Examining the unique relations between anxiety sensitivity factors and suicidal ideation and past suicide attempts

Meaning-focused coping as a cultural process: A mixed quantitative and PhotoVoice study of adolescents with Arab backgrounds overcoming stigma and harassment

Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n = 171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors.

A One-Arm Pilot Trial of a Telehealth CBT-Based Group Intervention Targeting Transdiagnostic Risk for Emotional Distress

The COVID-19 pandemic had a significant impact on mental health, straining an already overburdened healthcare system. A modular, transdiagnostic approach to treating psychopathology may be ideal to target common transdiagnostic risk factors for emotional distress and related disorders likely to be impacted by circumstances related to this once-in-a-lifetime environmental stressor. Anxiety sensitivity (AS), or fear of anxious arousal, intolerance of uncertainty (IU), or distress when confronted with uncertainty, and loneliness are three transdiagnostic risk factors impacted by the pandemic and robust predictors of emotional distress beyond that. We completed a pilot feasibility, acceptability, and utility trial of Coping Crew, our group, telehealth-delivered transdiagnostic treatment protocol in 17 participants who completed the intervention (M age = 22.00, SD = 4.46; 71% female). The intervention and study protocol were feasible to deliver and were rated as acceptable and useful to address intervention targets. Evidence was mixed regarding feasibility, acceptability, and usefulness of the mobile app component. Sixteen of 17 participants (94%) completed at least one survey a day on 80% of the days but only 6 participants (35%) completed at least 80% of the mobile app surveys delivered over the course of the intervention. Most participants rated use of the app as acceptable and relevant to psychological improvements made due to the intervention. Sizeable effect size reductions in transdiagnostic risk factors were found at post-intervention and maintained at 1- and 3-month follow-up, supporting next steps in the development of this modular transdiagnostic treatment.

Pandemic Fatigue and Anxiety Sensitivity as Associated Factors With Posttraumatic Stress Symptoms Among University Students in South Korea During the Prolonged COVID-19 Pandemic

Objectives: The global impact of COVID-19 driven by new variants may add to the negative mental health consequences of the prolonged pandemic, including posttraumatic stress symptoms (PTSS). University students may be prone to develop a series of PTSS due to life plan disruptions as well as increased uncertainty caused by the pandemic. The purpose of this study was to assess the associations between pandemic fatigue, anxiety sensitivity (AS), and PTSS among university students in South Korea.

Methods: Using convenience sampling, 400 students participated in this cross-sectional online survey. Descriptive statistics and linear mixed models were used to examine factors associated with PTSS.

Results: About one-third (32.3%) of the participants reported clinically significant levels of PTSS. Multivariate analyses revealed that pandemic fatigue (β = 0.124, p < 0.001) and AS (β = 0.212, p < 0.001) were significantly associated with PTSS while controlling for other study variables.

Conclusion: Young adults who feel more fatigue related to the COVID-19 pandemic and with high AS should be given access to mental health resources to better manage their mental health and reduce PTSS.

Anxiety sensitivity and suicide risk: Mindfulness as a psychological buffer for Black adults

BACKGROUND

Anxiety sensitivity (AS), defined as the fear of anxiety-related sensations, is associated with increased risk for suicide and related behavior. However, investigations of AS have centered on primarily non-Hispanic White men and women and with limited attention to clinically relevant underlying factors.

METHODS

The purpose of this preliminary study was to examine the indirect effect of AS on suicide ideation and elevated suicide risk through mindfulness in a sample of 307 Black adults (79.2% female; M_age = 22.4, SD = 5.6). Participants completed an online questionnaire battery that included measures of AS, mindfulness, suicide ideation, and elevated suicide risk.

RESULTS

After controlling for age and gender, results indicated that AS was directly and indirectly associated with suicide ideation and elevated suicide risk via lower levels of mindfulness.

LIMITATIONS

Limitations include using a cross-sectional methodological design and exclusive reliance on self-report measures.

CONCLUSIONS

These findings provide preliminary insight into novel risk and protective factors that influence suicide ideation and elevated suicide risk among Black Americans.

Anxiety sensitivity and suicidal ideation/suicide risk: A meta-analysis

OBJECTIVE

Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized.

METHOD

This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk.

RESULTS

Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32).

CONCLUSIONS

AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Anxiety sensitivity and suicide risk among firefighters: A test of the depression-distress amplification model

BACKGROUND

Firefighters represent an occupational group at increased suicide risk. How suicidality develops among firefighters is poorly understood. The depression-distress amplification model posits that the effects of depression symptoms on suicide risk will be intensified in the context of anxiety sensitivity (AS) cognitive concerns. The current study tested this model among firefighters.

METHODS

Overall, 831 firefighters participated (mean [SD] age = 38.37 y [8.53 y]; 94.5% male; 75.2% White). The Center for Epidemiologic Studies Depression Scale (CES-D), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess for depression symptoms, AS concerns (cognitive, physical, social), and suicide risk, respectively. Linear regression interaction models were tested.

RESULTS

The effects of elevated depression symptoms on increased suicide risk were augmented when AS cognitive concerns were also elevated. Unexpectedly, depression symptoms also interacted with AS social concerns; however, consistent with expectations, depression symptoms did not interact with AS physical concerns in the prediction of suicide risk.

CONCLUSIONS

In the context of elevated depression symptoms, suicide risk is potentiated among firefighters reporting elevated AS cognitive and AS social concerns. Findings support and extend the depression-distress amplification model of suicide risk within a sample of firefighters. Interventions that successfully impact AS concerns may, in turn, mitigate suicide risk among this at-risk population.

Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity

Posttraumatic stress disorder (PTSD) symptoms are positively related to suicide risk among firefighters. One mechanism that may account for this relationship is anxiety sensitivity (AS) cognitive concerns-the fear that cognitive symptoms of anxiety will have catastrophic consequences. We sought to replicate the mediating effect of AS cognitive concerns on the relationship between PTSD symptoms and suicide risk among 214 trauma-exposed male firefighters with non-zero suicide risk. Bootstrap mediation analyses tested AS cognitive concerns as a statistical mediator of PTSD symptoms (total and symptoms clusters scores) and suicide risk, controlling for depression symptoms and relevant demographic variables. AS cognitive concerns statistically mediated the relationship between PTSD symptoms (total score, as well as intrusion, avoidance, and arousal-reactivity symptoms clusters) and suicide risk; however, the reverse was also true. AS cognitive concerns may confer risk for suicide among trauma-exposed firefighters. Firefighters may benefit from AS-specific interventions, which are shown to reduce PTSD symptoms and suicidality.

Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters

OBJECTIVE

Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk.

METHOD

A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R).

RESULTS

Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model.

CONCLUSIONS

Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors.

The role of anxiety sensitivity cognitive concerns in suicidal ideation: A test of the Depression-Distress Amplification Model in clinical outpatients

Suicide constitutes a significant public health burden as global suicide rates continue to increase. Thus, it is crucial to identify malleable suicide risk factors to develop prevention protocols. Anxiety sensitivity, or a fear of anxiety-related sensations, is a potential malleable risk factor for the development of suicidal ideation. The Depression-Distress Amplification Model (DDAM) posits that the anxiety sensitivity cognitive concerns (ASCC) subfactor interacts with depressive symptoms to amplify the effects of depression and lead to suicidal ideation. The current study tested the DDAM across the two most widely-replicated factors of depressive symptoms (cognitive and affective/somatic) in comparison to a risk factor mediation model where ASCC are related to suicidal ideation via depressive symptoms. Participants included 295 clinical outpatients from a community clinic. The interaction between ASCC and depressive symptoms in the prediction of suicidal ideation was not significant for either cognitive or affective/somatic symptoms of depression. However, results revealed a significant indirect effect of ASCC through cognitive symptoms of depression in the prediction of suicidal ideation. These cross sectional findings are not consistent with the DDAM. Rather, the relationship may be better conceptualized with a model in which ASCC is related to suicidal ideation via cognitive symptoms of depression.