI), affect lability and other suicide risk factors in 323 suicidal attempters diagnosed with major depressive disorder (MDD). We analyzed the network structure and centrality of the total sample, and compared single versus multiple attempters and subjects with low and high suicidal ideation. RESULTS SI was connected with anxiety (trait) and hopelessness. Central nodes for global and specific groups were affect lability (from anxiety to depression), anxiety as a trait, and harm avoidance. We observed some specific differences between clinical profiles of repeaters and non-repeaters and significant network density between high and low SI. LIMITATIONS Because our cross-sectional design, we cannot establish casual relationships among variables. We only examined associations at group level but not at single subject level. CONCLUSIONS Affect lability (mainly the shifts from anxiety to depression) and trait anxiety were central in each estimated network. These symptoms might be suitable targets for early detecting and treating suicidal patients.
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Affiliation(s)
- D Núñez
- Faculty of Psychology, Universidad de Talca, Chile.; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay.
| | - J L Ulloa
- Faculty of Psychology, Universidad de Talca, Chile
| | - S Guillaume
- Département d'Urgences & Post Urgence Psychiatrique, CHU Montpellier, University of Montpellier, France
| | - E Olié
- Département d'Urgences & Post Urgence Psychiatrique, CHU Montpellier, University of Montpellier, France
| | - A Alacreu-Crespo
- Département d'Urgences & Post Urgence Psychiatrique, CHU Montpellier, University of Montpellier, France
| | - P Courtet
- Département d'Urgences & Post Urgence Psychiatrique, CHU Montpellier, University of Montpellier, France
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NAMLI Z, TAMAM L, DEMİRKOL ME, ÇAKMAK S. Bipolar bozukluk ve şizofrenide anksiyete duyarlılığı. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.723876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Porta-Casteràs D, Fullana MA, Tinoco D, Martínez-Zalacaín I, Pujol J, Palao DJ, Soriano-Mas C, Harrison BJ, Via E, Cardoner N. Prefrontal-amygdala connectivity in trait anxiety and generalized anxiety disorder: Testing the boundaries between healthy and pathological worries. J Affect Disord 2020; 267:211-219. [PMID: 32217221 DOI: 10.1016/j.jad.2020.02.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/17/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Current brain-based theoretical models of generalized anxiety disorder (GAD) suggest a dysfunction of amygdala-ventromedial prefrontal cortex emotional regulatory mechanisms. These alterations might be reflected by an altered resting state functional connectivity between both areas and could extend to vulnerable non-clinical samples such as high worriers without a GAD diagnosis. However, there is a lack of information in this regard. METHODS We investigated differences in resting state functional connectivity between the basolateral amygdala and the ventromedial prefrontal cortex (amygdala-vmPFC) in 28 unmedicated participants with GAD, 28 high-worriers and 28 low-worriers. We additionally explored selected clinical variables as predictors of amygdala-vmPFC connectivity, including anxiety sensitivity. RESULTS GAD participants presented higher left amygdala-vmPFC connectivity compared to both groups of non-GAD participants, and there were no differences between the latter two groups. In our exploratory analyses, concerns about the cognitive consequences of anxiety (the cognitive dimension of anxiety sensitivity) were found to be a significant predictor of the left amygdala-vmPFC connectivity. LIMITATIONS The cross-sectional nature of our study preclude us from assessing if functional connectivity measures and anxiety sensitivity scores entail an increased risk of GAD. CONCLUSIONS These results suggest a neurobiological qualitative distinction at the level of the amygdala-vmPFC emotional-regulatory system in GAD compared to non-GAD participants, either high- or low-worriers. At this neural level, they question previous hypotheses of continuity between high worries and GAD development. Instead, other anxiety traits such as anxiety sensitivity might confer a greater proneness to the amygdala-vmPFC connectivity alterations observed in GAD.
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Affiliation(s)
- D Porta-Casteràs
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - M A Fullana
- Institute of Neurosciences, Hospital Clinic, CIBERSAM, Barcelona, Spain
| | - D Tinoco
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Pujol
- MRI Research Unit,Hospital del Mar, CIBERSAM G21, Barcelona,Spain
| | - D J Palao
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - E Via
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain; Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
| | - N Cardoner
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Niacin biological challenge: A paradigm to evaluate social concerns. J Behav Ther Exp Psychiatry 2019; 65:101489. [PMID: 31170623 DOI: 10.1016/j.jbtep.2019.101489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/02/2019] [Accepted: 05/22/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Anxiety sensitivity (AS) social concerns, the fear of observable anxiety symptoms is posited as a risk factor for social anxiety by increasing fear reactivity in social situations when observable anxiety symptoms are present. Experimental evaluation of AS social concerns is limited. The current study utilized several manipulations designed to be relevant to AS social concerns or fear of negative evaluation (FNE), a distinct social anxiety risk factor. The effects of these manipulations on fear reactivity to a speech were examined. METHODS Participants (N = 124 students; M age = 19.44, SD = 2.45; 64.5% female) were randomized to one of four conditions in a 2 (100 mg niacin vs 100 mg sugar pill) X 2 (instructional set) design. For the instructional set manipulation, participants were told their speech performance would be evaluated by a judge based on their performance (i.e., FNE-relevant) or their observable anxiety symptoms (i.e., AS social concerns-relevant). RESULTS There was a main effect for vitamin condition with participants in the niacin condition reporting higher panic symptoms post-speech relative to those in the placebo condition. There was no main effect for speech instructions. As hypothesized, these effects were qualified by an interaction indicating that AS social concerns significantly predicted panic symptoms for those receiving niacin. LIMITATIONS Limitations include the reliance on self-reports of outcome variables and the use of an undergraduate student sample. CONCLUSIONS These findings highlight a distinct role of AS social concerns in fear responding to socially evaluative situations in the context of physically observable arousal.
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Repeated Exposure to Perceptual Illusion Challenges Reduces Anxiety Sensitivity Cognitive Concerns: Evidence From a Randomized Clinical Trial. Behav Ther 2019; 50:1173-1184. [PMID: 31735251 PMCID: PMC6866663 DOI: 10.1016/j.beth.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anxiety sensitivity cognitive concerns (ASCC), or fear of cognitive dyscontrol sensations, confers risk for anxiety and mood psychopathology. Recent work demonstrated that novel perceptual challenges generated by a head mounted display can elicit fear among those with elevated ASCC. This suggests that interoceptive exposure to perceptual challenges may offer a means to mitigate ASCC. This study was designed to evaluate whether repeated exposure to novel perceptual challenges can reduce ASCC, and if these effects are stronger among those experiencing greater negative emotionality as a proxy for individuals likely to present for treatment. METHODS Participants with elevated ASCC (N = 57) were randomized to one of three experimental conditions utilizing a head-mounted display. In the rotations condition (n = 20), participants viewed themselves spinning in a circle. In the opposite directions condition (n = 20), participants turned their head while the camera moved in the opposite direction creating dissonance in their visual field. In the control condition (n = 17), participants completed a series of simple arithmetic problems. RESULTS Participants in the rotation condition, relative to control, reported significant reductions in ASCC from pre- to post-exposure and these effects were strongest for those with elevated negative affect. The main effect of the opposite directions exposure on post-treatment ASCC was non-significant, but follow-up analyses revealed that reductions in ASCC were observed among those with elevated negative affectivity. DISCUSSION Perceptual illusion challenges appear to have utility for reducing ASCC through repeated exposure. There was evidence for the perceptual illusion exercises, particularly the rotations condition, specifically reducing ASCC, making this challenge the first we are aware of that specifically targets ASCC-related concerns. LIMITATIONS As a proof-of-concept study, the present sample was not recruited for clinically-significant psychopathology, and only a brief follow-up was utilized. Future research should utilize a longer follow-up and test if these exposures mitigate ASCC-relevant psychopathology among clinical samples.
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Foroughi AA, Mohammadpour M, Khanjani S, Pouyanfard S, Dorouie N, Parvizi Fard AA. Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:254-261. [PMID: 31644692 DOI: 10.1590/2237-6089-2018-0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/07/2019] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Anxiety sensitivity plays a prominent role in the etiology of anxiety disorders. This construct has attracted widespread interest from experts and researchers. The Anxiety Sensitivity Index (ASI-3) is the most common scale for measuring anxiety sensitivity. OBJECTIVE To analyze the psychometric properties and factor structure of the ASI-3 in Iranian student samples. METHODS 220 students (135 women, 85 men) from Kermanshah University of Medical Sciences were selected by the convenience sampling method to evaluate the psychometric properties and analyze the factor structure of the ASI-3. The subjects were also asked to complete the Acceptance and Action Questionnaire-II (AAQ-II), Whiteley Index, Intolerance of Uncertainty, and Neuroticism scales. LISREL and SPSS were used to analyze the data. Cronbach's alpha and correlation coefficients were calculated and confirmatory factor analysis was conducted. RESULTS The results of the confirmatory factor analysis revealed a three-factor structure with physical, cognitive, and social components (comparative fit index = 0.94; normed fit index = 0.91; root mean square error of approximation = 0.09). The ASI-3 had positive and significant correlations with health anxiety (0.59), intolerance of uncertainty (0.29), and neuroticism (0.51). Furthermore, the ASI-3 had a negative and significant correlation with the AAQII (-0.58). Cronbach's alpha coefficients for the whole scale and for the physical, cognitive, and social concerns factors were 0.90, 0.74, 0.79, and 0.78, respectively. The invariance of the index was significant compared to the original English version. CONCLUSION In general, the results support the adequacy of the psychometric properties of the Persian version of the ASI-3. Theoretical and applied implications will be discussed.
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Affiliation(s)
- Ali Akbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Mohammadpour
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajad Khanjani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Pouyanfard
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nadia Dorouie
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Parvizi Fard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Baek IC, Lee EH, Kim JH. Differences in anxiety sensitivity factors between anxiety and depressive disorders. Depress Anxiety 2019; 36:968-974. [PMID: 31344315 DOI: 10.1002/da.22948] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/27/2019] [Accepted: 07/04/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Anxiety sensitivity (AS) refers to the tendency to fear physical sensations associated with anxiety due to concerns about potential physical, social, or cognitive consequences. Many previous studies were limited by the use of the anxiety sensitivity index (ASI) or the ASI-revised (ASI-R), which are both measurements with unitary or unstable structures. No recent study that has utilized the ASI-3 examined the relations between AS dimensions and depression. Thus, we examined multiple relationships between AS and anxiety disorders and depression using the ASI-3. METHODS The total sample consisted of 667 outpatients, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth text revision as assessed by a structured clinical interview. There were eight patient groups: multiple anxiety disorder, major depressive disorder (MDD), panic disorder (PD), social phobia (SP), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and anxiety disorder not otherwise specified (AD NOS). We conducted one-way analysis of variances and post hoc tests to compare the ASI-3 total and subscale scores across the groups. RESULTS The physical concern score was higher in patients with PD than patients with MDD, SP, OCD, or GAD. The social concern score was higher in the SP group than those with MDD, PD, GAD, and AD NOS. Patients with GAD and PTSD showed higher cognitive concern scores than the patients with PD. CONCLUSION Results partially replicated the relationship between PD and physical concern, between SP and social concern, and between GAD and cognitive concern examining the relationships between AS dimensions and anxiety disorders.
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Affiliation(s)
- In-Chul Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun-Ho Lee
- Depression Center, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji-Hae Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Examining the cross-sectional and longitudinal effects of anxiety sensitivity on indicators of disease severity among patients with inflammatory arthritis. J Anxiety Disord 2019; 67:102117. [PMID: 31445391 DOI: 10.1016/j.janxdis.2019.102117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/08/2019] [Accepted: 07/24/2019] [Indexed: 12/29/2022]
Abstract
Few studies have investigated anxiety sensitivity (AS) in the context of inflammatory arthritis (IA), despite evidence of a relationship between AS and pain. This study examined cross-sectional and longitudinal relationships between AS and indicators of IA severity in 148 participants with IA. AS and its factors (social, physical, cognitive) were self-reported. Arthritis severity was physician-assessed (disease activity scales) and self-reported (physical function; pain and fatigue). Cross-sectional correlations assessed the association between AS and arthritis severity outcomes. Longitudinal multivariable mixed-effect regressions assessed the association of AS total and AS factors at each visit with disease severity outcomes. All AS factors were significantly and positively correlated (at the same visit) with function, pain, and fatigue. AS total significantly predicted pain, fatigue, and function. Cognitive AS significantly predicted fatigue, and physical AS significantly predicted pain and fatigue. Social AS significantly predicted pain, fatigue, function and weighted joint count (articular burden). AS is associated with several indicators of disease severity among those with IA; unique findings emerged across factors with the broadest disease impact by social AS. The AS factors, especially social AS, may contribute to the development and severity of IA symptoms, which may have implications for interventions.
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Allan NP, Gros DF, Lancaster CL, Saulnier KG, Stecker T. Heterogeneity in Short-Term Suicidal Ideation Trajectories: Predictors of and Projections to Suicidal Behavior. Suicide Life Threat Behav 2019; 49:826-837. [PMID: 29938818 DOI: 10.1111/sltb.12480] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/02/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Little is known about suicidal ideation stability, including whether stability is heterogeneous or homogeneous between individuals. Studies of this kind are necessary to understand the progression from suicidal ideation to action. METHOD This study examined suicidal ideation trajectories, using growth mixture modeling, in a sample of 359 past/current military service members (M age = 32.1 years, SD = 7.7; 88.3% male). Self-reported suicidal ideation information was collected at baseline and follow-up sessions at months 1, 3, 6, and 12. Following extraction of the best-fitting solution, predictors of trajectory status were examined and trajectory status was used to predict suicidal behavior between baseline and month 12 assessments. RESULTS Results revealed four trajectories, Low-Stable (n = 125), Moderate-Stable (n = 101), High-Stable (n = 76), and High-Rapidly Declining (n = 57). In general, the High-Stable trajectory had the highest levels of perceived burdensomeness, thwarted belongingness, PTSD symptoms, and drug use. The High- and Moderate-Stable trajectories had the highest rates of suicidal behavior between baseline and month 12. CONCLUSIONS Suicidal ideation, even in individuals with elevated ideation, is not a homogeneous construct over time. Stability of suicidal ideation might be an important risk factor, even if ideation is only moderately elevated.
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Affiliation(s)
| | - Daniel F Gros
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Cynthia L Lancaster
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | | | - Tracy Stecker
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Anxiety sensitivity, its stability and longitudinal association with severity of anxiety symptoms. Sci Rep 2019; 9:4314. [PMID: 30867472 PMCID: PMC6416311 DOI: 10.1038/s41598-019-39931-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/31/2019] [Indexed: 11/28/2022] Open
Abstract
Anxiety sensitivity is associated with the onset of panic attacks, anxiety, and other common mental disorders. Anxiety sensitivity is usually seen as a relative stable trait. However, previous studies were inconclusive regarding the longitudinal stability of anxiety sensitivity and differed in study designs and outcomes. The current study examines the stability of anxiety sensitivity over time and its longitudinal associations with severity of anxiety symptoms. Participants from the Netherlands Study of Depression and Anxiety with and without an anxiety, depressive, or comorbid anxiety-depressive disorder diagnosis were included (N = 2052). Stability in anxiety sensitivity over two year follow-up and the longitudinal association between the change in anxiety sensitivity and change in severity of anxiety symptoms were tested. Results indicated that two-year stability of anxiety sensitivity was high (r = 0.72), yet this test-retest estimate leaves room for changes in anxiety sensitivity in some individuals as well. Change in anxiety sensitivity was positively associated with change in severity of anxiety symptoms (B = 0.64 in univariable analysis and B = 0.52 in multivariable analysis). The longitudinal association of anxiety sensitivity with severity of anxiety symptoms indicates that targeting anxiety sensitivity may be of additional benefit in clinical practice.
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Type D personality, anxiety sensitivity, social anxiety, and disability in patients with acne: a cross-sectional controlled study. Postepy Dermatol Alergol 2019; 36:51-57. [PMID: 30858779 PMCID: PMC6409878 DOI: 10.5114/ada.2019.82824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/13/2017] [Indexed: 11/29/2022] Open
Abstract
Introduction Acne has long been associated with many psychiatric comorbidities. Aim To determine anxiety and depression levels, social phobia frequency, social anxiety level, subjective stress perception, anxiety sensitivity, disability, and the frequency of type D personality in patients with acne. Material and methods In total, 61 patients with acne aged > 16 years and 61 age, gender, and educationally matched healthy volunteers were included in the study. The patients and healthy controls were evaluated using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria for social anxiety disorder and completed the Liebowitz Social Anxiety Scale, Sheehan Disability Scale, Anxiety Sensitivity Index, Hospital Anxiety and Depression Scale, Perceived Stress Scale (PSS), and Type D Scale-14. Results Depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability levels were significantly higher in patients with acne than in healthy controls (p < 0.05). Type D personality was more prevalent in patients with acne than in healthy controls (49% vs. 18%, p < 0.001). Conclusions To our knowledge, this study is the first reported in which type D personality and anxiety sensitivity, as well as social anxiety disorder according to the DSM-5 criteria, was evaluated in patients with acne compared with healthy controls. This study shows that patients with acne have higher levels of depression, anxiety, social anxiety, self-reported stress, anxiety sensitivity, and disability, and a greater prevalence of type D personality, than healthy controls. Psychiatric evaluation of patients with acne may aid the detection of mental disorders.
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Hudiburgh SE, Shaw AM, Arditte Hall KA, Timpano KR. Anxiety Sensitivity Differentially Predicts Factors of Interpersonal-Psychological Suicide Risk: A Consideration of Specificity. Suicide Life Threat Behav 2019; 49:264-277. [PMID: 29108113 DOI: 10.1111/sltb.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/07/2017] [Indexed: 11/28/2022]
Abstract
Recent studies have identified anxiety sensitivity (AS) as a risk factor for suicidality; however, limited work has been performed to understand this risk within the context of the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005). The current study examined the relationship between overall AS, each AS subfactor (cognitive, social, and physical), and the three IPTS domains (perceived burdensomeness, thwarted belongingness, and acquired capability). While each AS subfactor uniquely predicted one IPTS domain, greater overall AS only predicted greater acquired capability, suggesting that assessment of AS at the subfactor level may offer us more information about an individual's interpersonal suicide risk.
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Affiliation(s)
| | | | - Kimberly A Arditte Hall
- National Center for PTSD/VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Allan NP, Judah MR, Albanese BJ, Macatee RJ, Sutton CA, Bachman MD, Bernat EM, Schmidt NB. Gender differences in the relation between the late positive potential in response to anxiety sensitivity images and self-reported anxiety sensitivity. Emotion 2019; 19:70-83. [PMID: 29553758 PMCID: PMC6146078 DOI: 10.1037/emo0000420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Anxiety sensitivity (AS), or the fear of anxious arousal, is a transdiagnostic risk factor predictive of a wide variety of affective disorders. Whereas AS is widely studied via self-report, the neurophysiological correlates of AS are poorly understood. One specific issue this may help resolve is well-established gender differences in mean levels of AS. The current study evaluated late positive potential (LPP) for images designed to target AS during an emotional picture viewing paradigm. Structural equation modeling was used to examine convergent and discriminant validity for self-report AS and the LPP for AS images, considering gender as a potential moderator. Analyses were conducted in an at-risk sample of 251 community adults (M age = 35.47, SD = 15.95; 56.2% female; 53.6% meeting for a primary Axis I anxiety or related disorder). Findings indicated that the AS image LPP was significantly, uniquely associated with self-report AS, controlling for the LPP for unpleasant images, in females only. Mean levels of AS self-report as well as the AS image LPP were higher in females than in males. These findings provide initial support for the AS image LPP as a useful neurophysiological correlate of AS self-report in females. These findings also provide support for a biological cause for gender differences in AS. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Nicholas P. Allan
- Ohio University, Department of Psychology, 209 Porter Hall, Athens, OH 45701
| | - Matt R. Judah
- Old Dominion University, Department of Psychology, Norfolk, VA 23529
| | - Brian J. Albanese
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306
| | - Richard J. Macatee
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306
| | - Carson A. Sutton
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306
| | - Matthew D. Bachman
- Duke University, Center for Cognitive Neuroscience, 308 Research Drive, Durham, NC, 27710
| | - Edward M. Bernat
- University of Maryland, Department of Psychology, 4094 Campus Dr., College Park, MD 20742
| | - Norman B. Schmidt
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32306
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Stein AT, Medina JL, Rosenfield D, Otto MW, Smits JAJ. Examining experiential avoidance as a mediator of the relation between anxiety sensitivity and depressive symptoms. Cogn Behav Ther 2018; 49:41-54. [DOI: 10.1080/16506073.2018.1546768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Johnna L. Medina
- Stanford University School of Medicine, Stanford, California, USA
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