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Negative-reinforcement drinking motives mediate the relation between anxiety sensitivity and increased drinking behavior

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Abstract

We examined whether certain “risky” drinking motives mediate the previously established relation between elevated anxiety sensitivity (AS) and increased drinking behavior in college student drinkers (n=109 women, 73 men). Specifically, we administered the Anxiety Sensitivity Index (ASI), Revised Drinking Motives Questionnaire, and a quantity-frequency measure of typical drinking levels. Participants were parceled according to high (n=30), moderate (n=29), and low (n=34) AS levels. As expected, high AS participants reported a higher typical weekly drinking frequency than the low and moderate AS students regardless of gender. Similarly, high AS participants (particularly high AS men) reported a higher yearly excessive drinking frequency than low AS students. Only the negative reinforcement motives of Coping and Conformity were found to independently mediate the relations between AS and increased drinking behavior in the total sample. High AS women's greater drinking behavior was largely explained by their elevated Coping Motives, while heightened Conformity Motives explained the increased drinking behavior of high AS men. Finally, associations between AS and increased drinking behavior in university students were largely attributable to the “social concerns” component of the ASI. We discuss the observed relations with respect to the psychological functions of drinking behavior that may portend the development of alcohol problems in young adult high AS men and women.

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... Collins et al., 2021;Goldsmith et al., 2009;Zaso & Read, 2020) and related constructs (e.g. anxiety sensitivity; Stewart et al., 2001;Zack et al., 2007) that also evidence strong relationships with alcohol misuse (McCaul et al., 2017;Schmidt et al., 2007;Turner et al., 2018;Wheaton et al., 2012). Collectively, this suggests a connection between alcohol use and self-medication for distress originating from OCS and associated anxiety. ...
... Further, the findings are consistent with theory and empirical work suggesting that drinking to cope may act as negative reinforcement to promote alcohol misuse in the context of fear-and anxiety-related symptoms (e.g. Collins et al., 2021;Goldsmith et al., 2009;Stewart et al., 2001;Zaso & Read, 2020). Taken together, it seems that drinking to cope with negative affect could explain why people with elevated OCS are also more likely to develop an AUD. ...
... The only other known examination of drinking motives in the context of OCS found conformity motives to be significantly associated with both OCS and risky drinking, but this drinking motivation was not a significant mediator between the two (Bakhshaie Lewis et al., 2008;Terlecki & Buckner, 2015;Villarosa et al., 2014). Conformity motives have also been found to mediate the relationship between AS and excessive drinking behavior (Stewart et al., 2001). People with greater OCS might consume alcohol for motivations to "fit in" beyond avoiding pressure to drink from others-but may also drink to mask potentially observable OCS when in social drinking settings. ...
Article
Objective: Despite the commonly observed co-occurrence of obsessive–compulsive symptoms (OCS) and substance use in clinical populations, few researchers have examined potential mechanisms which contribute to this relationship. This study assessed the mediating role of drinking motives in the relationship between OCS, alcohol consumption, and its resulting health risks among U.S. adults. Methods: Adult participants (n = 1966; Mage = 47.72, SD = 17.91; 76.30% female; 86.10% non-Hispanic White) sourced from Research Match answered an online questionnaire containing measures related to substance use and anxiety-related symptoms. Results: As hypothesized, there was a significant positive indirect path between OCS and both alcohol consumption and risky alcohol use through coping motives. However, there were also small indirect effects of OCS through social motivations for consumption and conformity motivations for risky alcohol use. Conclusions: These results add evidence that coping motives play a role in OCS and alcohol misuse and highlights the need to also consider drinking motives related to social facilitation and conformity in those with co-occurring OCS and alcohol misuse.
... A recent review concluded that anxiety sensitivity may predispose individuals to seek the negative reinforcement that alcohol misuse can elicit; in other words, alcohol is used to cope with the distress of anxiety sensitivity (DeMartini & Carey, 2011). Further work has demonstrated that the relationship between anxiety sensitivity and alcohol use is mediated by negative reinforcement drinking motives (coping and conformity; Stewart et al., 2001). Thus, individuals with AUD and high anxiety sensitivity would likely be driven by coping drinkin motives associated with the relief phenotype. ...
... Further research has demonstrated that negative reinforcement drinking motives mediate the relationship between anxiety and alcohol use in college students (Stewart et al., 2001). In contrast to these past studies, the present findings are among the first to compare the relationship among intolerance of uncertainty, anxiety sensitivity, and drinking motives in individuals with AUD compared to healthy controls. ...
... The study findings also demonstrated that both coping and conformity drinking motives were associated with greater anxiety sensitivity among the AUD sample and not in the healthy control group. These findings replicate past research showing an association between negative drinking motives and anxiety sensitivity (DeMartini & Carey, 2011;Stewart et al., 2001). Synthesizing prior research and our current findings, one possible implication is that a lower threshold for uncertainty may drive individuals with AUD and heightened anxiety sensitivity to drink as a coping mechanism to alleviate their symptoms. ...
Article
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Alcohol use disorder (AUD) is a highly prevalent, yet heterogenous condition linked to anxiety, reward sensitivity, and cognitive biases. Understanding cognitive mechanisms of specific AUD symptoms is crucial for developing tailored, effective interventions. This pilot study sought to assess whether two potential cognitive correlates of AUD—intolerance of uncertainty and delay discounting—differentially influence the relationship between AUD, anxiety sensitivity, and drinking motives. Individuals with mild-to-moderate AUD (n = 31) and healthy control participants (n = 31) completed a single-session lab study in which they performed a decision making under uncertainty task as a behavioral measure of uncertainty tolerance, completed a delay discounting task as a measure of reward sensitivity, and responded to surveys related to anxiety sensitivity, state and trait anxiety, intolerance of uncertainty, and drinking motives. Hierarchical regression results demonstrated a significant interaction between AUD status (AUD vs. control) on both self-reported (β = 0.687, p = .020) and behavioral (β = 0.777, p = .012) intolerance of uncertainty. Greater anxiety sensitivity was associated with heightened intolerance of uncertainty in those with AUD but not controls. Correlations showed that the coping drinking motive was significantly positively associated with anxiety sensitivity (r = 0.462, p = .010), self-reported (r = 0.535, p = .002), and behavioral intolerance of uncertainty (r = 0.396, p < .027) in participants with AUD but not controls. No significant associations between anxiety sensitivity, drinking motives, and delay discounting were observed in either the AUD or the control group. Intolerance of uncertainty may therefore represent a cognitive bias in which individuals with AUD and anxiety sensitivity drink to cope with environmental and internal uncertainty.
... All effects were expected above and beyond theoretically relevant covariates, including trauma load (i.e., number of traumatic event types endorsed), age, and biological sex (i.e., sex assigned at birth). These covariates were included due to their relevance to study variables, mainly PTSS, AS, and alcohol-related outcomes (Kachadourian et al., 2014;Stewart et al., 2001). For instance, trauma load has been shown to be uniquely and positively associated with PTSS and alcohol use severity, particularly among university students (Berenz et al., 2016). ...
... Regarding the non-significant interaction between PTSS and AS social concerns, it may be the case that these specific AS-related experiences (e.g., fear of appearing anxious in public) do not exacerbate PTSS but can still impact motives for use. Indeed, AS social concerns did evince a main effect on coping-motivated drinking, which is consistent with past research (Stewart et al., 2001). Taken together, AS is a promising treatment target to help reduce hazardous and coping-related drinking (Olthuis et al., 2015;Watt et al., 2006). ...
... Nonetheless, the extant literature on the associations between PTSD, AS, and alcohol use is fairly mixed. Indeed, previous studies among university students and trauma-exposed populations indicate that AS may not be directly related to alcohol use, but rather, indirectly related via motives for use (Lebeaut et al., 2020;Stewart et al., 2001). For example, a student with high AS may be more motivated to consume alcohol to decrease distress rather than to increase their frequency and/or quantity of alcohol use. ...
... Individuals with anxiety sensitivity are at a greater risk of developing an AUD and tend to consume larger amounts of alcohol than individuals without anxiety sensitivity (Schmidt et al., 2007). The association between anxiety sensitivity and AUDs might be mediated by depression, anxiety, and other demographic variables, such as gender (DeMartini & Carey, 2011;Schmidt et al., 2007;Stewart, Zvolensky, & Eifert, 2001). For example, depression and anxiety were found to mediate the relationship between anxiety sensitivity and alcohol problems (Allan, Albanese, Norr, Zvolensky, & Schmidt, 2015). ...
... It is evident that there is at least some degree of avoidance in individuals with alcohol dependence and comorbid anxiety and/or depression (Carpenter & Hasin, 1999;Crum et al., 2013;DeMartini & Carey, 2011;Lechner et al., 2014). As such, it may be the case that the commonly observed relationship between alcohol-dependence and anxiety and depression, could be accounted for by experiential avoidance (Chawla & Ostafin, 2007;Forsyth, Parker, & Finlay, 2003;Levin et al., 2012;Stewart et al., 2001;Westrup, 1999). Stewart et al. (2001) examined experiential avoidance and anxiety sensitivity as predictors of motives for alcohol consumption in a sample of young adults. ...
... As such, it may be the case that the commonly observed relationship between alcohol-dependence and anxiety and depression, could be accounted for by experiential avoidance (Chawla & Ostafin, 2007;Forsyth, Parker, & Finlay, 2003;Levin et al., 2012;Stewart et al., 2001;Westrup, 1999). Stewart et al. (2001) examined experiential avoidance and anxiety sensitivity as predictors of motives for alcohol consumption in a sample of young adults. The results indicated that experiential avoidance significantly predicted increased alcohol consumption for negative reinforcement (i.e., coping) and positive reinforcement (i.e., enhancement) purposes. ...
Chapter
Schizophrenia is a mental disorder that affects how a person reacts with the surrounding world. Patients with schizophrenia have a lower quality of life. The long-term cost for supporting patients with schizophrenia is far greater than that of many other mental disorders. The cost of supporting schizophrenia patients is about 1%–3% of the national health care cost in most of the developed nations. This cost is almost up to 20% of the direct expenses of all types of mental health cost. Case studies are detailed qualitative investigation where a single or few participants are investigated. Case studies can explain social phenomena, that is, events happening in the society that relate to everyday living problem. Data in case studies can be gathered by documentation, interview, archival records, direct observation, participant observation, and physical artifact. Interview is a well-established technique for data collection in case study. There are various case studies on managing different symptoms and quality of life associated with schizophrenia patients. In the current study, the eligibility criteria for the selection of case studies are their effectiveness in addressing issues related to the management of schizophrenia. This chapter reviews prior case studies of the management of schizophrenia and explains why case studies are important for understanding and treating schizophrenia.
... Individuals with anxiety sensitivity are at a greater risk of developing an AUD and tend to consume larger amounts of alcohol than individuals without anxiety sensitivity (Schmidt et al., 2007). The association between anxiety sensitivity and AUDs might be mediated by depression, anxiety, and other demographic variables, such as gender (DeMartini & Carey, 2011;Schmidt et al., 2007;Stewart, Zvolensky, & Eifert, 2001). For example, depression and anxiety were found to mediate the relationship between anxiety sensitivity and alcohol problems (Allan, Albanese, Norr, Zvolensky, & Schmidt, 2015). ...
... It is evident that there is at least some degree of avoidance in individuals with alcohol dependence and comorbid anxiety and/or depression (Carpenter & Hasin, 1999;Crum et al., 2013;DeMartini & Carey, 2011;Lechner et al., 2014). As such, it may be the case that the commonly observed relationship between alcohol-dependence and anxiety and depression, could be accounted for by experiential avoidance (Chawla & Ostafin, 2007;Forsyth, Parker, & Finlay, 2003;Levin et al., 2012;Stewart et al., 2001;Westrup, 1999). Stewart et al. (2001) examined experiential avoidance and anxiety sensitivity as predictors of motives for alcohol consumption in a sample of young adults. ...
... As such, it may be the case that the commonly observed relationship between alcohol-dependence and anxiety and depression, could be accounted for by experiential avoidance (Chawla & Ostafin, 2007;Forsyth, Parker, & Finlay, 2003;Levin et al., 2012;Stewart et al., 2001;Westrup, 1999). Stewart et al. (2001) examined experiential avoidance and anxiety sensitivity as predictors of motives for alcohol consumption in a sample of young adults. The results indicated that experiential avoidance significantly predicted increased alcohol consumption for negative reinforcement (i.e., coping) and positive reinforcement (i.e., enhancement) purposes. ...
Chapter
Depression and anxiety are the most common psychological disorders to have a comorbid diagnosis with alcohol use disorders (AUDs). There have been inconsistent findings regarding the direction of these relationships, and few studies have attempted to determine the causal direction of the relationship between AUDs and the development of depression and anxiety. To provide some clarity on this debate, we provide an overview of the different factors that are contributing to this common comorbid diagnosis. We explain the complex relationship between these disorders by discussing the association between alcohol dependence and depressive symptoms; and the association between alcohol dependence and anxiety symptoms—with some discussion of the causal role of genetic predisposition to developing a comorbid diagnosis. The role of anxiety sensitivity, the mediating role of rumination, and experiential avoidance are discussed; with a focus on how self-medication contributes to individuals utilizing alcohol to cope with the negative affect associated with depression and anxiety. We also show how specific psychosocial risk factors are contributing to comorbidity. Based on our review, we suggest that our understanding of the comorbidity between AUDs, anxiety, and depression can be enhanced by identifying multiple risk factors that might be predictive of a comorbid diagnosis.
... Similarly, AS has been positively related to hazardous alcohol use (Guillot, Blumenthal, Zvolensky, & Schmidt, 2018;Paulus, Manning, Hogan, & Zvolensky, 2017) and has also been strongly related to drinking motives. For instance, elevated AS is related to both alcohol-related coping (i.e., drinking to alleviate distress; Novak, Burgess, Clark, Zvolensky, & Brown, 2003;Stewart & Zeitlin, 1995) and conforming motives (i.e., drinking to assimilate; Berenz et al., 2016;Stewart, Zvolensky, & Eifert, 2001, 2002. ...
... Theoretically, individuals with heightened PTSD symptoms (e.g., intrusions, negative cognitions and mood, arousal and reactivity) in response to trauma may be more sensitized to anxiety symptoms and thus develop or intensify fears of anxiety-related sensations (i.e., heightened AS). As a result, anxiety-related sensations may be especially distressing for such individuals, which may lead to increased alcohol use in order to cope and manage negative emotions (e.g., Haddock et al., 2017;Jahnke et al., 2014;Smith et al., 2018;Stewart, Zvolensky, & Eifert, 2001;Zack, Poulos, Aramakis, Khamba, & MacLeod, 2007). AS may thus account for the established association between PTSD symptomatology and alcohol use and coping-oriented alcohol use motives in firefighters. ...
... Results further indicate that AS was positively associated with enhancement, conformity, and social motives, which aligns with the extant literature (e.g., Berenz et al., 2016;Stewart, Karp, Pihl, & Peterson, 1997;Stewart et al., 2001Stewart et al., , 2002. However, past studies have found a negative association between AS and social motives (e.g., DeMartini & Carey, 2011;Stewart et al., 1997), which suggests firefighters may be more inclined to use alcohol to facilitate socialization compared to other populations. ...
Article
Introduction: Firefighters are vulnerable to developing posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Anxiety sensitivity (AS) is a cognitive-affective mechanism with clinical relevance to both PTSD and AUD. The current study examined the potential role of AS in the association of PTSD symptomatology with alcohol use severity and alcohol use motives among a large sample of firefighters. Heightened PTSD and high AS were expected to be associated with alcohol use severity and coping-oriented alcohol use motives. Heightened PTSD symptomatology was expected to be indirectly associated with alcohol use severity and coping motives through high AS. Covariates included number of years in the fire service and the number of traumatic event types endorsed. Methods: Participants included 652 urban firefighters (93.3% male; Mage = 38.7, SD = 8.57). Firefighters completed an online questionnaire battery. Results: PTSD symptomatology was positively associated with alcohol use and coping motives. AS was positively associated with alcohol use coping motives but not alcohol use severity. AS partially explained the association between PTSD symptomatology and coping, conformity, and social motives, but did not significantly account for the relationship between PTSD symptom severity and enhancement motives or alcohol use severity. Conclusions: Among firefighters, the association between PTSD and alcohol use coping, conformity, and social motives is partially accounted for by AS. Clinical and research implications are discussed.
... Similarly, researchers who investigated college students noted associations between depression and binge watching (Sung et al., 2015;Wheeler, 2015). Researchers have also identified relationships between binge drinking and stress (Kenney, Lac, LaBrie, Hummer, & Pham, 2013;Newton et al., 2014), depression (Martin, Usdan, Cremeens, & Vail-Smith, 2013), and anxiety (Martin et al., 2013;Stewart, Zvolensky, & Eifert, 2001). In addition, binge eating has been related to depression (American Psychiatric Association, 2013;Araujo et al., 2010;Azarbad et al., 2010) and stress (Sulkowski et al., 2011). ...
... Binge drinking among college students is considered a public health concern because of the prevalence on college campuses and consequences experienced by those who engage in the activity (Brown-Rice, Furr, & Jorgensen, 2015;Center for Behavioral Health Statistics and Quality, 2016;NIAAA, 2015). Hazardous alcohol consumption has also been related to stress (Kenney et al., 2013;Newton et al., 2014), depression (Martin et al., 2013), and anxiety (Martin et al., 2013;Stewart et al., 2001). Furthermore, various theories have been used to explain problem drinking, including escape theory (Baumeister, 1991) and the theory of planned behavior (Ajzen, 1991). ...
... Various researchers have identified relationships between hazardous alcohol consumption and stress (Kenney et al., 2013;Newton et al., 2014), depression (Martin et al., 2013), and anxiety (Martin et al., 2013;Stewart et al., 2001). However, a more recent study found no significant associations between hazardous drinking, depression, and anxiety among college students (Nourse, Adamshick, & Stoltzfus, 2017). ...
Thesis
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Binge eating and drinking have been studied with respect to stress, anxiety, and depression, but little is known about the emerging phenomenon of binge watching television programming. Guided by escape theory and the uses and gratification theory, this cross-sectional, correlational study addressed multivariate relations of binge drinking, binge eating, and binge watching with depression, anxiety, and stress among 102 college students ages 18 to 24. Multivariate canonical correlation results revealed that participants with low anxiety scores tended to have low scores on binge eating and drinking but high scores on binge watching. Participants with low stress scores and high anxiety scores tended to have low scores on binge watching and eating. In a regression model, anxiety, stress, and gender were important predictors of binge eating. Binge drinking was influenced by where a student lived, fraternity/sorority status, athletic participation, depression, and stress. Binge watching was best predicted by a model including stress, anxiety, athletic participation, and whether binge episodes were planned or unplanned. More binge watching occurred among participants not involved in athletics to pass time but not for information. Results may provide college mental health student services centers with empirical data to create programs to identify maladaptive binge behaviors among students and help them more effectively cope with stress, anxiety, and depression.
... Previous studies have shown that these traits are risk factors for alcohol-related problems in student populations, as they increase the probability of adverse alcohol-related outcomes [9]. Specifically, these traits have been shown to predict increased alcohol quantity and frequency [10][11][12] and greater alcohol-related harms [4,[13][14][15] among college students. ...
... There must be other mediators in the model, with an opposite direction of influence, that explain the risk pathway [57]. Coping and conformity motives [11], as well as generalized anxiety or depression [59], are positively correlated with AS and alcohol-related problems. Thus, they are potential candidates for mediators of the AS to harms risk pathway that works against the protective PBS pathway. ...
Article
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Alcohol consumption and associated harms are an issue among emerging adults, and protective behavioral strategies (PBS) are actions with potential to minimize these harms. We conducted two studies aimed at determining whether the associations of at-risk personality traits (sensation-seeking [SS], impulsivity [IMP], hopelessness [HOP], and anxiety-sensitivity [AS]) with increased problematic alcohol use could be explained through these variables’ associations with decreased PBS use. We tested two mediation models in which the relationship between at-risk personality traits and increased problematic alcohol use outcomes (Study 1: Alcohol volume; Study 2: Heavy episodic drinking and alcohol-related harms) was partially mediated through decreased PBS use. Two samples of college students participated (N1 = 922, Mage1 = 20.11, 70.3% female; N2 = 1625, Mage2 = 18.78, 70.3% female). Results partially supported our hypotheses, providing new data on a mechanism that helps to explain the relationships between certain at-risk personality traits and problematic alcohol use, as these personalities are less likely to use PBS. In contrast, results showed that AS was positively related to alcohol-related harms and positively related to PBS, with the mediational path through PBS use being protective against problematic alcohol use. This pattern suggests that there are other factors/mediators working against the protective PBS pathway such that, overall, AS still presents risks for alcohol-related harms.
... Accordingly, AS heightens the need to avoid negative affect or some other undesirable experience. AS is a risk factor that may impact smoking frequency and nicotine dependence (Zvolensky, Mayorga, & Garey, 2018a), as well as problematic drinking behaviour (Stewart & Zeitlin, 1995;Stewart, Zvolensky, & Eifert, 2000). ...
... Given that the SSLRV group has lower coping and conformity motives relative to the ASLRV group, females are more vulnerable to vaping. This vulnerability matches past findings that revealed stronger AS to coping motive links for females with respect to alcohol use (e.g., Stewart et al., 2000;Stewart & Zeitlin, 1995) and adds that this vulnerability is evident with vaping, even with lower scores on other SURPS dimensions. Lastly, employed respondents are overrepresented in the GLRV group, suggesting employment is a protective factor against EC use based on lower SURPS scores and motives. ...
Article
Introduction Research concerning e-cigarette use has revealed links between personality traits and motives for use. However, no studies have examined how these traits holistically relate to motives. Methods E-cigarette users (N = 468) residing in Nova Scotia, Canada (aged 16–24) completed an online survey containing a demographic and vaping questionnaire, the Substance Use Risk Profile Scale, and a modified Drinking Motives Questionnaire. A k-means cluster analysis and one-way MANOVA were used to segment users and measure differences in motives for use by cluster membership. Crosstabulation analyses were conducted to measure demographic differences. Results A four-cluster solution generated groups that differed based on SURPS: Anxiety sensitivity laden risk, global high-risk, global low-risk, and sensation seeking laden risk vape users. The global low-risk group had the lowest levels of coping, conformity, and social motives, while the global high-risk group had the highest levels of these motives except coping. Females were overrepresented in the anxiety sensitivity laden risk group and underrepresented in the sensation seeking laden risk group. Employed individuals were overrepresented in the global low-risk group. Conclusion Segmenting e-cigarette users based on SURPS can identify groups with stronger vaping motives to better prevent initiation and continued use.
... Altered interoceptive-related neural processing has been implicated in SUD in combination with emotion dysregulation and decision-making deficits, resulting in suboptimal behavioral adjustments and the propensity to continue drug use despite negative consequences [7][8][9][10][11][12]. To date, examination of the brain mechanisms involved in interoception and negative reinforcement has focused on adult SUD and little research has examined these concepts among adolescent substance users [13][14][15]. ...
... Adolescent participants (n = 47, ages [15][16][17] were recruited through local high schools by flyers that advertised an adolescent neuroimaging research study consisting of a clinical interview and neuroimaging session. The University of California San Diego Human Research Protections Program approved the study protocol. ...
Article
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Alcohol and cannabis use are highly prevalent among adolescents and associated with negative consequences. Understanding motivations behind substance use in youth is important for informing prevention and intervention efforts. The present study aims to examine negative reinforcement principles of substance use among adolescent cannabis and alcohol users by pairing a cue reactivity paradigm with an aversive interoceptive stimulus. Adolescents (ages 15–17), classified as controls (CTL; n = 18), cannabis and/or alcohol experimenters (CAN+ALC-EXP; n = 16), or individuals meeting clinical criteria for cannabis and/or alcohol use disorder (CAN+ALC-SUD; n = 13) underwent functional magnetic resonance imaging during which they experienced an aversive interoceptive probe delivered via breathing load while simultaneously performing a cue reactivity paradigm. Participants also provided self-report ratings of how their substance use is positively or negatively reinforced. While experiencing the breathing load, CAN+ALC-SUD exhibited greater (p < 0.05) deactivation in the right amygdala, the left inferior frontal gyrus, and the left parahippocampal gyrus than CAN+ALC-EXP and CTL, who did not differ. Across all substance users, activation during the breathing load within the left parahippocampal gyrus negatively correlated with cannabis and alcohol lifetime use episodes and the left inferior frontal gyrus activity negatively correlated with lifetime alcohol use episodes. CAN+ALC-SUD reported experiencing more positive and negative reinforcement of using their substance of choice than CAN+ALC-EXP; both user groups reported higher levels of positive than negative reinforcement. Adolescents with a cannabis/alcohol use disorder demonstrate an altered response to interoceptive perturbations. However, adolescent cannabis/alcohol use does not appear to be driven by negative reinforcement, as viewing substance images did not dampen this response. Based on self-report data, the experience of positive reinforcement may be stronger for adolescents. Future studies should examine whether positive reinforcement contributes to adolescent substance use.
... Also, Diraditsile and Rasesigo (2018) result supported the present finding that substance use predicted mental health among adolescents. Finally, extant results (Cranford et al., 2009;Stewart et al., 2001) also confirmed the negative effects of substance use on mental health among their study participants. ...
... Indeed, it is possible that individuals with, or at risk for, GAD may rely on alcohol to avoid social judgment when uncertainty-related distress is leading to inaction in social contexts. Cannabis use, negative affect, and anxiety sensitivity were selected as covariates due to associations between each of these factors and alcohol use (e.g., Gunn et al., 2018;Martens et al., 2008;Schmidt et al., 2007) and coping and conformity drinking motives (e.g., Armeli et al., 2010;Goldsmith et al., 2009;Simons et al., 2000;Stewart et al., 2001). Both a greater trait-like propensity to experience a variety of negative affective states (i.e., negative affect/neuroticism) and greater amplification of anxiety symptoms due to catastrophic misinterpretations that they are dangerous (i.e., anxiety sensitivity) may drive more frequent use of alcohol in order to alleviate such negative emotional states. ...
Article
Background: Hazardous drinking has remained high for college students in recent years, and individuals who endorse drinking to cope with emotional distress or to conform socially report higher levels of alcohol use. Intolerance of uncertainty, a core process underlying generalized anxiety disorder, has been linked to negative reinforcement drinking motives; however, no research, to date, has examined the role of intolerance of uncertainty in terms of alcohol use motives and hazardous drinking among individuals with generalized anxiety disorder. Objective: The current study was designed to examine the relationships between intolerance of uncertainty, coping and conformity alcohol use motives, and hazardous drinking in an analogue generalized anxiety disorder sample. Methods: Participants were 323 college students (Mage = 19.25, SD = 2.23, Range = 18-40) who endorsed past-year alcohol use and clinically elevated levels of worry. Self-report measures were completed online for course credit. Results: Partially consistent with our hypotheses, uncertainty paralysis predicted greater levels of coping motives, but not conformity motives. Desire for predictability did not predict either drinking motive. Mediation analyses revealed that there was a significant indirect effect of uncertainty paralysis on more hazardous drinking through greater coping motives. Conclusion: Overall, these findings highlight the potential utility of targeting behavioral inhibition due to uncertainty to reduce unhealthy coping via alcohol use and subsequent hazardous alcohol use.
... Heightened AS is crosssectionally and prospectively related to greater alcohol use (DeMartini & Carey, 2011;Vujanovic et al., 2018). Among college students, higher levels of AS, compared to low or moderate levels, are related to greater weekly alcohol use (Stewart et al., 2001). Further, among college women exposed to interpersonal trauma, AS is related to alcohol use, alcohol use problems, and alcohol use coping motives, as well as PTSD symptom severity (Berenz et al., 2016). ...
Article
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Objective: Hispanic/Latina students experience elevated rates of binge drinking, interpersonal trauma, and posttraumatic stress disorder (PTSD) symptoms. Research has indicated anxiety sensitivity (AS; i.e., fear of anxiety-related bodily sensations) and distress tolerance (DT; i.e., ability to tolerate negative emotional states) are modifiable psychological mechanisms related to alcohol use and PTSD symptoms. However, a dearth of literature has focused on factors that may account for associations between alcohol use and PTSD among Hispanic/Latina students. Method: The project examined, among 288 Hispanic/Latina college students (Mage = 23.3 years, SD = 5.4) with interpersonal trauma histories, the indirect effects of PTSD symptom severity on (a) alcohol use and (b) alcohol use motives (i.e., coping, conformity, enhancement, social) via DT and AS, evaluated as parallel statistical mediators. Results: Results PTSD symptom severity had an indirect effect on (a) alcohol use severity; (b) conformity motives for alcohol use; and (c) social motives for alcohol use via AS but not DT. PTSD symptom severity was associated with coping-oriented drinking via both AS and DT. Conclusions: This research has the potential to advance culturally-informed literature on factors that may impact co-occurring PTSD symptoms and alcohol use.
... AS, defined as the fear of anxiety-related sensations and cognitions (e.g., concerns related to increased heart rate and/or racing thoughts) [23,24], is a malleable [25], cognitive-affective vulnerability risk factor that is conceptually distinct from both trait anxiety [26] and PTSD [27]. AS has been positively related to hazardous drinking [28][29][30] and coping-oriented drinking motives across various populations [31][32][33][34] and is related to increased rates of consumption and alcohol use disorder (AUD) [35,36]. Further, AS is implicated in the development and maintenance of PTSD [37][38][39] and may underlie hazardous drinking-PTSD comorbidity by amplifying PTSD symptomatology (e.g., hyperarousal) and motivating drinking to down-regulate such affect [22,40,41]. ...
Article
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Background: Hazardous drinking and posttraumatic stress disorder (PTSD) are commonly co-occurring conditions among adults. Motivational enhancement interventions, such as personalized feedback interventions (PFI), have demonstrated efficacy for reducing hazardous drinking. Emerging though scant literature has evaluated PFI for co-occurring PTSD and hazardous alcohol use. A transdiagnostic risk factor that may underlie this co-occurrence and inform novel PFI development is anxiety sensitivity (AS). Objective: To use a randomized controlled trial to evaluate the efficacy of a novel, computer-based PFI for hazardous drinkers with at least subclinical PTSD and elevated AS (AP-PFI), against a time-matched comparison condition (C-PFI). Methods: Participants (N=100) will be recruited and enrolled from the Houston, TX community. The study includes: an in-person visit (baseline diagnostic assessment, a brief intervention, and a post-intervention assessment) and two follow-up assessments (1-week and 1-month). Participants who meet study inclusion criteria will be randomized to one of two conditions at baseline: AP-PFI or C-PFI. AP-PFI will consist of a brief, single-session, computer-delivered, PFI-based intervention that provides integrative and normative feedback about alcohol use, AS, and PTSD symptoms. C-PFI will be time-matched but will only include alcohol-related feedback. Conclusions: AP-PFI is designed to provide feedback about alcohol use, PTSD symptoms, and AS and their interplay and deliver psychoeducation on harm-reduction techniques, interoceptive exposure exercises, and stress management strategies. The intervention may address extant gaps in treatment for these co-occurring conditions by providing a brief, evidence-based, motivational enhancement intervention that is cost-effective with potential to be disseminated across a variety of healthcare settings.
... Our findings are partially consistent with the large body of theoretical and empirical research linking AS with the tendency to drink for negative reinforcement reasons (i.e., to cope and reduce tension; Chandley et al., 2014;Kushner et al., 2001). Moreover, consistent with the literature (e.g., Stewart et al., 2001), increases in AS lead to increases in alcohol use, but inconsistent with the literature (e.g., Karp, 1993), our study found no association between AS and alcohol problems. However, the association between AS, alcohol cognitions, and alcohol use and problems is not well-defined; though some studies have found AS to directly predict alcohol problems (e.g., Schmidt et al., 2010;Stewart et al., 1999), several studies have found that motives and expectancies impact this association (O'Connor et al., 2008). ...
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Objective: Alcohol use and related problems increase during adolescence and peak in early adulthood. Tension reduction theories suggest that those high in anxiety sensitivity (AS) may be at risk for misusing alcohol for its anxiolytic effects. Cognitive theories point to drinking motives and alcohol expectancies as explanatory mechanisms of this risk pathway. This study examined AS risk for prospective alcohol misuse, as explained by an unfolding cognitive process, among those transitioning out of Collège d’enseignement général et professionnel (CEGEP, i.e., junior college equivalent in Quebec, Canada). We hypothesized that there would be trait-like (average levels over time), positive associations between AS, coping motives, tension-reduction alcohol expectancies, and alcohol use and problems, and that AS would lead to state-like (occasion-specific, reciprocal associations) bidirectional and positive associations between alcohol cognitions and outcomes. Method: Final-year CEGEP students (N = 193) completed three online questionnaires at 6-month intervals assessing AS, drinking motives (coping, enhancement), alcohol expectancies (tension reduction, sociability/liquid courage), and alcohol use/problems. State–trait modeling was used for hypothesis testing. Results: Consistent with hypotheses, at the “trait” level, drinking motives and alcohol expectancies were positively associated, and drinking motives and sociability/liquid courage expectancies were positively associated with alcohol problems. At the “state” level, AS positively predicted coping motives and alcohol use, tension-reduction expectancies positively predicted coping motives, and coping motives and sociability/liquid courage expectancies positively predicted alcohol use. Conclusions: Results suggest that AS is a risk factor for coping-motivated drinking, and that there is interplay between cognitions that may help understand emerging adult alcohol risk pathways.
... The link between mental health and alcohol use may be partially explained by "selfmedication" hypothesis (Turner, Mota, Bolton, & Sareen, 2018). Individuals may be prone to use alcohol for coping reasons because it helps them managing negative feelings (Gilson, Bryant, & Judd, 2017;Stewart, Zvolensky, & Eifert, 2001;van Gils et al., 2020) or even physical pain (Gilson et al., 2017). ...
Article
Objectives: Gender has been identified as an important social determinant for health. This study investigates gender-specific characteristics for alcohol use (AU) among community-dwelling older adults. Methods: This is a retrospective cross-sectional study in 1.406 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behavior, mental health, drinking motives and resilience by using, respectively, the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI), the Drinking Motives Questionnaire (DMQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multiple linear regression was used to identify the joint contribution of those factors on AU. Hierarchical regression was used to investigate the influence of the interaction between gender and those factors on AU. Results: Linear regression analyses showed different associations with AU in men and women. Hierarchical regression analyses showed that gender presented a two-way interaction effect with enhancement and anxiety variables related to AU. Conclusions: Different characteristics were found as predictors for AU among older men and women. Clinical implications: Clinicians and health-care providers should be aware of these differences in order to provide tailored screening and intervention programs to reduce AU in older adults.
... In regard to scalability, the current interventions are completely computer-guided thereby requiring no or minimal clinical contact and potentially allowing for remote delivery or implementation. Moreover, risk factors such as AS are transdiagnostic as they have been shown to be relevant to substance use, pain and other health related behaviors (Stewart et al., 2001;Horenstein et al., 2018;McHugh & Kneeland, 2019;Lejuez et al., 2006;Asmundson, 2019). Although these outcomes were not assessed in the current report, it is notable that these intervention programs may offer even broader preventative benefits beyond anxiety and mood psychopathology. ...
... For example, men often engage in social drinking, but women tend to drink to relieve negative emotions. In this context, many studies have pointed to psychosocial factorssuch as stress and coping mechanisms [18,19], low selfesteem, depression, social support, and social networks [20][21][22]-as predictors of problem drinking in women. Furthermore, sociodemographic factors such as age, education level, marital status, income, economic activity status [9,16,[23][24][25], one-person households [26], and relationship-related factors [27,28] have also been mooted as predictors of female drinking. ...
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Background: In recent years, female drinking has been on the rise worldwide, and this trend can be observed in Korea as well. Accordingly, this study aimed to examine the heterogeneous longitudinal changes in drinking patterns among Korean women, while also exploring the determinants of these changes. In particular, the study identified the gender perspective-related determinants of the classified patterns of problem drinking. Methods: Data on 4615 adult women who participated in the Korea Welfare Panel Study (KOWEPS) for 3 years (2018-2020) were analyzed longitudinally using SPSS Statistics 22.0 and M-plus 7.0. The changes in female drinking patterns were analyzed using latent class growth analysis. Subsequently, multinomial logistic regression analysis was performed to identify the predictive factors affecting the changes in drinking patterns. Results: Latent class analysis yielded three classes: "low problem drinking/decreased," "moderate problem drinking/maintained," and "high problem drinking/increased." Of the participants, 80.4% were in the first class, 14.5% in the second, and 5.1% in the third. After controlling for sociodemographic and psychosocial factors, we found: i) domestic violence, work-family balance stress, and gender role perception were not statistically significant for the "moderate problem drinking/maintained" class; lower levels of depression (odds ratio; OR = .750, p < .05) and higher levels of satisfaction with social relationships (OR = 1.257, p < .05) increased the probability of belonging to the "moderate problem drinking/maintained" group compared to the low problem drinking/decreased class; ii) in the "high problem drinking/increased" class, relative to the low problem drinking/decreased class, experience of domestic violence (OR = 1.857, p < .05), work-family balance stress (OR = 1.309, p < .05), and gender role perception (OR = .705, p < .05) were significant predictors of drinking behavior. Conclusions: Problem drinking in Korean women demonstrated heterogeneous patterns of change, with gender-specific factors being the main predictors of this change. Therefore, this study developed a strategy for reducing the harmful effects of female drinking, which considers the characteristics of the changes in women's drinking patterns as well as factors from the gender perspective.
... thinking. Anxiety-sensitive youth exhibit an increased risk for anxiety disorders and tend to use alcohol as a coping, reduction, or avoidance strategy for negative emotions and social criticism (Maller et al., 1992;Stewart et al., 1997;Stewart et al., 2001;Conrod, 2007). Similarly, hopelessness/negative thinking personalities show a link to depressive disorders, with alcohol being used as a pain-reduction strategy to selfmedicate, specifically amongst Indigenous youth (Stewart et al., 2005). ...
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Considering the growing prevalence of substance use amongst young people, prevention programs targeting children and adolescents are needed to protect against related cognitive, psychological, and behavioural issues. Preventative programs that have been adapted to Canadian Indigenous cultures in school and family settings are discussed. The first and second phase of the Life Skills Training (LST) program and the Maskwacis Life Skills Training (MLST) program are reviewed, as well as Bii-Zin-Da-De-Da (BZDDD; “Listening to One Another”) and a culturally sensitive smoking prevention program. Motivating factors, comorbid disorders, and at-risk personality types associated with substance use amongst Canadian children and adolescents, specifically Indigenous youth, are considered through the application of the biopsychosocial model. This paper aims to describe the requital efforts being made in Canada towards Indigenous communities, to compare substance use prevention programs targeting Indigenous children and adolescents, and to provide suggestions for future research on preventative interventions directed towards substance use within minority groups.
... Previous prospective analyses revealed that baseline cannabis use was associated with increased anxiety at the follow-up assessment among young adults (Wittchen et al., 2007). In addition, studies found that persons with higher anxiety sensitivity -the fear of arousal-related bodily sensations-had more risky drinking motives that were correlated with drinking frequency (Stewart et al., 2001). More importantly, the present study implies that the COVID-19 pandemic may contribute to the new onset of concurrent disorders (i.e., co-occurring addiction and mental health problems) or relapse of pre-existing dual disorders for both genders (Volkow, 2020). ...
Article
Free access to the article could be found here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799934/pdf/main.pdf ------------------------------------------------------------------------------------------------------------------------------------------------------------- Background: Growing evidence has demonstrated the mental health sequelae of the COVID-19 pandemic. Few studies have examined how pandemic-related stressors and resilience factors of anxiety affect women and men differently in Canada. Methods: Population-based data from the Canadian Perspective Survey Series (CPSS-4: July 20 to 26, 2020) were analyzed to examine the relationship between Generalized Anxiety Disorder-7 scale (GAD-7) with COVID-19 misinformation exposure, precarious employment, and health behavior changes, after adjusting for socio-demographic variables. Stratified by gender, two multinomial logistic regression were conducted to calculate the likelihood of having minimal–mild anxiety (1≤ GAD score <10) and moderate–severe anxiety (GAD score ≥10), compared to no anxiety symptoms (GAD=0). Results: Overall, respondents (n = 3,779) were mainly Canadian-born (76.3%), aged >25 years (85.4%) and high school graduate (87.9%). The population prevalence of moderate–severe GAD was 13.6%, with women significantly higher than men (17.2% vs. 9.9%, p<0.001). For women (n = 2,016), GAD was associated with being absent from work due to COVID-19 reasons (OR=3.52, 99% CI:1.12–11.04), younger age (ORs range from 2.19 to 11.01, p's<0.01), being single/widowed (OR=2.26, 99% CI 1.18–4.33), no past-week contacts outside household (OR=2.81, 99% CI:1.24–6.37), no outdoor exercise (OR=1.86, 99% CI:1.13–3.07). For men (n = 1,753), GAD was associated with frequent fake news exposure (dose-response relations: ORs range from 3.14 to 6.55, p's<0.01), increased time of watching TV (OR=2.62, 99% CI: 1.31 – 5.27), no indoor exercise (OR=1.91, 99% CI:1.07–3.42). . For both genders, GAD was associated with increased intake of alcohol, cannabis, and junk/sweet food (p's<0.01). Limitations: Cross-sectional data prohibits causal inferences; self-reporting biases of GAD symptoms requires confirmation with diagnostic records. Conclusion: The gendered impact of the COVID-19 pandemic was observed in the associations between clinically significant anxiety with COVID-19 misinformation exposure, job precarity, and addictive behaviors in Canada. Mental health interventions need to be gender responsive and should tackle upstream social determinants of health in this public health emergency
... After initial application to anxiety disorders, AS has emerged as an important transdiagnostic marker of pathology. In addition to elevations across anxiety/fear, depressive, and substance use disorders (e.g., McHugh & Kneeland, 2019;Naragon-Gainey, 2010;Olatunji & Wolitzky-Taylor, 2009;Stewart et al., 2001), AS has been associated with a host of health-related behaviors in over 160 studies of cardiac, pain, respiratory, and gastrointestinal patients (Horenstein et al., 2018). In particular, AS is associated with fear of medical symptoms, avoidance of healthy behaviors, and engagement in unhealthy behaviors (Horenstein et al., 2018). ...
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Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.
... As hypothesized, higher personal coping drinking motives and higher selfreported anxiety were associated with greater alcohol consumption during lockdown. However, anxiety was no longer significant in the final model, suggesting that anxiety is accounted for by other variables known to be associated with consumption, such as coping motives (Stewart et al., 2001). Social positive and social coping motives were not longitudinally associated with alcohol consumption but were positively associated with alcohol consumption at baseline. ...
Article
Background Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown. Methods An online survey was distributed through social media (8th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was ‘weekly unit consumption’ and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety. Findings A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores). Conclusions Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support.
... Alcohol use disorders (AUDs) have a significant comorbidity rate with anxiety disorders (ANX; [1][2][3][4][5][6]), with estimates of approximately 6 million U.S. adults having comorbid AUD/ANX [7]. Comorbid AUD/ANX is associated with more severe and chronic symptoms, as well as worse disability than when either disorder presents alone [2,6,[8][9][10][11][12][13][14][15]. Unfortunately, compared to individuals with AUD or ANX alone, those with AUD/ANX report more barriers to care [16]. ...
Article
Alcohol Use Disorder (AUD) and anxiety disorders (ANX) are each highly prevalent and frequently co-occur, resulting in a complex clinical presentation. The existing literature to date has not yet identified how to best treat comorbid AUD/ANX, partially due to limitations in understanding what factors and mechanisms are implicated in their co-occurrence. This manuscript describes the rationale and methods for an ongoing randomized-controlled trial designed to evaluate the efficacy of a cognitive behavioral intervention, the Unified Protocol for transdiagnostic treatment of emotional disorders (UP), compared to Take Control (TC), a psychosocial and motivational treatment serving as a control condition in this study, for comorbid AUD/ANX. Sixty individuals with comorbid AUD/ANX will be randomized to UP or TC, and complete assessments at pre- and post-treatment, as well as one- and six-month follow-up points. We hypothesize that the UP, compared to TC, will result in significantly greater reductions in drinking-related outcomes, as well as anxiety and depressive-related outcomes. Additionally, the current study is designed to evaluate exploratory aims to contribute to our theoretical understanding of why AUD and ANX frequently co-occur. Specifically, we will examine the relationship between changes in AUD and ANX symptoms in relation to changes in emotional disorder mechanisms, such as emotion regulation. Because the UP is a transdiagnostic treatment that specifically targets underlying components of emotional disorders generally, it may be well suited to effectively target comorbid AUD/ANX.
... Regarding primary outcomes, it was expected that those in the PFI condition would evidence greater improvements in motivation to change their alcohol use, hazardous alcohol use, and anxiety sensitivity from baseline through three month follow-up. Finally, as secondary outcomes, reductions in emotional symptoms (anxiety and depression) were examined as well as negative reinforcement drinking motives (drinking to cope with anxiety, drinking to cope with depression, and drinking to conform), which have been previously linked to anxiety sensitivity and alcohol misuse (Stewart, Zvolensky, & Eifert, 2001). ...
Article
Hazardous drinkers with emotional vulnerabilities (e.g., elevated anxiety sensitivity) remain an underserved group. This study aimed to evaluate the feasibility, acceptability, and initial efficacy of a single session remotely-delivered personalized feedback intervention (PFI) targeting alcohol (mis)use and anxiety sensitivity among college students. Hazardous drinkers with elevated anxiety sensitivity (N=125; 76.8% female; Mage = 22.14; 66.4% racial/ethnic minorities) were randomized to receive the integrated PFI (n=63) or attention control (n=62). Follow-up assessments were conducted one-week, one-month and three-months post-intervention. Latent growth curve modeling was used to test pilot outcomes. It was feasible to recruit and retain hazardous drinking students with elevated anxiety sensitivity through follow-up with no group differences in retention. The integrated PFI was rated as more acceptable than the control with medium/large differences (p’s<0.004; d’s=0.54-0.80). The integrated PFI group had statistically significantly greater change in primary outcomes: motivation, hazardous alcohol use, and anxiety sensitivity (p’s <0.05; d’s=0.08-0.37) with larger within-group effect sizes (d’s=0.48-0.61) than in control (d’s=0.26-0.54). Despite a small sample size, this one-session intervention offers promise among a high-risk group of drinkers with emotional vulnerabilities. The computer-based format may allow for mass distribution of a low-cost intervention in the future; however, follow-up testing in larger samples is needed.
... Another possible interpretation is that there are other factors at play that wedid not account for inthe assessment battery. For example, some researchhas shownpersonality traits, suchasanxiety sensitivity, may play a role in stress-induced drinking (e.g., Stewart et al., 2001). In addition, sleep problems, which have been shown to partially mediate the relation between PTSD and substance use disorders (Vandrey et al., 2014), may serve as an important factor to consider that was not measured in the current study. ...
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Objective: To understand how interpersonal trauma (IPT), stress response, and drinking to cope converge to predict stress-induced drinking, a risk factor for alcohol use disorder. Method: Young adults with no substance use disorder were classified into three trauma history groups: (a) IPT with PTSD (n = 27), (b) IPT without PTSD (n = 35), and (c) Control (no trauma-history/no PTSD; n = 36). Participants completed a baseline assessment, including a structured clinical interview, to confirm PTSD diagnosis, followed by the Trier Social Stressor Task (TSST) and an alcohol use task. Subjective units of distress and blood serum cortisol were collected at standardized timepoints throughout the tasks. Results: In all three groups (PTSD, IPT, control), males consumed more alcohol in the lab than females. Participants in the PTSD group had significantly higher drinking to cope motives, which were associated with greater subjective reactivity; however, neither drinking to cope motives nor subjective reactivity to the TSST predicted post-stressor alcohol consumption for those with PTSD. Conclusions: The interplay among trauma history, stress, and drinking among young adults is nuanced; additional lab-based studies are needed to further clarify the nuanced connection between trauma history, acute stress reactions, and alcohol use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Specifically, AS has been found to be crosssectionally and prospectively related to the use of various licit substances that have real or perceived anxiolytic properties including alcohol (DeMartini & Carey, 2011) and nicotine (Powers et al., 2016). Consistent with motivational models of substance use, individuals with elevated levels of AS report the expectation that such substances will reduce negative affective states and report using for this reason (Guillot, Pang, & Leventhal, 2014;Langdon et al., 2018;Stewart, Zvolensky, & Eifert, 2001). Emerging evidence also supports an association between AS and several illicit substances with real or perceived anxiolytic properties including cannabis and opioids. ...
Article
Background: The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. Methods: The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. Results: AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. Conclusions: Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
... Researchers have proposed that AS is a multidimensional construct, including cognitive, physical, and social components (Allan, Albanese, Short, Raines, & Schmidt, 2015;Taylor et al., 2007). AS is associated with negative physical and psychiatric conditions, psychological symptoms, and outcomes (Taylor, Koch, & McNally, 1992;Stewart, Zvolensky, & Eifert, 2001;Zvolensky & Schmidt, 2003;Cox, Enns, Freeman, & Walker, 2001;Olatunji, & Wolitzky-Taylor, 2009). Although AS is a transdiagnostic construct relevant to many populations and conditions, research suggests that intervening on AS may be especially useful for individuals with a history of mild traumatic brain injury (mTBI). ...
Article
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Objective: Anxiety sensitivity (AS) is a transdiagnostic risk factor for persistent physical and psychological symptoms relevant to veterans, such as postconcussive symptoms following mild traumatic brain injury (mTBI). The Cognitive Anxiety Sensitivity Treatment (CAST) computerized intervention has been shown to reduce AS but has not been widely used among veterans. The purpose of this study was to assess the acceptability and feasibility of CAST among veterans with elevated AS and mTBI eligible to receive Veterans Health Administration (VHA) care. Design: Twenty-two veterans with mTBI, elevated cognitive AS, and history of deployment to Iraq and/or Afghanistan completed a single assessment and intervention session. Acceptability was assessed with the Client Satisfaction Quesitonnaire-8 (CSQ-8) and a qualitative interview. Measures of feasibility included study enrollment, ease of participation, and intervention completion. AS was assessed pre- and post-CAST completion. Results: Consistent with interview responses, 77.3% of participants’ CSQ-8 scores indicated that veterans found the intervention acceptable. Technological issues, such as internet connectivity, decreased feasibility of consistently delivering the intervention in the research setting readily available to the study team. Decreases on pre-to-post intervention AS outcomes were observed. Conclusions: Acceptability of the CAST intervention in this sample was generally supported. Feasibility of implementing CAST in this study was limited by technological issues. Data did not indicate a critical need to revise content of the CAST intervention. Identified strategies for increasing the feasibility of future research and clinical implementation of CAST are discussed.
... Further, various maladaptive emotional schemas, including beliefs that emotions are uncontrollable, intolerable, and dangerous, are also commonly endorsed by persons who habitually engage in dysregulated behaviors, such as binge-eating and alcohol use (Corstorphine 2006;Manser et al. 2012;Stewart et al. 2001). ...
Article
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Recent advancements in emotion theory propose that emotional schemas—individualized conceptualizations and beliefs about emotions—serve a fundamental function in guiding emotional processes. To critically assess the validity of this suggestion, the current research proposed and evaluated an integrative model of emotional functioning. Two studies were completed using a combination of behavioral (Mirror Tracing Persistence Task), performance-based (Perception of Affect Task), and self-report (Leahy Emotional Schema Scale-II, Cognitive-Behavioral Avoidance Scale, Generalized Expectancy for Negative Mood Regulation Scale, UPPS-P Impulsive Behavior Scale) measures of maladaptive emotional schemas and emotional functioning. Results supported the model and suggested complex interrelations between maladaptive emotional schemas, emotion-processing deficits, avoidant coping, emotion-regulation ineffectiveness, and behavioral dysregulation, with emotional schemas playing a key role in guiding emotional experience and functioning. Given the centrality of beliefs about emotion and emotional functioning in empirically supported therapies, the proposed model may inform future research on mechanisms of change in these treatments.
... In previous research on alcohol related problems in SAD, individuals with elevated social anxiety drink to cope with their negative emotions (coping motives) or to conform as a means of getting along with others and ensure that they are not isolated (conformity motives) [10][11][12]. Moreover, accumulating evidence suggests that certain SAD symptoms, such as social anxiety or fear of evaluation, with the mediation of coping and conformity motives, are associated with drinking situations and alcohol related problems [13][14][15][16]. Considering that drinking with coping and conformity motives differs from socially acceptable drinking and is strongly related to alcohol related problems, even when drinking quantity is controlled [17], it is not surprising that people with SAD become dependent on it to regulate their symptoms and therefore experience more alcohol related problems, even if they drink a small amount of alcohol [10]. ...
Article
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Background: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of the development of alcohol related problems among individuals with elevated social anxiety. We investigated the moderation effect of difficulties in emotion regulation on the relationship between symptoms of social anxiety, coping and conformity motives and alcohol related problems. Methods: In a sample of university students (N = 647) in South Korea, we examined whether cognitive (fear of negative evaluation), behavioral (social avoidance), and physiological symptoms (concerns over physiological symptoms) of social anxiety affect alcohol related problems with the mediation of coping and conformity motives. Furthermore, difficulties in emotion regulation were hypothesized to moderate each mediational path. Results: Results showed that the fear of negative evaluation and concerns over physiological symptoms were associated with alcohol related problems with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by difficulties in emotion regulation. Conclusions: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of social anxiety were related to alcohol related problems. In addition, individuals with high levels of difficulties in emotion regulation were prone to exhibit more alcohol related problems.
... Both coping and conformity drinking motives are related to hazardous drinking (DeMartini & Carey, 2011). Extant work has found that coping motives for alcohol use mediate the relationship between psychological distress and hazardous drinking (Mohr et al., 2018) while other research has shown that negative-reinforcement drinking motives mediate the relationships between anxiety sensitivity and increased drinking among college students (Stewart et al., 2001). ...
Article
Alcohol use is associated with poorer smoking cessation-related outcomes, and smokers with elevated levels of worry experience greater smoking cessation problems. Yet, little is known about the explanatory mechanisms that may underlie the relationship between trait worry and hazardous drinking among smokers. Therefore, this study explored the explanatory roles of coping and conformity drinking motives in the relationship between trait worry and hazardous drinking outcomes including alcohol consumption, alcohol problems, maximum number of drinks, and the number of prior alcohol quit attempts among treatment-seeking smokers. Participants included 377 treatment-seeking smokers who consumed at least one alcoholic drink in the last year (48% female; 86.2% Caucasian; M age = 34.83 years, SD = 13.38). Results showed a significant indirect effect of trait worry through coping-related drinking motives in relation to alcohol consumption, alcohol problems, maximum number of drinks, and number of prior drinking quit attempts. These findings were evident after controlling for gender, cigarette dependence, and current psychopathology. These findings suggest that coping drinking motives are one mechanism that may explain the relation between trait worry and hazardous drinking outcomes among treatment-seeking smokers.
... The literature on motivations for cannabis use has been largely based on research on the motives for alcohol use (Cooper, 1994;Cooper et al., 1995;Stewart et al., 2001;Zvolensky et al., 2007). Thus, other authors have advocated the need to examine cannabis-specific motives and develop new measures. ...
Article
Cannabis is the most commonly used illicit substance worldwide. Given the increasing trends of its use and the impression of its harmlessness, it is important to understand the user’s motivation to adjust prevention and intervention strategies. Thus, the present study sought to explore the psychometric properties of the motives to use cannabis among Portuguese cannabis users, describing the main motives for cannabis use and their associated factors. A sample of Portuguese adolescent and youth users (N = 212) were administered a sociodemographic questionnaire; a set of questions from the European School Survey Project on Alcohol and Other Drugs regarding lifetime, annual, monthly and weekly use; the Cannabis Abuse Screening Test; and the Comprehensive Marijuana Motives Questionnaire. The results allowed us to identify an adequate structure and reliability of the measure, with internal consistency ranging from .719 to .907. The main motives for using cannabis were to celebrate, enjoy and experiment, with some gender and age differences. Moderate correlations were found between cannabis use and sleep, altered perception and experimentation, explaining 46.5% of the variance in cannabis use. The results are discussed, and future directions are presented.
... In previous research on alcohol related problems in SAD, individuals with elevated social anxiety drink to cope with their negative emotions (coping motives) or to conform as a means of getting along with others and ensure that they are not isolated (conformity motives) [10][11][12]. Moreover, accumulating evidence suggests that certain SAD symptoms, such as social anxiety or fear of evaluation, with the mediation of coping and conformity motives, are associated with drinking situations and alcohol related problems [13][14][15][16]. Considering that drinking with coping and conformity motives differs from socially acceptable drinking and is strongly related to alcohol related problems, even when drinking quantity is controlled [17], it is not surprising that people with SAD become dependent on it to regulate their symptoms and therefore experience more alcohol related problems, even if they drink a small amount of alcohol [10]. ...
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Background: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of the development of alcohol related problems among individuals with elevated social anxiety. We investigated the moderation effect of difficulties in emotion regulation on the relationship between symptoms of social anxiety, coping and conformity motives and alcohol related problems. Methods: In a sample of university students (N = 647) in South Korea, we examined whether cognitive (fear of negative evaluation), behavioral (social avoidance), and physiological symptoms (concerns over physiological symptoms) of social anxiety affect alcohol related problems with the mediation of coping and conformity motives. Furthermore, difficulties in emotion regulation were hypothesized to moderate each mediational path. Results: Results showed that the fear of negative evaluation and concerns over physiological symptoms were associated with alcohol related problems with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by difficulties in emotion regulation. Conclusions: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of social anxiety were related to alcohol related problems. In addition, individuals with high levels of difficulties in emotion regulation were prone to exhibit more alcohol related problems.
... In previous research on alcohol related problems in SAD, individuals with elevated social anxiety drink to cope with their negative emotions (coping motives) or to conform as a means of getting along with others and ensure that they are not isolated (conformity motives) [10][11][12]. Moreover, accumulating evidence suggests that certain SAD symptoms, such as social anxiety or fear of evaluation, with the mediation of coping and conformity motives, are associated with drinking situations and alcohol related problems [13][14][15][16]. Considering that drinking with coping and conformity motives differs from socially acceptable drinking and is strongly related to alcohol related problems, even when drinking quantity is controlled [17], it is not surprising that people with SAD become dependent on it to regulate their symptoms and therefore experience more alcohol related problems, even if they drink a small amount of alcohol [10]. ...
Preprint
Full-text available
Background: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of development of alcohol related problems (ARP) among individuals with elevated social anxiety (SA). We examined the moderation effect of difficulties in emotion regulation (DER) on the relationship between cognitive-behavioral-physiological symptoms of SA, coping and conformity motives and ARP. Methods: In a sample of university students (N = 647) in South Korea, the proposed model in which fear of negative evaluation (FNE), social avoidance, and concerns over physiological symptoms (CPS) were supposed to affect ARP with the mediation of coping and conformity motives was tested. Furthermore, DER was hypothesized to moderate each meditational path. Results: Results showed that FNE and CPS predicted ARP with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by DER. Conclusions: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of SA were related to ARP. In addition, individuals with high levels of DER were prone to exhibit more ARP.
... In previous research on alcohol related problems in SAD, individuals with elevated social anxiety drink to cope with their negative emotions (coping motives) or to conform as a means of getting along with others and ensure that they are not isolated (conformity motives) [10][11][12]. Moreover, accumulating evidence suggests that certain SAD symptoms, such as social anxiety or fear of evaluation, with the mediation of coping and conformity motives, are associated with drinking situations and alcohol related problems [13][14][15][16]. Considering that drinking with coping and conformity motives differs from socially acceptable drinking and is strongly related to alcohol related problems, even when drinking quantity is controlled [17], it is not surprising that people with SAD become dependent on it to regulate their symptoms and therefore experience more alcohol related problems, even if they drink a small amount of alcohol [10]. ...
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Background: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of the development of alcohol related problems among individuals with elevated social anxiety. We examined the moderation effect of difficulties in emotion regulation on the relationship between cognitive-behavioral-physiological symptoms of social anxiety, coping and conformity motives and alcohol related problems. Methods: In a sample of university students (N = 647) in South Korea, the proposed model in which cognitive (fear of negative evaluation)-behavioral (social avoidance)-physiological symptoms (concerns over physiological symptoms) were supposed to affect alcohol related problems with the mediation of coping and conformity motives was tested. Furthermore, difficulties in emotion regulation were hypothesized to moderate each mediational path. Results: Results showed that the fear of negative evaluation and concerns over physiological symptoms predicted alcohol related problems with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by difficulties in emotion regulation. Conclusions: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of social anxiety were related to alcohol related problems. In addition, individuals with high levels of difficulties in emotion regulation were prone to exhibit more alcohol related problems.
... One possibility is that AS may be related more to alcohol problems and less to alcohol consumption, which further tends to weaken the relationship between AS and hazardous drinking since AUDIT total scores partially consist of AUDIT Alcohol Consumption (with the other AUDIT subfactor being Alcohol Problems). Indeed, though several studies have reported a relation between AS and greater alcohol consumption (Cox, Swinson, Shulman, Kuch, & Reichman, 1993;Lammers, Kuntsche, Engels, Wiers, & Kleinjan, 2013;Paulus, Manning, et al., 2017;Stewart, Peterson, & Pihl, 1995;Stewart, Zvolensky, & Eifert, 2001), the large majority of studies have not found evidence of an association between AS and greater alcohol consumption (Buckner, Bonn-Miller, Zvolensky, & Schmidt, 2007;Chavarria et al., 2015;Guillot et al., 2018;Johnson et al., 2008;Leyro, Zvolensky, Vujanovic, & Bernstein, 2008;Novak, Burgess, Clark, Zvolensky, & Brown, 2003;Paulus, Valadka, et al., 2017;Paulus, Vujanovic, & Wardle, 2016;Woicik, Stewart, Pihl, & Conrod, 2009;Zvolensky et al., 2007), including the current study. Also concordant with this possibility, the evidence for an association between AS and hazardous drinking (AUDIT total scores) has been mixed, with some studies reporting evidence of this association (Guillot et al., 2018;Paulus, Manning, et al., 2017;Zvolensky et al., 2019;Zvolensky et al., 2014) and other studies not finding evidence of this association (Bakhshaie, Zvolensky, Allan, Vujanovic, & Schmidt, 2015;Haas et al., 2019;Paulus, Valadka, et al., 2017;Zvolensky, Kotov, Antipova, & Schmidt, 2003), including the current study. ...
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Anxiety sensitivity (AS)—fearfulness of anxiety symptoms—has been implicated in the etiology of emotional disorders (e.g., depressive and anxiety disorders) and linked to cigarette smoking and other substance use (SU). However, studies examining AS in relation to SU primarily have been conducted with racially/ethnically heterogeneous or mostly European American samples. Hence, this cross-sectional study involving secondary analysis of baseline data focused on investigating associations of AS with cigarette smoking and other SU in a sample of 630 non-treatment-seeking African American smokers (37.3% female; M age = 49.6 years; M cigarettes smoked per day = 15.4). After screening out individuals with non-nicotine substance dependence, participants reported their demographics, AS, dysphoria symptoms (i.e., depression and anxiety symptoms), and SU. In regression analyses controlling for dysphoria symptoms, age, education level, income level, and years of regular smoking, AS was positively associated with tobacco withdrawal severity (β = .12, p = .007), overall smoking motives (β = .17, p < .001), alcohol use problems (β = .12, p = .005), and other (non-nicotine, nonalcohol) SU problems (β = .16, p < .001). Though lacking the passage of time between assessments needed to provide strong evidence of mediation, unplanned analyses further revealed indirect associations of AS with several SU variables through dysphoria symptoms. Current findings are consistent with those found in prior samples and suggest that AS is similarly related to SU in African Americans, who may benefit from interventions that have been helpful in improving AS, dysphoria symptoms, and SU in other groups.
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Studies have shown that those high in anxiety were at increased risk for alcohol use during the COVID-19 pandemic. Tension reduction theory points to anxiety sensitivity (AS) as a potential risk factor. Drinking to cope may further increase this risk. During the pandemic, those high in AS may have experienced increased stress and drank to cope, which may have put them at risk for misusing alcohol. Objective: The current study tested the association between AS and alcohol outcomes, mediated by perceived stress and drinking motives, among young adults during the COVID-19 pandemic. Participants and Methods: Young adults (N = 143) self-reported on AS, perceived stress, drinking motives, and alcohol outcomes (i.e., use and problems). Results: A mediation analysis revealed that AS positively predicted alcohol problems, via coping motives, and positively predicted alcohol use, via perceived stress and enhancement/sociability motives. Conclusion: These results confirm AS-risk for young adult alcohol use during the pandemic and highlight perceived stress and drinking motives as mechanisms of risk.
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Le présent article résume notre programme de recherche sur la sensibilité à l’anxiété (SA) – un facteur dispositionnel cognitif et affectif impliquant des craintes de sensations liées à l’anxiété en raison de croyances selon lesquelles ces sensations entraînent des conséquences catastrophiques. La SA et ses dimensions d’ordre inférieur sont considérées comme des facteurs transdiagnostiques de risque ou de maintien des troubles émotionnels et des troubles addictifs. La compréhension des mécanismes par lesquels la SA exerce ses effets peut révéler des cibles d’intervention clés pour les programmes de prévention et de traitement axés sur la SA. Dans le présent article, je passe en revue les recherches fondamentales que nous avons menées pour comprendre les mécanismes qui relient la SA à ces troubles et à leurs symptômes. Je décris également les interventions transdiagnostiques ciblées sur la SA et j’illustre la manière dont la recherche fondamentale a permis d’orienter le contenu de ces interventions. Enfin, je passe en revue les projets en cours dans mon laboratoire et je souligne les orientations futures importantes dans ce domaine. Bien que des progrès considérables aient été réalisés au cours des trois dernières décennies et que la recherche ait considérablement fait avancer notre compréhension de la SA en tant que facteur transdiagnostique, de nombreuses questions restent en suspens. Les réponses devraient nous aider à affiner les interventions afin d’en faire bénéficier au maximum les personnes qui ont une grande peur d’avoir peur.
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Introduction Perceptions of cannabis as a potential medical treatment for mood and anxiety disorders have been increasing in the context of legalizations, availability, and medical cannabis programs, though current evidence predominately indicates risks and negative effects of cannabis use (CU) on mental health outcomes. This study aims to understand motivations, perceptions, effects, and patterns of CU in individuals with mood and anxiety disorders. Methods Thirty-six adult patients diagnosed with mood or anxiety disorders, obsessive-compulsive disorder, or posttraumatic stress disorder who were currently using cannabis completed an in-depth qualitative interview on individual motivations, perceptions, experiences, effects, and patterns of their CU. The thematic analysis focused on phases of CU and sources of cannabis products and information. Results Reported motivations for initiation of CU included curiosity, peer pressure, and dissatisfaction with conventional treatments. Factors such as psychotropic effects and coping with mental health symptoms and insomnia contributed to the continuation of CU. More negative effects, including cognitive dysfunction, worsening of mood, and anxiety symptoms, were acknowledged with ongoing CU. Concerning findings included common initiation of CU before age 18, combined medical and recreational CU, rare consultation of medical professionals on CU, and potential effects and harms. Discussion Findings indicate individual complexity of motivations, perceptions, and patterns of CU in the study population. The reported potential beneficial effects of specific cannabis products should be further investigated. Findings emphasize patient-provider dialogue on both CU and conventional treatments. Information from this study can contribute to and inform the development of education, prevention, and intervention strategies.
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Despite their brevity, prior work indicates that computer-based interventions can substantially impact risk factors for psychopathology including anxiety sensitivity (AS), thwarted belongingness (TB), and perceived burdensomeness (PB). However, very few studies have assessed the long-term (> 1 year) effects of these interventions. The primary aim of the current study was to evaluate post-hoc, the long-term (3 year) durability of brief interventions targeting risk factors for anxiety and mood psychopathology using data from a pre-registered randomized clinical trial. Moreover, we were interested in evaluating whether mitigation in these risk factors mediated long-term symptom change. A sample determined to be at-risk for anxiety and mood pathology based on elevations on several risk factors (N = 303) was randomly assigned to one of four experimental conditions focused on: (1) reducing TB and PB; (2) reducing AS, (3) reducing TB,PB, and AS; or (4) a repeated contact control condition. Participants were assessed at post-intervention, one, three, six, 12, and 36 month follow-ups. Participants in the active treatment conditions showed sustained reductions in AS and PB through long-term follow-up. Mediation analyses suggested that reductions in AS mediated long-term reductions in anxiety and depression symptoms. These findings suggest that brief and scalable risk reduction protocols have long-term durability and efficacy both in terms of reducing risk factors for psychopathology.
Article
Background: Previous research suggests that high anxiety sensitivity (AS) - a fear of arousal-related body sensations - may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model. Method: Participants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis. Results: Results revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators. Limitations: Results are limited by the cross-sectional nature of the data. Conclusions: The present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.
Thesis
Angsterkrankungen stellen mit einer 12-Monats-Prävalenz von 14% die häufigsten psychischen Erkrankungen in der westlichen Gesellschaft dar. Angesichts der hohen querschnittlichen wie sequentiellen Komorbidität von Angsterkrankungen, der ausgeprägten individuellen Einschränkungen sowie der hohen ökonomischen Belastung für das Gesundheitssystem ist neben therapeutischen Behandlungsansätzen die Entwicklung von kurzzeitigen, kostengünstigen und leicht zugänglichen Präventionsmaßnahmen von großer Bedeutung und steht zunehmend im Fokus des gesundheitspolitischen Interesses, um die Inzidenz von Angsterkrankungen zu reduzieren. Voraussetzung für die Entwicklung von gezielten und damit den effektivsten Präventionsmaßnahmen sind valide Risikofaktoren, die die Entstehung von Angsterkrankungen begünstigen. Ein Konstrukt, das in der Literatur als subklinisches Symptom in Form einer kognitiven Vulnerabilität für Angsterkrankungen und damit als Risikofaktor angesehen wird, ist die sogenannte Angstsensitivität (AS). AS umfasst die individuelle Tendenz, angstbezogene körperliche Symptome generell als bedrohlich einzustufen und mit aversiven Konsequenzen zu assoziieren. Das Ziel der vorliegenden Arbeit war daher die Etablierung und Validierung eines Präventionsprogramms zur Reduktion der AS an einer nicht-klinischen Stichprobe von 100 Probanden (18-30 Jahre) mit einer erhöhten AS (Anxiety Sensitivity Index [ASI-3] ≥17) sowie die Rekrutierung von 100 alters- und geschlechtsangeglichenen Probanden mit niedriger Angstsensitivität (ASI-3 <17). In einem randomisiert-kontrollierten Studiendesign durchliefen die Probanden mit hoher AS entweder das über fünf Wochen angelegte „Kognitive Angstsensitivitätstraining“ (KAST) als erste deutschsprachige Übersetzung des Computer-basierten „Cognitive Anxiety Sensitivity Treatment“ (CAST) von Schmidt et al. (2014) oder wurden der Wartelisten-Kontrollgruppe zugeteilt. Das KAST Training bestand aus einer einmaligen Vermittlung kognitiv-behavioraler Psychoedukation zum Thema Stress und Anspannung sowie deren Auswirkungen auf den Körper und der Anleitung von zwei interozeptiven Expositionsübungen (‚Strohhalm-Atmung‘ und ‚Hyperventilation‘), die über den anschließenden Zeitraum von fünf Wochen in Form von Hausaufgaben wiederholt wurden. Es konnte gezeigt werden, dass die Teilnehmer des KAST-Programms nach Beendigung des Trainings (T1) eine signifikant niedrigere AS-Ausprägung im Vergleich zur Wartelisten-Kontrollgruppe aufwiesen und diese Reduktion auch über den Katamnese-Zeitraum von sechs Monaten (T2) stabil blieb. Ergänzend wurde auch die Targetierbarkeit weiterer intermediärer Risikomarker wie der Trennungsangst (TA), des Index der kardialen Sensitivität sowie der Herzratenvariabilität (HRV) untersucht, die jedoch nicht durch das KAST-Training direkt verändert werden konnten. Im Vergleich der Subgruppen von Probanden mit hoher AS und gleichzeitig hoher TA (Adult Separation Anxiety Questionnaire [ASA-27] ≥22) und Probanden mit hoher AS, aber niedriger TA (ASA-27 <22) zeigte sich, dass die AS-TA-Hochrisikogruppe ebenfalls gut von der KAST-Intervention profitieren und eine signifikante Reduktion der AS erzielen konnte, indem sie sich bei T1 dem Niveau der Gruppe mit niedriger TA anglich. Zudem korrelierte die prozentuale Veränderung der Einstiegswerte der inneren Anspannung während der Strohhalm-Atmungsübung positiv mit der prozentualen Veränderung der dimensionalen TA bei T1. Zusammenfassend weisen die Ergebnisse der vorliegenden Arbeit erstmalig auf die Wirksamkeit der deutschsprachigen Übersetzung des CAST-Programms (Schmidt et al., 2014), eines Computer-basierten, und damit leicht zu implementierenden sowie kostengünstigen Programms, in Bezug auf die Reduktion der AS sowie indirekt der TA hin und können damit zur indizierten und demnach besonders effektiven Prävention von Angsterkrankungen in Hochrisikogruppen beitragen.
Article
The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is highly prevalent among military veterans and represents a difficult-to-treat comorbidity. Distress intolerance (DI; i.e., the perceived inability to tolerate negative emotional states) and anxiety sensitivity (AS, i.e., the fear of anxiety-related sensations) are two promising targetable mechanisms with potential to predict and improve treatment outcomes for veterans with PTSD/SUD. We hypothesized that PTSD symptom severity would be related to (a) alcohol use severity and (b) drug use severity through DI and AS, evaluated concurrently. Participants included 120 military veterans (98.3% male; Mage = 41.41, SD = 10.77) presenting for psychological services at a Veterans Affairs PTSD/SUD clinic. Results indicated that PTSD symptom severity was related to alcohol use severity through AS, but not DI; and PTSD symptom severity was related to drug use severity through DI, but not AS. Clinical and research implications are discussed.
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Given the high prevalence and considerable clinical and societal burden of anxiety disorders, preventive measures are urgently warranted to reduce their incidence and overall healthcare impact. Anxiety sensitivity (AS) – a key element in learning theories of anxiety disorders in the context of interoceptive conditioning – constitutes a malleable risk factor of particularly panic disorder and separation anxiety, which share developmental, nosological, epidemiological and pathomechanistic characteristics. The computer-assisted ‘Cognitive Anxiety Sensitivity Treatment’ (CAST) targeting interoceptive anxiety symptoms (cf. Schmidt et al., 2014) was translated, intensified and culturally adapted to German and evaluated in a sample of 105 healthy adult volunteers with elevated AS (mean ASI-3: 29.5) applying a randomized design. Success of the intervention was measured as a function of AS and separation anxiety (ASA-27) ∼6 weeks (T1) and ∼6 months (T2) after the intervention. As compared to waitlist, CAST resulted in a significant reduction of AS at both T1 and T2. Separation anxiety was not directly reduced by the intervention, but decreased mediated by a decline in AS. A composite interoceptive score capturing changes in sensitivity to respiratory symptoms during the baseline therapist-accompanied CAST session was shown to be predictive of overall response at T1. In sum, CAST-German Version was successfully established as an effective intervention reducing AS, while at the same time indirectly decreasing separation anxiety. A composite interoceptive score predicting treatment response might aid in further delineating risk markers informing targeted preventive interventions for anxiety disorders.
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Anxiety sensitivity, or the fear of anxiety-related sensations, has demonstrated relevance to a broad range of psychiatric conditions, including substance use disorders (SUDs). Anxiety sensitivity is typically measured through self-report instruments, most commonly the Anxiety Sensitivity Index-3 (ASI-3). Despite the widespread use of the ASI-3 in studies of SUDs, little is known about its psychometric properties within this population. Patients on an inpatient detoxification unit seeking treatment for SUDs (N = 1248) completed a battery of self-report measures, including the ASI-3. Psychometric properties of the ASI-3 were examined. An exploratory factor analysis with half of the sample (n = 624) supported a 3-factor structure corresponding to the ASI-3 subscales (Social Concerns, Cognitive Concerns, Physical Concerns). Confirmatory factor analysis was used to validate this 3-dimensional structure in a separate subsample (n = 624), resulting in adequate fit when testing a second-order hierarchical model. Internal consistency and convergent and discriminant validity results also supported the use of the ASI-3 in people with SUDs. Despite its widespread use in SUD research, this is the first psychometric investigation of the ASI-3 among individuals seeking treatment for SUDs.
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Objective Anxiety sensitivity, distress tolerance, and emotion regulation difficulties have each demonstrated significant individual associations with problematic alcohol use and negative reinforcement motives for alcohol use among college students. However, extant research has yet to examine these three factors simultaneously with regard to the possibility of differential associations with alcohol consumption, alcohol-related problems and coping and conformity motives for alcohol use. As such, the present study sought to examine whether such differential associations exist within a sample of undergraduates reporting past year alcohol use. Methods: Participants were 379 undergraduate students reporting alcohol use in the past year who completed self-report measures for course credit. Results: After controlling for the effects of sex, lifetime marijuana use status, and negative affectivity, greater anxiety sensitivity social concerns and difficulties with emotional awareness were associated with more alcohol-related problems. Greater anxiety sensitivity social concerns and impulse control difficulties were associated with greater conformity alcohol use motives, and greater impulse control and emotional clarity difficulties were associated with greater coping motives. Conclusions: These findings suggest that greater fears of anxiety symptoms because of their potential negative social consequences and certain emotion regulation difficulties (i.e., impulse control, emotional clarity, emotional awareness) may be particularly problematic because they are associated with alcohol-related problems and negative reinforcement motives for use among undergraduates.
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Background: Hazardous alcohol use among college students is a growing problem. Alcohol is commonly used in the context of pain due to acute analgesic effects, although the role of pain among hazardous drinkers has not been examined. Little is known regarding factors that may moderate pain-alcohol relations. One factor is anxiety sensitivity, which reflects the fear of physiological sensations. Pain severity and anxiety sensitivity may interact such that those with high anxiety sensitivity may have stronger pain-alcohol relations.Objectives: The current study examined interactive associations of pain severity and anxiety sensitivity in relation to hazardous drinking severity, alcohol consumption, and alcohol problems among hazardous drinking college students (n = 370; 78.1% female).Methods: Self report measures of alcohol use, pain severity, and anxiety sensitivity were collected and moderation analyses were conducted.Results: There was a significant interaction of pain severity and anxiety sensitivity in relation to hazardous drinking severity (β = 0.25, p = .037); pain severity was significantly related to hazardous drinking for high (β = 0.28, p < .001) but not low (β = 0.09, p = .202) anxiety sensitivity. There was a similar interaction for alcohol consumption (β = 0.35, p = .008). For alcohol problems, there was no significant interaction, but there were unique main effects of both pain severity (β = 0.23, p < .001) and anxiety sensitivity (β = 0.34, p < .001).Conclusions: These findings suggest that drinkers with high anxiety sensitivity may use alcohol hazardously (and in greater quantities) in the context of pain. If replicated with longitudinal samples, the findings may inform clinical practice in terms of screening for and treatment of anxiety sensitivity.
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Objective: The opioid epidemic is a significant public health problem largely driven by opioid prescriptions for chronic pain. Among those with chronic pain, anxiety and depressive symptoms have been linked to opioid misuse, and individual differences in anxiety and depressive symptoms among adults with chronic pain may be important for better understanding pain. Yet, little work has examined mechanisms that may link anxiety and depressive symptoms to opioid misuse among adults with chronic pain. Anxiety sensitivity, or the fear of anxiety-related physical sensations, may be one candidate construct that has been linked independently to anxiety and depressive symptoms as well as opioid misuse. Method: Therefore, the current survey-based study examined the indirect association of anxiety sensitivity in the relation between anxiety and depressive symptoms and opioid misuse among 429 adults with chronic pain currently using prescription opioid medication (73.9% female, Mage= 38.32▒y, SD = 11.07). Results: Results from the current study, using structural equation modeling, support anxiety sensitivity as a potential construct in the interrelation between anxiety and depressive symptoms and opioid misuse. However, an alternative model found equally strong empirical support, as mental health symptoms may serve as an explanatory factor between anxiety sensitivity and opioid misuse. Discussion: Thus, bi-directional effects are apt to be involved among the studied variables. Future prospective research is needed to replicate the study results and isolate the temporal patterning between the studied constructs. Nonetheless, the data overall highlight the importance of both anxiety sensitivity and anxiety/depressive symptoms in terms of understanding opioid misuse among adults with chronic pain.
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Drug addiction may be a goal-directed choice driven by excessive drug value in negative affective states, a habit driven by strong stimulus−response associations, or a compulsion driven by insensitivity to costs imposed on drug seeking. Laboratory animal and human evidence for these three theories is evaluated. Excessive goal theory is supported by dependence severity being associated with greater drug choice/economic demand. Drug choice is demonstrably goal-directed (driven by the expected value of the drug) and can be augmented by stress/negative mood induction and withdrawal—effects amplified in those with psychiatric symptoms and drug use coping motives. Furthermore, psychiatric symptoms confer risk of dependence, and coping motives mediate this risk. Habit theory of addiction has weaker support. Habitual behaviour seen in drug-exposed animals often does not occur in complex decision scenarios, or where responding is rewarded, so habit is unlikely to explain most human addictive behaviour where these conditions apply. Furthermore, most human studies have not found greater propensity to habitual behaviour in drug users or as a function of dependence severity, and the minority that have can be explained by task disengagement producing impaired explicit contingency knowledge. Compulsion theory of addiction also has weak support. The persistence of punished drug seeking in animals is better explained by greater drug value (evinced by the association with economic demand) than by insensitivity to costs. Furthermore, human studies have provided weak evidence that propensity discount cost imposed on drug seeking is associated with dependence severity. These data suggest that human addiction is primarily driven by excessive goal-directed drug choice under negative affect, and less by habit or compulsion. Addiction is pathological because negative states powerfully increase expected drug value acutely outweighing abstinence goals.
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The Cultural Involvement and Detachment Anxiety Questionnaire (D. W. McNeil, C. A. Porter, M. J. Zvolensky, & J. M. Chaney, 1998) and the Multigroup Ethnic Identity Measure (J. S. Phinney, 1992) were administered to 160 Navajo college students to explore the relation between ethnic identity and culturally related anxiety, compare level of ethnic identity in reference to standardized samples, and test for gender differences. Correlations indicated a notable lack of relation between ethnic identity and cultural anxiety. This particular Navajo sample evidenced significantly higher levels of ethnic identity in comparison to students of Caucasian, Asian, Hispanic, or mixed ethnicity. There were no significant gender differences in culturally related anxiety. Results are discussed in relation to culturally related anxiety and ethnic identity in the Navajo, with implications for better understanding the nature of cultural anxiety in other American Indians and Alaska Natives.
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Expectancy theory posits that anxiety sensitivity may serve as a premorbid risk factor for the development of anxiety pathology (S. Reiss, 1991). The principal aim of the present study was to determine whether anxiety sensitivity acts as a specific vulnerability factor in the pathogenesis of anxiety pathology. A large, nonclinical sample of young adults (N = 1,401) was prospectively followed over a 5-week highly stressful period of time (i.e., military basic training). Anxiety sensitivity was found to predict the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety. Approximately 20% of those scoring in the upper decile on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1987) experienced a panic attack during the 5-week follow-up period compared with only 6% for the remainder of the sample. Anxiety sensitivity also predicted anxiety symptomatology, functional impairment created by anxiety, and disability. These data provide strong evidence for anxiety sensitivity as a risk factor in the development of panic attacks and other anxiety symptoms.
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Anxiety sensitivity (AS) is the fear of anxiety sensations which arises from beliefs that these sensations have harmful somatic, social, or psychological consequences. Over the past decade, AS has attracted a great deal of attention from researchers and clinicians with more than 100 peer-reviewed journal articles published. In addition, AS has been the subject of numerous symposia, papers, and posters at professional conventions. Why this growing interest? Theory and research suggest that AS plays an important role in the etiology and maintenance of many forms of psychopathology, including anxiety disorders, depression, chronic pain, and substance abuse. Bringing together experts from a variety of different areas, this volume offers the first comprehensive state-of-the-art review of AS--its conceptual foundations, assessment, causes, consequences, and treatment--and points new directions for future work. It will prove to be an invaluable resource for clinicians, researchers, students, and trainees in all mental health professions.
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Aims. To examine the consistency and/or variability of gender differences in drinking behavior cross-culturally. Design, setting, participants. Women's and men's responses in 16 general population surveys from 10 countries, analyzed by members of the International Research Group on Gender and Alcohol. Measurements. Comparable measures of drinking, versus abstention, typical drinking frequencies and quantities, heavy episodic drinking, intoxication, morning drinking, and alcohol-related family and occupational problems. Findings. Women and men differed little in the probability of currently drinking versus abstaining, but men consistently exceeded women in typical drinking frequencies and quantities and in rates of heavy drinking episodes and adverse drinking consequences, while women were consistently more likely than;men to be life-time abstainers. In older age groups, both men and women drank smaller quantities of alcohol,and were more likely to stop drinking altogether, but drinking frequencies did nor change consistently with age. Conclusions. A theoretical synthesis proposes that gender roles may amplify biological differences in;reactions to alcohol, and that gender differences in drinking behavior may be modified by macrosocial factors that modify gender role contrasts.
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Two studies were designed to establish whether high anxiety sensitive (AS) university students selectively process threat cues pertaining to their feared catastrophic consequences of anxiety, and to examine potential gender differences in the selective processing of such threat cues among high versus low AS subjects. Forty students (20 M; 20 F) participated in Study 1. Half were high AS and half low AS, according to scores on the Anxiety Sensitivity Index (ASI). Subjects completed a computerised Stroop colournaming task involving social/psychological threat (e.g. EMBARRASS; CRAZY), physical threat (e.g. CORONARY; SUFFOCATED), and neutral (e.g. MOTEL; TOWEL) target words. High AS subjects demonstrated more threat-related interference in colour-naming than did low AS subjects, overall. High AS menevidencedgreater interference relative to low AS men only for the social/psychological threat stimuli; highAS women evidencedgreater interference relative to low AS women only for the physical threat stimuli. Study 2 was designed to replicate and extend the novel Study 1 finding of a cognitive bias favouring the processing of social/psychological threat cues among high AS men. Participants were 20 male university students (10 high AS; 10 low AS). In addition to social/psychological threat, physical threat, and neutral words, a category of positive emotional words (e.g. HAPPINESS; CELEBRATION) was included as a supplementary control on the Stroop. Consistent with Study 1, high AS males evidenced greater Stroop interference than did low AS males, but only for social/psychological threat words. No AS group differences in Stroop interference were revealed for the physical threat or positive words. Clinical implications, and potential theoretical explanations for the gender differences, are discussed.
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Despite consistent evidence that alcohol can be used to cope with negative emotions or to enhance positive emotions, research on drinking motives has focused primarily on coping and social motives. This article reports on the development of a 3-factor measure that also assesses enhancement motives. Using confirmatory factor analysis, the authors demonstrated that enhancement motives are empirically distinct from coping and social motives and that a correlated 3-factor model fits the data equally well across race and gender groups in a large representative sample. Each drinking motive was also shown to predict distinct aspects of alcohol use and abuse. Finally, interaction analyses suggested that coping and enhancement motives differ in the magnitude of their effects on drinking behavior across Blacks and Whites and that enhancement motives differ in their effects across men and women. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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A 4-factor measure of drinking motives based on a conceptual model by M. Cox and E. Klinger (see PA, Vol 75:32975; see also 1990) is presented. Using data from a representative household sample of 1,243 Black and White adolescents, confirmatory factor analyses showed that the hypothesized model provided an excellent fit to the data and that the factor pattern was invariant across gender, race, and age. Each drinking motive was related to a distinct pattern of contextual antecedents and drinking-related outcomes, and these relationships did not generally vary across demographic subgroups. Results support both the conceptual validity of Cox and Klinger's model and the utility of this measure for clinical and research purposes across a diverse range of adolescent populations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Examined the effects of anxiety-sensitivity (AS) levels, and 1.00 ml/kg alcohol, on autonomic and subjective-emotional responses to aversive stimulation (i.e., noise bursts). Ss were 30 university women divided into 3 AS groups (high, moderate, and low), on the basis of Anxiety Sensitivity Index (ASI) scores. When sober, high-AS women provided higher emotional arousal ratings while anticipating the noise bursts than did low-AS women. Alcohol dampened the noise burst-anticipation ratings, particularly in the high-AS group. ASI scores were positively correlated with degree of sober skin conductance level (SCL) reactivity and with degree of alcohol dampening of SCL reactivity. Thus, high-AS women may use alcohol to normalize their anticipatory emotional and electrodermal overreactivity to threat. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Anxiety sensitivity (AS) is the fear of anxiety sensations which arises from beliefs that these sensations have harmful somatic, social, or psychological consequences. Over the past decade, AS has attracted a great deal of attention from researchers and clinicians with more than 100 peer-reviewed journal articles published. In addition, AS has been the subject of numerous symposia, papers, and posters at professional conventions.© 1999 by Lawrence Erlbaum Associates, Inc. Why this growing interest? Theory and research suggest that AS plays an important role in the etiology and maintenance of many forms of psychopathology, including anxiety disorders, depression, chronic pain, and substance abuse. Bringing together experts from a variety of different areas, this volume offers the first comprehensive state-of-the-art review of AS--its conceptual foundations, assessment, causes, consequences, and treatment--and points new directions for future work. It will prove to be an invaluable resource for clinicians, researchers, students, and trainees in all mental health professions. © 1999 by Lawrence Erlbaum Associates, Inc. All rights reserved.
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The Anxiety Sensitivity Index (ASI) is one of the most widely used measures of the construct of anxiety sensitivity. Until the recent introduction of a hierarchical model of the ASI by S. O. Lilienfeld, S. M. Turner, and R. G. Jacob (1993), the factor structure of the ASI was the subject of debate, with some researchers advocating a unidimensional structure and others proposing multidimensional structures. In the present study, involving 432 outpatients seeking treatment at an anxiety disorders clinic and 32 participants with no mental disorder, the authors tested a hierarchical factor model. The results supported a hierarchical factor structure consisting of 3 lower order factors and 1 higher order factor. It is estimated that the higher order, general factor accounts for 60% of the variance in ASI total scores. The implications of these findings for the conceptualization and assessment of anxiety sensitivity are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Objective. —To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus.Design. —Self-administered survey mailed to a national representative sample of US 4-year college students.Setting. —One hundred forty US 4-year colleges in 1993.Participants. —A total of 17592 college students.Main Outcome Measures. —Self-reports of drinking behavior, alcohol-related health problems, and other problems.Results. —Almost half (44%) of college students responding to the survey were binge drinkers, including almost one fifth (19%) of the students who were frequent binge drinkers. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior than other students. Almost half (47%) of the frequent binge drinkers experienced five or more different drinking-related problems, including injuries and engaging in unplanned sex, since the beginning of the school year. Most binge drinkers do not consider themselves to be problem drinkers and have not sought treatment for an alcohol problem. Binge drinkers create problems for classmates who are not binge drinkers. Students who are not binge drinkers at schools with higher binge rates were more likely than students at schools with lower binge rates to experience problems such as being pushed, hit, or assaulted or experiencing an unwanted sexual advance.Conclusions. —Binge drinking is widespread on college campuses. Programs aimed at reducing this problem should focus on frequent binge drinkers, refer them to treatment or educational programs, and emphasize the harm they cause for students who are not binge drinkers.(JAMA. 1994;272:1672-1677)
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The purpose of the present study was to place drinking motives within the context of the Five-Factor Model of personality. Specifically, we sought to determine whether certain personality domains and facets of the Revised NEO Personality Inventory (NEO-PI-R) predict Enhancement, Coping, Social, and/or Conformity drinking motives from the Revised Drinking Motives Questionnaire (DMQ-R). A sample of 256 university student drinkers (M age =21.3 years) completed the NEO-PI-R and DMQ-R. In bivariate correlations, the two negative reinforcement motives (Coping and Conformity) were positively correlated with Neuroticism and negatively correlated with Extraversion. The two positive reinforcement motives (Enhancement and Social) were positively correlated with Extraversion and negatively correlated with Conscientiousness. Multiple regression analyses revealed that personality domain scores predicted two of the four drinking motives (i.e. the internal drinking motives of Coping and Enhancement), after controlling for the influences of alternative drinking motives. Enhancement Motives were predicted by high Extraversion and low Conscientiousness, and Coping Motives by high Neuroticism. Supplementary correlational analyses involving certain personality facet scores revealed that the depression and self-consciousness facets of the Neuroticism domain were positively correlated with residual Coping and Conformity Motives, respectively, and that the excitement-seeking and gregariousness facets of the Extraversion domain were positively correlated with residual Enhancement and Social Motives, respectively. These results provide further validation of Cox and Klinger’s 2×2 (valence [positive vs negative reinforcement]×source [internal vs external]) model of drinking motivations, and confirm previous speculations that drinking motives are distinguishable on the basis of personality domains and facets. Understanding the relations between personality and drinking motives may prove useful in identifying young drinkers whose drinking motivations may portend the development of heavy and/or problem drinking.
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The purpose of the paper is to describe a more generally applicable method of factor analysis which has no restrictions as regards group factors and which does not restrict the number of general factors that are operative in producing the intercorrelation. Applications of the method to different types of correlation problems are suggested. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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151 college students to whom the Anxiety Sensitivity Index (ASI) was administered in 1984 were retested in 1987 for anxiety sensitivity and tested for panic attacks, state-trait anxiety, and anxiety disorder history. ASI scores in 1984 predicted the frequency and intensity of panic attacks in 1987. Compared to Ss with low 1984 ASI scores, Ss with high 1984 ASI scores were 5 times more likely to have an anxiety disorder during the period 1984 to 1987. Test-retest reliability for the ASI across 3 yrs was .71. Data provide evidence for the stability of anxiety sensitivity over time and that the concept of anxiety sensitivity should be considered a personality variable. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Evaluated a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences), the Child Anxiety Sensitivity Index (CASI), in 76 7th–9th graders and 33 emotionally disturbed children (aged 8–15 yrs). The CASI had sound psychometric properties for both samples. The view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children was supported. The CASI correlated with measures of fear and anxiety and accounted for variance on the Fear Survey Schedule for Children—Revised and the State-Trait Anxiety Inventory for Children (Trait form) that could not be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorder in children is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Background: Previous research suggests that high levels of anxiety sensitivity (AS; fear of anxiety symptoms) may constitute a risk factor for alcohol abuse. The present study evaluated the hypothesis that high AS levels may increase risk for alcohol abuse by promoting a heightened sober reactivity to theoretically relevant stressors and heightened sensitivity to alcohol's emotional reactivity dampening effects, which would negatively reinforce drinking in this population. Methods: One hundred and two undergraduate participants (51 high AS, 51 low AS) with no history of panic disorder were assigned to either a placebo, low‐dose alcohol, or high‐dose alcohol beverage condition (17 high AS, 17 low AS per beverage condition). After beverage consumption and absorption, participants underwent a 3 min voluntary hyperventilation challenge. Results and Conclusions: High‐AS/placebo participants displayed greater affective and cognitive reactivity to the challenge than low‐AS/placebo participants, which indicated increased fear and negative thoughts (e.g., “losing control”) during hyperventilation among sober high AS individuals. Dose‐dependent alcohol dampening of affective and cognitive reactivity to hyperventilation was observed only among high‐AS participants, which suggested that high‐AS individuals may be particularly sensitive to alcohol‐induced reductions in their degree of fear and negative thinking in response to the experience of physical arousal sensations. In contrast, dose‐dependent alcohol dampening of self‐reported somatic reactivity was observed among both high‐ and low‐AS participants. We discuss implications of these results for understanding risk for alcohol abuse in high‐AS individuals, as well as directions for future research.
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Fears of anxiety symptoms, panic attacks, and negative evaluation as well as assertiveness were examined in 102 patients with a diagnosis of panic disorder alone, social phobia alone, comorbid social phobia and panic disorder, or comorbid social phobia and depressive disorder. The results indicated that social phobia and panic disorder can be differentiated by fears of negative evaluation and by assertiveness, but a substantial overlap between these disorders exists with regard to anxiety sensitivity and catastrophic beliefs about panic attacks. The boundaries between social phobia and panic disorder were especially blurred by the presence of comorbid depression within social phobia. Mood-specific biases in catastrophic thoughts and pessimistic attitudes may account for the findings for depression. Treatment implications are discussed.