Anxiety Sensitivity Subfactors Research Articles

Longitudinal associations between anxiety sensitivity and substance use in adolescents: Mediation by depressive affect.

Though anxiety sensitivity (AS)-fear of anxiety-related experiences-is primarily tied to anxiety vulnerability, AS has also been prospectively associated with general negative affect and depression. Furthermore, depression has been longitudinally associated with different forms of substance use, and some AS subfactors (e.g., cognitive concerns) have been associated more consistently with depression and substance use than others. However, no previous study has investigated if longitudinal associations of AS with substance use may be mediated by depression or whether aspects of AS may be prospectively associated with substance use among adolescents. Hence, the present study tested depressive affect (the negative affective aspect of depression) as a prospective mediator of AS associations with substance use and examined longitudinal AS subfactor associations with substance use and problems. High school 9th graders (N = 2,877; Mage = 14.1 years; 55.3% female) completed self-report measures at baseline and at 6 months and 1 year later. Depressive affect mediated AS associations with subsequent alcohol, cigarette, electronic cigarette, cannabis, benzodiazepine, and opioid use. Also, AS cognitive and social concerns (vs. physical concerns) were more consistently associated with later depressive affect and substance use and problems. Current findings suggest that adolescents high in anxiety sensitivity tend to prospectively experience greater depressive affect, which in turn is related to a higher likelihood of engaging in several different forms of substance use. Thus, it is possible that interventions which target AS (particularly AS cognitive concerns) may help to treat or prevent depression and substance use among adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A preliminary assessment of the link between anxiety sensitivity cognitive concerns and suicidal thoughts through dissociative symptoms

ABSTRACT Anxiety sensitivity (AS) and AS subfactors (physical, cognitive, and social) have been found to have robust associations with suicide risk. While the direct association between AS subfactors and suicide risk have been explored, little is known about how specific mechanisms, such as dissociation, might explain this relationship. This study aimed to run three analyses to examine the direct and indirect effects of suicidal thoughts and AS via dissociative symptoms. We predicted that dissociation would be a pathway through which AS physical concerns (ASPC) and AS cognitive concerns (ASCC) predicts suicidal ideation. Participants included 84 undergraduate students from a Southeastern University who were elevated on ASCC. Participants completed measures examining dissociative experiences, anxiety sensitivity, and current suicidal ideation. Results revealed that dissociation had a significant indirect effect with ASPC but not ASCC. The current preliminary study showed that ASCC had direct associations with suicide risk; however, those with lower levels of ASPC and dissociation may also be more likely to develop suicide risk. Future research should explore the possibility that the dissociation/ASPC and ASCC pathways are separate, but related, paths to suicidality.

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

Suicide is a global public health concern. To inform the prevention and treatment of suicidality, it is crucial to identify transdiagnostic vulnerability factors for suicide and suicide-related conditions. One candidate factor is anxiety sensitivity (AS)-the fear of anxiety-related sensations-which has been implicated in the pathogenesis of a host of mental health outcomes, including suicidal thoughts and behaviors. Importantly, AS is distinct from trait anxiety and negative affectivity, highlighting its potential incremental utility in the understanding of psychopathology. Despite a burgeoning body of literature demonstrating that AS is linked to suicidal thoughts and behaviors, this research has yet to be synthesized. This meta-analysis includes 33 articles representing 34 nonredundant samples (N = 14,002) that examined at least one relationship between AS global or subfactor (i.e., cognitive, physical, social) scores and suicidal ideation and/or suicide risk. Findings revealed small-to-moderate and moderate associations between global AS and suicidal ideation (r = .24, 95% confidence interval (CI): [.21, .26], p < .001) and suicide risk (r = .35, 95% CI [.31, .38], p < .001), respectively. All AS subfactors evinced significant associations with suicidal ideation (rs = .13-.24) and suicide risk (rs = .22-.32). AS is related to suicidal ideation and global suicide risk. Research is needed to disentangle AS from other indices of distress in the prediction of suicidal thoughts and behaviors. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Clarifying the relation of acculturative stress and anxiety/depressive symptoms: The role of anxiety sensitivity among Hispanic college students.

Recent work has highlighted the link between acculturative stress and depression/anxiety symptoms among Hispanic young adults, but the nature of these relations is not well understood. The present study aimed to clarify the relation between acculturative stress and depression/anxiety symptoms by examining anxiety sensitivity, globally and via subfactors, as an explanatory variable. A cross-sectional sample of 788 Hispanic college students (80.8% female; Mage = 20.83 years, SD = 1.93) was recruited from a southwestern public university and completed an online self-report assessment battery. Acculturative stress exerted an indirect effect, via the global construct of anxiety sensitivity, on depression symptoms, suicidality, anxious arousal, and social anxiety symptoms. Follow-up simultaneous analytic models demonstrated indirect effects via the anxiety sensitivity subfactors that were pathognomonic with each of the specific affective outcomes. These findings suggest the utility of assessing and targeting anxiety sensitivity in the treatment of acculturative stress-related depression/anxiety problems among Hispanic college students. (PsycINFO Database Record

Anxiety Sensitivity Differentially Predicts Factors of Interpersonal-Psychological Suicide Risk: A Consideration of Specificity.

Recent studies have identified anxiety sensitivity (AS) as a risk factor for suicidality; however, limited work has been performed to understand this risk within the context of the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005). The current study examined the relationship between overall AS, each AS subfactor (cognitive, social, and physical), and the three IPTS domains (perceived burdensomeness, thwarted belongingness, and acquired capability). While each AS subfactor uniquely predicted one IPTS domain, greater overall AS only predicted greater acquired capability, suggesting that assessment of AS at the subfactor level may offer us more information about an individual's interpersonal suicide risk.

Anxiety Sensitivity Prospectively Predicts Posttraumatic Stress Symptoms Following a Campus Shooting

Anxiety sensitivity (AS), the feared consequences of anxious arousal, is known to be related to posttraumatic stress symptoms (PTSS) concurrently and longitudinally. However, no studies have demonstrated whether AS prior to a Criterion A traumatic event predicts later PTSS. The present study evaluated whether preshooting AS predicted PTSS following a campus shooting, as well as whether preshooting AS interacted with shooting exposure to predict PTSS. Participants comprised undergraduates (N=71) who completed a self-report battery upon enrolling in Introductory Psychology. After a campus shooting later in the semester, they were invited to complete measures of PTSS and level of exposure to the shooting. Preshooting levels of AS significantly predicted PTSS after the shooting. This effect was qualified by a significant AS by shooting exposure interaction, such that those with high AS who were exposed to the shooting reported the greatest levels of PTSS. Though all three of the preshooting physical, cognitive, and social AS subfactors demonstrated main effects significantly predicting postshooting PTSS, only AS physical concerns significantly interacted with shooting exposure. The implications of this study concerning AS as a causal risk factor for PTSD are discussed.

Decomposing the Relationship Between Anxiety Sensitivity and Alcohol Use.

The misuse of alcohol is related to numerous detrimental health effects. Research has determined anxiety sensitivity (AS) to be a risk factor for problematic alcohol use. To date, no studies have investigated this relationship using a bifactor model of AS. This study used a bifactor model to determine the effects of the general AS factor and the cognitive, physical, and social concerns subfactors on alcohol-related outcomes. The sample consisted of 329 participants selected from a larger sample of individuals in a brief smoking-cessation intervention. Latent factor models were used to determine the effects of the bifactor model of AS on alcohol use behavior. The general AS factor was significantly associated with alcohol use problems but not alcohol consumption. The AS subfactors of cognitive, physical, and social concerns were not significantly related to either alcohol variable. The findings are inconsistent with previous research that has found associations between the AS subfactors and alcohol-related outcomes. The use of a bifactor model of AS allowed the variance associated with AS to be parceled out of the subfactors, indicating that general AS accounts for the relationship between AS and alcohol misuse.

Anxiety Sensitivity: An Examination of the Relationship With Authoritarian, Authoritative, and Permissive Parental Styles.

A substantial literature has investigated the role of parenting on a child's development. Several classifications of parenting styles (i.e., permissive, authoritarian, authoritative) have been linked to a wide range of negative outcomes such as mood and anxiety problems; however, their respective associations to anxiety sensitivity (AS) remain unclear. Using a nonclinical sample of young adults (N = 227), this study is the first to empirically investigate whether parenting styles were differentially associated with AS, controlling for general depression and anxiety symptoms. Hierarchical linear regression analyses showed that authoritarian and permissive styles were associated with elevated AS. Permissive parenting was associated with the AS physical subfactor, whereas authoritarian parenting was associated with the AS social subfactor. Moreover, AS was found to mediate the relationship between specific parental styles and anxiety symptoms as well as depressive symptoms. Findings suggest that AS may mediate the relationship between parenting styles and negative psychological outcomes.

Obsessive compulsive disorder and anxiety sensitivity: Identification of specific relations among symptom dimensions

Anxiety sensitivity (AS) is a well-established individual difference variable reflecting the tendency to fear bodily sensations associated with anxious arousal. AS is composed of three subfactors including physical, cognitive, and social concerns. Although AS has been consistently linked to the development and maintenance of several anxiety disorders, little research has examined the relationship between AS subfactors and obsessive–compulsive (OC) symptoms. The primary aim of the current investigation was to extend previous research by examining the relationships between these constructs within a clinical population. The sample consisted of 76 treatment seeking adults with a primary diagnosis of OCD. Multiple regression analyses revealed that AS was significantly associated with OC symptom severity even after controlling for anxiety and MDD diagnoses. In addition, the three subfactors of AS were found to be differentially related to the five OC symptom domains (checking, ordering, neutralizing, washing, and obsessing). These results corroborate previous work suggesting a unique and important relationship between AS and OC symptoms. In addition, the current study provides initial evidence clarifying the nature of this relationship within an OCD population.

Anxiety Sensitivity: A Potential Vulnerability Factor For Compulsive Hoarding

Compulsive hoarding is defined as the accumulation of and failure to discard a large number of possessions that appear to be useless or limited in value. Severe hoarding can result in illnesses due to unsanitary conditions, social isolation, work disability, and even death. Despite the severity of impairment associated with this clinical syndrome, research examining potential vulnerability factors is limited. Two independent studies have demonstrated that hoarding behaviors are significantly associated with anxiety sensitivity (AS), a well-known risk factor for anxiety pathology. However, the relationship between AS subfactors and hoarding behaviors is somewhat unclear. The primary aim of this investigation was to examine the relationships between hoarding and AS subfactors utilizing the anxiety sensitivity index-3, a measure designed to more accurately assess AS subfactors. Participants consisted of 279 college students, as well as 210 non-selected clinical participants. Consistent with initial predictions, hoarding behaviors were significantly associated with overall AS. Moreover, when looking at the relationships among hoarding behaviors and specific AS subfactors, hoarding was significantly associated with the physical concerns subscale. Finally, when examining the relationships among overall AS and specific hoarding facets, results indicated that the difficulty discarding subfactor of hoarding was associated with overall AS. Implications for future research and treatment are discussed.

A cross-cultural replication of an interactive model of anxiety sensitivity relevant to suicide

Recent findings indicate a relationship between anxiety sensitivity (AS) and suicide in a variety of populations in the United States. However, the link between AS and suicide has not been evaluated in other cultures. Suicide rates in Russia are among the highest worldwide making it an excellent choice to evaluate the cross-cultural robustness of these findings. The current investigation sought to replicate and extend the investigation of AS subfactors (i.e., cognitive, physical, and their interaction) in relation to suicidality in a sample of Russian adults. Participants were 390 adults recruited from Moscow using a geographic sampling method. Findings from the current study indicate that the interaction of AS cognitive concerns and AS physical concerns are associated with elevated rates of suicidality and previous suicide attempt, above and beyond negative affectivity and hazardous alcohol use. Clinicians may benefit from implementing AS reduction strategies with individuals who endorse elevated suicide risk as well as elevated AS cognitive concerns and low AS physical concerns.

Neuropeptide S receptor gene (NPSR) and life events: G × E effects on anxiety sensitivity and its subdimensions

Objectives. The pathogenesis of anxiety is assumed to be interactively influenced by genetic and environmental factors. Thus, a gene–environment interaction (G × E) study of the neuropeptide S receptor gene (NPSR) A/T polymorphism (rs324981) and life events was conducted with respect to anxiety sensitivity (AS) as an intermediate phenotype of anxiety disorders. Methods. A sample of 475 healthy German subjects was genotyped for NPSR and assessed for AS, childhood maltreatment (CTQ) and recent life events (LTE). Influences on AS and its subdimensions were determined by a step-wise hierarchical regression and a multiple indicator multiple cause (MIMIC) model. Results. Significant main effects of NPSR and CTQ as well as significant G × E were observed, with T/T homozygosity and a high CTQ score resulting in increased anxiety sensitivity. MIMIC modelling yielded association of AS subfactor “concern about mental/cognitive incapacitation” and the basal somatic subdimension “concern about physical sensations” to be associated with CTQ and its interaction with NPSR, while the acute somatic subfactor “concern about heart/lung failure” was associated with NPSR and its interaction with LTE. Conclusions. Results indicate G × E effects of the more active NPSR rs324981 T allele and life events on AS with differential effects of temporally proximal and distal factors on specific AS subdimensions.

Suicidality and Anxiety Sensitivity in Adults with HIV

Suicide rates among HIV-positive individuals are more than three times higher than in the general population. Anxiety sensitivity (AS) may be clinically relevant to increasing our understanding of suicide among individuals with HIV. Specifically, relations between AS cognitive concerns and suicide related outcomes have been observed across a range of populations. The current investigation sought to examine the effect of AS and individual AS subfactors (i.e., cognitive, physical, and social concerns) in relation to suicidality in a sample of adults with HIV. Participants were 164 adults with HIV (17.1% women; mean age=48.40) recruited from AIDS service organizations in Vermont/New Hampshire and New York City. Findings from the current study indicate that AS cognitive concerns (β=0.46, p=0.001), but not the global AS factor, are positively associated with elevated rates of suicidality among persons with HIV above and beyond demographics, HIV relevant factors, and negative affectivity. There was also a negative trend for AS physical concerns in terms of suicidality (β=-0.25, p=0.07). Clinicians may benefit from implementing AS reduction strategies with HIV-positive persons who endorse elevated suicide risk as well as elevated AS cognitive concerns. The current study is limited by a cross-sectional design and lack of suicide attempt history. Future work would benefit from longitudinal examination of the observed relations, further inquiry regarding the relation between AS physical concerns and suicidality and a more comprehensive assessment of suicidality.

Anxiety sensitivity cognitive concerns predict suicidality among smokers

Anxiety along with anxiety-related risk factors is receiving increased attention in regard to its role in elevated suicidality. One such risk factor, anxiety sensitivity (AS), refers to a fear of anxiety-related symptoms. Emerging research indicates that components of AS, particularly the AS subfactor focused on cognitive arousal concerns, are significantly associated with elevated suicidality in samples of diverse clinical outpatients, clinical outpatients with PTSD symptoms, and Air Force cadets undergoing a stressful life experience. Cigarette smokers represent another relevant population for this line of research due to recent reports indicating that cigarette smoking and nicotine dependence may be related to elevated suicidality. Study 1 examined the role of AS and the AS subfactors in a large sample (n=343) of community adult smokers. Study 2 examined the role of AS and AS subfactors in a sample of "pack-a-day" adult smokers (n=78) who were seeking outpatient treatment for substance abuse issues. Study 1 results were consistent with our a priori hypothesis that AS cognitive concerns would be significantly associated with suicidality. Additionally, after covarying for relevant substance use variables, Study 2 results were also consistent with our hypothesis that AS cognitive concerns were significantly associated with suicidality. Limitations included the use of suicide related outcomes, not death by suicide, and cross-sectional design. These findings suggest that suicide potential in cigarette smokers may be related to AS cognitive concerns and add to the emerging literature suggesting AS cognitive concerns are a risk factor for suicidality.

Anxiety Sensitivity and Panic Attacks

The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among college students, the authors replicated the vulnerability effect of AS on panic onset. By measuring AS according to its hierarchical structure, the authors found an AS subfactor--AS-Mental Incapacitation Concerns--to be a significant predictor of panic onset. The authors also demonstrate that AS is not only statistically significant but also clinically/pragmatically important for the onset of panic. The association between panic and increased AS was confirmed in this study, although it remains for future research to conclude whether this association should be attributed to a "scar effect" of panic. Theoretical and methodological issues regarding tests of the scar effect hypothesis are discussed.