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Aims To test whether the relations between anxiety sensitivity ( AS), a transdiagnostic risk factor, and alcohol problems are explained by chained mediation models, from AS through anxiety or depressive symptoms then drinking motives in an at-risk sample. It was hypothesized that AS would influence alcohol problems through generalized anxiety or depression symptoms and then through negatively reinforced drinking motives (i.e. drinking to cope with negative affect and drinking to conform). Design Cross-sectional single- and chained-mediation models were tested. Setting Self-report measures were completed in clinics at Florida State University and the University of Vermont, USA. Participants Participants consisted of 523 adult daily cigarette smokers [mean age = 37.23, standard deviation ( SD) = 13.53; 48.6% female]. Measurements As part of a larger battery of self-report measures, participants completed self-report measures of AS, generalized anxiety, depression, drinking motives and alcohol problems. Findings Chained mediation was found from AS to alcohol problems through generalized anxiety then through drinking to cope with negative affect [ B = 0.04, 90% confidence interval ( CI) = 0.004, 0.10)]. Chained mediation was also found from AS to alcohol problems through depression then through drinking to cope with negative affect ( B = 0.11, 90% CI = 0.05, 0.21) and, separately, through socially motivated drinking ( B = 0.05, 90% CI = 0.003, 0.11). Conclusions Anxiety sensitivity and alcohol problems are indirectly related through several intervening variables, such as through generalized anxiety or depression and then through drinking to cope with negative affect. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Although past work has documented relations between HIV/AIDS and negative affective symptoms and disorders, empirical work has only just begun to address explanatory processes that may underlie these associations. The current investigation sought to test the main and interactive effects of HIV symptom distress and anxiety sensitivity in relation to symptoms of panic disorder (PD), social anxiety disorder (SA), and depression among people with HIV/AIDS. Participants were 164 adults with HIV/AIDS (17.1% women; mean age, 48.40) recruited from AIDS service organizations (ASOs) in Vermont/New Hampshire and New York City. The sample identified as 40.9% white/Caucasian, 31.1% black, 22.0% Hispanic, and 6.1% mixed/other; with more than half (56.7%) reporting an annual income less than or equal to $10,000. Both men and women reported unprotected sex with men as the primary route of HIV transmission (64.4% and 50%, respectively). HIV symptom distress and anxiety sensitivity (AS) were significantly positively related to PD, SA, and depression symptoms. As predicted, there was a significant interaction between HIV symptom distress and anxiety sensitivity in terms of PD and SA symptoms, but not depressive symptoms. Results suggest that anxiety sensitivity and HIV symptom distress are clinically relevant factors to consider in terms of anxiety and depression among people living with HIV/AIDS. It may be important to evaluate these factors among patients with HIV/AIDS to identify individuals who may be at a particularly high risk for anxiety and depression problems. Limitations included recruitment from ASOs, cross-sectional self-report data, and lack of a clinical diagnostic assessment. [ABSTRACT FROM AUTHOR]

This investigation first examined the incremental validity of distress tolerance in terms of alcohol use coping motives within a trauma-exposed community sample of adults, beyond the variance contributed by posttraumatic stress symptom severity, difficulties in emotion regulation, alcohol consumption, and other (noncriterion) alcohol use motives. Secondly, the potential mediating role of distress tolerance in the association between posttraumatic stress symptom severity and alcohol use coping motives was tested. Participants were 83 community-recruited individuals (63.8% women; Mage = 22.98, SD = 9.24) who endorsed exposure to at least one traumatic life event and past-month alcohol use. Participants were assessed using structured diagnostic interviews and a series of self-report inventories. Results were consistent with hypotheses, because distress tolerance was significantly and incrementally associated with alcohol use coping motives; and distress tolerance at least partially mediated the association between posttraumatic stress and alcohol use coping motives. Theoretical and clinical implications as well as future directions regarding the association between distress tolerance and alcohol use motives among trauma-exposed persons are discussed. [ABSTRACT FROM AUTHOR]

Objective: The present investigation examined self-defined serious quit attempts (lifetime) in relation to current indices of anxious arousal, anhedonic depression symptoms, anxiety sensitivity, and severity of problems experienced in past efforts to quit. Method: Participants in the present sample included 144 adult smokers (59.7% women; mean [SD] age = 29.48 [11.621 years) who were recruited from the Burlington, VT, community. Results: After controlling for daily cigarette smoking rate, total years as a regular smoker, current alcohol-use problems, and gender, the number of past quit attempts was significantly and uniquely associated with anxious arousal symptoms, anxiety sensitivity, and severity of problems experienced in past quit at- tempts; however, the number of past quit attempts was not significantly associated with anhedonic depression symptoms. Conclusions: These results suggest that clinicians may benefit by assessing for affective factors as part of a smoking-assessment process and integrating them into interventions for smoking cessation. [ABSTRACT FROM AUTHOR]

Abstract: 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 CO2-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. [Copyright &y& Elsevier]

Little work has focused on the underlying mechanisms that may link financial strain and smoking processes. The current study tested the hypothesis that financial strain would exert an indirect effect on cognitive-based smoking processes via depressive symptoms. Three clinically significant dependent variables linked to the maintenance of smoking were evaluated: negative affect reduction motives, negative mood abstinence expectancies, and perceived barriers for quitting. Participants included 102 adult daily smokers (Mage=33.0years, SD=13.60; 35.3% female) recruited from the community to participate in a self-guided (unaided; no psychological or pharmacological intervention) smoking cessation study. Results indicated that depressive symptoms explain, in part, the relation between financial strain and smoking motives for negative affect reduction, negative mood abstinence expectancies, and perceived barriers for quitting. Results indicate that smoking interventions for individuals with high levels of financial strain may potentially benefit from the addition of therapeutic tactics aimed at reducing depression. [ABSTRACT FROM AUTHOR]

Objective: The present investigation examined anxious arousal and anhedonic depression symptoms in relation to frequency of past-30-day marijuana use, as well as the role of marijuana-use coping motives in terms of mediating this relation. Method: The present sample included current young adult marijuana users (N= 154; 48.1% female; mean [SD] age = 20.75 [5.97] years) who were recruited via study flyers and printed advertisements in local newspapers placed throughout the Burlington, VT, community. Results: After controlling for daily cigarette smoking rate, alcohol consumption, and gender, anxious arousal symptoms, but not anhedonic depression symptoms, were significantly and uniquely associated with the frequency of marijuana use. In addition, coping motives for marijuana use mediated the relation between anxious arousal symptoms and the frequency of current marijuana use. Conclusions: These results provide novel information related to the explanatory role of marijuana-use coping motives in the relation between anxious arousal symptoms and the frequency of marijuana use among young adult active users. Clinical implications for the current findings are discussed. [ABSTRACT FROM AUTHOR]

Scientific evidence suggests that pain contributes to the maintenance of tobacco cigarette smoking among individuals with varying levels of pain. Yet, little is understood about factors that may moderate relations between pain severity and smoking processes. Considering that women are more likely to experience deleterious pain- and smoking-related outcomes, female smokers may be a particularly vulnerable group when considering pain in the maintenance of maladaptive smoking behavior. Thus, it is important to investigate the role of sex in pain-smoking relations. The current cross-sectional study examined sex differences in the relation between reported levels of pain and cessation-relevant smoking processes (i.e. cigarette dependence, barriers for cessation, and past cessation-related problems). Participants included 100 adult daily cigarette smokers (M age  = 32.57 years, SD = 13.58; 33% female). Results indicated that greater pain was significantly associated with greater cigarette dependence, greater perceived barriers to cessation, and greater cessation-related problems among female, but not male, smokers. The current findings identify sex as a potentially important moderator of complex associations between pain and tobacco smoking and suggests that women may constitute a group that is especially vulnerable to the effects of pain in the maintenance of tobacco dependence. Based on the present data, integrated pain-smoking treatments may be especially useful for female, versus male, smokers., (Published by Elsevier Ltd.)

Background: Previous research suggests that females may be more motivated to smoke for negative reinforcement (NR) than males. However, it remains unclear whether gender differences in smoking outcome expectancies for negative smoking reinforcement-an important theoretical and clinical target defined as beliefs that smoking alleviates negative affect-exist above and beyond gender differences in depression and/or other outcome expectancies., Methods: Relations between gender and negative smoking reinforcement expectancies were examined in two independent samples. Sample 1 consisted of non-treatment seeking daily smokers (Male n = 188; Female n = 91) recruited from Southern California (49.5% Black, 32.2% Caucasian, and 18.3% other race/ethnicity). Sample 2 consisted of treatment seeking daily smokers (Male n = 257; Female n = 237) in Northern Florida and Vermont (10.7% Black, 82.9% Caucasian, and 6.4% other)., Results: Females (vs. males) reported stronger NR smoking expectancies with and without statistically controlling for nicotine dependence, other smoking expectancies, and anxiety and depression in both samples (βs = .06 to .14, ps = .06 to < .001)., Conclusions: Beliefs that smoking alleviates negative affect may reflect a gender-specific etiological process disproportionately prominent in women. Enhancing ability to cope with negative affect without smoking or challenge NR expectancies may be particularly important for cessation treatment in women., (© The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The present investigation examined the relation between exercise intensity and alcohol use coping motives among trauma-exposed adults. Participants were 114 adults (58 women; M(age)=22.31 years, SD=8.89) who reported exposure to at least one traumatic event (American Psychiatric Association, 2000) and alcohol use in the past 30 days. Partially consistent with expectation, engagement in vigorous-intensity activities (≥6 resting metabolic rate [MET] score) demonstrated a significant, incremental (negative) association with alcohol use coping motives. This incremental association was observed after accounting for current alcohol consumption, non-criterion alcohol use motives, anxiety sensitivity, posttraumatic stress symptom severity, as well as engagement in light- and moderate-intensity activities (<6 resting MET score). Results are discussed in terms of better understanding the association between vigorous-intensity aerobic exercise and coping-oriented alcohol use among trauma-exposed individuals., (Published by Elsevier Ltd.)

Anxiety sensitivity, distress tolerance, and discomfort intolerance have been identified as important factors related to alcohol use motives and alcohol-related problems. Yet, these variables are highly correlated and little work has delineated whether these psychological vulnerability factors are differentially related to alcohol use motives and problems. To fill this gap in the existing literature, the present study evaluated whether anxiety sensitivity, distress tolerance, and discomfort intolerance were differentially related to high-risk alcohol use motives (i.e., coping and conformity motives) and alcohol use problems among 224 young adult, current drinkers (52.3% women; M(age)=21.18, SD=7.08). Results indicated that distress tolerance, but not anxiety sensitivity or discomfort intolerance, was significantly related to coping motives for alcohol use. Additionally, anxiety sensitivity, but not distress tolerance or discomfort intolerance, was significantly related to conformity motives for drinking. For both sets of analyses, the observed significant effects were evident above and beyond the variance accounted for by alcohol consumption level, smoking rate, negative affectivity, and non-criterion alcohol use motives. Additionally, discomfort intolerance and anxiety sensitivity each predicted alcohol use problems; effects were not attributable to negative affectivity, cigarettes smoked per day, or shared variance with distress tolerance. Findings are discussed in relation to the role of emotional sensitivity and intolerance in terms of the motivational bases for alcohol use and alcohol use problems among young adult drinkers., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Despite initial evidence linking distress tolerance to posttraumatic stress disorder (PTSD) symptom severity, there is a need for the investigation of interrelations among multiple measures of distress tolerance and PTSD symptom severity. Therefore, the present study investigated concurrent relations among multiple measures of distress tolerance, as well as the relations between these measures and PTSD symptom severity, within a trauma-exposed community sample. The sample consisted of 81 trauma-exposed adults (63.1% women). Results indicated that Distress Tolerance Scale (Simons & Gaher, 2005) scores, but no other measures of distress tolerance were significantly related to PTSD symptom severity above and beyond the variance accounted for by number of traumas, trait-level neuroticism, and participant sex. Implications and future directions are discussed.

The present investigation sought to evaluate the unique explanatory relevance of pain-related anxiety in relation to negative and positive reinforcement smoking outcome expectancies among 135 (40.7% female; M(age) = 26.11, SD = 11.23) adult daily cigarette smokers. As predicted, pain-related anxiety was significantly related to greater expectancies that smoking will decrease negative affect, and lesser expectancies that smoking will result in positive outcomes. The observed effects were evident above and beyond the variance accounted for by gender, current level of non-specific bodily pain, daily cigarette use, relations with non-criterion outcome expectancies, and shared variance with anxiety sensitivity. Results suggest that there may be segments of the smoking population who are at relatively greater risk for certain expectancies for tobacco smoking by virtue of individual differences in pain-related anxiety., (Copyright 2010 Elsevier Ltd. All rights reserved.)

The present cross-sectional study evaluated whether people who engage in vigorous-intensity exercise are better able to regulate negative affective states, thereby changing core maintenance factors of smoking. Participants were a community sample of adults (n = 270) who completed self-report measures of physical activity, cigarette smoking, anxiety sensitivity, and negative affect. Consistent with hypothesis, vigorous-intensity exercise was related to lower levels of cigarette smoking, accounting for 10% of the variance in smoking. Additionally, negative affect mediated the relationship between vigorous-intensity physical activity and cigarette smoking, accounting for about 12% of this relation. Furthermore, these relationships were stronger for individuals with high anxiety sensitivity than for those with low anxiety sensitivity; including anxiety sensitivity as a moderator of the mediated relationship increased the amount of variance accounted for by negative affect to 17%. The findings are discussed in relation to developing further scientific insight into the mechanisms and pathways relevant to understanding the association among vigorous-intensity exercise, smoking, and emotional vulnerability., (Copyright 2010 Elsevier Ltd. All rights reserved.)

The present study evaluated differences among daily smokers with posttraumatic stress disorder (PTSD), panic disorder (PD), panic attacks (PA), and no axis I psychopathology (past 6 months) in terms of several cognitive-affective variables implicated in both the onset and maintenance of anxiety psychopathology and cigarette smoking. The sample consisted of 123 daily smokers (62% women: M(age)=29.7, SD=11.9). Compared to the PA and no psychopathology groups, the PTSD group reported significantly higher levels of anxiety sensitivity, discomfort intolerance, negative affectivity, anxious arousal, and anhedonic depression; and, the PTSD group reported significantly lower levels of perceived control over anxiety-related events than the PA group. The PD group, compared to those in the PA and no psychopathology groups, reported significantly higher levels of anxiety sensitivity, negative affectivity, and anxious arousal; and significantly lower levels of perceived control over anxiety-related events. No significant differences were evident between the PTSD and PD groups. Theoretical and clinical implications of the present findings are discussed in terms of smoking and emotional vulnerability., (Published by Elsevier Ltd.)

The aim of the current investigation was to examine uni-morbid and co-occurring tobacco and marijuana use in relation to the negative emotional symptoms of anxiety and depression. Participants were 250 adult individuals (132 women; mean age = 22.43 years, standard deviation = 9.00 years) who were divided into one of four non-overlapping substance use categories: tobacco use only (n = 39), marijuana use only (n = 62), co-occurring tobacco and marijuana use (n = 82), and neither tobacco nor marijuana use (n = 67). Results revealed three key findings. First, tobacco-only using individuals reported significantly greater negative affectivity than any of the other groups. Second, tobacco-only users reported greater anxious arousal symptoms than either the marijuana or non-substance use groups, but not the combined group. Third, tobacco-only users reported greater levels of depressive symptoms than either marijuana users or non-substance users. These findings provide novel information about tobacco and marijuana use and how these variables relate to the experience of general and specific types of negative emotional symptoms.

Despite the documented association between trauma exposure and sexual problems (sexual dissatisfaction and sexual functioning), only a paucity of studies have investigated possible mechanisms underlying this association. The present study tested the role of emotion dysregulation in regard to levels of sexual dissatisfaction and functioning among a sample of 43 trauma-exposed cigarette smokers (17 women; M(age) = 20.20, SD = 10.87). When controlling for negative affectivity, type of trauma (sexual vs. nonsexual), daily smoking rate, posttraumatic stress symptoms, and anxiety sensitivity, emotion dysregulation provided an independent and unique contribution to sexual dissatisfaction but not to sexual function. These preliminary findings suggest that emotion dysregulation may be more important to understanding certain sexual problems (dissatisfaction) among cigarette-smoking trauma survivors than previously recognized, and this topic is, therefore, worthy of further investigation.

The present investigation examined the extent to which the cognitive factors of anxiety sensitivity (AS) and perceived control over anxiety-related events are independently related to smoking outcome expectancies and perceived barriers to quitting. Participants were 125 community-recruited adult, daily smokers. Consistent with hypotheses, AS and perceived control over anxiety-related events independently and significantly predicted smokers' expectancies for negative affect reduction from smoking, whereas only AS predicted expectancies for negative personal consequences from smoking. Also as hypothesized, AS and perceived control over anxiety-related events each independently and significantly predicted level of general perceived barriers to quitting smoking. All of the observed significant effects were evident above and beyond the variance accounted for by gender, alcohol consumption, number of cigarettes smoked per day, and negative affectivity. Together, these findings further the literature on the relation between anxiety-relevant cognitive factors and psychological smoking processes.

The present investigation examined incremental associations between anxiety sensitivity (AS) subfactors (e.g. physical, psychological, and social concerns) and posttraumatic stress and panic symptoms among trauma-exposed adults. These effects were examined above and beyond other theoretically relevant factors, including negative affectivity and number of types of trauma exposures. The 239 participants were selected from a university- and community-based sample (129 women; mean age = 23.0 years; SD = 9.6, range = 18-65), all of whom endorsed exposure to traumatic life events. The AS psychological concerns and AS physical concerns lower order factors evidenced distinct associations with posttraumatic stress symptoms and panic-relevant symptoms, respectively. Specifically, the AS psychological concerns facet was significantly incrementally predictive of posttraumatic stress-relevant avoidance symptoms. The AS physical concerns facet was significantly incrementally predictive of panic-relevant symptoms, including anxious arousal, body vigilance, and perceived control over anxiety-related events. Results are discussed in the context of the relevant theoretical literature pertaining to shared vulnerability and comorbidity between posttraumatic stress and panic.

The present investigation examined the relationships between anxiety sensitivity and motivation to quit smoking, barriers to smoking cessation, and reasons for quitting smoking among 329 adult daily smokers (160 females; M (age) = 26.08 years, SD = 10.92). As expected, after covarying for the theoretically relevant variables of negative affectivity, gender, Axis I psychopathology, nonclinical panic attack history, number of cigarettes smoked per day, and current levels of alcohol consumption, we found that anxiety sensitivity was significantly incrementally related to level of motivation to quit smoking as well as current barriers to quitting smoking. Partially consistent with the hypotheses, after accounting for the variance explained by other theoretically relevant variables, we found that anxiety sensitivity was significantly associated with self-control reasons for quitting smoking (intrinsic factors) as well as immediate reinforcement and social influence reasons for quitting (extrinsic factors). Results are discussed in relation to better understanding the role of anxiety sensitivity in psychological processes associated with smoking cessation.

The present study examines the relation between posttraumatic stress symptom severity and motives for marijuana use among 103 (55 women) young adult marijuana users (current) who reported experiencing at least one traumatic event in their lifetime. As expected, after covarying for the theoretically relevant variables of frequency of past 30-day marijuana use, number of cigarettes smoked per day, and volume of alcohol consumed, posttraumatic stress symptom severity was significantly related to marijuana use coping motives, but no other motives for marijuana use. Results are discussed in relation to better understanding the role of coping-motivated marijuana use among young adults experiencing posttraumatic stress.

The aim of the present investigation was to evaluate the moderating role of anxiety sensitivity (AS) in the relation between smoking rate and panic vulnerability variables, both concurrently and prospectively (3 months), among a community-based sample of 125 daily smokers (60 females; M(age) =26.02 years, S.D. =10.98). Consistent with prediction, the interaction between AS and smoking rate significantly predicted concurrent agoraphobic avoidance (3.2% of unique variance) and change in levels of anticipatory anxiety during the 3-month follow-up period (4.7% unique variance). Smokers high in AS who also smoked at greater rates reported the highest levels of avoidance and greatest increase in anticipatory anxiety. Overall, these data suggest that AS is an important individual difference factor that, when coupled with higher rates of smoking, is associated with greater levels of avoidance and anticipatory anxiety among daily smokers.

The present investigation evaluated anxious and fearful responding to bodily sensations as a function of panic disorder (PD) and smoking status. Participants completed a voluntary hyperventilation procedure that elicits panic-relevant bodily sensations. Psychophysiological data were collected throughout the study procedures. Assessments of anxiety and bodily distress were conducted pre-challenge baseline, post-hyperventilation, and during a recovery period following the challenge. Results indicated that smokers with PD reported greater levels of anxiety and bodily distress than smokers without PD and than nonsmokers with PD at the post-challenge assessment and recovery period. No differences in autonomic responding were evident during the challenge or in the recovery phase. In terms of rate of recovery, the linear decrease in anxiety, but not bodily distress, was significantly more steep for nonsmokers with PD than for smokers with PD. These findings are discussed in relation to better understanding the potential role that smoking may play in terms of anxious and fearful responding to bodily sensations.