Anxiety Sensitivity in Patients with Alcohol Dependence: A Cross-Sectional Case-Control Study

Andrea Pozza^{1, 2,} , Davide Berardi², Sandro Domenichetti³ and Davide Dèttore^{2, 4}

¹Department of Experimental and Clinical Medicine, University of Florence, Italy

²Miller Institute for Behavioural and Cognitive Psychotherapy, Genoa, Italy

³Department of Mental Health, Florence, Italy

⁴Department of Health Sciences, University of Florence, Italy

Cite this paper

Andrea Pozza, Davide Berardi, Sandro Domenichetti and Davide Dèttore. Anxiety Sensitivity in Patients with Alcohol Dependence: A Cross-Sectional Case-Control Study. American Journal of Public Health Research. 2014; 2(6):260-265. doi: 10.12691/AJPHR-2-6-8

Abstract

Anxiety Sensitivity (AS) is a cognitive risk and maintenance factor for anxiety disorders, and it consists of three dimensions: Physical concerns, Cognitive concerns, and Social concerns. No study has investigated the role of AS in individuals with Alcohol-Dependence (A-D), comparing a group of patients with Alcohol-Dependence (A-D) to patients with Anxiety Disorders (AD) and healthy individuals on AS dimensions. Specific dimensions of AS might play a role as cognitive vulnerability and maintenance factors also for A-D-related problems. Examination of AS in patients with A-D might inform clinical practice and public health policy suggesting the integration of treatments specifically targeting AS in A-D patients. The current study aimed to explore the relationship between AS dimensions and A-D. One hundred twenty-five participants, including patients with a diagnosis of A-D (n= 35), patients with a diagnosis of any Anxiety Disorder (AD) (n= 40) and healthy individuals as a control group (CG) (n= 50) completed the ASI-3, STAI-Y and BDI-II. After controlling for anxious traits, A-D patients had stronger Social concerns. Physical and Cognitive concerns appeared, however, significantly more severe among the AD group than the other two groups. Given the strong association between Social concerns and A-D, treatments for A-D patients should also target Social concerns. Study limitations, implications for mental health policy and intervention programs are addressed.

Keywords

Anxiety Sensitivity, Alcohol-Dependence, Anxiety Disorders, Cognitions, Cognitive Behavioural Therapy

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	REISS, S. & McNaLLY, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107-121). San Diego, CA: Academic Press.
[2]	DEACON, B. & ABRAMOWITZ, J.S. (2006). Anxiety sensitivity and its dimensions across the anxiety disorders. Journal of Anxiety Disorders, 20, 837-857.
[3]	OLATUNJI, B.O. & WOLITZKY-TAYLOR, K.B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135, 974-999.
[4]	SCHMIDT, N.B., ZVOLENSKY, M.J. & MANER, J.K. (2006). Anxiety sensitivity: Prospective prediction of panic attacks and Axis I pathology. Journal of Psychiatric Research, 40 (8), 691-699.
[5]	TAYLOR, S. (1999). Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. Mahwah, NJ: Erlbaum.
[6]	TAYLOR, S., ZVOLENSKY, M.J., COX, B., DEACON, B., HEIMBERG, R., LEDLEY, D.R. et al. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety sensitivity Index-3 (ASI-3). Psychological Assessment, 19 (2), 176-188.
[7]	WHEATON, M.G., DEACON, B. J., McGRATH, P.B., BERMAN, N.C. & ABRAMOWITZ, J.S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26, 401-408.
[8]	REISS, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141-153.
[9]	STEWART, S.H., PETERSON, J.B. & PIHL, R.O. (1995). Anxiety sensitivity and self-reported alcohol consumption rates in university women. Journal of Anxiety Disorders, 9 (4), 283-292.
[10]	DeMARTINI, K.S. & CAREY, K.B. (2011). The role of anxiety sensitivity and drinking motives in predicting alcohol use: A critical review. Clinical Psychology Review, 31, 169-177.
[11]	CONROD, P.J., PIHL, R.O. & VASSILEVA, J. (1998). Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes. Alcoholism: Clinical and Experimental Research, 22 (3), 585-597.
[12]	LAWYER, S.R., KARG, R.S., MURPHY, J.G. & MCGLYNN, F.D. (2002). Heavy drinking among college students is influenced by anxiety sensitivity, gender, and contexts for alcohol use. Journal of Anxiety Disorders, 16, 165-173.
[13]	NOVAK, A., BURGESS, E.S., CLARK, M., ZVOLENSKY, M.J. & BROWN, R.A. (2003). Anxiety sensitivity, self-reported motives for alcohol and nicotine use, and level of consumption. Journal of Anxiety Disorders, 17, 165-180.
[14]	HOWELL, A.N., LEYRO, T.M., HOGAN, J., BUCKNER, J.D. & ZVOLENSKY, M.J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use problems among young adult drinkers. Addictive Behaviors, 35, 1144-1147.
[15]	DEHAAS, R.A.B., CALAMARI, J.E. & BAIR, J.P. (2002). Anxiety sensitivity and the situational antecedents to drug and alcohol use: An evaluation of anxiety patients with substance use disorders. Cognitive Therapy and Research, 26 (3), 335-353.
[16]	DEHAAS, R.A., CALAMARI, J.E., BAIR, J.P. & MARTIN, E.D. (2001). Anxiety sensitivity and drug or alcohol use in individuals with anxiety and substance use disorder. Addictive Behaviors, 26, 787-801.
[17]	SCHMIDT, N.B., BUCKNER, J.D. & KEOUGH, M.E. (2007). Anxiety sensitivity as a prospective predictor if alcohol use disorders. Behavior Modification, 31 (2), 202-219.
[18]	WATT, M.C., STEWART, S.H., BIRCH, C. & BERNIER, D. (2006). Brief CBT for high anxiety sensitivity decreases drinking problems, relief alcohol outcome expectancies, and conformity drinking motives: Evidence from a randomized controlled trial. Journal of Mental Health, 15 (6), 683-695.
[19]	SPIELBERGER, C.D., GORSUCH, R.K., LUCHENE, R., VAGG., P.R. & JACOBS, G.A. (1983). Manual for the state-trait anxiety inventory (Form Y). Palo Alto, CA: Consulting Psychologist Press.
[20]	BECK, A.T., STEER, R.A., & BROWN, G.K. (1996). Beck Depression Inventory Second Edition Manual. San Antonio (TX): The Psychological Corporation Harcourt Brace & Company.
[21]	AMERICAN PSYCHIATRIC ASSOCIATION (2000). Diagnostic and Statistical Manual of mental Disorders, 4th edn, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
[22]	AMERICAN PSYCHOLOGICAL ASSOCIATION (1992). Ethical Principles of Psychologist and code of conduct. Washington, DC: American Psychological Association.
[23]	OLEJNIK, S. & ALGINA, J. (2003). Generalized eta and omega squared statistics: measures of effect size for some common research designs. Psychological Methods, 8 (4), 434.
[24]	NARAGON-GAINEY, K. (2010). Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychological Bulletin, 136, 128-150.
[25]	ALLAN, N.P., CAPRON, D.W., RAINES, A.M. & SCHMIDT, N.B. (2014). Unique relations among anxiety sensitivity factors and anxiety, depression, and suicidal ideation. Journal of Anxiety Disorders, 28, 266-275.
[26]	OLTHUIS, J.V., WATT, M.C. & STEWART, S.H. (2014). Anxiety Sensitivity Index (ASI-3) subscales predict unique variance in anxiety and depressive symptoms. Journal of Anxiety Disorders, 28, 115-124.
[27]	SMITH, J.P., & BOOK, S. W. (2010). Comorbidity of generalized anxiety disorder and alcohol use disorders among individuals seeking outpatient substance abuse treatment. Addictive Behaviors, 35, 42-45.
[28]	CLARK, D.M. A cognitive approach to panic. Behaviour Research and Therapy, 24 (4), 461-470.
[29]	KEMPER, C.J., LUTZ, J., BÄHR, T., RÜDDEL, H. & HOCK, M. (2012). Construct validity of the Anxiety Sensitivity Index-3 in Clinical Samples. Assessment, 19 (1), 89-100.
[30]	WILSON, K.A. & HAYWARD, C. (2006). Unique contributions of anxiety sensitivity to avoidance: A prospective study in adolescents. Behaviour Research and Therapy, 44, 601-609.
[31]	NORTON, P.J. & PRICE, E.C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. The Journal of Nervous and Mental Disease, 195 (6), 521-531.
[32]	HEIMBERG, R.G. (2002). Cognitive-behavioral therapy for social anxiety disorder: current status and future directions. Biological psychiatry, 51 (1), 101-108.
[33]	SMITS, J.A.J., BERRY, A.C., TART, C.D. & POWERS, M.B. (2008). The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: A meta-analytic review. Behaviour Research and Therapy, 46, 1047-1054.
[34]	ZVOLENSKY, M.J., YARTZ, A.R., GREGOR, K., GONZALES, A. & BERNSTEIN A. (2008). Interoceptive exposure-based cessation intervention for smokers high in anxiety sensitivity: A case series. Journal of Cognitive Psychotherapy, 22 (4), 346-365.