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According to the US Centers for Disease Control and Prevention, 17% of Latinx high school students report considering attempting suicide within the United States. Given that a large proportion of Latinx youth have an immigrant caregiver, there is a clinical need to address the sociocultural, practical, and resource-related barriers of immigrant Latinx families who have youth experiencing acute suicide risk. To support effective and culturally aligned clinical approaches at the acute, indicated level of care (eg, emergency department, psychiatric hospitalization), we present 3 recommendations contextualized within the flexible and often time-limited nature of clinical responses to acute youth suicidality. The recommendations assume the presence of suicide risk assessment, safety planning, and disposition planning for a level of care that is optimally therapeutic and least restrictive (referred to as standard care).1 [ABSTRACT FROM AUTHOR]

Black individuals who smoke in the United States experience health disparities related to tobacco use (e.g., greater nicotine dependence, less success in quitting smoking) and interoceptive distress (e.g., somatic symptoms, anxiety). Individual difference factors that amplify interoceptive distress and contribute to poorer smoking behaviors and outcomes warrant further attention and investigation. Thus, the present study sought to explore the association between anxiety sensitivity and clinically-relevant smoking variables of perceived barriers for quitting, smoking inflexibility, and problems experienced during past quit attempts. Participants in the current study included 98 Black adult smokers (71.4% male; Mage = 44.08 years, SD = 11.44 years). Results indicated greater levels of anxiety sensitivity were associated with greater levels of perceived barriers for quitting smoking (b = 0.10, SE = 0.08, p = 0.01), smoking inflexibility (b = 0.02, SE <.001, p <.001), and problems experienced during past smoking quit attempts (b = 0.17, SE = 0.07, p = 0.02). Clinical implications and future directions are further discussed as it relates to anxiety sensitivity and efforts to reduce or quit smoking for this health disparities population. [ABSTRACT FROM AUTHOR]

Objective: Pain affects a significant proportion of college students in the United States and has been linked to anxiety and depressive symptoms. Rumination and worry, two transdiagnostic factors linked to comorbidity, may explain the relationship between pain and mental health symptoms. Current Study: The current study examined worry and rumination as explanatory factors in the relationship between pain and anxiety and depressive symptoms in a sample of college students with pain (n = 1,577; 79.9% female). Results: Results indicated that both rumination and worry explained the relationship between pain and depressive and social anxiety symptoms, while rumination alone explained the relationship between pain and anxious arousal symptoms. Conclusion: The current study provides novel empirical evidence that worry and rumination each help explain the relationship between pain and anxiety and depressive symptoms among college students with current pain, and college students in pain may benefit from targeted psychosocial strategies aimed at decreasing worry and ruminative responses.

Author(s): Michael J. Zvolensky [sup.1] [sup.2] [sup.3] , Lorra Garey [sup.1] , Nubia A. Mayorga [sup.1] , Andrew H. Rogers [sup.1] , Michael F. Orr [sup.1] , Joseph W. Ditre [...], The present study examined past-month pain severity in relation to e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about risks associated with using e-cigarettes. Participants were 322 e-cigarette users from the United States (60.2% female, M.sub.age= 36.78 years, SD = 10.62). Results indicated that pain severity was significantly and positively related to e-cigarette dependence, perceived risks of e-cigarette use, and perceived barriers to quitting e-cigarettes. The observed effects were evident above and beyond the variance accounted for by sex, age, education, income, dual cigarette use, frequency of e-cigarette use, and perceived health status. The present study provides novel empirical evidence that pain experience is related to a moderate, yet clinically-meaningful, proportion of the variance in e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about e-cigarette risks. These findings suggest there is merit to exploring the role of pan experience in the onset and maintenance of e-cigarette use.

Background: Latinx individuals experience significant tobacco cigarette smoking-related diseases and illnesses. Although most Latinx smokers report a desire to quit smoking, evidenced-based cessation treatments are underutilized in this group, which may partially be due to lower likelihood of receiving advice from a healthcare professional. Further, there are a lack of cessation treatments that account for comorbid symptoms/conditions (e.g., co-occurring pain) and social determinants of health (e.g., perceived discrimination). Extant work has established the reciprocal relation between pain and smoking trajectories. Additionally, although social determinants, such as perceived racial/ethnic discrimination, have demonstrated clinical relevance to a variety of health-related behaviors, limited work has examined the role of perceived discrimination in pain-smoking relations. The current study examined the effects of perceived discrimination and pain severity in relation to smoking cessation problems and self-efficacy for quitting among Latinx cigarette smokers. Method: Participants included 226 (Mage = 34.95 years, SD = 8.62; 38.5% female) adult Latinx daily cigarette smokers. Results: Results indicated that the interaction of pain and perceived discrimination was predictive of greater quit problems (p = 0.041) as well as greater confidence in the ability to refrain from smoking in response to internal (p < 0.001) and external stimuli (p < 0.001). Conclusions: Overall, this work provides a more nuanced understanding of the psychosocial contexts in which Latinx smokers may encounter problems related to quitting, and this data is important for future smoking cessation research and treatment. [ABSTRACT FROM AUTHOR]

As a multi-systemic disease, COVID-19 infection engendered a rise in co-occurring mental and physical health symptoms, particularly affecting the Latinx population. The current work sought to evaluate the main and interactive influence of acculturative stress and anxiety sensitivity in terms of mental and physical health symptoms among 181 Latinx persons (30.4% female, Mage = 34.1 years, SD = 8.20). Data were collected during a period of high COVID-19 impact (2020–2021) and analyses included five separate, two-step hierarchical regressions that were conducted for each of the criterion variables: (1) fear of coronavirus; (2) somatic symptoms; (3) fatigue severity; (4) anxiety symptoms; and (5) depression symptoms. For all analyses, step 1 covariates included years living in the U.S. COVID-19 impact, gender identity, education, and work life distress and home life distress. Results revealed an interactive effect of anxiety sensitivity and acculturative stress on COVID-19 fear, unique main effects for both anxiety sensitivity and acculturative stress on COVID-19 related fear and somatic symptoms, and main effects for anxiety sensitivity alone in relation to fatigue severity, anxiety, and depression. Overall, this study represents an initial investigation of the associations between acculturative stress, anxiety sensitivity, and a range of salient COVID-19 related outcomes among Latinx persons. [ABSTRACT FROM AUTHOR]

The purpose of the present investigation was to develop and test a measure of negative emotional reactivity to racial/ethnic minoritized stress. In Study 1, we developed item content for a measure of negative emotional reactivity to racial/ethnic minoritized stress. We then evaluated item performance and produced a refined 15-item scale among a large sample of racial/ethnic minority adults (N = 1,343). Results supported a unidimensional construct and high levels of internal consistency. The factor structure and internal consistency were replicated and extended to a sample of Latinx persons who smoke (N = 338) in Study 2. There was evidence of convergent validity of the Emotional Reactivity to Minoritized Stress (ERMS) total score in terms of theoretically consistent and statistically significant relations with indices of mental health problems, social determinants of health, and substance use processes. There was also evidence that the ERMS demonstrated divergent validity in that it was negatively associated with psychological well-being, health literacy, subjective social status in Study 1, and positive abstinence expectancies in Study 2. Overall, the present study establishes the reliability and validity of measuring individual differences in negative emotional reactivity to racial/ethnic minority stress with the ERMS and that such responsivity is associated with behavioral health problems. [ABSTRACT FROM AUTHOR]

Latinx persons have endured elevated rates of traumatic stress related to the COVID‐19 pandemic. The effect of potentially traumatic pandemic stressors on anxiety‐related sleep disturbances, a factor implicated in trauma‐related psychopathology, is largely unexamined in this population. The present study evaluated the additive effect of potentially traumatic pandemic stressors (e.g., hospitalization) on anxiety‐related sleep disturbances. Further, given within‐group disparities across Latinx communities with intersectional identities and COVID‐19–related risk factors, comparisons of the likelihood of pandemic stressors, by subgroup (i.e., older persons, individuals with chronic illness, and Black Latinx persons), were evaluated. Participants were 292 (29.8% female, Mage = 35.03 years, SD = 8.72) Latinx adults who completed a questionnaire battery during a period of high contagion (June 2020–July 2021). There were statistically significant differences across groups such that participants who experienced any potentially traumatic pandemic stressors reported elevated scores on indices of anxiety, depressive symptoms, and anxiety‐related sleep disturbances compared to those who had not experienced these stressors, ds = 0.54–93. Hierarchical regression analysis revealed that hospitalization was associated with anxiety‐related sleep disturbances after controlling for age, sex, chronic illness history, other stressors, anxiety, depressive symptoms, and somatic symptom burden, ΔR2 =.01. Black Latinx identity and chronic illness were significantly associated with potentially traumatic pandemic‐related stressors. This is the first empirical work to evaluate the role of potentially traumatic pandemic stressors on sleep disturbances among Latinx persons and indicates that hospitalization in a pandemic context has an incremental effect on sleep disturbances in this minoritized group. [ABSTRACT FROM AUTHOR]

Latinx persons are exposed to higher rates of traumatic events and conditional risks for developing posttraumatic stress disorder (PTSD) symptoms and comorbid mental health symptoms compared to other minority groups. The study evaluated PTSD symptom severity for global and specific cluster severity relating to co-occurring anxiety, social anxiety, depression, and suicidal ideation among 326 Latinx adults who endorsed trauma exposure. Results indicated that global PTSD symptom severity was significantly related to greater social anxiety, anxious arousal, depression, and suicidal ideation symptoms. PTSD arousal and reactivity symptom cluster had the strongest relation to anxious arousal, social anxiety, and depression, whereas negative alterations in cognitions and mood symptoms had the strongest association with social anxiety, depression, and suicidal ideation. The findings suggest that global PTSD symptom severity, alongside arousal and reactivity and negative alterations in cognitions and mood, are related to a range of concurrent negative mental health symptoms among trauma exposed Latinx young adults. [ABSTRACT FROM AUTHOR]

Background: Opioid misuse in the context of pain management exacts a significant public health burden. Past work has established linkages between negative mood (i.e., symptoms of anxiety and depression) and opioid misuse/dependence, yet the mechanisms underlying these associations have received little scientific investigation. Anxiety sensitivity (AS), the fear of the negative consequences of internal states, may be relevant to better understanding negative mood-opioid relations among adults with chronic pain. Methods: Simultaneous indirect effects of negative mood on opioid misuse and opioid dependence via lower-order factors of AS (physical, cognitive, and social concerns) were examined cross-sectionally in the present study. The study sample consisted of 428 adults (74.1% female, Mage = 38.27 years, SD = 11.06) who self-reported current moderate to severe chronic pain and opioid use for chronic pain. Results: Results indicated that negative mood was (in part) indirectly related to opioid misuse (in part) via AS physical and cognitive concerns and was (in part) indirectly related to opioid dependence via AS cognitive concerns only. No significant indirect effects via social concerns were observed. Discussion and Conclusions: Findings suggest the importance of further exploring the role of anxiety sensitivity cognitive and physical concerns in terms of opioid misuse and dependence among adults with chronic pain. [ABSTRACT FROM AUTHOR]

The mental and behavioral health burden resulting from COVID-19 has disproportionately affected the Latinx population. Yet, no work has investigated the influence of resilience as a protective factor against COVID-19 related consequences. The aim of the current study was to evaluate resilience in relation to COVID-19 related fear, anxiety symptoms, COVID-19 anxiety-related sleep disturbances, and depression among Latinx persons (178 Latinx persons [31.5% female, Mage = 34.1 years, SD = 8.2]). It was hypothesized that greater levels of resilience would be associated with lower levels of all COVID-19 related behavioral health outcomes above and beyond the variance accounted for by years living in the United States (U.S.), degree of COVID-19 exposure, sex, age, education, and COVID-19 related work and financial troubles and home-life distress. Results indicated that greater levels of resilience were associated with lower levels of COVID-19 related fear (ΔR2 =.06, p <.001), anxiety symptoms (ΔR2 =.03, p =.005), COVID-19 anxiety-related sleep disturbances (ΔR2 =.06, p <.001), and depression (ΔR2 =.04, p =.001). Overall, the present study is the first to document the potential importance of resilience in relation to common and clinically significant COVID-19 behavioral health problems among Latinx persons. [ABSTRACT FROM AUTHOR]

Fatigue sensitivity, or the misattribution that fatigue symptoms will lead to negative personal consequences, is one individual difference factor related to adverse behavioral health consequences. The current study investigated whether fatigue sensitivity was related to panic symptoms, depression, as well as fatigue severity among 166 persons of diverse racial/ethnic backgrounds with severe fatigue. As hypothesized, fatigue sensitivity was statistically significantly related to greater panic symptoms, general depression, and fatigue severity. These results were evident over the variance explained by age, sex, neuroticism, and somatic symptoms. This work is the first to evaluate fatigue sensitivity in terms of behavioral health outcomes among a racial/ethnically diverse sample with severe fatigue. [ABSTRACT FROM AUTHOR]

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults (Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population. [ABSTRACT FROM AUTHOR]

In this study we provide information on e-cigarette use characteristics in relation to racial and ethnic characteristics in a sample of 535 adult e-cigarette users. We also evaluated how anxiety sensitivity (AS; fear of anxiety) interacted with race/ethnicity to predict vaping outcomes. We found an association between greater AS and higher e-cigarette dependence for White, but not Black, participants. A similar trend was observed for level of risk perception. Also, Hispanic status was associated with higher perception of e-cigarette benefits. Overall, the present study contributes to the understanding of factors linked to e-cigarette use. [ABSTRACT FROM AUTHOR]

Objectives: Cigarette smoking is the leading preventable cause of death and disability. Although most US smokers want to quit, more than 95% of cessation attempts end in relapse within 6 months. To improve cessation outcomes, research has turned to targetable mechanisms, such as anxiety sensitivity (AS), which maintain smoking behaviour, impede cessation success, and can be effectively targeted in the context of psychosocial interventions. Although integrated treatment programmes that address AS reduction in the context of smoking cessation have demonstrated promising results, presently, no mobile, technology‐based integrated treatment exists to expressly address smoking and AS. The current study evaluated the initial feasibility and acceptability of a mobile smoking cessation intervention, Mobile Anxiety Sensitivity Program for smoking (MASP). Methods: Participants were 15 daily adult combustible cigarette smokers (females n = 6, Mage = 46.5 years, SD = 13.3) who completed a 6‐week total intervention period (baseline visit, 2 weeks pre‐quit, 4 weeks post‐quit, follow‐up visit). Results: Most participants (N = 12) completed the full 6‐week intervention, and participant engagement with MASP was high. Participants reported that MASP was acceptable. Biochemical verification of smoking abstinence indicated 25% of smokers were abstinent for at least 24 hr prior to the in‐person 4 weeks post‐quit follow‐up visit. Conclusions: Findings indicated that MASP has the potential to provide effective assistance to those wanting to quit cigarettes. Practitioner points: Mobile‐based smoking cessation interventions may be a promising treatment option, particularly for those of lower socio‐economic status.Targeting AS in the context of a mobile‐based smoking cessation app may be a viable way to improve smoking cessation success and treatment outcome.Due to the pilot nature of this study, there was no control group. Thus, comparative conclusions and generalizability based on the current study must be made with caution. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarette (e-cigarette) use has risen dramatically in the United States among young adults; however, little is understood about potential factors that are related to e-cigarette use and maintenance among this population. Fatigue severity is one promising individual difference factor, as past work indicates that it is related to greater withdrawal symptoms and greater dependence on e-cigarettes, and more barriers to quitting. In addition, anxiety sensitivity and severe fatigue are both uniquely related to poor e-cigarette use outcomes; yet, no known studies have examined whether these individual difference factors are related to e-cigarette outcomes among young adults. Method: The current study sought to examine the unique and interactive effects of anxiety sensitivity and fatigue severity in predicting a variety of e-cigarette outcomes among 685 (69.1% female; Mage = 19.61 years, SD = 1.44) young adult e-cigarette users. Results: Results indicated that anxiety sensitivity was significantly associated with greater barriers for cessation (β =.63, p <.001) and e-cigarette cravings (β =.67, p =.001), but not dependence. Fatigue severity was significantly associated with greater e-cigarette dependence (β =.58, p <.001), barriers to cessation (β = 1.56, p <.001), and e-cigarette cravings (β = 3.34, p <.001). The interactive effects of anxiety sensitivity and fatigue severity did not significantly predict the outcomes. Discussion: Results suggest that anxiety sensitivity and fatigue severity independently predict greater e-cigarette maintenance factors among young adults. The current investigation highlights the importance of targeting anxiety sensitivity and fatigue severity among young adult e-cigarette users. [ABSTRACT FROM AUTHOR]