Browsing by Subject "Anxiety sensitivity"

Now showing 1 - 4 of 4
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    Examining experiential avoidance as a mediator of the relation between anxiety sensitivity and depressive symptoms
    (2019-06-20) Stein, Aliza Tova; Smits, Jasper A.J.
    Initial evidence suggests that experiential avoidance (EA) mediates the relation between anxiety sensitivity (AS) and depression. We examined the AS-EA-depression pathway, examining both concurrent, and prospective (cross-lag), mediation models. Utilizing data from a study that examined the effects of exercise on AS (N = 60), we modeled depressive symptoms, EA, and AS over four time points. Time-varying predictors were disaggregated into between- subjects (each person’s mean level of the predictor) and within- subjects change (each person’s deviations, at each time point, from their mean level on the predictor) components. Tests of the concurrent relations were partially consistent with predictions, with mean EA levels, but not within-subjects changes in EA, partially mediating the relation between AS and depression symptom severity. However, the prospective, cross-lag mediation model, in which AS predicted future EA controlling for previous EA, and EA predicted future depression, controlling for previous depression, yielded no significant effects. These results suggest that observed between-subjects mediation findings, found here and in previous studies, may not replicate using more stringent, quasi-causal, cross-lag mediation analyses. These results highlight the importance of estimating causal pathways in mediation analyses. Clinical implications and directions for future research are discussed
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    Reducing anxiety sensitivity : effects of anxiety education and interoceptive exposure with CO₂
    (2011-08) Pai, Anushka Vasudeva; Telch, Michael Joseph; Bartholomew, John; Beevers, Christopher; Hixon, John; Holahan, Charles
    Anxiety sensitivity, defined as the fear of anxiety-related sensations and their consequences (Reiss & McNally, 1985), has been consistently shown to be associated with risk for anxiety psychopathology as well as other mental health problems. The primary objective of the present secondary prevention trial sought to examine strategies to reduce anxiety sensitivity among persons with elevated anxiety sensitivity by testing the singular and combined efficacy of two commonly used strategies in multi-component interventions for reducing anxiety sensitivity: (a) anxiety psychoeducation emphasizing the benign nature of stress and (b) interoceptive exposure (i.e. repeated inhalations of 35% CO₂ gas mixture). To provide a stringent control for non-specific effects associated with anxiety psychoeducation and interoceptive exposure with CO₂, two control strategies were included in the study design: general health and nutrition education and repeated inhalations of regular room air. Utilizing a 2X2 design, participants were randomly assigned to receive an education component and intervention sessions consisting of one of two gas mixtures. The current study did not support the relative efficacy of hypothesized active intervention strategies. Rather, all conditions led to significant reductions in anxiety sensitivity. In addition, within-condition effect sizes for conditions in the present study were comparable to effect sizes of active interventions that were efficacious in previous research. Findings from the present study support that anxiety sensitivity is malleable following brief, cost-efficient interventions and these reductions are maintained over a one-month follow-up period. Data from the present study suggest that in the presence of stringent control conditions, hypothesized active intervention strategies provided little additional benefit. The present study has implications for methodological considerations for future secondary prevention trials for the reduction of anxiety sensitivity. The absence of stringent control groups might lead to premature conclusions that reductions in anxiety sensitivity are due to the specific effects of active interventions. Further research is needed to elucidate specific effects of intervention strategies for the reduction of anxiety sensitivity in at risk populations in order to refine secondary prevention interventions aimed to reduce risk for psychopathology.
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    tDCS-augmented exposure therapy for pathological fears
    (2019-08) Cobb, Adam Roark; Telch, Michael Joseph; González-Lima, Francisco, 1955-; Schnyer, David M; Smits, Jasper A; Bikson, Marom
    Exposure therapy is remarkably effective for treating anxiety and stress-related problems. Still, there is a need to enhance the efficacy, efficiency, and palatability of exposure. Recent efforts have sought to optimize extinction learning, through procedural variations, or by targeting underlying cellular mechanisms. Guided by evidence that brain stimulation can functionally target brain networks implicated in fear expression and extinction learning, the present study is a 2-arm, double-blind, placebo-controlled trial testing whether transcranial direct current stimulation (tDCS) can augment exposure therapy for several forms of pathological fear. Participants (N = 49) with at least moderate distress in response to snakes, spiders, or contamination-related threats were randomized to receive either active tDCS (1.7 mA, 20 min.; n = 27), or sham tDCS (1.7mA, 30 sec.; n = 22), followed by 30 min. of in-vivo exposure. Electrodes targeted excitation of the left medial prefrontal cortex (lmPFC) and inhibition of the right dorsolateral prefrontal cortex (rdlPFC) for those assigned to active tDCS, whereas polarity was counterbalanced across controls. The active tDCS group exhibited greater gains compared to sham tDCS in primary and secondary outcomes, including reductions in distress and threat appraisals through the 1-month follow-up, although these findings did not uniformly generalize to an untrained context. The active tDCS group also exhibited more rapid cognitive change during exposure, and enhanced approach in early exposure trials. Active tDCS also especially enhanced outcomes for those with greater phobic severity, a poorer response to exposure, elevated anxiety sensitivity, and an avoidant coping style. Exploratory analyses revealed tDCS-augmentation effects were partially accounted for by increased attentional and behavioral engagement with threat. Future research should apply tDCS to more severe conditions, and yoke stimulation to individual differences to maximize and promote the retention of clinical gains