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Effects of alcohol administration on psychophysiological and subjective-emotional responses to aversive stimulation in anxiety-sensitive women.
Abstract
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.
... This finding supports previous research that demonstrated increased emotional and psychological reactions to hyperventilation among sober high-versus low-AS participants (Asmundson et al., 1994; Donnell and McNally, 1989; O'Brien and Chafetz, 1982; Rapee and Medoro, 1994). The absence of sober AS group differences on the somatic HVQ subscale suggests that the high-and low-AS/placebo individuals experienced the same degree of physical symptoms in response to hyperventilation but interpreted the arousal differently (i.e., high-AS/placebo individuals may have interpreted the arousal as more dangerous or " catastrophic " and thus may have experienced more anxiety; Rapee and Medoro, 1994; Shostak and Peterson, 1990; Stewart and Pihl, 1994 ). This finding provides evidence for the notion of AS as an " anxiety amplifying " factor (Reiss, 1991), at least in the sober state. ...
... administered alcohol reported less somatic reactivity to the hyperventilation challenge than placebo participants, which suggests that alcohol exerted some overall physiological stressresponse dampening effects (Sher, 1987). However, alcohol dampening effects specific to the high-AS group were seen on the affective and cognitive HVQ subscales (cf. Stewart and Pihl, 1994), consistent with our second hypothesis that high-AS individuals would be particularly susceptible to alcohol's dampening of affective and cognitive components of the fear response. There are several possible interpretations—not necessarily mutually exclusive— of the reduced reported fear in response to hyperventilation among the high-A ...
... Although the HVQ assessed several aspects of participants' reactions to the challenge (affective, cognitive, somatic ), a final potential limitation involved our use of a single dependent measure in a single response domain (self-report). Given the often poor correspondence between various dimensions of anxious responding (Rachman and Hodgson, 1974), future research in this area should include direct physiological (e.g., Stewart and Pihl, 1994) and/or behavioral (e.g., Kushner et al., 1997) measures of anxious responding during challenge as supplements to self-report. In summary, the present findings confirm past reports that sober high-AS individuals display increased emotional responses to the experience of arousal-related bodily sensations . ...
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.
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.
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.
... More specifically, individuals with high anxiety proneness were more likely to seek for alcohol or anxiolytic substances to reduce the tension or other negative affect (e.g. [19,20]), but less likely to use stimulants such as marijuana (e.g. [21]). ...
... As we mentioned previously, anxiety sensitivity was found to be mostly related to alcohol or anxiolytic substance use, but not stimulant substance use (e.g. [19][20][21], and hopelessness was found to mostly related to analgesic drugs [23]. This is because these types of substances are often desired by users who wish to reduce their anxiety or affective pain levels. ...
This paper explores how personality factors affect substance use disorders (SUDs) using explanatory item response modeling (EIRM). A total of 606 Chinese illicit drug users participated in our study. After removing the cases with missing values on the covariate measures, a final sample of 573 participants was used for data analysis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was used to measure the illicit drug users’ SUD level. Four personality factors–anxiety sensitivity, impulsivity, sensation seeking and hopelessness–along with gender and alcohol use were included in EIRM as person covariates. The results indicated that gender, alcohol use, and their interaction significantly predicted the SUD level. The only personality factor that strongly predicted the SUD level was sensation seeking. In addition, the interaction between gender and hopelessness was also found to be a significant predictor of the SUD level, indicating that the negative effect of hopelessness on SUD is stronger for women than for men. The findings suggest that sensation seeking plays an important role in influencing SUDs, and thus, it should be considered when designing intervention or screening procedures for potential illicit drug users. In addition, several DSM-5 SUD symptoms were found to exhibit differential effects by gender, alcohol use, and personality factors. The possible explanations were discussed.
... Brunelle et al. [ 148 ] ), while individuals who are high on inhibited traits like anxiety sensitivity display reduced electrodermal activity to threat cues when moderate to high levels of alcohol have been consumed (e.g. Stewart and Pihl [ 149 ] ). Brunelle et al. [ 148 ] showed that it was sensation seeking that was associated with a heightened heart rate response to alcohol and positive feelings after alcohol intoxication. ...
... In general, studies have found that individuals with a family history of alcoholism have an increased sensitivity to the dampening effects of alcohol on stress response [ 155,156 ] with fi ndings showing that personality factors, particularly those related to anxiety (i.e. anxiety-sensitivity), also seem to play an important role [ 48,149 ] . For example, Conrod, Pihl and Vassileva [ 102 ] found that men with higher self-reported levels of anxiety sensitivity experienced electrodermal response and heart rate dampening effects to aversive stimulation after alcohol administration, compared to low anxiety sensitive men, which the authors interpreted as a pharmacologic sensitivity that is produced by an interaction between sedative drug effects and anxious personality to produce a highly negatively reinforcing fear reduction. ...
The emphasis made on the significance of personality in the development of substance use problems has varied substantially through the years. Although early research has focused on identifying a single personality trait that conferred risk for substance use and misuse, recent research has highlighted the complex nature and heterogeneity of substance use behaviours and profiles, identifying a number of traits and risk pathways to substance use problems. This chapter reviews the evidence which provides support for the important aetiological role of a number of personality traits in the development and maintenance of substance use problems. Four personality-based causal pathways to substance misuse are proposed that help to explain some of the underlying mechanisms linking substance misuse with other mental disorders. Finally, implications for prevention and clinical practise are discussed.
... Also high AS students were more likely to report drinking primarily for coping motives, and less likely to report drinking primarily for social motives (i.e., to affiliate with others), compared with low AS students (see also Stewart, Karp, Pihl, & Peterson, 1997). High AS students' increased use of alcohol to cope (i.e., for negative reinforcement) is likely related to the enhanced sensitivity to alcohol's emotional reactivity-dampening effects found among high AS young adults compared with low AS young adults in studies using the alcohol challenge paradigm (Baker, MacDonald, Stewart, & Skinner, 1998; Conrod, Pihl, & Vassileva, 1998; Stewart & Pihl, 1994). Different drinking motives have been found to be associated with different situational antecedents and consequences of alcohol use (Cooper, 1994, Cooper et al., 1992). ...
... The present results are also consistent with the finding that individuals with higher AS levels are more sensitive to alcohol's emotional reactivitydampening properties (cf. Baker et al., 1998; Conrod et al., 1998; Stewart & Pihl, 1994) than individuals with lower AS levels. ASI scores were only significantly correlated with situations that do not necessitate the presence of others (Unpleasant Emotions, Physical Discomfort, Conflict with Others, and Testing Personal Control). ...
To assess the typical drinking situations of high anxiety sensitive individuals, relative to low anxiety sensitive individuals, a large sample of university student drinkers (N = 396) completed the 42-item version of the Inventory of Drinking Situations (IDS-42) and the Anxiety Sensitivity Index (ASI). As hypothesized, ASI scores were significantly positively correlated with drinking frequency on the higher order IDS-42 factor of negatively reinforcing drinking situations and not significantly correlated with drinking frequency on the higher order factor of positively reinforcing drinking situations. Also, ASI scores were significantly positively correlated with drinking frequency on the lower order drinking situations factors of Conflict with Others, Unpleasant Emotions, and Physical Discomfort. ASI scores were also unexpectedly significantly correlated with more frequent drinking on the higher order factor of temptation drinking situations and with more frequent drinking on the lower order drinking situations factor of Testing Personal Control. These results have important implications for designing early prevention and intervention programs for high anxiety sensitive university student drinkers by helping them to develop alternatives to drinking in those situations (e.g., negatively reinforcing drinking situations) which place them at greatest risk for alcohol misuse.
... Session order and carryover effects are explicitly modeled using Crosscarrys create-Carry. We added previous day drinking (PDD) as a covariate given its effects on skin conductance (Stewart & Pihl, 1994), cardiovascular responses (Romanowicz et al., 2011), and craving and mood measures (Koob & Le Moal, 2008). GEEs were applied to relevant questionnaires (PACs and PANAS), executive functioning tasks and all measures used throughout the psychophysiological alcohol cue reactivity task. ...
Background
Preclinical studies have demonstrated that cannabidiol (CBD) reduces alcohol‐seeking behaviors and may have potential for managing alcohol use disorder (AUD). In this study, we examined the effects of CBD versus placebo on (i) psychophysiological, craving and anxiety responses to alcohol and appetitive cues; (ii) tolerability measures including cognitive functioning.
Methods
Twenty‐two non‐treatment‐seeking individuals with AUD (DSM‐5) participated in a cross‐over, double‐blind, randomized trial, receiving either 800 mg of CBD or matched placebo over 3 days. A laboratory alcohol cue reactivity task with appetitive control (juice) and alcohol exposures, and subsequent recovery periods to examine regulation of cue‐elicited responses after cue‐offset (recovery) was completed, with psychophysiological indices of autonomic nervous system activity (skin conductance, high‐frequency heart rate variability [HF‐HRV]) and self‐reported measures (alcohol craving and anxiety). Self‐reported scales of sedation and neuropsychological executive function tasks were also completed.
Results
CBD sessions were significantly associated with elevated parasympathetic nervous system (PNS) activity across the task, as indicated by increased HF‐HRV. Reductions in self‐reported anxiety during cue exposure stages compared to placebo sessions were also evidenced. Reductions in self‐reported alcohol craving after cue exposure were seen during CBD sessions only. There were no significant differences between CBD and placebo on executive functioning performance.
Conclusions
In a short‐term regimen, CBD appears to modulate PNS activity, reduce cue‐elicited anxiety during cue exposure and reduce alcohol craving after cue exposure while not significantly impairing cognition. Large, parallel clinical trials with longer term regimens are now needed to determine the therapeutic potential of CBD in the management of AUD.
... As such, it is associated with a five-fold increased risk for the longer term development of panic-related anxiety disorders (Mailer & Reiss, 1992) and corresponds with self-reported rates of alcohol (Stewart, Peterson, & Pihl, 1995) and anxiolytic prescription drug use (Bruce, Speigel, Gregg, & Nuzzarello, 1992). Furthermore, this personality style is associated with sensitivity to the anxiety-reducing effects of alcohol and the tendency to self-report motives for alcohol use that reflect the desire to self-medicate negative emotions (Conrod, Pihl, & Vassileva, 1998;Stewart & Pihl, 1994). It has been sug-gested that anxiety sensitivity is a personality risk factor for dependence on drugs that posses anxiolytic properties (such as alcohol and benzodiazepines) that is due to a need to escape feared symptoms of anxiety (Stewart, 1996). ...
This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion–hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted–hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.
... profile, at least on the ascending limb of the BAG curve. Specifically, acute alcohol administration has been shown to increase heart rate, skin conductance, digital blood flow, and systolic and diastolic blood pressure (Levenson, Sher, Grossman, Newman, & Newlin, 1980;Stewart & Pihl, 1994;Turkkan, Stitzer, & McCaul, 1988). Therefore, it is plausible to argue that alcohol (on the ascending limb) may increase the probability of aggression, in part, by producing arousing physiological cues similar to those experienced prior to, and during, an aggressive engagement. ...
The authors assessed the biphasic effects of alcohol on human physical aggression. Sixty male social drinkers were assigned to 1 of 4 groups: alcohol ascending limb (AAL), alcohol descending limb (ADL), or 1 of 2 sober control groups. Aggression was assessed in the AAL and ADL groups at respective ascending or descending blood alcohol concentrations (BAC) of 0.08%. Each participant in the control groups was respectively yoked with a participant in either the AAL or the ADL group to control for the longer period of time needed to reach a BAC of 0.08% on the descending limb compared with the ascending limb (i.e., passage of time effect). The authors measured aggression using a modified version of the Taylor aggression paradigm (S. Taylor, 1967), in which electric shocks are received from and administered to a fictitious opponent during a competitive task. The AAL group was more aggressive than the ADL group. There were no differences between the ADL group and the control groups, which suggests that alcohol does not appear to increase aggression on the descending limb. The control groups did not differ in aggression, thus ruling out a passage of time effect.
... Indeed, this notion is consistent with observations that anxiety sensitivity and sensitivity to punishment are shared vulnerability factors [21,23,32]. Anxiety sensitivity reflects the propensity to react negatively or fearfully to anxiety-related sensations, thoughts, emotions, or environmental stimuli and has been linked to PTSD [57], SUD [58], comorbid SUD-PTSD [59], and increased responsivity to the fear-dampening effects of alcohol [60,61]. Further, there is indeed robust evidence of increased attentional bias toward social threat in anxietyrelated disorders [62][63][64] and PTSD [65]. ...
Significant trauma histories and post-traumatic stress disorder (PTSD) are common in persons with substance use disorders (SUD) and often associate with increased SUD severity and poorer response to SUD treatment. As such, this sub-population has been associated with unique risk factors and treatment needs. Understanding the distinct etiological profile of persons with co-occurring SUD and PTSD is therefore crucial for advancing our knowledge of underlying mechanisms and the development of precision treatments. To this end, we employed supervised machine learning algorithms to interrogate the responses of 160 participants with SUD on the multidimensional NIDA Phenotyping Assessment Battery. Significant PTSD symptomatology was correctly predicted in 75% of participants (sensitivity: 80%; specificity: 72.22%) using a classification-based model based on anxiety and depressive symptoms, perseverative thinking styles, and interoceptive awareness. A regression-based machine learning model also utilized similar predictors, but failed to accurately predict severity of PTSD symptoms. These data indicate that even in a population already characterized by elevated negative affect (individuals with SUD), especially severe negative affect was predictive of PTSD symptomatology. In a follow-up analysis of a subset of 102 participants who also completed neurocognitive tasks, comorbidity status was correctly predicted in 86.67% of participants (sensitivity: 91.67%; specificity: 66.67%) based on depressive symptoms and fear-related attentional bias. However, a regression-based analysis did not identify fear-related attentional bias as a splitting factor, but instead split and categorized the sample based on indices of aggression, metacognition, distress tolerance, and interoceptive awareness. These data indicate that within a population of individuals with SUD, aberrations in tolerating and regulating aversive internal experiences may also characterize those with significant trauma histories, akin to findings in persons with anxiety without SUD. The results also highlight the need for further research on PTSD-SUD comorbidity that includes additional comparison groups (i.e., persons with only PTSD), captures additional comorbid diagnoses that may influence the PTSD-SUD relationship, examines additional types of SUDs (e.g., alcohol use disorder), and differentiates between subtypes of PTSD.
... However, death anxiety was higher for alcohol users. A related theory indicates that individuals with high anxiety sensitivity resort to using alcohol to suppress negative emotional experiences (20). Understandably, high anxiety sensitivity causes death anxiety. ...
Introduction: The purpose of the present study was to examine the relationship between death anxiety-a significant issue for the elderly-and the pain levels in these individuals with increasing complaints of diseases with ageing. Materials and methods: This descriptive cross-sectional study included geriatric patients who presented to the Gaziantep University Faculty of Medicine between 15.12.2018 and15.02.2019 for outpatient treatment and scored over 25 in the Mini-Mental test (MMT). Geriatric Pain Measure (GPM) and Turkish Death Anxiety Scale (TDAS) were used for assessment. Results: Of the 315 individuals, aged 65 years and above, who participated in the study, 58.4% were in the 65-69 age group with 52.7% males. A positive and statistically significant relationship was observed between GPM total score and TDAS total score, as well as its subscales, namely ambiguity of death, exposure to death and agony of death. A positive and statistically significant relationship was determined between the TDAS total score and GPM subscales, namely disengagement, pain intensity, pain at ambulation and pain during vigorous activities. Conclusion: A positive relationship was observed between death anxiety and perceived pain in the elderly. The strongest relationship was determined between pain and anxiety because of the ambiguity of death. Many sociodemographic factors are related to death anxiety and the level of perceived pain. Therefore, death anxiety and pain may affect the quality of life for the elderly and should be promptly treated.
... Given this information, one may have expected a significant relationship between AS social concerns and alcohol consumption. Perhaps AS social concerns is tied to alcohol consumption, but there are moderators of this relationship, such as exposure to trauma [46] or stress, [66] particularly social stress. [67,68] Also of interest, AS social concerns were the only AS component associated with social and enhancement drinking motives. ...
Anxiety sensitivity (AS)- fear of anxiety symptoms and their potential negative consequences-has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.
... In a two-year prospective study, it was identified as a risk factor for alcohol use disorder development (Schmidt, Buckner, & Keough, 2007). High-AS individuals are more susceptible to the arousal-dampening (Stewart & Pihl, 1994) and fear-dampening (MacDonald, Baker, Stewart, & Skinner, 2000) effects of alcohol. They are vulnerable to its negatively reinforcing properties and report alcohol use motives that reflect a desire to self-medicate (Woicik et al., 2009). ...
Background:
Rates of alcohol abuse are high on Canadian postsecondary campuses. Individual trait differences have been linked to indices of alcohol use/misuse, including neurotic traits like anxiety sensitivity (AS) and hopelessness (HOP). We know little, though, about how these traits confer vulnerability. AS and HOP are related to anxiety and depression, respectively, and to drinking to cope with symptoms of those disorders. Neurotic personality may therefore increase risk of alcohol use/abuse via (1) emotional disorder symptoms and/or (2) coping drinking motives.
Objectives:
Allan and colleagues (2014) found chained mediation through AS-generalized anxiety-coping motives-alcohol problems and AS-depression-coping motives-alcohol problems. We sought to expand their research by investigating how emotional disorder symptoms (anxiety, depression) and specific coping motives (drinking to cope with anxiety, depression) may sequentially mediate the AS/HOP-to-hazardous alcohol use/drinking harms relationships among university students.
Methods:
This study used cross-sectional data collected in Fall 2014 as part of the Movember-funded Caring Campus Project (N = 1,883). The survey included the SURPS, adapted DMQ-R SF, and AUDIT-3.
Results:
AS and HOP were both related to hazardous alcohol and drinking harms via emotional disorder symptoms and, in turn, coping drinking motives. All indirect pathways incorporating both mediators were statistically significant, and additional evidence of partial specificity was found. Conclusions/Importance: The study's results have important implications for personality-matched interventions for addictive disorders.
... Thus, interventions that target reductions in stress and anxiety may be expected to have a greater impact on drinking frequency than on drinking intensity. Prior research has shown greater alcohol stress response dampening following a stressor in individuals with high compared with low AS (Conrod et al., 1998;MacDonald et al., 2000;Stewart and Pihl, 1994). Our findings corroborate these earlier studies showing that the current level of clinical anxiety symptoms and the underlying trait of AS were more robust predictors of alcohol craving than the more statebased measure of perceived stress. ...
Background:
Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol-related problems have been equivocal. This study examined relationships between scores on self-report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD.
Methods:
Media-recruited, heavy drinkers with AUD (N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper-and-pencil measures, including the Beck Anxiety Inventory (BAI), the Anxiety Sensitivity Index-3 (ASI-3), and the Perceived Stress Scale (PSS). Eligible subjects (N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected.
Results:
In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI-3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI-3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI-3 scores but not PSS scores were related to greater self-reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress-induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity.
Conclusions:
Overall, clinically oriented measures of anxiety compared with perceived stress were more strongly associated with a variety of alcohol-related measures in current heavy drinkers with AUD.
... STIMULATION DE L'ACTIVITÉ PHYSIOLOGIQUE ET MOTRICE. Laconsom mation de substances est susceptible de produire une élévation de l'acti vité physiologique (rythme cardiaque, pression artérielle, conductivité électrodermale [64]), dont les liens avec l'agression à court terme sont avérés [70,61]. Une telle stimulation de l'activité psychomotrice conduit à favoriser des comportements de recherche de sensation et d'agitation générale, ce qui influence les prises de risques individuelles ou collectives [16,35,62] ainsi qu'une minimisation de leUts consé quences perçues [25]. ...
La relation entre les drogues et la violence est susceptible d'être analysée selon des perspectives très diverses qui vont de l'étude des mécanismes biologiques fondamentaux à celle des mesures de coercition face à la dissémination des drogues illicites. Au-delà des formes d'associations de la drogue et des violences, l'élucidation de la nature véritablement causale de ce lien est fondamentale pour la santé publique. En effet, s'il s'avère que l'association n'est pas strictement causale, la diminution de la disponibilité et/ou de la consommation des drogues ne saurait être un gage de diminution corollaire des violences. A l'inverse, toute indication de causalité peut informer utilement la prévention, voire influencer de manière significative les politiques publiques. Pour conceptualiser les relations entre la drogue et la violence, plusieurs modèles fondamentaux mis à l'épreuve empiriquement sont décrits dans ce chapitre.
... Situational and individual speci®c psychological eects are the norm for alcohol (Stewart and Pihl, 1994), nicotine (Gilbert, 1995), caeine (Silverman et al., 1994a), and numerous other drugs (Janke, 1983;Silverman et al., 1994b). The STAR (Situation  Trait Adaptive Response) model of smoking and nicotine's eects (Gilbert, 1994(Gilbert, , 1995(Gilbert, , 1996 was recently proposed to make reactions to nicotine more predictable across persons and situations. ...
The major purpose of this book is to summarize and synthesize the literature on the relationship of smoking and smoking dependence/addiction to individual differences and affective processes. While it has long been noted that personality and emotional factors are intimately related to each other and to smoking, there is no model or book that integrates relevant findings and models in a comprehensive fashion. This lack of an integrative model stems from the fact that research in this area is scattered across a wide variety of disciplines so as to make integration a formidable challenge. This book reviews and attempts to integrate the numerous, complex, and interesting biological, psychological, and social mechanisms by which personality, psychopathology, emotion, and smoking influence each other and relate to smoking.
... Situational and individual speci®c psychological eects are the norm for alcohol (Stewart and Pihl, 1994), nicotine (Gilbert, 1995), caeine (Silverman et al., 1994a), and numerous other drugs (Janke, 1983;Silverman et al., 1994b). The STAR (Situation  Trait Adaptive Response) model of smoking and nicotine's eects (Gilbert, 1994(Gilbert, , 1995(Gilbert, , 1996 was recently proposed to make reactions to nicotine more predictable across persons and situations. ...
This review examines situational and trait factors that infuence drug use, craving, and the aect-modulating eects of drugs. Situation-and personality-dependent cognitive, emotional, and biological eects of psychoactive drugs are addressed within the context of the recently developed Situation by Trait Adaptive Response (STAR) model. It is argued that drugs do not have inherent (situation-and trait-independent) eects on emotion and related aective processes. Emotion modulation is accomplished by three overall mechanisms: (1) enhanced goal achievement via cognitive performance enhancement; (2) alteration of cognitive capacity and/or attentional processes; and (3) cognitive-aective information priming/biasing towards positive associations and away from negative schemas. Further, the lateralized neural network hypothesis of the STAR model is extended from previous formulations to provide an integrative framework for understanding relationships of cognitive, aective, and learning mechanisms underlying drug use urges and behaviour.
... Elevated levels of anxiety sensitivity are associated with increased risk for anxiety-related disorders (Maller & Reiss, 1992) and substance abuse (Stewart, Peterson, & Pihl, 1995). As a personality style, anxiety sensitivity has been found to be associated with sensitivity to the anxiety-reducing effects of alcohol (MacDonald, Baker, Stewart, & Skinner, 2000;Stewart & Pihl, 1994), as well as to higher levels of coping and conformity motives for drinking (Stewart, Zvolensky, & Eifert, 2001). ...
Co-morbidity is defined as the presence of any co-occurring condition in a patient with an index disease (Kranzler & Rosenthal, 2003). Epidemiologic surveys of psychopathology in the United States have found that while approximately half of the general population will experience a major psychiatric illness at some point over their lifetime, the majority of affected individuals will simultaneously meet diagnostic criteria for two or more disorders (Kessler et al., 1994). Co-morbidity has important clinical implications including: more severe symptoms, more functional disability, longer illness duration, and higher treatment service utilization (see de Graaf, Bijl, ten Have, Beekman, & Vollebergh, 2004).
One of the most common co-morbid conditions is anxiety disorder cooccurring with substance use disorder. Studies that have examined rates of alcohol dependence in anxiety disorder outpatient samples suggest ranges from 15% to 30% depending on the particular anxiety disorders (see Barlow, 1997). Other epidemiologic studies cite lifetime prevalence rates of clinically significant anxiety disorders in patients with alcohol dependence as ranging from 25% to 45% (Kushner et al., 2005). These rates of alcohol dependence in anxiety disorder patients, and of anxiety disorders in alcoholism patients, are markedly elevated relative to base-rates in the general population. Nonetheless, co-morbidity studies with patient populations can lead to overestimates of co-morbidity due to the issue of ‘‘Berkson’s bias’’ – the fact that individuals with more than one disorder may be more likely to seek treatment than those with only one disorder (Galbaud du Fort, Newman, & Bland, 1993). Thus, population-based studies are important to examine ‘‘true’’ rates of co-morbidity of anxiety and substance use disorders.
In the Epidemiological Catchment Area Survey (ECA), which included more than 20,000 respondents from five communities in the United States, alcoholics were significantly more apt to have a co-morbid anxiety disorder than non-alcoholics (19.4% vs. 13.1%) (Regier et al., 1990). Moreover, the ECA survey found that individuals with any anxiety disorder had a 50% increase in the odds of being diagnosed with a lifetime alcohol use disorder (alcohol abuse or dependence). Co-morbid psychiatric symptoms, such as anxiety, can make accurate assessment of substance use more difficult and is associated with a poorer substance use outcome following treatment (Kranzler & Rosenthal, 2003). Indeed, anxiety disorders may especially complicate the treatment of substance use disorders in that they have been found to take significantly longer to remit as compared to mood disorders (Wagner, Krampe, & Stawicki, 2004).
Another issue relates to whether the anxiety disorder is seen as being ‘‘independent’’ of the substance use disorder or ‘‘substance-induced’’. The former views onset of an anxiety disorder occurring before that of an alcohol disorder and/or persisting after the substance abuse is resolved and in need of specific treatment. The latter views onset of an anxiety disorder occurring after that of an alcohol disorder due to substance intoxication and/or withdrawal and not in need of specific treatment; rather, substance-induced anxiety disorders will resolve as the substance abuse is brought under control. Using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association [APA], 1994) in a large epidemiologic survey, Grant et al. (2004) concluded that the vast majority of the anxiety disorders
found in the general population and in alcoholism treatment settings are independent of substance abuse (see chapter 1).
... Anxiety Sensitive individuals have higher levels of alcohol use (Stewart, Peterson, & Pihl, 1995) -at least in young adults -and are particularly sensitive to the anxiety-reducing properties of alcohol (Stewart & Pihl, 1994). Sensation Seeking is associated with elevated rates of alcohol use . ...
... Vulnerable subjects are required, and one particularly vulnerable group is anxietysensitive individuals. In the paradigmatic study, these individuals are first shown stimuli when sober, which results in heightened physiological reactivity, which then is greatly diminished when they are alcohol intoxicated (Stewart & Pihl, 1994). Alcohol in this case is acting as an antianxiolytic, putatively by potentiating the action of the inhibitory neurotransmitter GABA. ...
Biological vulnerabilities to the development of psychopathology The history of psychopathology is replete with a fascination with biological explanations for various disorders. From the trepanations of early cave dwellers, in which holes were gouged in the skull; to the humoral theories of Hippocrates, circa 400 BCE; the custodial, animal-like treatment of the mentally ill of the Renaissance; the enlightened humanists period; the time of influential theorists such as Kraeplin, Freud, and Jung; and on to the present, the belief in biological mechanisms underlying pathology has existed. Nevertheless, today is not yesterday. Generally lacking even just 30 years ago was credible scientific evidence to support this specific and persistent belief. In fact, a sort of antibiological movement grew through the 1950s-1960s, and remnants of this view, which persist today, view mental illnesses as socially learned disorders treatable solely by behavioral interventions. Today, of course, the well-known vulnerability-stress model predominates as an ...
... Situational and individual speci®c psychological eects are the norm for alcohol (Stewart and Pihl, 1994), nicotine (Gilbert, 1995), caeine (Silverman et al., 1994a), and numerous other drugs (Janke, 1983;Silverman et al., 1994b). The STAR (Situation  Trait Adaptive Response) model of smoking and nicotine's eects (Gilbert, 1994(Gilbert, , 1995(Gilbert, , 1996 was recently proposed to make reactions to nicotine more predictable across persons and situations. ...
This review examines situational and trait factors that influence drug use, craving, and the aÄect-modulating eÄects of drugs. Situation- and personality-dependent cognitive, emotional, and biological eÄects of psychoactive drugs are addressed within the context of the recently developed Situation by Trait Adaptive Response (STAR) model. It is argued that drugs do not have inherent (situation- and trait-independent) eÄects on emotion and related aÄective processes. Emotion modulation is accomplished by three overall mechanisms: (1) enhanced goal achievement via cognitive performance enhancement; (2) alteration of cognitive capacity and/or attentional processes; and (3) cognitive-aÄective information priming/biasing towards positive associations and away from negative schemas. Further, the lateralized neural network hypothesis of the STAR model is extended from previous formulations to provide an integrative framework for understanding relationships of cognitive, aÄective, and learning mechanisms underlying drug use urges and behaviour. #1997 by John Wiley & Sons, Ltd.
... The present findings also do not establish whether the situation-specific drinking pattern of substance abusing women with significant PTSD symptoms is actually learned due to the negatively-reinforcing consequences of drinking in these situations. Lab-based alcohol challenge studies (e.g., Stewart & Pihl, 1994 ) could be used to examine the effects of alcohol administration in individuals with PTSD vs. controls, to determine whether PTSD patients are particularly sensitive to short-term alcohol-induced anxiety symptom-reduction effects, for example. Finally, alcohol self-administration methods (e.g., Samoluk et al., 1999) could be used to determine if exposure to relevant discriminative contextual stimuli (e.g., anxiety induction) increases drinking among PTSD patients in the lab. ...
Posttraumatic stress disorder (PTSD) and alcohol use disorders are frequently comorbid conditions (Stewart, 1996). Alcohol use may serve a “negatively-reinforcing” function among traumatized individuals with PTSD (Stewart, 1996; Stewart, Conrod, Pihl, & Dongier, 1999a; Stewart, Pihl, Conrod, & Dongier, 1998). As such, the heavy drinking behavior of those with PTSD should be relatively situation-specific (i.e., more frequent in “negative” discriminative contexts than in other types of contexts). To test this “situational-specificity” hypothesis, a lifetime measure of trauma exposure (Everstine & Everstine, 1993), the PTSD Symptom Self-Report Scale (Foa, Riggs, Dancu, & Rothbaum, 1993), and the 42-item Inventory of Drinking Situations (Annis, Graham, & Davis, 1987) were administered to a community-recruited sample of 294 adult women substance abusers. PTSD symptoms were significantly positively correlated with frequency of heavy drinking in negative situations, but unrelated to frequency of heavy drinking in positive and temptation situations. At the level of specific drinking situations, PTSD symptoms were significantly positively correlated with frequency of heavy drinking in the negative situations of Unpleasant Emotions, Physical Discomfort, and Conflict with Others. PTSD symptoms were unrelated to frequency of heavy drinking in the positive situations of Pleasant Times with Others and Social Pressure to Drink, or in the temptation situations of Testing Personal Control and Urges and Temptations. Additionally, PTSD symptoms were significantly negatively correlated with frequency of heavy drinking in positive situations involving Pleasant Emotions. Anxiety sensitivity (fear of anxiety-related sensations; Peterson & Reiss, 1992), but not Neuroticism (tendency to experience negative affect; Costa & McCrae, 1992), mediated the observed associations between PTSD symptoms and situation-specific heavy drinking in negative contexts in general, and Conflict with Others and Physical Discomfort situations in particular. Implications for designing potentially more effective interventions for women with comorbid PTSD-alcohol use disorders are discussed.
... 4 Thus, differential alcohol consumption on the taste test would not be predicted, and our findings cannot be considered evidence against the TRT. Research has shown that anticipatory stress measured by increased autonomic arousal is associated with increased alcohol consumption (Strickler et al., 1979), and HAS individuals have demonstrated increased anticipatory emotional and autonomic arousal to aversive stimulation when sober (Stewart & Pihl, 1994). It appears that the anticipatory anxiety manipulation utilized in the present investigation may have been less intense or salient than in these previous studies. ...
Individuals scoring high (HAS,
n = 28) and low (LAS,
n = 28) on the Anxiety Sensitivity Index (R. A. Peterson & S. Reiss, 1992) were exposed to a stress induction manipulation followed by a beverage taste-rating task in a study of coping-related alcohol consumption. Anticipation of an anxiety-relevant (AR) interview about their anxiety experiences did not result in greater alcohol consumption by HAS individuals as hypothesized. However, HAS individuals consumed significantly more alcohol than LAS individuals when anticipating an anxiety-irrelevant (AI) interview about their food preferences. The following explanations are explored: (a) Social-evaluative concerns may have suppressed alcoholic beverage consumption by HAS-AR individuals, and (b) enhanced interoceptive acuity and discomfort because of prior food deprivation may have increased alcoholic beverage consumption among HAS-AI individuals. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... For example, prospective daily diary studies in which comorbid PTSD—substance-abusing patients monitor their arousal symptoms (e.g., startle response or sleep difficulties) and their substance use behavior could be useful in better establishing true functional associations between substance misuse and PTSD Arousal symptoms. Laboratory-based drug challenge studies (e.g., MacPherson, Stewart, & Thompson , 1999; Stewart, Finn, & Pihl, 1992 Stewart & Pihl, 1994) could be used to examine the acute and chronic effects of alcohol, anxiolytic, or analgesic medications on various sets of PTSD symptoms (such as degree of startle response) in individuals with PTSD and controls, to determine whether PTSD patients are particularly sensitive to short-term druginduced PTSD symptom-reduction effects, for example. Finally, drug self-administration methods (e.g., Samoluk & Stewart, 1996; Samoluk, Stewart, Sweet, & MacDonald, in press) could be used to determine whether exposure to PTSD-relevant symptoms-cues (e.g., eliciting of the startle response or exposure to trauma cues) actually prompted increased drinking or prescription drug self-administration among PTSD patients in the laboratory. ...
The factor structure of posttraumatic stress disorder (PTSD) symptoms, and correlations between PTSD dimensions and substance dependence, were examined in 295 substance-abusing women. Participants completed self-report measures of trauma exposure, PTSD symptoms, and alcohol dependence and underwent interviews regarding dependence on prescription anxiolytics and analgesics. Overall, PTSD symptoms were moderate in intensity, and 46% of the sample met criteria for PTSD diagnoses. A principal-components analysis on PTSD item scores revealed a correlated 4-factor solution (i.e., Intrusions, Arousal, Numbing, and Avoidance factors). Alcohol dependence correlated with PTSD Arousal scores, anxiolytic dependence with Arousal and Numbing scores, and analgesic dependence with Arousal, Intrusions, and Numbing scores. Implications for understanding functional relations between PTSD and substance use disorders are discussed, as are suggestions for intervention with comorbid patients. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Elevated levels of anxiety sensitivity are associated with increased risk for anxiety-related disorders (Maller & Reiss, 1992) and substance abuse (Stewart, Peterson, & Pihl, 1995). As a personality style, anxiety sensitivity has been found to be associated with sensitivity to the anxiety-reducing effects of alcohol (MacDonald, Baker, Stewart, & Skinner, 2000;Stewart & Pihl, 1994), as well as to higher levels of coping and conformity motives for drinking (Stewart, Zvolensky, & Eifert, 2001). ...
... The mean age of the students in the present sample is representative of Canadian undergraduate university classes (e.g. Stewart, Knize & Pihl, 1992; Stewart, Peterson & Pihl, in press; Stewart & Pihl, 1994). Moreover, the variability in age within the present sample allowed for a breakdown of the sample into younger and older age groups for age-related comparisons on DMQ scores. ...
The literature on drinking motives suggests that individuals drink for three distinct reasons: coping motives (CM: to reduce and/or avoid negative emotional states); social motives (SM: to affiliate with others); and enhancement motives (EM: to facilitate positive emotions). Cooper, Russell, Skinner and Windle (1992) [Psychological Assessment, 4, 123–132] developed a 3-dimensional self-report instrument, the Drinking Motives Questionnaire (DMQ), with subscales designed to assess relative frequency of drinking for each of these three motives. This study was designed to examine the psychometric properties of the DMQ in a large sample of young adult university students. Three hundred and fourteen students voluntarily served as subjects; 266 students (85% of the total sample; 196F and 70M) reported drinking on the DMQ. These students were divided into two age groups [20 yr and under (n = 117); 21 yr and older (n = 149)]. Analyses of variance indicated: (a) main effects of gender, with men scoring significantly higher on the DMQ-EM subscale and tending to score higher on the DMQ-SM subscale when compared to women; (b) a main effect of age group on the DMQ-EM subscale, with younger students scoring significantly higher than older students; and (c) a significant main effect of drinking motive, with the most relatively frequent drinking reported for SM and the least for CM overall. Although mild-to-moderate shared variance between subscales was noted, the three subscales of the DMQ were found to possess adequate-to-high levels of internal consistency. A confirmatory factor analysis (CFA) showed that the hypothesized 3-factor model provided a better fit than either a unidimensional or 2-factor model in explaining the underlying structure of the DMQ. Some suggestions for improvements in DMQ item content are made. The present results replicate and extend previous findings by Cooper and colleagues to a sample of university students, and support the utility of using the DMQ in future investigations of the drinking motives of young adults.
... The present results are consistent. with previous findings that HAS individuals, particularly women, appear more likely than LAS controls to drink to excess (Stewart et al., in press), drink more alcohol per week (Stewart et al., in press; Cox et al., 1993 ), and experience potentially " negatively reinforcing " consequences from drinking (e.g., tension reduction) in the laboratory (Stewart, Achille, Dubois-Nguyen, & Pihl, 1992; Stewart, Achille, & Pihl, 1993; Stewart & Pihl, 1994). However, the ecological validity of the present self-report data remains to be established empirically. ...
The present study was designed to examine the relationship between anxiety sensitivity (AS; fear of anxiety symptoms) and alcohol use motives. The Anxiety Sensitivity Index (ASI), the State-Trait Anxiety Inventory-Trait Subscale (STAI-T), and the Drinking Motives Questionnaire (DMQ) were administered to 314 university students. Higher ASI scores were found to be significantly associated with greater scores on the Coping Motives (CM) subscale of the DMQ, particularly in the female subjects. In contrast, ASI scores were not found to be related in a linear fashion to scores on either the Enhancement Motives (EM) or Social Motives (SM) subscales of the DMQ. A regression equation involving a weighted linear combination of scores on the ASI and STAI-T significantly predicted scores on the CM subscale of the DMQ; the regression equation was significantly better at predicting the frequency of coping-related drinking in women than men. When “primary” motives were examined, a significantly greater percentage of high than low AS subjects (particularly high AS women) were found to drink primarily for coping-related motives, and a significantly greater percentage of low than high AS subjects were found to drink primarily for social-affiliative motives. This pattern of drinking motives points to potential difficulties with alcohol in individuals (particularly women) who are high in both AS and trait anxiety, since drinking primarily for CM as opposed to SM has previously been shown to be associated with more drinking alone, heavier alcohol consumption, and more severe alcohol-related problems.
... Analogue alcohol research has advanced the understanding of alcohol problems by providing more controlled assessment of motivational factors leading to alcohol use than possible with self-report methods. The alcohol challenge paradigm has shown that high AS individuals are particularly susceptible to alcohol's negative-affect reactivity-dampening effects (Baker et al., 1998; Stewart & Pihl, 1994). This increased sensitivity may explain high AS individuals' greater use of alcohol in negatively reinforcing, solitary drinking situations (). ...
An accumulating body of evidence suggests that individuals high in anxiety sensitivity (AS; fear of anxiety symptoms) may be at heightened risk for alcohol problems. Our study was designed to validate differences in self-reported drinking motives and contexts between high and low AS individuals using analogue methods. Participants were nonclinical young adults who scored high (n = 26) or low (n = 26) on the Anxiety Sensitivity Index. Participants were exposed to a social affiliative context manipulation where they played the same game, either alone (solitary context) or with two confederates (social context), followed by a mock beverage taste-rating task which provided an unobstrusive measure of ad-lib alcohol consumption. As predicted, high AS-solitary participants consumed significantly more alcohol as compared to high AS-social and low AS-solitary participants. Unexpectedly, high AS-social participants also consumed significantly more nonalcoholic control beverages as compared to high AS-social and low AS-solitary participants. However, only alcoholic beverage consumption was marginally positively correlated with negative affect scores and only for high AS participants. These results provide preliminary validation of previous self-report findings suggesting the use of high ASI scores as a potential marker for a pattern of context-dependent drinking that is associated with problematic alcohol use. We discuss some specific implications of our findings for prevention of the development of drinking problems, and the relevance of laboratory research for advancing behavior therapy in general.
... Another mechanism that may explain the anxiety sensitivity-trait anxiety interactive effect for coping motives involves sensitivity to the anxiolytic effects of certain drugs among high anxiety sensitive people. Previous lab-based experimental research has demonstrated that high anxiety sensitive individuals are particularly sensitive to alcohol-induced anxiety dampening ( Conrod et al., 1998;MacDonald, Baker, Stewart, & Skinner, 2000;Stewart & Pihl, 1994). This could explain our observed interaction between anxiety and trait anxiety in predicting the increased use of alcohol for coping reasons in youth: high anxiety sensitive/trait anxious teens are the group most likely to experience anxiety dampening rewards from drinking. ...
The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age=15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted “risky” substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety–coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.
... An MAS comparison group was included in addition to the LAS group due to suggestions that LAS individuals form not just a good group against which to contrast HAS individuals but, in fact, appear to be an extreme group that often behave/score differently than MAS individuals (e.g. Cox, 1996b;Shostak and Peterson, 1990;Stewart and Pihl, 1994). The mean (SD) ASI scores of the HAS, MAS, and LAS groups were 33.1 (6.4), 17.9 (1.4), and 6.3 (2.3), respectively. ...
Anxiety sensitivity (AS; the fear of anxiety-related sensations) has been proposed as a risk factor for the development of panic disorder. The present study involved a conceptual replication of Ehlers' (1993, Behaviour Research and Therapy, 31, 269–278) study on childhood learning experiences and panic attacks, but also extended her work by investigating the relationship between early learning experiences and the development of AS, in a non-clinical sample. A sample of 551 university students participated in a retrospective assessment of their childhood and adolescent instrumental and vicarious learning experiences with respect to somatic symptoms (i.e. anxiety and cold symptoms, respectively) using an expanded version of Ehler's (1993) Learning History Questionnaire. AS levels were assessed using the Anxiety Sensitivity Index, and panic history was obtained using the Panic Attack Questionnaire, Revised. Contrary to hypotheses, the learning experiences of high AS individuals were not found to be specific to anxiety symptoms, but involved parental reinforcement of sick-role behavior related to somatic symptoms in general. High AS subjects reported both more anxiety and cold symptoms prior to age 18 than individuals with lower levels of AS. In addition, both cold and anxiety symptoms elicited more special attention and/or instructions from parents for high AS individuals to take special care of themselves. These findings are contrasted with the results for self-reported panickers who reported more learning experiences (modeling and parental reinforcement) specific to anxiety-related symptoms, than the non-panickers. The results suggest that higher-than-normal levels of AS may arise from learning to catastrophize about the occurrence of bodily symptoms in general, rather than anxiety-related symptoms in particular.
... In addition, individuals with high AS report particularly more alcohol use in negative emotion situations than do low-AS individuals, in both clinical (DeHaas et al., 2001(DeHaas et al., , 2002Reyno et al., 2006) and nonclinical populations (Samoluk & Stewart, 1998). Individuals with high AS also have higher sensitivity to the fear-dampening effects of alcohol than do individuals with low AS (MacDonald, Baker, Stewart, & Skinner, 2000;Stewart & Pihl, 1994;Zack, Poulos, Aramakis, Khamba, & MacLeod, 2007), which likely contributes to the motivation for high-AS individuals to drink alcohol in stressful situations. This effect has been demon-strated in both men and women (MacDonald et al., 2000;Zack et al., 2007). ...
Existing research has shown that anxiety sensitivity (AS) is positively associated with alcohol use, and that individuals with high AS use alcohol to avoid or escape negative affect associated with aversive stimuli. The current study investigated the associations between AS and drinking behavior among individuals with comorbid alcohol dependence and posttraumatic stress disorder (PTSD). We assessed baseline PTSD symptoms, AS, and drinking behavior among 151 participants enrolled in a randomized clinical trial for alcohol dependence. We hypothesized that AS would moderate the association between PTSD symptoms and drinking behavior, with PTSD symptoms being more strongly associated with drinking behavior among individuals with high AS. Results showed that AS was strongly associated with PTSD (r = .48) and moderately associated with drinking behavior (r = .18). As predicted, the interaction of AS with severity of PTSD symptoms was associated with frequency of drinking; however, contrary to our hypothesis, PTSD symptoms were more strongly associated with drinking behavior among individuals with relatively low AS. The implication of the present results for treatment of both PTSD and alcohol dependence are discussed.
... Laboratory studies examining individual differences in the stress-dampening effects of alcohol (Levenson, Oyama, & Meek, 1987;Sher & Levenson, 1982) found that individuals characterized by outgoing, aggressive, impulsive, and antisocial characteristics had pronounced stress-response-dampening effects from alcohol, suggesting that these individuals may find alcohol consumption to be especially reinforcing. Similarly, individuals high in anxiety sensitivity, a "cognitive, individual difference variable characterized by a fear of arousal-related bodily sensations such as dizziness, trembling, and racing heartbeat" (Stewart & Kushner, 2001, p. 775), also demonstrate marked anxiolytic effects to alcohol (e.g., Conrod, Pihl, & Vassileva, 1998;MacDonald, Baker, Stewart, & Skinner, 2000;Stewart & Pihl, 1994;see Stewart & Kushner, 2001;Stewart, Samoluk, & MacDonald, 1999). ...
There is little question of whether personality is associated with problematic alcohol involvement (such as alcohol use disorders; AUDs); it clearly is. However, the question remains: how or why is personality related to risky drinking and AUDs? To address this question, theoretical models have been posited regarding the causal effects of personality on alcohol use and related problems. In this article, several of these models are summarized and reviewed. Future research directions are discussed, including possible frameworks that serve to integrate various models of the personality-AUD relation.
... Family history of substance use and N also affect pain response. Our results support the hypothesis that the combined phenotypes may enhance the risk for alcoholism through increased sensitivity to pain and heightened response to analgesia (Pihl et al., 1989;Schuckit et al., 2006;Stewart and Pihl, 1994). Identifying how individual phenotypes interact with one another can facilitate the development of preventative techniques and allow for more therapeutic specificity in treatment of alcoholism and pain. ...
Although personality factors and family history of substance abuse influence how individuals experience pain and respond to analgesics, the combined effects of those factors have not been extensively studied. The objective of this study was to consider the possible role of personality trait of neuroticism and family history of alcoholism on the experience of pain and their role in the analgesic response to an ethanol challenge.
Forty-eight healthy subjects participated in this study; thirty-one had a positive family history of alcoholism (FHP), seventeen had a negative family history of alcoholism (FHN). They were also categorized based on their neuroticism (N) scores (low N = 28, and high N = 20). This was a double-blind, placebo-controlled, randomized, within-subject design study of intravenous administration of three doses of ethanol. The testing consisted of 3 separate test days scheduled at least 3 days apart. Test days included a placebo day (saline solution), low-exposure ethanol day (targeted breathalyzer = 0.040 g/dl), and high-exposure ethanol day (targeted breathalyzer = 0.100 g/dl). Noxious electrical stimulation and pain assessments were performed prior to start of infusion and at the 60-minute infusion mark.
The analgesic effect of ethanol was mediated by an interaction between the personality trait of neuroticism and family history. Individuals with family history of alcoholism and high N scores reported significantly more analgesia on low dose of ethanol than those with low N scores. There was no difference in the analgesic response to ethanol among FHNs with low and high N scores.
These findings support the conclusion that neuroticism and family history of alcoholism both influence the analgesic response of alcohol. Individuals with high N scores and FHP have the strongest response to ethanol analgesia particularly on the low exposure to alcohol.
... Models of PD etiology (Barlow, 2002;Klein, 1993) suggest that certain aspects of bodily responsivity, especially skin conductance reactivity, may be related to panic vulnerability. Given such theories and limited overall data on the topic, in conjunction with higher levels of skin conductance reactivity among high-compared with low-AS persons (nonsmokers; Stewart & Pihl, 1994), a skin conductance reactivity effect was expected in the current investigation. ...
The present investigation examined the moderating role of anxiety sensitivity (AS) in regard to the relation between acute nicotine withdrawal and anxious and fearful responding to a 10% carbon dioxide-enriched air (CO2) procedure. Ninety daily smokers (35 women; M(age) = 28.87, SD = 12.12) were assigned randomly to one of two groups (12-hr nicotine deprivation or smoking "as usual") and subsequently underwent a 10% CO2 provocation challenge. Partially consistent with prediction, results indicated that the AS by nicotine withdrawal (group status) interaction was significantly predictive of peri-challenge anxiety ratings (anxiety during the challenge), but not skin conductance reactivity. Findings are discussed in the context of the role of AS in amplifying smoking-based fear responses to bodily sensations.
... Past work on AS using laboratory and non-laboratory (e.g., ambulatory monitoring) methodologies has typically not yielded significant relations to physiological indices (). Of the physiological variables that have occasionally shown a relation to AS, SCL has typically been the variable of interest (Stewart & Pihl, 1994). Most scholars have interpreted the lack of AS-physiological index findings to mean that this cognitive factor is primarily related to changes in cognitive-affective processes rather than objective physiologic change (Bernstein & Zvolensky, 2007; McNally, 2002). ...
The present investigation examined the singular and interactive effects of anxiety sensitivity and perceived control over anxiety-related events in the prediction of panic symptoms using a CO(2)-enriched air biological challenge. Two hundred and twenty-nine adult participants (M(age)=21.02, SD=7.55, 124 females) were recruited from the greater Burlington, Vermont community. Results indicated that pre-challenge anxiety sensitivity, but not perceived control over anxiety-related events, significantly predicted post-challenge panic attack symptoms, anxiety focused on bodily sensations, and, interest in returning for another challenge (behavioral avoidance). In regard to physiological findings, anxiety sensitivity was significantly related to skin conductance level whereas perceived control over anxiety-related events was related to respiration rate. Neither anxiety sensitivity nor perceived control over anxiety-related events was related to heart rate. There also were no interactive effects between anxiety sensitivity and perceived control over anxiety-related events for any of the studied dependent variables. Results are discussed in relation to multi-risk factor models of cognitive vulnerability for panic psychopathology.
... Our findings, if replicated, suggest that (a) different personality factors might be associated with choice of substance, and (b) different treatment strategies might be required for high and low AS chemical abusers. Based on Stewart and Pihl's (1994) findings, high AS people might be more likely to use alcohol to dampen feelings of anxiety and might be more likely to benefit from relaxation training or other stress-reducing procedures. This might not be so for people low on AS. ...
Sixty-four men and 49 women who applied for admission to outpatient substance abuse programs provided information on their preferred chemical (e.g., alcohol) and information on their alcohol and other chemical use. They also completed a package of self-report questionnaires including the Anxiety Sensitivity Index (ASI). The results showed that men who scored high on the ASI were more likely than low ASI subjects to prefer depressants, especially alcohol. Subjects who scored low on the ASI were more likely to prefer marijuana. ASI score did not predict chemical preference among women. All female ASI groups (high, medium and low) showed a preference for alcohol. The implications of these findings are discussed.
... In a study using a reliable and valid measure of self-reported drinking situations (Annis, Graham, & Davis, 1987;Carrigan, Samoluk, & Stewart, in press), Stewart (1995b) found that AS levels were strongly positively correlated with frequency of drinking in situations involving negative emotions, conflict with others, and physical discomfort (i.e., situations in which drinking may be negatively reinforcing through its tension-reducing effects). In laboratory-based studies, high AS individuals have demonstrated greater levels of stress-response-dampening than low AS individuals, following alcohol administration (Baker, MacDonald, Stewart & Skinner, forthcoming;Stewart & Pihl, 1994). ...
Two studies examined the relationships between anxiety sensitivity (AS), drug use, and reasons for drug use. In Study 1, 229 university students (57% F) completed the Anxiety Sensitivity Index (ASI) and a drug use survey, assessing use of a variety of drugs within the last month, and coping reasons for drug use. Consistent with a modified tension-reduction hypothesis, ASI scores were positively correlated with the number of both anxiety- and depression-related reasons for drug use endorsed. In Study 2, 219 university students (74% F) completed the ASI and a drug use survey, assessing use of several drugs (e.g., alcohol, cigarettes, caffeine, and marijuana/hashish) within the last year, and primary reasons (coping, affiliative, or enhancement) for the use of each drug. Marijuana/hashish users reported lower ASI scores than non-users supporting a negative relation between AS and the use of cannabis. ASI scores were positively correlated with the use of alcohol primarily to cope, and negatively correlated with the use of alcohol primarily to affiliate, among both gender groups, and ASI scores were positively correlated with the use of nicotine primarily to cope among the females. Implications of these findings for understanding risk for abuse of stress-response-dampening drugs by high AS individuals are discussed.
... In another study, Stewart et al. (1995) found that women with higher AS drink more overall and drink to excess more often than do those with low AS. Stewart and Pihl (1994) found that alcohol dampened anticipatory anxiety more among those with high AS than those with low AS. These findings led those investigators to speculate that those with anxiety will be more motivated to drink if they also have high AS because this group experiences greater alcohol-induced anxiety dampening. ...
Alcohol problems co-occur with anxiety disorders at a rate that far exceeds chance ("comorbidity"). One view suggests that risk for developing a comorbid alcohol use disorder is increased when alcohol is used routinely to cope with anxiety symptoms ("self-medication"). Indicating that this view is overly broad, however, the literature suggests that only a subgroup of anxiety-disordered individuals tend to drink to manage their symptoms. Therefore, we set out to identify psychological characteristics that might mark those for whom drinking to cope with anxiety is most likely. Our survey of the literature identified several possibilities, including anxiety-related personality traits (anxiety sensitivity, self-consciousness and Trait Anxiety); higher-order personality dimensions (Harm Avoidance, Reward Dependence, and Novelty Seeking); and, finally, alcohol outcome expectancies (specifically, those related to tension-reducing effects from alcohol).
In a sample of nonproblem drinkers with panic disorder, we regressed predictor variables on several alcohol use measures, including drinking aimed at the control of anxiety symptoms ("self-medication").
Although each variable related positively to a self-medicating style of drinking, expectancies for tension reduction from alcohol use accounted for about twice as much variance as did the other predictors. With simultaneous entry in a step-wise regression analysis, only tension-reduction alcohol outcome expectancies and the Harm Avoidance personality dimension were retained as significant predictors.
Findings suggest that development of a self-medicating style of drinking among individuals with panic disorder is predicated, in part, on specific psychological characteristics of the individual. Alcohol outcome expectancies emerged as the single most important predictor of drinking behavior in this anxiety-disordered sample.
... Furthermore, a study involving a hyperventilation challenge to induce arousal in a nonclinical sample also failed to find significant AS group (low vs. high) differences in heart rate reactivity (Asmundson, Norton, Wilson, & Sandler, 1994). Similarly, Stewart and Pihl (1994) failed to demonstrate significant AS group (low vs. moderate vs. high) differences in heart rate reactivity in response to a signaled loud noise burst stressor. ...
We examined the effects of anxiety sensitivity (AS) and arousal induction on heartbeat awareness and heart rate reactivity in a nonclinical undergraduate sample. Students were randomly selected from a larger screening sample to fill two groups (high and low AS; n = 15 per group) based on Anxiety Sensitivity Index (ASI) [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual (2nd ed. revised). Worthington, OH: International Diagnostic Systems] scores. Participants completed a mental arithmetic/spelling task to induce arousal. At two phases (i.e., baseline vs. stress), participants estimated their heart rates during specified intervals using a mental tracking paradigm. Actual heart rates were simultaneously measured. Although heart rate did increase significantly from baseline to stress phases, high and low AS groups did not differ in terms of heart rate reactivity to the stressor. As hypothesized, high AS individuals were more accurate in estimating their actual heart rate as compared to low AS individuals. Contrary to hypothesis, the AS group differences in accuracy of heartbeat estimations did not vary across baseline vs. stress phases. Interestingly, only low AS individuals provided heart rate estimates which were significantly lower than their actual heart rate readings. Although high and low AS individuals did not differ in actual heart rate, high AS individuals provided significantly higher heart rate estimates than low AS individuals. These results are consistent with the interoceptive sensitivity hypothesis. Implications of the greater heartbeat awareness of high AS individuals are discussed.
... This finding is especially relevant in that coping-related drinking may place individuals at greater risk for the development of significant alcohol use problems (Cooper, Russell, Skinner, & Windle, 1992). In another study, Stewart, Peterson, andPihl (1995)found that women with higher AS drank more overall and drank to excess more often than did those with low AS.Stewart and Pihl (1994)found that alcohol dampened anticipatory anxiety more among those with high AS than those with low AS. These findings led Stewart and Pihl to speculate that those with anxiety will be more motivated to drink if they also have high AS because this group experiences greater alcohol-induced anxiety dampening (see similar argument made byMcNally, 1996). ...
Anxiety sensitivity (AS), the tendency to interpret feelings of anxiety as dangerous, is a core dispositional trait in a well articulated and extensively studied cognitive model of proneness to anxiety disorder. In recent years, there has been an increasing body of findings that also links AS to the tendency to use alcohol in general and the tendency to use alcohol as a means of coping with negative affect in particular. We expand on this empirical base by proposing and testing a theoretical model in which anxiety symptoms mediate the association between AS and alcohol use. That is, we propose that AS promotes anxiety symptoms, which, in turn, promote alcohol use aimed at coping with anxiety and other negative affect states. Over a 1-year data collection period, we assessed 82 alcohol-dependent individuals shortly after they began an intensive alcoholism treatment program. Self-reported anxiety symptoms associated with distinct anxiety syndromes were obtained with reference to the month period preceding their entry into the treatment program. Other information, including the presence of withdrawal symptoms, was obtained via interview. We found that syndrome-related anxiety symptoms and Trait Anxiety, but not State Anxiety or withdrawal symptoms, mediated the significant association between AS and the self-reported tendency to use alcohol as a means of controlling anxiety symptoms. Demonstrating a similar pattern of findings, but much less robustly so, were tests of these mediator models using alcohol use aimed at coping with negative affect (vs. coping with anxiety per se) as an outcome. In discussing these findings, we attempt to further develop a coherent model that incorporates AS, anxiety symptoms, and drinking motives. Our findings suggest that these relationships may differ for negative affect not specifically related to anxiety. We also discuss the possible associations of AS to withdrawal symptoms implied by our findings.
... Moreover there has been considerable controversy about the conditions under which the main effect of gender on aggression holds (Eagly and Steffen, 1986). Although there is a paucity of research comparing autonomic dampening responses to alcohol among women, there is some evidence that the genders respond similarly (Stewart and Pihl, 1994). Due to the disagreement regarding the aggression-eliciting effects of alcohol in women, and the paucity of data investigating biological mediating factors, this investigation tested and compared male and female participants. ...
This article reviews which parts of the alcohol administration methodology were reported in 90 alcohol studies on humans published from 1994 to 1995. although several subject characteristics such as gender were regularly reported, other variables that can influence pharmacokinetics and responses to alcohol were not consistently reported. It is suggested that guidelines for reporting human alcohol administration studies be created and that journal editors and funding agencies require submissions to meet minimum standards for describing the study methodology. Potential guidelines are presented.
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.
The present study examines the relationship of familial and personality risk factors for alcoholism to individual differences in sensitivity to the positively and negatively reinforcing properties of alcohol. Sixteen sons of male alcoholics with multigenerational family histories of alcoholism (MFH) and 11 men who self-report heightened sensitivity to anxiety (HAS) were compared with 13 age-matched family history negative, low anxiety sensitive men (FH-LAS) on sober and alcohol-intoxicated response patterns. We were interested in the effects of alcohol on specific psychophysiological indices of “stimulus reactivity,” anxiety, and incentive reward. Alcohol significantly dampened heart rate reactivity to aversive stimulation for the MFH and HAS men equally, yet did not for the FH-LAS group. HAS men evidenced idiosyncrasies with respect to alcohol-induced changes in electrodermal reactivity to avenive stimulation (an index of anxiety/fear-dampening), and MFH men demonstrated elevated alcohol-intoxicated resting heart rates (an index of psychostimulation) relative to the FH-LAS men. The results are interpreted as reflecting a sensitivity to the “stimulus reactivity-dampening” effects of alcohol in both high-risk groups, yet population-specific sensitivities to the fear-dampening and psychostimulant properties of alcohol in the HAS and MFH groups, respectively.
This review article presents several potential functional pathways which may explain the frequent co-occurrence of PTSD and substance abuse disorders in traumatized individuals. Emerging empirical studies which have examined these potential pathways are reviewed, including studies on relative order of onset, PTSD patients’ perceptions of various drug effects, comparisons of PTSD patients with and without comorbid substance use disorders, and correlational studies examining the relations between severity of specific PTSD symptom clusters and substance disorder symptoms. Research on the acute and chronic effects of alcohol and other drugs on cognitive and physiological variables relevant to PTSD intrusion and arousal symptoms is reviewed to highlight ways in which these two sets of PTSD symptoms might be functionally interrelated with substance abuse. Finally, based on these findings, recommendations are made for the treatment of individuals with comorbid PTSD-substance use disorders.
Alcoholics have previously been found to be more sensitive to painful stimulation than controls, and more sensitive to the pain-reducing effects of alcohol. The present study was designed to examine these effects in men at high familial-genetic risk for alcoholism and controls. Subjects were assigned to one of four alcohol doses [0.135 (active placebo), 0.50, 0.75, or 1.00 ml 95% USP alcohol/kg body weight]. Ratings of the amount of discomfort and pain experienced during an aversive shock procedure were taken immediately post-shock, both while subjects were sober and after they had consumed one of the four alcohol doses. High risk men were found to rate the experience of the shock as more uncomfortable and painful overall than the low risk controls. Pharmacologically significant levels of alcohol were found to reduce or eliminate these group differences, suggesting that alcohol has a "normalizing" effect on pain and discomfort perceptions in high risk men. Only the higher doses of alcohol were found significantly to dampen subjects' shock rating scores. High risk males' increased sensitivity to pain and discomfort, combined with the negatively reinforcing effects of reducing these perceptions at moderate to high alcohol doses, may play a role in predisposing high risk males for the development of alcoholism.
In this review, the authors examine how psychophysiological research might better contribute to understanding the effects of alcohol on human emotion. They propose that future studies would benefit from greater use of contemporary theories of emotion that emphasize a dimensional structure of affective expression, incorporating the parameters of emotional arousal and emotional valence. Evidence suggests that, although alcohol exerts an overall dampening effect on arousal, it appears to modulate emotional response through its effects on higher order associative processes rather than at the level of primary brain motivational systems. They discuss methodological implications of this multidimensional, multilevel approach and suggest that alcohol-induced physiological changes need to be investigated as dynamic response patterns rather than isolated events tied to solitary measures.
The present study examines the relationship of familial and personality risk factors for alcoholism to individual differences in sensitivity to the positively and negatively reinforcing properties of alcohol. Sixteen sons of male alcoholics with multigenerational family histories of alcoholism (MFH) and 11 men who self-report heightened sensitivity to anxiety (HAS) were compared with 13 age-matched family history negative, low anxiety sensitive men (FH-LAS) on sober and alcohol-intoxicated response patterns. We were interested in the effects of alcohol on specific psychophysiological indices of "stimulus reactivity," anxiety, and incentive reward. Alcohol significantly dampened heart rate reactivity to aversive stimulation for the MFH and HAS men equally, yet did not for the FH-LAS group. HAS men evidenced idiosyncrasies with respect to alcohol-induced changes in electrodermal reactivity to aversive stimulation (an index of anxiety/fear-dampening), and MFH men demonstrated elevated alcohol-intoxicated resting heart rates (an index of psychostimulation) relative to the FH-LAS men. The results are interpreted as reflecting a sensitivity to the "stimulus reactivity-dampening" effects of alcohol in both high-risk groups, yet population-specific sensitivities to the fear-dampening and psychostimulant properties of alcohol in the HAS and MFH groups, respectively.
Electrodermal activity was registered during examination with the Defense Mechanism Test of 21 patients diagnosed with anxiety disorder, affective disorder, or schizophrenic disorder. The test can be interpreted as a model situation of how a person defends himself against a threat to avoid anxiety. We used Andersson's modified version of the test and tested the hypothesis that electrodermal activity should increase when there were responses categorised as Anxiety and decrease when there were responses categorised as defences or when the threat was correctly identified. We found significant increase in all electrodermal variables in connection with responses categorised as Anxiety. After exposures with responses categorised as Isolation, the maximal skin conductance level and the magnitude of late nonspecific responses were significantly decreased. After exposures when the threat was identified and thus no longer subliminal, the electrodermal activity was significantly decreased. All these findings support our hypothesis. After exposures with responses categorised as Denial all electrodermal variables were significantly increased. Similarly in responses categorised as Repression, Introaggression, and Disavowal or denial of hero's sex the frequency of late nonspecific responses were significantly increased. The increased electrodermal activity could be due to insufficient defence strategies as categorised in the Defense Mechanism Test.
This article reviews which parts of the alcohol administration methodology were reported in 90 alcohol studies on humans published from 1994 to 1995. although several subject characteristics such as gender were regularly reported, other variables that can influence pharmacokinetics and responses to alcohol were not consistently reported. It is suggested that guidelines for reporting human alcohol administration studies be created and that journal editors and funding agencies require submissions to meet minimum standards for describing the study methodology. Potential guidelines are presented.
This study explored the validity of classifying a community-recruited sample of substance-abusing women (N = 293) according to 4 personality risk factors for substance abuse (anxiety sensitivity, introversion-hopelessness, sensation seeking, and impulsivity). Cluster analyses reliably identified 5 subtypes of women who demonstrated differential lifetime risk for various addictive and nonaddictive disorders. An anxiety-sensitive subtype demonstrated greater lifetime risk for anxiolytic dependence, somatization disorder, and simple phobia, whereas an introverted-hopeless subtype evidenced a greater lifetime risk for opioid dependence, social phobia, and panic and depressive disorders. Sensation seeking was associated with exclusive alcohol dependence, and impulsivity was associated with higher rates of antisocial personality disorder and cocaine and alcohol dependence. Finally, a low personality risk subtype demonstrated lower lifetime rates of substance dependence and psychopathology.
The purpose of these analyses was to investigate the association between reported alcohol use during a sexual assault and perceptions of assault severity and physical and emotional peritraumatic reactions. Self-report data were collected on 57 sexually assaulted college women. Multivariate regression analyses revealed that perception of assault severity mediated the relationship between alcohol use and peritraumatic physical reactions.
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