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Pollard J, Reardon T, Williams C, Creswell C, Ford T, Gray A, Roberts N, Stallard P, Ukoumunne OC, Violato M. The multifaceted consequences and economic costs of child anxiety problems: A systematic review and meta-analysis. JCPP ADVANCES 2023; 3:e12149. [PMID: 37720587 PMCID: PMC10501703 DOI: 10.1002/jcv2.12149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 09/19/2023] Open
Abstract
Background Over a quarter of people have an anxiety disorder at some point in their life, with many first experiencing difficulties during childhood or adolescence. Despite this, gaps still exist in the current evidence base of the multiple consequences of childhood anxiety problems and their costs. Methods A systematic review of Medline, PsycINFO, EconLit and the National Health Service Economic Evaluation Database was conducted for longitudinal and economic studies reporting on the association between childhood anxiety problems and at least one individual-, family- or societal-level outcome or cost. All studies were synthesised narratively. For longitudinal studies, 'effect direction' was used as a common metric, with random effects meta-analysis undertaken where possible. Results Eighty-three studies met inclusion criteria and were synthesised narratively. We identified 788 separate analyses from the longitudinal studies, which we grouped into 15 overarching outcome domains. Thirteen of the studies were incorporated into 13 meta-analyses, which indicated that childhood anxiety disorders were associated with future anxiety, mood, behaviour and substance disorders. Narrative synthesis also suggested associations between anxiety problems and worse physical health, behaviour, self-harm, eating, relationship, educational, health care, employment, and financial outcomes. 'Effect direction' was conflicting in some domains due to a sparse evidence base. Higher economic costs were identified for the child, their families, healthcare providers and wider society, although evidence was limited and only covered short follow-up periods, up to a maximum of 2 years. Total annual societal costs per anxious child were up to £4040 (2021 GBP). Conclusions Childhood anxiety problems are associated with impaired outcomes in numerous domains, and considerable economic costs, which highlight the need for cost-effective interventions and policies to tackle them. More economic evidence is needed to inform models of the long-term, economic-related, consequences of childhood anxiety problems.
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Affiliation(s)
- Jack Pollard
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Tessa Reardon
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Chloe Williams
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Cathy Creswell
- Departments of Experimental Psychology and PsychiatryUniversity of OxfordOxfordUK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation TrustCambridgeUK
| | - Alastair Gray
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Nia Roberts
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | | | - Obioha C. Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC)University of ExeterExeterUK
| | - Mara Violato
- Health Economics Research CentreNuffield Department of Population HealthUniversity of OxfordOxfordUK
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2
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Jung B, Kim H. The validity of transdiagnostic factors in predicting homotypic and heterotypic continuity of psychopathology symptoms over time. Front Psychiatry 2023; 14:1096572. [PMID: 37275971 PMCID: PMC10235495 DOI: 10.3389/fpsyt.2023.1096572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/04/2023] [Indexed: 06/07/2023] Open
Abstract
Studies of the continuity of psychopathology symptoms mainly involved the traditional conceptualization that mental disorders are discrete entities. However, high comorbidity rates suggest a few transdiagnostic factors that underlie individual disorders. Therefore, the present study examined the validity of transdiagnostic factors in predicting homotypic and heterotypic continuity of comorbidity classes across two waves in a nationally representative sample. We conducted a latent transition analysis to investigate how transdiagnostic factors differentially affect the transition probabilities of comorbidity classes across time. Results found a notable predictive validity of transdiagnostic factors: (a) internalizing strongly predicted the stability of the internalizing class and transition from the externalizing class to internalizing class, and (b) externalizing predicted the transition from the internalizing class to externalizing class. The study also found a more dynamic prediction pattern leading to equifinality and multifinality of psychopathology symptoms. The findings suggest that transdiagnostic factors can provide information on how individuals' symptom manifestations change over time, highlighting the potential benefits of incorporating transdiagnostic factors into assessment, treatment, and prevention.
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Affiliation(s)
| | - Hyunsik Kim
- Department of Psychology, Sogang University, Seoul, Republic of Korea
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3
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Han Y, Yan H, Shan X, Li H, Liu F, Xie G, Li P, Guo W. Can the aberrant occipital-cerebellum network be a predictor of treatment in panic disorder? J Affect Disord 2023; 331:207-216. [PMID: 36965626 DOI: 10.1016/j.jad.2023.03.065] [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: 11/16/2022] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND This study aimed to detect altered brain activation pattern of patients with panic disorder (PD) and its changes after treatment. The possibilities of diagnosis and prediction of treatment response based on the aberrant brain activity were tested. METHODS Fifty-four PD patients and 54 healthy controls (HCs) were recruited. Clinical assessment and resting-state functional magnetic resonance imaging scans were conducted. Then, patients received a 4-week paroxetine treatment and underwent a second clinical assessment and scan. The fractional amplitude of low-frequency fluctuations (fALFF) was measured. Support vector machine (SVM) and support vector regression (SVR) analyses were conducted. RESULTS Lower fALFF values in the right calcarine/lingual gyrus and left lingual gyrus/cerebellum IV/V, whereas higher fALFF values in right cerebellum Crus II were observed in patients related to HCs at baseline. After treatment, patients with PD exhibited significant clinical improvement, and the abnormal lower fALFF values in the right lingual gyrus exhibited a great increase. The abnormal fALFF at pretreatment can distinguish patients from HCs with 80 % accuracy and predict treatment response which was reflected in the significant correlation between the predicted and actual treatment responses. LIMITATIONS The impacts of ethnic, cultural, and other regional differences on PD were not considered for it was a single-center study. CONCLUSIONS The occipital-cerebellum network played an important role in the pathophysiology of PD and should be a part of the fear network. The abnormal fALFF values in patients with PD at pretreatment could serve as biomarkers of PD and predict the early treatment response of paroxetine.
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Affiliation(s)
- Yiding Han
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haohao Yan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Guojun Xie
- Department of Psychiatry, The Third People's Hospital of Foshan, Foshan 528000, Guangdong, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Wenbin Guo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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4
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Early-life adversity and risk for depression and anxiety: The role of interpersonal support. Dev Psychopathol 2022; 35:863-875. [PMID: 35285426 DOI: 10.1017/s0954579422000116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Early-life adversity is a major risk factor for psychopathology, but not all who experience adversity develop psychopathology. The current study evaluated whether the links between child and adolescent adversity and depression and anxiety were described by general benefits and/or buffering effects of interpersonal support. Data from 456 adolescents oversampled on neuroticism over a 5-year period were examined in a series of discrete-time survival analyses to predict subsequent disorder onsets. Models examined linear, quadratic, and interactive effects of interpersonal support over time, as measured by chronic interpersonal stress interview ratings. Results did not support buffering effects of interpersonal support against either child or adolescent adversity in predicting depression or anxiety. However, there was support for the general benefits model of interpersonal support as evidenced by follow-up analyses of significant quadratic effects of interpersonal support, demonstrating that higher interpersonal support led to decreased likelihood of depression and anxiety onsets. Secondary analyses demonstrated that effects of interpersonal support remained after accounting for baseline depression and anxiety diagnoses. Further, quadratic effects were driven by social domains as opposed to familial domains when considering child adversity. Implications for interventions and randomized controlled prevention trials regarding interpersonal relationships are discussed.
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5
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Barzegar H, Farahbakhsh M, Azizi H, Aliashrafi S, Dadashzadeh H, Fakhari A. A descriptive study of agoraphobic situations and correlates on panic disorder. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00110-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
We aimed to identify the distribution and effective factors of agoraphobic situations and how they relate to panic disorder. We included confirmed 61 patients with agoraphobia in Bozorgmehr Psychiatric Clinic of Tabriz. Multiple logistic regression was used to measure panic disorder, agoraphobia, and effective factors.
Results
The average age of participants was 37.26 (SD 10.9), including 68.85% female and 31.15% male. Out of those, around three-fourths, 45 (73.7%), had panic disorder or comorbidity at least by one psychiatric disorder. Among various types of agoraphobia situations, leaving 34.63% and being 32.63% home alone had the most occurrences. A trend was observed between the rising of agoraphobia situations and panic risk. The final analysis was found a significant relationship between being bathroom alone (OR = 1.3; CI 1.12–1.56), having more than one psychiatric disorder (AOR = 8.25; CI 1.12–27.17), and panic risk.
Conclusions
We found leaving home alone, being home alone, being in a crowd, and standing in line as the most common agoraphobic situations. There appears agoraphobia and panic disorders are poorly understood in primary mental health care systems. The screening and treating programs are needed for increasing the quality of life and early identification of these disorders.
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The Role of Parental Anxiety Sensitivity and Beliefs About Child Anxiety in the Relationship Between Parent and Child Anxiety. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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7
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Hewitt OM, Tomlin A, Waite P. The experience of panic attacks in adolescents: an interpretative phenomenological analysis study. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1948742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Olivia Mary Hewitt
- Berkshire Healthcare NHS Foundation Trust
- Centre for Educational Development, Appraisal and Research (CEDAR), UK
| | - Alice Tomlin
- Berkshire Healthcare NHS Foundation Trust
- Oxford Institute of Clinical Psychology Training and Research
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
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Iorfino F, Marangoni C, Cui L, Hermens DF, Hickie IB, Merikangas KR. Familial aggregation of anxiety disorder subtypes and anxious temperament in the NIMH Family Study of Affective Spectrum Disorders. J Affect Disord 2021; 281:751-758. [PMID: 33267979 DOI: 10.1016/j.jad.2020.11.070] [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: 05/21/2020] [Revised: 09/30/2020] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Evidence from family and twin studies suggests that mood and anxiety disorders, and related temperamental factors may share common etiologic factors. We examine the familial aggregation and coaggregation of anxiety disorder subtypes and anxiety-related temperamental traits, and their association with mood disorders. METHODS A total of 477 probands and 549 first-degree adult relatives from a large community based family study of affective spectrum disorders completed semi-structured diagnostic interviews and self-reported assessments of temperamental traits including: negative affectivity on the 'Positive and Negative Affect Schedule' (PANAS), neuroticism anxiety on the 'Zuckerman-Kuhlman Personality Questionnaire' (ZKPQ), and anxiety sensitivity on the 'Anxiety Sensitivity Index' (ASI). RESULTS The anxiety-related temperamental traits of negative affectivity, neuroticism anxiety and anxiety sensitivity had significant familial specificity, even after controlling for comorbid mood and anxiety disorders in probands and relatives. Yet, these traits in probands did not predict anxiety disorders in relatives. Although some anxiety subtypes were familial, there were no longer familial links between anxiety disorder subtypes (generalized anxiety disorder, social anxiety or panic disorder) after controlling for mood disorder subtypes in probands and relatives. LIMITATIONS Cross-sectional interviews were used to estimate disorders, and self-report measures were used for temperamental traits. CONCLUSIONS These results confirm previous research regarding familial overlap between anxiety subtypes and mood disorders, however their shared liability cannot be fully explained by anxiety-related temperamental traits. These findings suggest that anxiety-related temperamental traits may indicate a vulnerability for mood and anxiety disorders or a potential consequence of these conditions.
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Affiliation(s)
- Frank Iorfino
- Brain and Mind Centre, University of Sydney, Australia.
| | - Ciro Marangoni
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Daniel F Hermens
- Brain and Mind Centre, University of Sydney, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Australia
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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9
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Saunders H, Osuch E, Anderson K, Martin J, Kunnilathu A, John-Baptiste A. Factors associated with initiation of community-based therapy for emerging adults with mood and anxiety disorders. Early Interv Psychiatry 2021; 15:123-132. [PMID: 31975541 DOI: 10.1111/eip.12920] [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: 07/30/2018] [Revised: 11/05/2019] [Accepted: 12/14/2019] [Indexed: 11/29/2022]
Abstract
AIM The First Episode Mood and Anxiety Program (FEMAP) is a community-based early intervention program that has been shown to improve health outcomes for emerging adults (EAs) with mood and anxiety disorders. However, not all EAs who are admitted to the program initiate treatment. Our aim was to identify factors that distinguish those who initiated treatment from those who did not. METHODS FEMAP administered questionnaires to EAs upon first contact with the program, collecting information on a range of socioeconomic, patient and condition-related factors. We compared EAs who initiated treatment in the program (n = 318, 87.4%) to those who did not (n = 46, 12.6%). To examine factors associated with treatment initiation, we specified a parsimonious logistic regression model, using the method of purposeful selection to choose from a range of candidate variables. RESULTS Anxiety Sensitivity Index - Revised (ASI-R), binge drinking and cannabis use were included in the final logistic regression model. Each one-point increment in the ASI-R score was associated with a 1% increase in the odds of treatment initiation (OR = 1.014; 95% CI [1.003, 1.026]). No other variable was significantly associated with treatment initiation. CONCLUSIONS Our study provides insight on the differences between EAs with mood and anxiety disorders who initiated targeted treatment services and those who did not. Anxiety sensitivity was significantly associated with treatment initiation at FEMAP. Our findings suggest that it may be anxiety sensitivity, rather than depression or functional impairment per se that drive treatment initiation among EAs.
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Affiliation(s)
- Hailey Saunders
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Elizabeth Osuch
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, First Episode Mood and Anxiety Program (FEMAP), London Health Sciences Centre, Lawson Health Research Institute, London, ON, Canada
| | - Kelly Anderson
- Department of Epidemiology and Biostatistics, Department of Psychiatry, Schulich School of Medicine and Dentistry, Lawson Health Research Institute, London, ON, Canada
| | - Janet Martin
- Department of Anesthesia and Perioperative Medicine, Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI Centre), London, ON, Canada
| | - Abraham Kunnilathu
- Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ava John-Baptiste
- Department of Anesthesia and Perioperative Medicine,Department of Epidemiology and Biostatistics, Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI Centre), Lawson Health Research Institute, London, ON, Canada
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10
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Weems CF, Camp RD, Neill EL, Scott BG. Developmental Differences in Child and Adolescent Reasoning about Anxiety Sensations. COGNITIVE THERAPY AND RESEARCH 2021; 45:166-178. [PMID: 33776171 PMCID: PMC7993367 DOI: 10.1007/s10608-020-10182-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The development of reasoning as to the potential negative consequences of emotional sensations is a critical aspect of emotion knowledge and central to cognitive risk for anxiety disorders. The purpose of this paper is to explore the reasoning children and adolescents give for negative interpretations of anxiety sensations, testing a priori hypotheses quantitatively and exploring the content of the reasons qualitatively. METHODS This study used a cross sectional design with interviews as well as cognitive and emotional assessments in a sample of 227 youth aged 6-17 years. Coding schemes to assess the logical validity, affective valence, and qualitative reasons that youth give to evaluate anxiety sensations and anxiety situations were developed. RESULTS Findings indicated diverse reasoning was used and responses could be reliably coded with developmental differences across age, cognitive, and verbal development. The logical sophistication of the reasoning used by youth increased across age in a non-linear manner and linearly with cognitive and verbal abilities. Child anxiety sensitivity and internalizing symptom levels moderated the main effect of age. CONCLUSIONS The results add to the existing understanding of emotional development and are consistent with the idea that the process of cognitive-emotional understanding is not a simple linear one because various domains may show differential development.
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Affiliation(s)
- Carl F Weems
- Human Development and Family Studies, Iowa State University
| | - Randie D Camp
- Human Development and Family Studies, Iowa State University
| | - Erin L Neill
- Human Development and Family Studies, Iowa State University
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11
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Dogan B, Kocabas O, Sevincok D, Baygin C, Memis CO, Sevincok L. Separation Anxiety Disorder in Panic Disorder Patients with and without Comorbid Agoraphobia. Psychiatry 2021; 84:68-80. [PMID: 33577430 DOI: 10.1080/00332747.2021.1875730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: Previous studies have focused on the relationship between childhood separation anxiety disorder (SAD) and adult panic disorder (PD)-agoraphobia. It is not clear enough whether SAD, which continues into adulthood, is associated with PD with and without comorbid agoraphobia in adult patients. Our primary hypothesis was that PD patients with comorbid agoraphobia had a higher rate of SAD that continues into adulthood than those without agoraphobia. We also hypothesized that adulthood SAD symptoms were more likely to be associated with PD-agoraphobia than PD without agoraphobia.Method: 151 patients who were diagnosed with PD with (n = 106), and without comorbid agoraphobia (n = 45) were compared using Panic and Agoraphobia Scale, Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory, Adult Separation Anxiety Questionnaire, and State-Trait Anxiety Inventory. We performed Student's t-test, Pearson correlation test, and multiple linear regression analysis in this study.Results: PD patients with comorbid agoraphobia were more likely to have SAD both in childhood and adulthood (p = .028), than those without agoraphobia. There were mild to moderate significant correlations between PD severity and state anxiety (p = .002), trait anxiety (p = .006), and SAD in childhood (p = .049), and in adulthood (p = .001). SAD in adulthood (β = 0.278, Exp(B) = 0.136, p = .003), and state anxiety (β = 0.236, Exp(B) = 0.164, p = .012) significantly predicted the severity of PD in patients with comorbid agoraphobia.Conclusion: SAD that continues in adulthood may be related to the severity of PD in patients with agoraphobia. Our findings might provide some evidence of the role of SAD in adulthood in patients with adult-onset PD-agoraphobia.
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12
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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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13
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Separating within-person from between-person effects in the longitudinal co-occurrence of depression and different anxiety syndromes in youth. JOURNAL OF RESEARCH IN PERSONALITY 2019. [DOI: 10.1016/j.jrp.2019.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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14
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Wauthia E, Lefebvre L, Huet K, Blekic W, El Bouragui K, Rossignol M. Examining the Hierarchical Influences of the Big-Five Dimensions and Anxiety Sensitivity on Anxiety Symptoms in Children. Front Psychol 2019; 10:1185. [PMID: 31231271 PMCID: PMC6558314 DOI: 10.3389/fpsyg.2019.01185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/06/2019] [Indexed: 01/04/2023] Open
Abstract
Anxiety sensitivity (AS), namely the fear of anxiety symptoms, has been described as a precursor of sub-threshold anxiety levels. Sexton et al. (2003) posited that increased AS would arise from an elevated neuroticism and that both would act as vulnerability factors for panic disorder (PD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) symptoms. Accordingly, this study aimed to (1) evaluate the applicability of this model to a pediatric population and (2) examine the influences of the other Big-Five personality dimensions on the four lower-order dimensions of AS (cognitive, physical, control, and physical) and on social phobia (SP), separation anxiety disorder (SAD) and depression symptoms. 200 children (104 girls) aged between 8 and 12 years old (mean age = 132.52 months, SD = 14.5) completed the Childhood Anxiety Sensitivity Index (Silverman et al., 1991), the Big Five Questionnaire for Children (Barbaranelli et al., 2003), and the Revised’s Children Anxiety and Depression Scale (Chorpita et al., 2000). Regression analyses confirmed that AS and neuroticism together significantly predicted the presence of PD, OCD, and GAD symptoms but also SP, SAD, and depression symptoms. Moreover, neuroticism interacted with extraversion, conscientiousness and agreeableness to significantly predict SP, GAD, and depression. Surprisingly, the global AS score was only predicted by agreeableness, while AS dimensions also specifically related to openness. Finally, AS dimensions did not predict the presence of specific anxiety symptoms. To conclude, the predicting model of anxiety symptoms in children sets neuroticism and AS on the same level, with an unexpected influence of agreeableness on AS, raising the importance of other trait-like factors in the definition of such models. Moreover, AS should be considered as a unitary construct when predicting the presence of anxiety symptoms in children. Future interventions must consider these associations to help children detect and recognize the symptoms of their anxiety and help them to interpret them correctly.
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Affiliation(s)
- Erika Wauthia
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,National Fund for Human Research (FRESH), National Fund for Scientific Research, Brussels, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Laurent Lefebvre
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Kathy Huet
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium.,Laboratory of Phonetics, Research Institute for Language Sciences and Technology, Faculty of Psychology and Education, University of Mons, Mons, Belgium
| | - Wivine Blekic
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,National Fund for Human Research (FRESH), National Fund for Scientific Research, Brussels, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
| | - Khira El Bouragui
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium.,Laboratory C2S, University of Reims Champagne-Ardenne, Reims, France
| | - Mandy Rossignol
- Department of Cognitive Psychology and Neuropsychology, Faculty of Psychology and Education, University of Mons, Mons, Belgium.,Interdisciplinary Research Center in Psychophysiology and Cognitive Electrophysiology, Mons, Belgium
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15
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Sewart AR, Zbozinek TD, Hammen C, Zinbarg RE, Mineka S, Craske MG. Positive Affect as a Buffer between Chronic Stress and Symptom Severity of Emotional Disorders. Clin Psychol Sci 2019; 7:914-927. [PMID: 31632843 DOI: 10.1177/2167702619834576] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Research has demonstrated that stressors play a critical role in the development of generalized anxiety disorder (GAD), social anxiety disorder (SAD), and major depressive disorder (MDD). Separately, deficits in positive affect (PA) have been identified in GAD, SAD, and MDD. While previous research has linked the buffering effects of PA in chronic illness, such effects have yet to be investigated for chronic stressors and emotional disorder-related symptom severity. The purpose of the present study was to examine PA as a moderator of chronic interpersonal and non-interpersonal stress on GAD, SAD, and MDD symptom severity. Using a multilevel statistical approach with a sample of adolescents and young adults (N=463), PA was found to significantly moderate the relationship between chronic interpersonal stress and symptom severity for MDD and SAD. Findings suggest that in times of chronic interpersonal stress, higher PA may serve as a buffer from development of SAD and MDD symptoms.
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Affiliation(s)
- Amy R Sewart
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA
| | - Tomislav D Zbozinek
- California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA 91125, USA
| | - Constance Hammen
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA.,California Institute of Technology, Humanities and Social Sciences, 1200 E. California Blvd., MC 228-77, Pasadena, CA 91125, USA.,Northwestern University, Department of Psychology, 2029 Sheridan Road, Swift Hall 102, Evanston, IL 60208, USA
| | - Richard E Zinbarg
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Swift Hall 102, Evanston, IL 60208, USA
| | - Susan Mineka
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Swift Hall 102, Evanston, IL 60208, USA
| | - Michelle G Craske
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA
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16
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Zvolensky MJ, Bakhshaie J, Shepherd JM, Peraza N, Garey L, Viana AG, Glover N, Brown JT, Brown RA. Anxiety sensitivity and smoking among Spanish-speaking Latinx smokers. Addict Behav 2019; 90:55-61. [PMID: 30359848 DOI: 10.1016/j.addbeh.2018.10.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/10/2018] [Accepted: 10/16/2018] [Indexed: 10/28/2022]
Abstract
Despite the documented health disparities for smoking among the Latinx population, there is limited understanding of transdiagnostic constructs that may help explain smoking among Spanish-speaking Latinx smokers. The present study examined one promising transdiagnostic factor, anxiety sensitivity (fear of anxiety and related sensations), in relation to cigarette dependence, perceived barriers for quitting, and severity of problems experienced when trying to quit among a large sample of Latinx smokers. Participants were 367 Spanish-speaking Latinx daily smokers (59.1% female, Mage = 33.20 years, SD = 11.81). As hypothesized, anxiety sensitivity was significantly related to the severity of cigarette dependence, perceived barriers for quitting, and problems when trying to quit. Inspection of the lower-order dimensions of anxiety sensitivity indicated that Physical Concerns was significantly related to cigarette dependence whereas Cognitive Concerns was associated with greater perceived barriers for quitting and severity of problems experienced during past quit attempts. The present study provides novel empirical evidence that anxiety sensitivity is related to a moderate, yet clinically meaningful, proportion of the variance in cigarette dependence, perceived barriers for quitting, and problems experienced during quit attempts. These findings underscore the value of examining anxiety sensitivity among Latinx smokers and focusing greater attention on this construct in efforts to reduce or quit smoking among this population.
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17
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Horton MK, Hsu L, Claus Henn B, Margolis A, Austin C, Svensson K, Schnaas L, Gennings C, Hu H, Wright R, Rojo MMT, Arora M. Dentine biomarkers of prenatal and early childhood exposure to manganese, zinc and lead and childhood behavior. ENVIRONMENT INTERNATIONAL 2018; 121:148-158. [PMID: 30205321 PMCID: PMC6373872 DOI: 10.1016/j.envint.2018.08.045] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Metal exposure alters neurodevelopmental outcomes; little is known about critical windows of susceptibility when exposure exerts the strongest effect. OBJECTIVE To examine associations between dentine biomarkers of manganese (Mn), zinc (Zn) and lead (Pb) and later childhood behaviors. METHODS Subjects enrolled in a longitudinal birth cohort study in Mexico City provided naturally shed deciduous teeth. We estimated weekly prenatal and postnatal dentine Mn, Zn and Pb concentrations in teeth using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) and measured behavior at ages 8-11 years of age using the Behavior Assessment System for Children, 2nd edition (BASC-2). We used distributed lag models and lagged weighted quantile sum regression to identify the role of individual and combined dentine biomarkers of Mn, Zn and Pb on behavioral outcomes controlling for maternal education and gestational age. RESULTS Among the 133 subjects included in this study, prenatal and early postnatal dentine Mn appeared protective against childhood behavioral problems, specifically hyperactivity and attention. Postnatal dentine Mn was associated with increased reporting of internalizing problems, specifically anxiety. At 6 months, a 1-unit increase (unit = 1 SD of log concentration) in Mn was associated with a 0.18-unit (unit = 1 SD of BASC-2 score) increase in internalizing symptoms score and a 0.25-unit increase in anxiety. Postnatal Pb was associated with increasing anxiety symptoms; at 12 months, a 1-unit increase in Pb was associated with a 0.4 unit increase in anxiety symptoms. When examined as a metal mixture, we observed two potential windows of susceptibility to increased anxiety symptoms: the first window (0-8 months) appeared driven by Mn, the second window (8-12 months) was driven by the metal mixture and dominated by Pb. A 1-unit increase in the mixture index was associated with a 0.7-unit increase in SD of anxiety symptoms. CONCLUSIONS Childhood behaviors may demonstrate postnatal windows of susceptibility to individual and mixed metal concentrations measured in deciduous teeth. Prenatal dentine Mn may be protective, while excessive early postnatal Mn may increase risk for adverse behaviors. In combination, higher concentrations of Mn, Zn and Pb may have an adverse impact on behavior.
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Affiliation(s)
- Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, United States of America
| | - Amy Margolis
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center, 1051 Riverside Drive New York, New York 10032, United States of America
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatología, Montes Urales 800, Lomas Virreyes, Mexico City CP 11000, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6(th) floor, Toronto M5T 3M7, Canada
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health (Mexico), Universidad 655, Cuernavaca 62100, Mexico.
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
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18
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Zvolensky MJ, Mayorga NA, Garey L. Worry, anxiety sensitivity, and electronic cigarettes among adults. Psychiatry Res 2018; 269:321-327. [PMID: 30173037 PMCID: PMC10034964 DOI: 10.1016/j.psychres.2018.08.087] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 12/27/2022]
Abstract
Although electronic cigarette (e-cigarette) use is now a common substance use behavior, there is little understanding of the individual difference factors related to e-cigarette use beliefs and dependence. The present investigation sought to test a theoretically-driven model of anxiety sensitivity as an explanatory element in a worry-e-cigarette beliefs and dependence model. Participants included 558 adult e-cigarette users (51.4% female; 35.2 years, SD = 10.1) who were nationally recruited via an online survey system. Participants completed a single survey that assessed their mood and e-cigarette behavior and beliefs. Results supported a statistically significant indirect pathway for worry in relation to perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity; effect sizes were small. The indirect effects were evident when accounting for several theoretically relevant covariates (sex, income, education, concurrent cigarette use, and neuroticism). This study provides the first empirical evidence of the role of anxiety sensitivity in the relation between worry and e-cigarette use beliefs and behavior, which may represent a novel intervention target.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 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.
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
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19
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Zvolensky MJ, Garey L, Fergus TA, Gallagher MW, Viana AG, Shepherd JM, Mayorga NA, Kelley LP, Griggs JO, Schmidt NB. Refinement of anxiety sensitivity measurement: The Short Scale Anxiety Sensitivity Index (SSASI). Psychiatry Res 2018; 269:549-557. [PMID: 30199696 PMCID: PMC6207458 DOI: 10.1016/j.psychres.2018.08.115] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/09/2018] [Accepted: 08/28/2018] [Indexed: 12/26/2022]
Abstract
Anxiety sensitivity, defined as the fear of anxiety and arousal-related sensations, has been among the most influential cognitive-based transdiagnostic risk and maintenance factors in the study and treatment of emotional and related disorders. The currently available anxiety sensitivity measures are limited by their length. Specifically, the length of these instruments discourages the adoption of routine anxiety sensitivity assessment in clinical or medical settings (e.g., primary care). The goals of this study were to develop and assess the validity and reliability of a short version of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007), entitled the Short Scale Anxiety Sensitivity Index (SSASI), using three independent clinical samples. Results indicated that the abbreviated five-item version of the SSASI had good internal consistency and a robust association with the ASI-3. Further, across the samples, there was evidence of unidimensionality and excellent convergent and discriminant validity. There also was evidence of partial measurement invariance across sex and full measurement invariance across time. Overall, the five-item scale offers a single score that can be employed to measure anxiety sensitivity. Use of the SSASI may facilitate screening efforts and symptom tracking for anxiety sensitivity, particularly within clinical settings where practical demands necessitate the use of brief assessment instruments.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX 77004, USA,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA,Correspondence concerning this article should be addressed to Michael J. Zvolensky, Ph.D. Dept. of Psychology 3695 Cullen Blvd., Room 126. University of Houston, Houston, TX, 77204. (713) 743-8056.
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Thomas A. Fergus
- Department of Psychology and Neuroscience, Baylor University, Waco, TX 76706, USA
| | | | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | | | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX 77004, USA
| | - Lance P. Kelley
- Waco Family Medicine Residency Program, Heart of Texas Community Health Center, Waco, TX 76706, USA
| | - Jackson O. Griggs
- Waco Family Medicine Residency Program, Heart of Texas Community Health Center, Waco, TX 76706, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida 32306, USA
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20
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Abstract
Anxiety sensitivity (AS) is the perception that anxiety symptoms and experiences have negative consequences, and has been identified as a risk factor for the development of anxiety disorders. AS has been measured in adults and in children, but to date, the construct of parent's sensitivity to their children's anxiety symptoms has not been identified, measured, or evaluated. The current study presents a novel measure of this construct, the Parent Sensitivity to Child Anxiety Index (PSCAI), and an initial evaluation of its psychometric properties. Factor analysis revealed a three-factor structure consisting of parents' concern for physical symptoms, concern of social evaluation, and fear of anxiety symptoms. The PSCAI demonstrated good internal consistency, and was positively correlated with relevant parental constructs such as parental accommodation, anxiety sensitivity, and trait anxiety. This new measurement system opens new avenues for researching the early development of anxiety disorders and the possibility for novel targeted interventions.
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21
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Ho SM, Dai DWT, Mak C, Liu KWK. Cognitive factors associated with depression and anxiety in adolescents: A two-year longitudinal study. Int J Clin Health Psychol 2018; 18:227-234. [PMID: 30487928 PMCID: PMC6224862 DOI: 10.1016/j.ijchp.2018.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/06/2018] [Indexed: 11/29/2022] Open
Abstract
Background/Objective: To examine the roles of anxiety sensitivity and attentional bias in the development of anxiety and depression symptoms among adolescents. Method: 214 grade 7 to grade 10 Hong Kong Chinese students completed a package of psychometric inventories to measure levels of anxiety sensitivity, selective attentional processing, and anxiety and depressive symptoms in 2016 and then again in 2017. Results: Girls, when compared with boys, exhibited more anxiety symptoms and anxiety sensitivity in 2016. They also reported a significant increase in mean depression level from 2016 to 2017. Regression analyses revealed that the physical-concerns dimension of anxiety sensitivity, positive attentional bias, and to a lesser extent negative attentional bias were related to the development of both anxiety and depression symptoms one year later. Fear of mental incapacity could predict depression one year later but not anxiety symptoms. Conclusions: Intervention through anxiety sensitivity training to reduce somatic concerns and attentional bias modification to increase habitual attention to positive stimuli and to disengage from negative stimuli can reduce anxiety and depression symptoms among high school students.
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Affiliation(s)
- Samuel M.Y. Ho
- Psychology Laboratory, Department of Applied Social Sciences, City University of Hong Kong
| | | | - Christine Mak
- Psychology Laboratory, Department of Applied Social Sciences, City University of Hong Kong
| | - Katy Wing Kei Liu
- Psychology Laboratory, Department of Applied Social Sciences, City University of Hong Kong
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22
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Olino TM, Finsaas M, Dougherty LR, Klein DN. Is Parent-Child Disagreement on Child Anxiety Explained by Differences in Measurement Properties? An Examination of Measurement Invariance Across Informants and Time. Front Psychol 2018; 9:1295. [PMID: 30108533 PMCID: PMC6079214 DOI: 10.3389/fpsyg.2018.01295] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 07/05/2018] [Indexed: 11/13/2022] Open
Abstract
There are numerous empirical studies demonstrating that agreement between parent-reports of youth and youth self-reports of internalizing behavior problems is modest at best. This has spurred much research on factors that influence the magnitude of associations between informants, including individual difference characteristics of the informants and contexts through which individuals interact with the child. There is also tremendous interest in understanding symptom trajectories longitudinally. However, each of these lines of work are predicated on the assumptions that the psychometric construct that is being assessed from each informant and at each measurement occasion is the same. This study examined measurement invariance between maternal and child reports and longitudinally across ages 9 and 12 on five dimensions of anxiety using the Screen for Child Anxiety and Related Disorders (SCARED; Birmaher et al., 1999). No cross-informant models for anxiety dimensions achieved acceptable fit and at least partial metric and scalar invariance. Moreover, few longitudinal models demonstrated acceptable fit and at least partial metric and scalar invariance. Thus, using the SCARED as an example, these results show that inter-informant agreement may be compromised by different item functioning, and highlight the need for testing invariance before using measures for longitudinal tracking of symptoms.
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Affiliation(s)
- Thomas M. Olino
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Megan Finsaas
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Lea R. Dougherty
- Department of Psychology, University of Maryland College Park, College Park, MD, United States
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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23
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Bardeen JR, Daniel TA. Anxiety sensitivity and attentional bias to threat interact to prospectively predict anxiety. Cogn Behav Ther 2018; 47:482-494. [DOI: 10.1080/16506073.2018.1466911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Thomas A. Daniel
- Department of Psychology, Westfield State University, Westfield, MA, USA
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24
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Ebbert AM, Patock-Peckham JA, Luk JW, Voorhies K, Warner O, Leeman RF. The Mediating Role of Anxiety Sensitivity in Uncontrolled Drinking: A Look at Gender-Specific Parental Influences. Alcohol Clin Exp Res 2018; 42:914-925. [PMID: 29573434 PMCID: PMC5915872 DOI: 10.1111/acer.13631] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/12/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Anxiety sensitivity (AS) reflects an individual's belief that experiencing anxiety will cause illness or embarrassment, and may be a reason individuals self-medicate with alcohol. Harsh or indulgent parenting could contribute to the development of AS. We examined the direct and indirect associations between parenting styles and alcohol-related variables through AS and impaired control over drinking (IC; i.e., perceived failure to adhere to limits on alcohol consumption in the future). METHODS A multiple-group structural equation model with 614 university students (344 men; 270 women) was examined. Structural invariance tests were conducted to evaluate moderation by gender. We used a bias corrected bootstrap technique to obtain the mediated effects. RESULTS Father authoritarianism and mother permissiveness were directly linked to AS among women, whereas father permissiveness was directly linked to AS among men. This suggests unique parental influences based on gender regarding AS. While AS was directly linked to alcohol-related problems for both men and women, several gender-specific associations were found. AS was directly linked to IC for men but not for women. For men, father permissiveness was directly related to AS, and AS mediated the indirect link between father permissiveness and IC along both the heavy episodic drinking and alcohol-related problems pathways. Similar to other internalizing constructs (e.g., neuroticism and depression), higher AS was directly associated with less heavy episodic drinking but more alcohol-related problems. CONCLUSIONS Our findings highlight the dangers of AS for men as an important correlate of under-controlled drinking behaviors. Additionally, permissive parenting of the same-gender parent was associated with AS, which is consistent with the gender-matching hypothesis. Together, these results underscore the importance of measuring the independent influence of both parents.
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Affiliation(s)
- Ashley M Ebbert
- Department of Psychology, Arizona State University, Tempe, Arizona
| | | | - Jeremy W Luk
- Division of Intramural Population Health Research, Health Behavior Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Kirsten Voorhies
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Olivia Warner
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Robert F Leeman
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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25
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Holtz K, Hamm AO, Pané-Farré CA. Repeated Interoceptive Exposure in Individuals With High and Low Anxiety Sensitivity. Behav Modif 2018; 43:467-489. [PMID: 29690770 DOI: 10.1177/0145445518772269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Interoceptive exposure is one component in cognitive behavioral therapy of panic disorder. The present investigation addressed changes in defensive mobilization during repeated interoceptive exposure using a standardized hyperventilation procedure. 26 high and 22 low anxiety sensitive persons (ASI, Peterson & Reiss, 1992) went through two guided hyperventilation and normoventilation procedures, spaced one week apart. Breathing parameters, startle response magnitudes and symptom reports were measured. All participants successfully adhered to the guided breathing procedures. Both groups comparably reported more symptoms during hyperventilation than normoventilation in both sessions. Only high-AS participants displayed potentiated startle magnitudes after the first hyperventilation vs. normoventilation. One week later, when the hyperventilation exercise was repeated, this potentiation was no longer present. Thus, high and low-AS groups no longer differed in their defensive mobilization to symptom provocation. Furthermore, the number of reported baseline symptoms also decreased from session one to session two in the high-AS group. While high-AS reported increased baseline anxiety symptoms in session 1, groups did not differ in session 2. Results indicate a reduction of defensive mobilization during repeated interoceptive exposure.
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26
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Jurin T, Biglbauer S. Anxiety sensitivity as a predictor of panic disorder symptoms: a prospective 3-year study. ANXIETY STRESS AND COPING 2018; 31:365-374. [DOI: 10.1080/10615806.2018.1453745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Tanja Jurin
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Sonja Biglbauer
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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27
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Feldker K, Heitmann CY, Neumeister P, Brinkmann L, Bruchmann M, Zwitserlood P, Straube T. Cardiorespiratory concerns shape brain responses during automatic panic-related scene processing in patients with panic disorder. J Psychiatry Neurosci 2018; 43. [PMID: 29252163 PMCID: PMC5747532 DOI: 10.1503/jpn.160226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Increased automatic processing of threat-related stimuli has been proposed as a key element in panic disorder. Little is known about the neural basis of automatic processing, in particular to task-irrelevant, panic-related, ecologically valid stimuli, or about the association between brain activation and symptomatology in patients with panic disorder. METHODS The present event-related functional MRI (fMRI) study compared brain responses to task-irrelevant, panic-related and neutral visual stimuli in medication-free patients with panic disorder and healthy controls. Panic-related and neutral scenes were presented while participants performed a spatially nonoverlapping bar orientation task. Correlation analyses investigated the association between brain responses and panic-related aspects of symptomatology, measured using the Anxiety Sensitivity Index (ASI). RESULTS We included 26 patients with panic disorder and 26 heatlhy controls in our analysis. Compared with controls, patients with panic disorder showed elevated activation in the amygdala, brainstem, thalamus, insula, anterior cingulate cortex and midcingulate cortex in response to panic-related versus neutral task-irrelevant stimuli. Furthermore, fear of cardiovascular symptoms (a subcomponent of the ASI) was associated with insula activation, whereas fear of respiratory symptoms was associated with brainstem hyperactivation in patients with panic disorder. LIMITATIONS The additional implementation of measures of autonomic activation, such as pupil diameter, heart rate, or electrodermal activity, would have been informative during the fMRI scan as well as during the rating procedure. CONCLUSION Results reveal a neural network involved in the processing of panic-related distractor stimuli in patients with panic disorder and suggest an automatic weighting of panic-related information depending on the magnitude of cardiovascular and respiratory symptoms. Insula and brainstem activations show function-related associations with specific components of panic symptomatology.
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Affiliation(s)
- Katharina Feldker
- Correspondence to: K. Feldker, Institute of Medical Psychology and Systems Neuroscience, Von-Esmarch-Straße 52, D-48149 Muenster, Germany;
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28
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Martin L, Hemmings SMJ, Kidd M, Seedat S. No gene-by-environment interaction of BDNF Val66Met polymorphism and childhood maltreatment on anxiety sensitivity in a mixed race adolescent sample. Eur J Psychotraumatol 2018; 9:1472987. [PMID: 29805780 PMCID: PMC5965035 DOI: 10.1080/20008198.2018.1472987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 04/20/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Anxiety disorders in youth are attributable to multiple causal mechanisms, comprising biological vulnerabilities, such as genetics and temperament, and unfavourable environmental influences, such as childhood maltreatment (CM). Objective: A gene-environment (G x E) interaction study was conducted to determine the interactive effect of the BDNF Val66Met polymorphism and CM to increase susceptibility to anxiety sensitivity (AS) in a sample of mixed race adolescents. Method: Participants (n = 308, mean age = 15.8 years) who were all secondary school students and who completed measures for AS and CM were genotyped for the BDNF Val66Met polymorphism. Hierarchical multiple regression analysis was conducted to assess G x E influences on AS. Age and gender were included in the models as covariates as age was significantly associated with AS total score (p < .05), and females had significantly higher AS scores than males (p < .05). Results: A main effect of CM on AS was evident (p < .05), however, no main effect of BDNF genotype on AS was observed (p > .05). A non-significant G x E effect on AS was revealed (p < .05). Conclusions: Our results suggest that CM does not have a moderating role in the relationship between the BDNF Val66Met genotype and the increased risk of anxiety-related phenotypes, such as AS. Given the exploratory nature of this study, findings require replication in larger samples and adjustment for population stratification to further explore the role of BDNF Val66Met and CM on AS in mixed race adolescents.
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Affiliation(s)
- Lindi Martin
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Martin Kidd
- Department of Statistics and Actuarial Science, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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29
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Baumann C, Schiele MA, Herrmann MJ, Lonsdorf TB, Zwanzger P, Domschke K, Reif A, Deckert J, Pauli P. Effects of an Anxiety-Specific Psychometric Factor on Fear Conditioning and Fear Generalization. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1027/2151-2604/a000304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract. Conditioning and generalization of fear are assumed to play central roles in the pathogenesis of anxiety disorders. Here we investigate the influence of a psychometric anxiety-specific factor on these two processes, thus try to identify a potential risk factor for the development of anxiety disorders. To this end, 126 healthy participants were examined with questionnaires assessing symptoms of anxiety and depression and with a fear conditioning and generalization paradigm. A principal component analysis of the questionnaire data identified two factors representing the constructs anxiety and depression. Variations in fear conditioning and fear generalization were solely associated with the anxiety factor characterized by anxiety sensitivity and agoraphobic cognitions; high-anxious individuals exhibited stronger fear responses (arousal) during conditioning and stronger generalization effects for valence and UCS-expectancy ratings. Thus, the revealed psychometric factor “anxiety” was associated with enhanced fear generalization, an assumed risk factor for anxiety disorders. These results ask for replication with a longitudinal design allowing to examine their predictive validity.
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Affiliation(s)
- Christian Baumann
- Department of Psychology and Center of Mental Health, University of Würzburg, Germany
- Center of Mental Health, König-Ludwig-Hospital, Würzburg, Germany
| | - Miriam A. Schiele
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Martin J. Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - Tina B. Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - Paul Pauli
- Department of Psychology and Center of Mental Health, University of Würzburg, Germany
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The Differential Role of Anxiety Sensitivity and its Components in the Relation between Emotional Nonacceptance and Anxiety and Depressive Symptoms and Disorders among Latinos in Primary Care. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9592-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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31
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Brandt C, Zvolensky MJ, Woods SP, Gonzalez A, Safren SA, O'Cleirigh CM. Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature. Clin Psychol Rev 2017; 51:164-184. [PMID: 27939443 PMCID: PMC5195877 DOI: 10.1016/j.cpr.2016.11.005] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 09/09/2016] [Accepted: 11/04/2016] [Indexed: 12/21/2022]
Abstract
There are over 35 million people worldwide infected with the Human Immunodeficiency Virus (HIV) and its progression to Acquired Immunodeficiency Syndrome (AIDS; WHO, 2014). With the advent of combined antiretroviral therapy (i.e., cART) in 1996, persons living with HIV/AIDS (PLWHA) now have much longer life expectancies. However, living with HIV remains challenging, as it is associated with a number of significant and recurrent (chronic) stressors including physical pain, side effects of cART, social stigma, and discrimination, among other social stressors. Presumably, as a result of these types of stressors, a disproportionately high number of PLWHA struggle with clinically-significant psychiatric symptoms and disorders. Although much scientific and clinical attention has focused on depressed mood and psychopathology among PLWHA, there has been comparably less focus on anxiety and its disorders. The paucity of work in this area is concerning from a public health perspective, as anxiety symptoms and disorders are the most common class of psychiatric disorders and often maintain a large negative impact on life functioning.
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Affiliation(s)
- Charles Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd. Houston, Texas, 77030, United States
| | - Steven P Woods
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, United States
| | - Steven A Safren
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33124, United States
| | - Conall M O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, Suite 701, Boston Ma, 02114, United States
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32
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Farris SG, Brown LA, Goodwin RD, Zvolensky MJ. Panic attack history and smoking topography. Drug Alcohol Depend 2017; 171:84-90. [PMID: 28033542 PMCID: PMC5263108 DOI: 10.1016/j.drugalcdep.2016.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/16/2016] [Accepted: 11/20/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Little is known about panic attacks and puffing topography, a behavioral index of the value of smoking reinforcement. This study examined smoking style during the course of smoking of a single cigarette among adult daily smokers with and without a history of panic attacks. METHOD Participants (n=124, Mage=43.9, SD=9.7; 44.4% female) were non-treatment seeking daily smokers. Lifetime panic attack history was assessed via diagnostic assessment; 28.2% (n=35) of the sample had a panic attack history. Participants smoked one cigarette during an ad libitum smoking trial. Puff volume, duration, and inter-puff interval were measured using the Clinical Research Support System (CReSS) pocket device. RESULTS Regression analyses revealed that panic attack status was not associated with significant differences in average puff volume, duration, or inter-puff interval. Multi-level modeling was used to examine puffing trajectories. Puff-level data revealed that there was a significant quadratic time x panic effect for puff volume and duration. Those with a panic attack history demonstrated relatively sustained levels of both puff volume and duration over time, whereas those without a history of panic attacks demonstrated an increase followed by a decrease in volume and duration over time. These effects were not accounted for by the presence of general psychopathology. DISCUSSION Smokers with a panic attack history demonstrate more persistent efforts to self-regulate the delivery of nicotine, and thus may be at risk for continued smoking and dependence. Tailored treatment may be needed to address unique vulnerabilities among this group.
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Affiliation(s)
- Samantha G. Farris
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 345 Blackstone Blvd., Providence, RI 02906 USA,The Miriam Hospital, Centers for Behavioral and Preventative Medicine, 164 Summit St., Providence, RI 02906 USA,Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906 USA,Corresponding author: Samantha G. Farris, Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior; 345 Blackstone Blvd, Butler Hospital, Providence, RI 02906. ; Phone: 401-455-6219; Fax: 401-455-6685
| | - Lily A. Brown
- University of Pennsylvania Perlman School of Medicine, Department of Psychiatry, 3535 Market St., Philadelphia, PA 19103
| | - Renee D. Goodwin
- Queens College, Department of Psychology and The Graduate Center, City University of New York (CUNY), 6530 Kissena Blvd., Queens, NY 11367 USA,Mailman School of Public Health, Department of Epidemiology, Columbia University, 722 W 168th St, New York, NY 10032 USA
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology, 126 Fred J. Heyne Building, Houston, TX 77204 USA,The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler St., Houston, TX 77230 USA
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33
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Reitzel LR, Childress SD, Obasi EM, Garey L, Vidrine DJ, McNeill LH, Zvolensky MJ. Interactive Effects of Anxiety Sensitivity and Subjective Social Status on Psychological Symptomatology in Black Adults. Behav Med 2017; 43:268-276. [PMID: 26963636 PMCID: PMC6093854 DOI: 10.1080/08964289.2016.1150805] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Anxiety sensitivity is the fear of anxiety-related sensations and subjective social status is a self-perception of social standing relative to others: both constructs have been linked to psychological symptomatology. This study investigated the interactive effects of anxiety sensitivity and social status in relation to anxiety and depressive symptomatology expression among 124 black adults. Participants provided sociodemographics and completed self-report questionnaires. The interactive associations between anxiety sensitivity and social status on anxiety symptomatology and depressive symptomatology were examined with hierarchical linear regressions adjusted for sociodemographics and negative affectivity. Significant interactions between anxiety sensitivity and social status were evident only for anxiety symptoms: specifically, the association between anxiety sensitivity and anxiety symptoms was much stronger for individuals with lower (versus higher) subjective social status. Black adults with this higher anxiety sensitivity/lower social status phenotype may be at heightened risk for the expression of anxiety symptomatology, and may benefit from interventions to reduce anxiety sensitivity.
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Affiliation(s)
- Lorraine R. Reitzel
- University of Houston, Department of Psychological, Health, and Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029
| | - Sarah D. Childress
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, P.O. Box 301402, Houston, TX 77230-1402
| | - Ezemenari M. Obasi
- University of Houston, Department of Psychological, Health, and Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029
| | - Lorra Garey
- The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, 126 Heyne Building, Suite 104, Houston, TX 77204
| | - Damon J. Vidrine
- The University of Oklahoma Stephenson Cancer Center, Department of Family and Preventative Medicine, Oklahoma City, OK
| | - Lorna H. McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Unit 1440, P.O. Box 301402, Houston, TX 77230-1402
| | - Michael J. Zvolensky
- The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, 126 Heyne Building, Suite 104, Houston, TX 77204
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Wolitzky-Taylor K, Sewart A, Vrshek-Schallhorn S, Zinbarg R, Mineka S, Hammen C, Bobova L, Adam EK, Craske MG. The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood. J Youth Adolesc 2016; 46:15-27. [PMID: 27613006 DOI: 10.1007/s10964-016-0566-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 08/30/2016] [Indexed: 01/21/2023]
Abstract
Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N = 457; Female 68.9 %) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 11075 Santa Monica Blvd, Suite 200, Los Angeles, CA, 90025, USA
| | - Amy Sewart
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA
| | - Suzanne Vrshek-Schallhorn
- Department of Psychology, University of North Carolina-Greensboro, 296 Eberhart Building, PO Box 26170
- Greensboro, NC 27402-6170, Greensboro, NC, 27412, USA
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, 2029 Sheridan Road - 102 Swift Hall, Evanston, IL, 60208-2710, USA
| | - Susan Mineka
- Department of Psychology, Northwestern University, 2029 Sheridan Road - 102 Swift Hall, Evanston, IL, 60208-2710, USA
| | - Constance Hammen
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA
| | - Lyuba Bobova
- Clinical Psychology, Adler University, 17 N. Dearborn Street, Chicago, IL, 60602, USA
| | - Emma K Adam
- School of Education and Social Policy and Institute for Policy Research, Northwestern University, 2120 Campus Drive, Evanston, IL, 60208, USA
| | - Michelle G Craske
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall-Box 951563, Los Angeles, CA, 90095, USA.
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35
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Powers MB, Davis ML, Kauffman BY, Baird SO, Zvolensky M, Rosenfield D, Marcus BH, Church TS, Frierson G, Otto MW, Smits JAJ. Anxiety sensitivity and smoking variability among treatment seeking smokers. ADDICTIVE DISORDERS & THEIR TREATMENT 2016; 15:136-142. [PMID: 27672353 PMCID: PMC5034872 DOI: 10.1097/adt.0000000000000075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Anxiety sensitivity (AS) is associated with poor smoking cessation outcomes. One reason may be that smokers with high AS smoke differently (i.e., to manage negative affect and uncomfortable bodily sensations) than other smokers, leading to stronger addiction (due to an affect/sensation based and thereby highly variable rather than a regular smoking routine). Thus, we examined the relationship between AS and smoking variability in a group of treatment-seeking smokers. METHODS Participants (N = 136; 52.2% female; Mage = 44.19 years, SD = 11.29) were daily smokers with elevated AS (AS≥20 on the Anxiety Sensitivity Index 16-item at prescreen) recruited as part of a larger randomized controlled trial for smoking cessation. Most participants were Caucasian (73%), educated (with 76% attending some college), unmarried (73%), and employed full-time (56%). They smoked, on average, 17 cigarettes per day. RESULTS Consistent with prediction, a regression analysis of baseline assessments and a longitudinal analysis with multilevel modeling (MLM) both showed higher AS was associated with greater variability in cigarettes smoked per day while controlling for gender, age, ethnicity, and income. CONCLUSIONS This finding encourages investigation of how AS might interact with clinical strategies using a fixed smoking taper as part of quit attempts.
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Affiliation(s)
- Mark B. Powers
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michelle L. Davis
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Brooke Y. Kauffman
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Scarlett O. Baird
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Bess H. Marcus
- Department of Family Medicine and Public Health, University of California, San Diego, CA
| | | | | | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Jasper A. J. Smits
- Department of Psychology & Institute for Mental Health Research, The University of Texas at Austin, Austin, TX
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36
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Ebesutani C, Kim M, Park HH. The utility of the bifactor model in understanding unique components of anxiety sensitivity in a South Korean sample. Asian J Psychiatr 2016; 22:116-23. [PMID: 27520911 DOI: 10.1016/j.ajp.2016.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/08/2016] [Accepted: 06/19/2016] [Indexed: 10/21/2022]
Abstract
The present study was the first to examine the applicability of the bifactor structure underlying the Anxiety Sensitivity Index-3 (ASI-3) in an East Asian (South Korean) sample and to determine which factors in the bifactor model were significantly associated with anxiety, depression, and negative affect. Using a sample of 289 South Korean university students, we compared (a) the original 3-factor AS model, (b) a 3-group bifactor AS model, and (c) a 2-group bifactor AS model (with only the physical and social concern group factors present). Results revealed that the 2-group bifactor AS model fit the ASI-3 data the best. Relatedly, although all ASI-3 items loaded on the general AS factor, the Cognitive Concern group factor was not defined in the bifactor model and may therefore need to be omitted in order to accurately model AS when conducting factor analysis and structural equation modeling (SEM) in cross cultural contexts. SEM results also revealed that the general AS factor was the only factor from the 2-group bifactor model that significantly predicted anxiety, depression, and negative affect. Implications and importance of this new bifactor structure of Anxiety Sensitivity in East Asian samples are discussed.
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37
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Vujanovic AA, Arrindell WA, Bernstein A, Norton PJ, Zvolensky MJ. Sixteen-Item Anxiety Sensitivity Index. Assessment 2016; 14:129-43. [PMID: 17504886 DOI: 10.1177/1073191106295053] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420) from the Netherlands. Confirmatory factor analysis was used to comparatively evaluate two-factor, three-factor, and four-factor models of the anxiety sensitivity construct. Support was found for a hierarchical structure of anxiety sensitivity, with one global higher-order factor and four lower-order factors. Internal consistency for the global and lower-order factors of the 16-item ASI was adequate. Convergent and discriminant associations between the 16-item ASI and general mood and panic-specific variables were consistent with anxiety sensitivity theory. In addition, incremental validity of the anxiety sensitivity construct was established, relative to negative affectivity, for unexpected panic attacks and agoraphobic avoidance.
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38
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Weems CF, Costa NM, Watts SE, Taylor LK, Cannon MF. Cognitive Errors, Anxiety Sensitivity, and Anxiety Control Beliefs. Behav Modif 2016; 31:174-201. [PMID: 17307934 DOI: 10.1177/0145445506297016] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the interrelations among negative cognitive errors, anxiety sensitivity, and anxiety control beliefs and explored their unique and specific associations with anxiety symptoms in a community sample of youth. Existing research has suggested that these constructs are related to childhood anxiety disorder symptoms; however, additional research is needed to test the interrelations among negative cognitive errors, anxiety sensitivity, and anxiety control beliefs and to determine if they show unique and specific associations with anxiety symptoms. The results of this study indicated that negative cognitive errors, anxiety sensitivity, and anxiety control beliefs were associated with each other and that they demonstrated unique concurrent associations with childhood anxiety disorder symptoms. Moreover, certain cognitive biases showed specificity in their association with anxiety symptoms versus depressive symptoms.
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Affiliation(s)
- Carl F Weems
- Department of Psychology, University of New Orleans, LA 70148, USA.
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39
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Abstract
The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among college students, the authors replicated the vulnerability effect of AS on panic onset. By measuring AS according to its hierarchical structure, the authors found an AS subfactor—AS-Mental Incapacitation Concerns—to be a significant predictor of panic onset. The authors also demonstrate that AS is not only statistically significant but also clinically/pragmatically important for the onset of panic. The association between panic and increased AS was confirmed in this study, although it remains for future research to conclude whether this association should be attributed to a “scar effect” of panic. Theoretical and methodological issues regarding tests of the scar effect hypothesis are discussed.
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Affiliation(s)
- Wen Li
- Cognitive Neurology and Alzheimer's Disease Center, Northwestern University, USA
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40
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Schoth DE, Golding L, Johnson E, Liossi C. Anxiety sensitivity is associated with attentional bias for pain-related information in healthy children and adolescents. J Health Psychol 2016; 21:2434-44. [DOI: 10.1177/1359105315578303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This investigation explored the association between anxiety sensitivity and attentional bias for threatening information in children and adolescents ( N = 40). Participants completed a pictorial version of the visual-probe task, featuring pain-related, health-threat and general-threat images presented for 500 and 1250 ms. Regression analyses revealed significant associations between anxiety sensitivity and attentional bias towards pain-related images presented for 500 ms and between state anxiety and attentional bias towards general-threat images presented for 1250 ms. These results suggest that in children and adolescents, anxiety sensitivity is associated with attentional bias for negative information of personal relevance.
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41
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Zanon C, Hutz CS, Reppold CT, Zenger M. Are happier people less vulnerable to rumination, anxiety, and post-traumatic stress? Evidence from a large scale disaster. PSICOLOGIA-REFLEXAO E CRITICA 2016. [DOI: 10.1186/s41155-016-0038-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Schmidt NB, Raines AM, Allan NP, Zvolensky MJ. Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic. Behav Res Ther 2016; 77:138-46. [PMID: 26752327 PMCID: PMC4752863 DOI: 10.1016/j.brat.2015.12.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
Abstract
Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers.
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Affiliation(s)
| | | | | | - Michael J Zvolensky
- University of Houston, Houston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA
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43
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Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015. [DOI: 10.1007/s10862-015-9522-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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44
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Graham RA, Weems CF. Identifying Moderators of the Link Between Parent and Child Anxiety Sensitivity: The Roles of Gender, Positive Parenting, and Corporal Punishment. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 43:885-93. [PMID: 25301177 PMCID: PMC4393333 DOI: 10.1007/s10802-014-9945-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A substantial body of literature suggests that anxiety sensitivity is a risk factor for the development of anxiety problems and research has now begun to examine the links between parenting, parent anxiety sensitivity and their child's anxiety sensitivity. However, the extant literature has provided mixed findings as to whether parent anxiety sensitivity is associated with child anxiety sensitivity, with some evidence suggesting that other factors may influence the association. Theoretically, specific parenting behaviors may be important to the development of child anxiety sensitivity and also in understanding the association between parent and child anxiety sensitivity. In this study, 191 families (n = 255 children and adolescents aged 6-17 and their parents) completed measures of child anxiety sensitivity (CASI) and parenting (APQ-C), and parents completed measures of their own anxiety sensitivity (ASI) and their parenting (APQ-P). Corporal punishment was associated with child anxiety sensitivity and the child's report of their parent's positive parenting behaviors moderated the association between parent and child anxiety sensitivity. The child's gender was also found to moderate the association between parent and child anxiety sensitivity, such that there was a positive association between girls' and their parents anxiety sensitivity and a negative association in boys. The findings advance the understanding of child anxiety sensitivity by establishing a link with corporal punishment and by showing that the association between parent and child anxiety sensitivity may depend upon the parenting context and child's gender.
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Affiliation(s)
- Rebecca A Graham
- Department of Psychology, University of New Orleans, New Orleans, LA, 70148, USA
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45
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Brandt CP, Bakhshaie J, Garey L, Schmidt NB, Leventhal AM, Zvolensky MJ. The Moderating Role of Smoking Amount Per Day on the Relations Between Anxiety Sensitivity, Smoking Dependence, and Cognitive-Affective Aspects of Smoking Among Treatment Seeking Smokers. Addict Behav Rep 2015; 1:26-33. [PMID: 26114159 PMCID: PMC4476409 DOI: 10.1016/j.abrep.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 11/30/2022] Open
Abstract
The current study examined the moderating effects of smoking amount per day on the relation between anxiety sensitivity and nicotine dependence, cigarette smoking outcome expectancies, and reasons for quitting smoking among 465 adult, treatment-seeking smokers (48% female; Mage = 36.6, SD = 13.5). Smoking amount per day moderated the relation between anxiety sensitivity and nicotine dependence, smoking expectancies for negative consequences and appetite control as well as intrinsic reasons for quitting. However, no moderating effect was evident for negative reinforcement expectancies. The form of the significant interactions indicated across dependent variables lower levels of smoking amount per day suppressed the relation between anxiety sensitivity and smoking related dependent variable, such that the positive relation of anxiety sensitivity to smoking dependence and cognitive-affective aspects of smoking is weaker in heavier smokers and more robust in lighter smokers.
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Affiliation(s)
- Charles P. Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, 1107 West Call St, Tallahassee, FL 32306, United States
| | - Adam M. Leventhal
- Department of Psychology and Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 9033, United States
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, United States
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States
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46
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015; 41:17-24. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 01/14/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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Knapp AA, Blumenthal H, Mischel ER, Badour CL, Leen-Feldner EW. Anxiety Sensitivity and Its Factors in Relation to Generalized Anxiety Disorder among Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 44:233-44. [DOI: 10.1007/s10802-015-9991-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bardeen JR. Short-term pain for long-term gain: the role of experiential avoidance in the relation between anxiety sensitivity and emotional distress. J Anxiety Disord 2015; 30:113-9. [PMID: 25723652 DOI: 10.1016/j.janxdis.2014.12.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/23/2014] [Accepted: 12/30/2014] [Indexed: 10/24/2022]
Abstract
Research has provided evidence of an interactive effect between anxiety sensitivity (AS) and experiential avoidance (EA) in predicting both anxiety and posttraumatic stress (PTS) symptomatology. Additionally, theory suggests that EA alleviates distress in the short-term, but exacerbates it in the long-term. The present cross-sectional study was developed to replicate the noted findings and examine the interaction (EA × AS) in the context of an emotionally evocative task. It was predicted that, among high AS participants, high EA would (a) reduce the likelihood of experiencing short-term increases in negative affect following the task, and (b) increase the likelihood of anxiety and PTS symptomatology. Undergraduate participants (N=199) completed a battery of self-report questionnaires and an emotionally evocative task. As predicted, positive associations were observed between AS and both anxiety and PTS symptoms, but only among high EA participants. Additionally, AS only predicted increases in negative affect following the emotionally evocative task for those with lower levels of EA, thus providing empirical evidence of the affect regulatory function of EA among those who fear anxiety-related bodily sensations. These findings help to elucidate the motives for the use of avoidance among those high in AS. Conceptual and clinical implications are discussed.
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Affiliation(s)
- Joseph R Bardeen
- Department of Psychology, Auburn University, Auburn, AL, United States.
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50
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An attempt to target anxiety sensitivity via cognitive bias modification. PLoS One 2015; 10:e0114578. [PMID: 25692491 PMCID: PMC4332857 DOI: 10.1371/journal.pone.0114578] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 11/11/2014] [Indexed: 11/29/2022] Open
Abstract
Our goals in the present study were to test an adaptation of a Cognitive Bias Modification program to reduce anxiety sensitivity, and to evaluate the causal relationships between interpretation bias of physiological cues, anxiety sensitivity, and anxiety and avoidance associated with interoceptive exposures. Participants with elevated anxiety sensitivity who endorsed having a panic attack or limited symptom attack were randomly assigned to either an Interpretation Modification Program (IMP; n = 33) or a Control (n = 32) condition. During interpretation modification training (via the Word Sentence Association Paradigm), participants read short sentences describing ambiguous panic-relevant physiological and cognitive symptoms and were trained to endorse benign interpretations and reject threatening interpretations associated with these cues. Compared to the Control condition, IMP training successfully increased endorsements of benign interpretations and decreased endorsements of threatening interpretations at visit 2. Although self-reported anxiety sensitivity decreased from pre-selection to visit 1 and from visit 1 to visit 2, the reduction was not larger for the experimental versus control condition. Further, participants in IMP (vs. Control) training did not experience less anxiety and avoidance associated with interoceptive exposures. In fact, there was some evidence that those in the Control condition experienced less avoidance following training. Potential explanations for the null findings, including problems with the benign panic-relevant stimuli and limitations with the control condition, are discussed.
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