Nicholas P Allan

• Doctor of Philosophy
• Professor (Assistant) at Ohio University

The PTSD Checklist for DSM‐5 (PCL‐5) is the most widely used self‐report measure of posttraumatic stress disorder (PTSD) and is frequently modeled as having four correlated factors consistent with the DSM‐5 symptom structure. Some researchers have argued that item order may influence factor structure. Although two studies have examined this, they w...

Introduction Previous research has identified a variety of barriers to mental health care among military personnel and veterans, despite high rates of mental health symptoms. The current study is the first to examine beliefs about mental health treatment barriers among post‐9/11 military personnel and veterans at elevated suicide risk not involved...

This study is aimed at pilot testing the experimental procedure for inducing state levels of intolerance of uncertainty (IU) using a sample of 62 undergraduate psychology students (M = 23.13, SD = 2.88, female 90.3%). Although similar procedures were used in other cultural contexts, this is the first time this phenomenon has been tested in Serbia....

Social anxiety disorder is one of the most prevalent anxiety disorders. There is a need to develop brief, virtual, single-session interventions targeting constructs associated with social anxiety, such as anxiety sensitivity social concerns (ASSC). ASSC is the maladaptive belief about consequences arising from observable symptoms of anxious arousal...

Transdiagnostic treatments have been designed to target common processes for clusters of disorders. One such treatment, transdiagnostic behavior therapy (TBT), targets avoidance across emotional disorders, including posttraumatic stress disorder (PTSD), depressive disorders, and anxiety disorders, and has demonstrated efficacy in randomized control...

Background: Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexe...

Objective: An understanding of the incremental value of social support in predicting psychopathology above transdiagnostic risk factors could speak to the benefit of leveraging social factors into existing, evidence-based interventions in veterans with emotional disorders. This cross-sectional study aimed to expand our understanding of association...

Purpose of Review Suicide has a profound impact on individuals, families, and society. One prominent, if understudied, risk factor for suicide is anxiety. More than 70% of people with at least one suicide attempt meet diagnostic criteria for an anxiety disorder. There are several limitations to exploring the associations between anxiety and suicide...

Objective Military members and Veterans at-risk for suicide are often unlikely to seek behavioral health treatment. The primary aim of this study was to test the efficacy of brief CBT for Treatment Seeking (CBT-TS) to improve behavioral health treatment utilization among U.S. military service members and Veterans at-risk for suicide.MethodsA total...

Background: Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are among the most prevalent forms of psychopathology. The hierarchical model of cognitive vulnerability proposes that higher order risk factors explain co-occurrence among internalizing disorders, whereas lower order risk factors explain discordance. Methods: Par...

Background and Objectives: Intolerance of uncertainty (IU) is an important transdiagnostic risk factor for the development and maintenance of anxiety- and depression-related disorders. Although traditionally targeted within the context of cognitive behavioral treatments, no studies to date have examined the efficacy of IU specific interventions. To...

Anxiety sensitivity social concerns (ASSC), or the fear of observable anxiety symptoms, is a risk factor for social anxiety. ASSC predicts anxiety following the niacin biological challenge, a paradigm in which niacin is used to manipulate facial flushing during a speech task. However, it remains unclear if ASSC predicts physiological arousal during...

Comorbidity is common in the emotional disorders. Despite this, most evidence-based psychotherapies are designed to target a primary diagnosis, with the expectation that secondary benefits will be realized for comorbid diagnoses. In contrast, newer transdiagnostic psychotherapies target common underlying symptoms to address multiple diagnoses at on...

Objective: Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that frequently presents alongside other comorbid diagnoses. Although several evidence-based psychotherapies have been well-studied for PTSD, limited research has focused on the influence of diagnostic comorbidity on their outcomes. The present study sought to investi...

Background Anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index-3 (ASI-3), exhibits three-factor and bifactor structures for younger adults. Less is known about the scale's structure within older adult samples. Methods We explored the ASI-3's factor structure in a sample of 135 older adults who completed the ASI-3 alongside measu...

Introduction: Suicide is a substantial public health burden, particularly among veterans. Risk factors have been delineated for suicide; however, the dynamic interrelations between risk factors have not been fully examined. Such research has the potential to elucidate processes that contribute to suicide risk between individuals with a past suicid...

Background : Predictors of dropout in individuals with PTSD and a comorbid severe mental illness (SMI; i.e., schizophrenia, bipolar disorder) have yet to be investigated. As part of a larger randomized controlled trial evaluation of Prolonged Exposure for PTSD plus treatment as usual (PE+TAU) relative to treatment as usual (TAU) alone, the current...

In addition to impacting the physical health of millions of Americans, the novel-coronavirus (COVID-19) pandemic is a significant psychological stressor due to both the threat of the illness itself and the mitigation strategies used to contain the spread. To facilitate understanding of the impact of COVID-19, validated measures are needed. Using a...

To better understand how social anxiety develops, it is crucial to identify mechanisms that influence anxiety following social stressors. Anxiety sensitivity social concerns (ASSC; fear of publicly observable anxiety symptoms) and fear of negative evaluation (FNE; distress arising from concerns about negative judgment) are constructs that amplify a...

Perfectionistic self-presentation (PSP) is a transdiagnostic risk factor typically assessed using the Perfectionistic Self-Presentation Scale (PSPS). The PSPS consists of three subscales, Self-Promotion, Nondisplay of Imperfection, and Nondisclosure of Imperfection. Overlap among these factors and inconsistent evidence for discriminant validity sug...

Background Despite high rates of comorbidity between pain and posttraumatic stress disorder (PTSD), little is known about factors that may account for this association. Previous research demonstrates that anxiety sensitivity (AS), the tendency to fear bodily sensations associated with anxious arousal, is elevated among patients with these condition...

Background Intolerance of uncertainty (IU), perceived attentional control (AC), and poor cognitive control abilities are risk factors for anxiety; however, few studies have examined their interactive effects in relation to anxiety. A more complete understanding of interplay between IU, perceived AC, and cognitive control could inform intervention e...

Background: Intolerance of uncertainty (IU) is a transdiagnostic risk factor for emotional disorders. Exploring the nature of IU might allow us to understand better a difference between pathological and normal worry processes. For that purpose, factor mixture modeling (FMM) can be used to test the latent structure of IU across a categorical-dimens...

The present study examined temporal patterns of symptom change during treatment for comorbid posttraumatic stress disorders (PTSD) and substance use disorders (SUDs). We hypothesized that PTSD symptom severity would predict subsequent‐session substance use and that this association would be particularly strong among patients who received an integra...

Intolerance of uncertainty (IU) and anxiety sensitivity (AS) predict distress during the COVID-19 pandemic. However, little is known about how AS and IU jointly predict COVID-19 worries and behaviors. Structural equation modeling was used to examine the direct and interactive effects of AS and IU as related to COVID-19 worries and behaviors in two...

Research has attempted to explain how emotion dysregulation and impulsivity relate to alcohol use problems. This study extended the literature by testing different pathways to problem alcohol use. We hypothesized that approach impulsivity/disinhibition and alcohol use frequency would mediate the relationship between emotion dysregulation and negati...

Public health measures enacted early in response to the COVID-19 pandemic resulted in unprecedented physical isolation. Social isolation, or the objective experience of being alone, and loneliness, the subjective feeling of being lonely, are both implicated in suicidal ideation. Anxiety sensitivity (i.e., fear of somatic anxiety) and intolerance of...

Background The purpose of this study was to identify classes of pain intensity trajectories among veterans reporting suicidal ideation with no prior mental health treatment experience. We were interested in also assessing factors associated with the pain trajectory classes. Methods A total 747 participants completed measures of pain, depression, s...

Background and Objectives Difficulties participating in social activities are associated with increased mortality and are underemphasized in addressing the opioid epidemic. This study assessed the association of difficulties participating in social activities and opioid use disorder (OUD) and suicidal ideation and suicide attempts and difficulties...

Insomnia symptoms are common among individuals with psychiatric disorders, and associated with increased symptom severity. However, the Insomnia Severity Index (ISI) has rarely been psychometrically evaluated in a psychiatric sample. Furthermore, the latent structure of the ISI has not been evaluated using factor mixture modeling, which improves up...

Objectives: Despite the existence of several first-line treatments for obsessive-compulsive disorder (OCD), many patients fail to experience symptom reduction and/or do not complete treatment. As a result, the field has increasingly moved towards identifying and treating malleable underlying risk factors that may in turn improve treatment efficacy...

Anxiety sensitivity (AS) is a promising intervention target due to its relevance to negative health behaviors broadly, and substance use specifically. The aim of the current study was to evaluate the direct and indirect pathways through which elevated AS could relate to recent substance use among a national adolescent sample recruited via social-me...

Objective Accurate threat appraisal is central to survival. In the case of the coronavirus pandemic, accurate threat appraisal is difficult due to incomplete medical knowledge as well as complex social factors (e.g., mixed public health messages). The purpose of this study was to evaluate the degree to which individuals accurately perceive COVID-19...

Drug courts have been in operation for decades to provide treatment alternatives to individuals whose substance use and related behaviors have brought them into contact with the criminal justice system. As research on drug courts have evolved, it has been demonstrated that different types of offenders have different mental health and substance use...

The COVID-19 pandemic has resulted in dramatic changes to sleep patterns and higher prevalence of insomnia, which threaten overall mental and physical health. We examined whether safety behaviors in response to COVID-19, worry in response to COVID-19, and depression predicted insomnia, with age, race, and sex as covariates. A community sample from...

Background : Depression and suicide are prominent and increasing U.S. public health issues, which suggests novel assessment and treatment approaches are needed. Reiss’ Expectancy Model of Fear, Anxiety, and Panic states that fear is based on two classes of variables, expectations and sensitivities, which has led to much research on anxiety sensitiv...

Background Anxiety sensitivity (AS), or the fear of anxious arousal, is a transdiagnostic risk factor. Despite the proliferation of self-report research showing AS is related to anxiety, cognitive processes underlying AS are poorly understood. Specifically, AS may reflect processes related to early attentional orientation and response monitoring (r...

Background: The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized t...

Chronic pain is a significant public health problem associated with functional impairment, increased medical expenditures, and opioid misuse. Recent work has suggested that certain transdiagnostic psychosocial factors may be more important than pain intensity to better understand pain and opioid outcomes. Specifically, pain-related anxiety, anxiety...

Background and Objectives Previous research demonstrates the utility of goals in attaining improved drinking outcomes. Considerably less is known about the association between substance use goals and outcomes among persons with comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD). This secondary analysis examined the assoc...

Optimizing treatment for co-occurring post-traumatic stress disorder and substance use disorder (PTSD+SUD) is critically important. Whereas treatments have been designed that target PTSD+SUD with some success, these treatments do not benefit all. Data-driven approaches that combine person- and variable-centered methods, such as parallel process lat...

The United States (US) population consumes an estimated 68% of the world's prescribed opioids each year, and over 2 million adults in the US suffer from an opioid use disorder. Although chronic pain populations are among the highest risk segments of the general population for opioid misuse and dependence, there is little understanding of individual...

Background: Studies examining Posttraumatic Stress Disorder symptom clusters, suicidal ideation, and variables described in the Joiner's interpersonal theory of suicidal behavior were cross-sectional. Methods: We tested whether the relation between the Posttraumatic Stress Disorder symptom clusters and suicidal ideation is mediated by perceived bur...

Objectives Despite advances in understanding associations among attention‐deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD‐relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent‐report questionnaire of ED conceptualiz...

The opioid epidemic is a significant public health crisis in the United States, and chronic pain is a leading precipitating and maintaining factor for opioid misuse. To better understand substance misuse generally, research has examined motivational models of why people use substances, and pain management and affect-driven coping are cited as prima...

The opioid epidemic is having a disproportionate impact on veterans. Indeed, veterans are twice as likely to die from an accidental overdose than members of the general population, even after accounting for gender and age distribution. Although many veterans seek treatment, a large proportion drop out prematurely and/or relapse highlighting the nee...

Prior studies suggest that the Attentional Control Scale (ACS) consists of two correlated factors. These models do not include a general factor, though this is assumed often in theory and practice. Using an adult North American sample collected through Amazon Mechanical Turk (N = 419), we examined a revised version of the ACS with positive keying o...

The Table 2 in the original version of this article contained mistakes.

Objective: Anxiety sensitivity (AS; fear of anxiety) is a malleable risk factor for anxiety and depression. Brief computerized interventions, including elements of psychoeducation, interoceptive exposure, and cognitive bias modification (CBM) can reduce anxiety and depression through AS reductions. These interventions are not equally efficacious f...

Objective: Adult research supports the efficacy of targeting the malleable risk factor of anxiety sensitivity (AS) in preventing anxiety and related psychopathology. However, very little work has evaluated the impact of AS reduction among youth, which is unfortunate given adolescence is a "core risk" period in terms of disorder onset. Method: Th...

The current study sought to explore suicidal concomitants, both demographic and psychological, among former military personal. The sample included 645 veterans who are at increased risk for suicide but have not yet pursued Veterans Health Administration (VHA) services. Descriptive statistics revealed that these veterans are primarily young Caucasia...

There are some notions that anxiety symptoms (AS) are multidimensional and that they may be differentially related to the development of different forms of psychopathology. However, little research has examined the structure and dynamics of AS within different diagnostic groups from the perspective of the network approach. Studies that focused on t...

Objective: To date, transdiagnostic treatments have primarily investigated treatment outcomes of general psychiatric symptomatology, rather than the specific transdiagnostic symptoms implicated in their protocols. The present study sought to address this significant gap in the literature by investigating the effect of transdiagnostic behavior ther...

Background: The current study examines the unique and interactive effects of posttraumatic stress disorder (PTSD) symptoms and days using alcohol, opioids, and marijuana on PTSD symptoms, suicidal ideation, and suicidal behavior up to 1 year, later in a high-risk sample of military personnel not active in mental health treatment. Methods: Curren...

This randomized controlled trial (RCT) compared the efficacy of Transdiagnostic Behavior Therapy (TBT) to Behavioral Activation Treatment for Depression (BATD) in veterans diagnosed with affective disorders. TBT is a transdiagnostic psychotherapy designed to address depressive, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Preliminar...

Introduction Numerous models explicating the role of transdiagnostic risk factors in the development of internalizing psychopathology have been developed. One such model, the "weakest link" model posits that an individual's most elevated risk factor contributes disproportionately to his or her internalizing symptoms. However, this model has only be...

Anxiety Sensitivity (AS) is a transdiagnostic risk factor defined as the fear of anxiety sensations based on irrational beliefs that these sensations could have detrimental physical, cognitive, and social consequences. Initially, AS was regarded as a multidimensional construct but later taxometric studies suggested its categorical nature. Finally,...

Background and objectives: Anxiety sensitivity (AS) social concerns, the fear of observable anxiety symptoms is posited as a risk factor for social anxiety by increasing fear reactivity in social situations when observable anxiety symptoms are present. Experimental evaluation of AS social concerns is limited. The current study utilized several man...

Background: Despite evidence that insomnia symptoms exacerbate alcohol use disorder symptoms, there is a dearth of prospective research testing bidirectional associations between these variables. Furthermore, no studies have prospectively examined these associations among military personnel, a vulnerable population for sleep- and alcohol-related p...

Attentional control (AC) comprises the abilities to attend to a desired stimulus, to shift focus to other stimuli, and to ignore distracting stimuli. Despite prior research demonstrating that AC generally relates to emotion regulation (ER), only one study, conducted by O’Bryan and colleagues (2017), has focused on AC in relation to specific ER diff...

Depression is often modeled as a unidimensional construct despite evidence for distinct symptom dimensions (i.e., cognitive, affective, and somatic symptoms). Intolerance of uncertainty (IU; a cognitive bias that increases distress in uncertain situations) is a risk factor implicated in the development of depression. However, it is unclear how IU l...

This study sought to examine the effect of general PTSD symptoms as well as specific PTSD symptom clusters on suicidal ideation and suicidal attempts. We first compared a correlated factors solution consistent with the DSM-5 symptom clusters for PTSD with a bifactor solution comprising a General PTSD factor and orthogonal specific factors. Using th...

Perfectionism, a trait-like individual difference variable reflecting the tendency to set extremely high standards along with critical evaluations of one's own behavior, has long been regarded as a risk and maintenance factor for obsessive-compulsive disorder (OCD). However, research exploring the relationship between these constructs is mixed. One...

Intimate-partner violence (IPV) in adolescent and young-adult dating relationships is a prevalent and serious public health problem. The measurement of IPV across adolescence has most commonly relied on the Conflict in Adolescent Dating Relationship Inventory (CADRI; Wolfe et al., 2001), which postulates 5 distinct yet related types of IPV (i.e., t...

Body dysmorphic disorder (BDD) is a body image disturbance of perceived ugliness that is underdiagnosed and often untreated. Although the nature of BDD is assumed to be synonymous with its conceptualization as a discrete DSM category, recent research suggests the possibility of a more complex latent structure. To clarify BDD's latent structure, dat...

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly prevalent and commonly co-occur. The dual diagnosis of PTSD/AUD is associated with serious negative sequalae, and there are currently no effective pharmacological treatments for this comorbidity. Both PTSD and AUD are characterized by dysregulation of the hypothalamic-pi...

Objectives: Person-centered approaches are underutilized to identify people with shared risk profiles. Methods: An at-risk sample of 773 past/current military personnel (Mage = 31.3 years, SD = 6.8) with current ideation (90.6%) and/or a prior suicide attempt (43.9%) were assessed using latent profile analysis. Variables included prior suicide atte...

Psychogenic movement disorders (PMDs) are common, associated with significant psychosocial impairments, and frequently comorbid with other physical and psychiatric conditions. However, treatment of PMDs has been largely unsuccessful. Recently, treatments focused on conditions comorbid with PMDs have been hypothesized as a possible improvement to PM...

Objective The acquired capability for suicide (ACS) is one of the most important breakthroughs in suicide research. ACS refers to an individual's increased fearlessness about death over time from experiencing painful and provocative events (PPE) and is based on opponent‐process theory—a habituation model. Few studies have investigated how ACS devel...

Suicide rates for service members and veterans are growing rapidly in the United States (U. S.). Despite availability of evidence-based approaches, a large number of high risk individuals are reluctant to seek out treatment. The present study used the interpersonal theory of suicide, involving three primary predictors of death by suicide to investi...

There is strong evidence that inattention is a correlate of reading-related skills; however, less research has examined the unique and longitudinal relations between multiple informants' ratings of inattention and the development of early reading skills across the preschool year. This study used latent growth curve analysis to examine whether ratin...

Objective Little is known about suicidal ideation stability, including whether stability is heterogeneous or homogeneous between individuals. Studies of this kind are necessary to understand the progression from suicidal ideation to action. Method This study examined suicidal ideation trajectories, using growth mixture modeling, in a sample of 359...

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i...

Objective: High anxiety sensitivity (AS) and poor attention control (AC) are established risk factors for posttraumatic stress symptoms (PTSS), but little is known about the combined influence of these variables. Consistent with dual-systems models suggesting facets of executive function (e.g., AC) will modulate the effects of other risk factors (...

Anxiety sensitivity (AS), or the fear of anxious arousal, is a transdiagnostic risk factor predictive of a wide variety of affective disorders. Whereas AS is widely studied via self-report, the neurophysiological correlates of AS are poorly understood. One specific issue this may help resolve is well-established gender differences in mean levels of...

The current study is the first to examine racial differences in suicidal thoughts and behaviors, risk factors, and intention to seek treatment in a sample of Black and White OEF/OIF suicidal military members who are not engaged in mental health care. Participants completed the one-hour assessment by telephone. Compared to White military members, Bl...

Background: The suicide rate in the Unites States continues to increase suggesting novel intervention strategies are needed. Anxiety sensitivity (AS), or a fear of anxiety-related sensations, is a suicide risk factor that can be ameliorated via a single-session, computerized intervention called the Cognitive Anxiety Sensitivity Treatment (CAST). R...

Background: Interventions aimed at preventing suicidal thoughts target people at risk for suicide based on risk factor elevations. Based on the interpersonal psychological theory of suicide, elevated perceived burdensomeness (PB) and thwarted belongingness (TB) are potential targets for prevention of the occurrence of suicidal thoughts. PB is the...

Cyberchondria refers to a clinical phenomenon in which repeated Internet searches regarding medical information result in excessive concerns about physical health. Cyberchondria is positively associated with symptoms of health anxiety, though it remains unclear as to whether cyberchondria poses a unique public burden. The current study replicated p...

Distress intolerance (DI), a trait-like individual difference reflective of the inability to endure aversive affective states, is relevant to multiple forms of psychopathology, but its relations to theoretically relevant neurobiological systems have received little attention. Altered cognitive control-related neurobiology has been theorized to unde...

Insomnia disorder is impairing and prevalent, particularly among individuals with comorbid anxiety disorders. Despite the availability of effective computerized treatments for insomnia, there are few that target both insomnia as well as co-occurring anxiety symptoms. The current study tests the efficacy of a computerized treatment for anxiety sensi...

Obsessive-compulsive disorder (OCD) is a notably heterogeneous disorder. As such, there has been increased interest in subtyping OCD into homogeneous entities using biological characteristics such as sex. Whereas there is large consensus in the literature regarding sex differences in the phenotypic expression of OCD, there are numerous disadvantage...

Despite the high levels of comorbidity between post-traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD-specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia-specific (...

Within a hierarchical framework for depressive and anxiety disorders, negative affect (NA) is posited to be indirectly related to social anxiety and depression through cognitive vulnerabilities, including intolerance of uncertainty (IU) and anxiety sensitivity (AS). However, few prior studies have considered whether the lower-order dimensions of IU...

Background: Post-traumatic stress disorder (PTSD) is a highly prevalent and impairing condition for which there are several evidence-based psychotherapies. However, a significant proportion of patients fail to complete a 'sufficient dose' of psychotherapy, potentially limiting treatment gains. Aims: The present study investigated predictors of p...

Recent research has highlighted the etiological role of sleep disturbance in posttraumatic stress disorder (PTSD); however it is currently unknown how daily changes in sleep are associated with next-day PTSD symptoms. Furthermore, sleep is critical for maintaining appropriate affect, leading some to hypothesize that affective dysfunction may accoun...

Background: Despite recent research establishing high rates of comorbidity between hoarding disorder and alcohol use disorders (AUD), no studies have systemically examined the associations between symptoms of hoarding and alcohol use. Moreover, no studies have explored potential mechanisms that may help to explain these relations. Objectives: Th...

A growing body of research suggests the importance of anxiety sensitivity (AS) in the development and maintenance of posttraumatic stress symptoms (PTSS). Specifically, AS cognitive concerns (fears of cognitive dyscontrol) may be particularly relevant for those with elevated PTSS. Preliminary research has suggested that interventions targeting AS m...